Dysfunctional family environment in affected versus unaffected offspring of parents with bipolar disorder

Objective: Children of parents with bipolar disorder (BD) are at heightened risk for developing mood and other psychiatric disorders. We proposed to evaluate the environment of families with at least one parent with BD type I (BDF) with affected offspring (aBDF) and unaffected offspring (uBDF) compared with control families without a history of DSM-IV Axis I disorder (CF).Method: We used the Family Environment Scale (FES) to evaluate 47 BDF (aBDF + uBDF) and 30 CF. Parents were assessed through the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Diagnosis of the offspring was determined through the Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) interview.Results: There were statistically significant differences between aBDF, uBDF and CF in cohesion (p = 0.003), intellectual-cultural orientation (p = 0.01), active-recreational orientation (p = 0.007), conflict (p = 0.001), control (p = 0.01), moral-religious emphasis (p = 0.01) and organization (p = 0.001). the aBDF showed higher levels of control (p = 0.02) when compared to the uBDF.Conclusions: Families with a BD parent presented more dysfunctional interactions among members. Moreover, the presence of BD or other psychiatric disorders in the offspring of parents with BD is associated with higher levels of control. These results highlight the relevance of psychosocial interventions to improve resilience and family interactions.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)National Alliance for Research on Schizophrenia and Depression (NARSAD)American Psychiatric Association/AstraZeneca Young Minds in Psychiatry International AwardsL'Oreal-ABC-Unesco - Para Mulheres na Ciencia, Brazil.Univ São Paulo, Sch Med, Dept Psychiat, Bipolar Res Program, São Paulo, BrazilUniv São Paulo, Sch Med, Dept Psychiat, Lab Psychiat Neuroimaging LIM 21, São Paulo, BrazilUniv São Paulo, Ctr Support Res Appl Neurosci, NAPNA, São Paulo, BrazilUniv Texas Med Sch, Dept Psychiat & Behav Sci, Houston, TX USAFed Univ São Paulo UNIFESP, Dept Psychiat, Child & Adolescent Psychiat Unit UPIA, São Paulo, BrazilFed Univ São Paulo UNIFESP, Dept Psychiat, Child & Adolescent Psychiat Unit UPIA, São Paulo, BrazilWeb of Scienc