ARTICLES
Child Comorbidity, Maternal Mood Disorder, and Perceptions of Family Functioning Among Bipolar Youth

https://doi.org/10.1097/01.chi.0000222785.11359.04Get rights and content

ABSTRACT

Objective:

To examine the association between youth comorbid psychiatric disorders, maternal mood disorder, and perceptions of family cohesion and conflict among youth diagnosed with pediatric bipolar disorder (PBD).

Method:

Three hundred eighty-nine bipolar youths and their parents completed a diagnostic interview and instruments assessing family psychiatric history and functioning. Family functioning was assessed with the Family Adaptability and Cohesion Scales-II and the Conflict Behavior Questionnaire.

Results:

The presence of a maternal mood disorder was associated with lower family cohesion. The presence of a youth externalizing disorder with or without a co-occurring anxiety disorder was also associated with lower family cohesion as well as higher family conflict. Furthermore, the negative relationship between maternal mood disorder and family functioning was stronger in the presence of a youth externalizing disorder.

Conclusions:

Youth comorbidity and maternal mood disorders appear to be associated with worse family functioning among bipolar youths. Family-based treatments with bipolar youths may need to integrate treatment of youth comorbidity and address maternal mood disorder for optimal results.

Section snippets

Participants

Participants included 389 children and adolescents ranging from 7 to 18 years of age (mean 12.8; SD = 3.2) and their parents. They were drawn from a baseline sample of 405 youths who indicated contact with a parent figure in the past 2 weeks and thus were asked to complete current family functioning measures. Forty-seven percent of youths were female and 84% were white. The socioeconomic status (SES) strata (Hollingshead, 1975) of families enrolled, from highest to lowest, were as follows: 7%

RESULTS

Before conducting the main study analyses, a series of correlations, two-tailed t tests, and one-way analyses of variance were conducted to determine whether sociodemographic variables (Table 1), bipolar characteristics (Table 2), nonaffective maternal disorders, or paternal disorders (Table 3) were associated with parent or youth report of family conflict or cohesion. To preserve degrees of freedom, with the exception of sociodemographics, which were routinely controlled, only those variables

DISCUSSION

The primary purpose of this study was to examine the association between youth comorbidity, maternal mood disorder, and perceptions of family functioning in a sample of children and adolescents diagnosed with PBD. As hypothesized, comorbid conditions were associated with parent and youth perceptions of higher family conflict and lower family cohesion. For parents, this relationship was primarily driven by the presence of externalizing disorders in their child. This finding is consistent with

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    This work was supported by grants MH59929 (Dr. Birmaher), MH59977 (Dr. Strober), and MH59691 (Dr. Keller) from the National Institute of Mental Health .

    Article Plus (online only) materials for this article appear on the Journal's Web site:www.jaacap.com.

    Disclosure: Dr. Ryan has received research support from GlaxoSmithKline, Abbott, Pfizer, and Janssen. Dr. Strober has been on the speakers' bureau for AstraZeneca. Dr. Keller has received research support from Bristol-Myers Squibb, Collegium, Cypress Bioscience, Cyberonics, Eli Lilly, Forest Laboratories, Janssen, Merck, Organon, Otsuka, Pfizer, Pharmastar, Sepracor, Vela Pharmaceuticals, Wyeth, Abbott Laboratories, Cephalon, GlaxoSmithKline, Mitsubishi Pharma, Somerset Pharmaceuticals, Scirex, and Sanofi-Synthelab during the past 2 years. The other authors have no financial relationships to disclose.

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