Substance use disorders in adolescent and young adult relatives of probands with bipolar disorder

What drives the increased risk?

Leslie Hulvershorn, Jennifer King, Patrick Monahan, Holly C. Wilcox, Philip B. Mitchell, Janice M. Fullerton, Howard Edenberg, Gloria M.P. Roberts, Masoud Kamali, Anne L. Glowinski, Neera Ghaziuddin, Melvin McInnis, Priya A. Iyer-Eimerbrink, John Nurnberger

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Adults with bipolar disorder (BD) have higher rates of substance use disorders (SUDs) compared to the general population. SUD rates in young offspring/relatives of BD probands, as well as factors which drive those rates, are not as well-characterized. Methods We aimed to examine SUD prevalence among adolescent/young adult offspring and relatives of probands with and without BD. Data were collected from five sites in the US and Australia during 2006–2011. Youth offspring/relatives (“Relatives of BD probands;” n = 267; mean age = 16.8 years; ± 2.9 S.D.), identified through a proband family member with DSM-IV BD (Type I or II), were compared to offspring/relatives of control probands (“relatives of control probands;” n = 149; mean age = 17.4 years; ± 2.9 S.D.). Logistic regression with generalized estimating equations was used to compare the groups across a range of substance use and SUD variables. Odds ratios were calculated for lifetime prevalence of substance outcomes. Results Bivariate analyses showed DSM-IV SUDs were more prevalent among relatives of BD probands than among relatives of control probands (29% vs. 18%; p = 0.01). Generalized estimating equation models showed BD mood and childhood-onset externalizing disorders in adolescent and young adult relatives to each significantly increase the odds (OR = 2.80–3.17; p < 0.02) for the development of several substance variables among all relatives, whereas the risk of SUDs in relatives was not increased when the relatives had no mood or externalizing disorders themselves. Conclusion Relatives of BD probands with lifetime mood and externalizing disorders report more substance use/SUDs than relatives of control probands. In contrast, SUD outcomes in relatives of BD probands without mood or externalizing disorders were no different from control relatives without psychopathology. Early recognition and treatment of psychiatric disorders may lead to less substance use in this highly vulnerable population.

Original languageEnglish (US)
Pages (from-to)130-139
Number of pages10
JournalComprehensive Psychiatry
Volume78
DOIs
StatePublished - Oct 1 2017

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Bipolar Disorder
Substance-Related Disorders
Young Adult
Drive
Diagnostic and Statistical Manual of Mental Disorders
Adult Children
Vulnerable Populations
Psychopathology
Mood Disorders
Psychiatry

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Substance use disorders in adolescent and young adult relatives of probands with bipolar disorder : What drives the increased risk? / Hulvershorn, Leslie; King, Jennifer; Monahan, Patrick; Wilcox, Holly C.; Mitchell, Philip B.; Fullerton, Janice M.; Edenberg, Howard; Roberts, Gloria M.P.; Kamali, Masoud; Glowinski, Anne L.; Ghaziuddin, Neera; McInnis, Melvin; Iyer-Eimerbrink, Priya A.; Nurnberger, John.

In: Comprehensive Psychiatry, Vol. 78, 01.10.2017, p. 130-139.

Research output: Contribution to journalArticle

Hulvershorn, L, King, J, Monahan, P, Wilcox, HC, Mitchell, PB, Fullerton, JM, Edenberg, H, Roberts, GMP, Kamali, M, Glowinski, AL, Ghaziuddin, N, McInnis, M, Iyer-Eimerbrink, PA & Nurnberger, J 2017, 'Substance use disorders in adolescent and young adult relatives of probands with bipolar disorder: What drives the increased risk?', Comprehensive Psychiatry, vol. 78, pp. 130-139. https://doi.org/10.1016/j.comppsych.2017.07.010
Hulvershorn, Leslie ; King, Jennifer ; Monahan, Patrick ; Wilcox, Holly C. ; Mitchell, Philip B. ; Fullerton, Janice M. ; Edenberg, Howard ; Roberts, Gloria M.P. ; Kamali, Masoud ; Glowinski, Anne L. ; Ghaziuddin, Neera ; McInnis, Melvin ; Iyer-Eimerbrink, Priya A. ; Nurnberger, John. / Substance use disorders in adolescent and young adult relatives of probands with bipolar disorder : What drives the increased risk?. In: Comprehensive Psychiatry. 2017 ; Vol. 78. pp. 130-139.
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abstract = "Background Adults with bipolar disorder (BD) have higher rates of substance use disorders (SUDs) compared to the general population. SUD rates in young offspring/relatives of BD probands, as well as factors which drive those rates, are not as well-characterized. Methods We aimed to examine SUD prevalence among adolescent/young adult offspring and relatives of probands with and without BD. Data were collected from five sites in the US and Australia during 2006–2011. Youth offspring/relatives (“Relatives of BD probands;” n = 267; mean age = 16.8 years; ± 2.9 S.D.), identified through a proband family member with DSM-IV BD (Type I or II), were compared to offspring/relatives of control probands (“relatives of control probands;” n = 149; mean age = 17.4 years; ± 2.9 S.D.). Logistic regression with generalized estimating equations was used to compare the groups across a range of substance use and SUD variables. Odds ratios were calculated for lifetime prevalence of substance outcomes. Results Bivariate analyses showed DSM-IV SUDs were more prevalent among relatives of BD probands than among relatives of control probands (29{\%} vs. 18{\%}; p = 0.01). Generalized estimating equation models showed BD mood and childhood-onset externalizing disorders in adolescent and young adult relatives to each significantly increase the odds (OR = 2.80–3.17; p < 0.02) for the development of several substance variables among all relatives, whereas the risk of SUDs in relatives was not increased when the relatives had no mood or externalizing disorders themselves. Conclusion Relatives of BD probands with lifetime mood and externalizing disorders report more substance use/SUDs than relatives of control probands. In contrast, SUD outcomes in relatives of BD probands without mood or externalizing disorders were no different from control relatives without psychopathology. Early recognition and treatment of psychiatric disorders may lead to less substance use in this highly vulnerable population.",
author = "Leslie Hulvershorn and Jennifer King and Patrick Monahan and Wilcox, {Holly C.} and Mitchell, {Philip B.} and Fullerton, {Janice M.} and Howard Edenberg and Roberts, {Gloria M.P.} and Masoud Kamali and Glowinski, {Anne L.} and Neera Ghaziuddin and Melvin McInnis and Iyer-Eimerbrink, {Priya A.} and John Nurnberger",
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T1 - Substance use disorders in adolescent and young adult relatives of probands with bipolar disorder

