The British Journal of Psychiatry (2009) 195: 457-458. doi: 10.1192/bjp.bp.108.062810
© 2009 The Royal College of Psychiatrists
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SHORT REPORT

Early course of bipolar disorder in high-risk offspring: prospective study

Anne Duffy, MD and Martin Alda, MD

Department of Psychiatry, Dalhousie University, Halifax, Canada

Tomas Hajek, MD, PhD

Department of Psychiatry, Dalhousie University, Halifax, Canada, and Prague Psychiatric Center, Prague, Czech Republic

Paul Grof, MD, PhD

Mood Disorders Centre of Ottawa, Ottawa, Canada

Correspondence: Anne Duffy, MD, Department of Psychiatry, Dalhousie University IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, Canada B3K 6R8. Email: anne.duffy{at}dal.ca

Declaration of interest

None.

We studied the course of major mood disorders in the offspring of parents with well-characterised bipolar disorder prospectively for up to 15 years. All consenting offspring were assessed annually or anytime symptomatic. The participants began to develop major mood episodes in adolescence and not before. The index major mood episode was almost always depressive, as were the first few recurrences. Onsets and recurrences continued throughout the observation period into adulthood. We did not find evidence of pre-pubertal mania. In summary, adolescence marks the beginning of the high-risk period for major mood episodes related to bipolar disorder.