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Heredity -- what age do children exhibit symptoms?

Q: My daughter in-law has been diagnosed with Bipolar disorder since childhood. She had her first baby, a girl, this year, and my daughter in law's symptoms became worse while she was expecting. I want to know if this disorder is hereditary, and at what age children begin to exhibit symptoms of this disorder. Thank you. Anne

Dear Anne --
Hereditary: yes, strongly so compared to other mental health conditions (of which many are also quite strongly genetic, but bipolar the most of all).  There's a lovely article about estimating the risk in a child based on the family history in Journal of Clinical Psychiatry this year, but I'm having trouble digging up the reference.  When I find it I'll email it to you as well as posting it on my website -- I should have done that when I saw it go by!  The bottom line of the article is that even though you'll often hear "25%" as the risk of a child's having BP, if one parent has it; that there are other factors to be taken into account that may dramatically affect that rough estimate, increasing it, or often decreasing it.  So wait until I send you the article!

What age?   It varies: pre-pubertal is relatively rare; pubertal is very common, and the most common ages are mid-adolescence and early 20's (depending on how you define "first episode"). 

Dr. Phelps

Published December, 2000

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