T2 - What drives the increased risk?

AU - Hulvershorn, Leslie

AU - King, Jennifer

AU - Monahan, Patrick

AU - Wilcox, Holly C.

AU - Mitchell, Philip B.

AU - Fullerton, Janice M.

AU - Edenberg, Howard

AU - Roberts, Gloria M.P.

AU - Kamali, Masoud

AU - Glowinski, Anne L.

AU - Ghaziuddin, Neera

AU - McInnis, Melvin

AU - Iyer-Eimerbrink, Priya A.

AU - Nurnberger, John

PY - 2017/10/1

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N2 - Background Adults with bipolar disorder (BD) have higher rates of substance use disorders (SUDs) compared to the general population. SUD rates in young offspring/relatives of BD probands, as well as factors which drive those rates, are not as well-characterized. Methods We aimed to examine SUD prevalence among adolescent/young adult offspring and relatives of probands with and without BD. Data were collected from five sites in the US and Australia during 2006–2011. Youth offspring/relatives (“Relatives of BD probands;” n = 267; mean age = 16.8 years; ± 2.9 S.D.), identified through a proband family member with DSM-IV BD (Type I or II), were compared to offspring/relatives of control probands (“relatives of control probands;” n = 149; mean age = 17.4 years; ± 2.9 S.D.). Logistic regression with generalized estimating equations was used to compare the groups across a range of substance use and SUD variables. Odds ratios were calculated for lifetime prevalence of substance outcomes. Results Bivariate analyses showed DSM-IV SUDs were more prevalent among relatives of BD probands than among relatives of control probands (29% vs. 18%; p = 0.01). Generalized estimating equation models showed BD mood and childhood-onset externalizing disorders in adolescent and young adult relatives to each significantly increase the odds (OR = 2.80–3.17; p < 0.02) for the development of several substance variables among all relatives, whereas the risk of SUDs in relatives was not increased when the relatives had no mood or externalizing disorders themselves. Conclusion Relatives of BD probands with lifetime mood and externalizing disorders report more substance use/SUDs than relatives of control probands. In contrast, SUD outcomes in relatives of BD probands without mood or externalizing disorders were no different from control relatives without psychopathology. Early recognition and treatment of psychiatric disorders may lead to less substance use in this highly vulnerable population.

AB - Background Adults with bipolar disorder (BD) have higher rates of substance use disorders (SUDs) compared to the general population. SUD rates in young offspring/relatives of BD probands, as well as factors which drive those rates, are not as well-characterized. Methods We aimed to examine SUD prevalence among adolescent/young adult offspring and relatives of probands with and without BD. Data were collected from five sites in the US and Australia during 2006–2011. Youth offspring/relatives (“Relatives of BD probands;” n = 267; mean age = 16.8 years; ± 2.9 S.D.), identified through a proband family member with DSM-IV BD (Type I or II), were compared to offspring/relatives of control probands (“relatives of control probands;” n = 149; mean age = 17.4 years; ± 2.9 S.D.). Logistic regression with generalized estimating equations was used to compare the groups across a range of substance use and SUD variables. Odds ratios were calculated for lifetime prevalence of substance outcomes. Results Bivariate analyses showed DSM-IV SUDs were more prevalent among relatives of BD probands than among relatives of control probands (29% vs. 18%; p = 0.01). Generalized estimating equation models showed BD mood and childhood-onset externalizing disorders in adolescent and young adult relatives to each significantly increase the odds (OR = 2.80–3.17; p < 0.02) for the development of several substance variables among all relatives, whereas the risk of SUDs in relatives was not increased when the relatives had no mood or externalizing disorders themselves. Conclusion Relatives of BD probands with lifetime mood and externalizing disorders report more substance use/SUDs than relatives of control probands. In contrast, SUD outcomes in relatives of BD probands without mood or externalizing disorders were no different from control relatives without psychopathology. Early recognition and treatment of psychiatric disorders may lead to less substance use in this highly vulnerable population.

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