Bipolar Offspring Study
This study is no longer recruiting.
As the Pittsburgh Bipolar Offspring Study (BIOS) enters its 20th and final year, we thought that it would be a great time to share a summary of the main results of the study. It has been a very busy, productive few decades for this very long, successful study and we have you to thank for it!
The BIOS study, which is funded by the National Institute of Mental Health (NIMH), under the direction of Boris Birmaher, MD, sought to recruit two groups of participants including parents diagnosed with Bipolar Disorder (BP), as well as parents without a diagnosis of BP (controls), who had children between the ages of 2-18 years old. The initial goal was to follow both groups every other year for a 5-year period. The NIMH was so pleased with the progress that was being made in the area of bipolar disorder research that they agreed to financially support the grant thru three more 5-year funding cycles and here we are today!
To obtain the data used for analysis, the study interviewers have worked to collect information from you, our study participants, by conducting study visits, primarily, in your homes. Participants consented to completing assessments about their mood state, metabolic (medical) screenings and provided samples for genetic study. A small group of adolescents also completed magnetic resonance imaging (MRI) scans of the brain. Additionally, over the last year and a half we have begun interviewing the 3rd generation (offspring of offspring) of our families. Many study participants have also agreed to participate in other sister studies within the Department of Psychiatry at the University of Pittsburgh, including studies involving innovative treatments such as meditation and psychotherapy.
Study Numbers/Facts:
- Total # of participants enrolled in the study-1450 (parents: 588; offspring:862) To date, 3rd generation participants enrolled; 139
- During the study about 90% of participants remained in the study
- To date, total # of publications in peer-reviewed journals: 62
Among the many findings obtained during the BIOS study, below is a brief summary of some pertinent information determined during the study:
- So far, about 20% of the children of parents with BP have developed BP in comparison with 4% children of control parents. Thus, most of children of parents with BP did not develop BP indicating that a family history of BP does not necessarily mean that children will develop BP
- BP was more often diagnosed during adolescences and young adulthood and very rarely before age 6
- Most children of BP parents did not develop BP, however the question regarding how we can identify the children who are at highest risk to develop BP remains. In BIOS we found that when children of parents with BP, particularly parents who had an early onset of BP (e.g., before age 21), and who have ongoing depressive symptoms, anxiety, irritability, poor sleep, and mild symptoms of mania where at higher risk to develop BP
- Offspring of parents diagnosed with BP also showed to have more episodes of depression and behavioral problems than the offspring of the controls. The symptoms of these disorders may be confused with the symptoms of BP. Thus, a thorough evaluation is necessary to determine a proper diagnosis, because in most cases the child does not have BP. This is important because the treatment of these disorders is different from that of BP
- Parents with BP more commonly had other psychiatric disorders which require identification and treatment to improve theirs and their family’s wellbeing and functioning
- There are certain neural circuits in the brain and genes that appear to be associated with the development of bipolar disorder
- A novel tool has been developed, using data from the study. The tool can be used by clinicians/mental health professionals to determine the likelihood for a child of a parent with BP developing bipolar disorder. This tool is very similar to the ones used in medicine to predict the risk of developing other illnesses such as breast cancer, cardiovascular conditions, and diabetes
In summary, although most children of parents with BP do not develop this disorder, children who present with significant mood and behavior symptoms seem to be at higher risk to develop BP. Because symptoms of BP commonly develop during adolescence, it is an important time to observe and offer early intervention for those individuals who are at higher risk to develop this disorder. We have also learned that it is important to routinely assess the functioning of the whole family when a parent has been diagnosed with a mental health disorder, in an effort to provide appropriate interventions and offer additional support for the parent and the children, alike.
Future plans:
- Continue to publish data gathered during the BIOS Study
- Develop and initiate new studies based on BIOS data analysis, including:
- Brain scan studies to better understand the biology of BP and develop targeted treatments
- Treatment studies are being developed with the intention to delay/possibly prevent the onset of BP symptoms and improve treatment of existing symptoms
In closing, the analysis of the vast amount of data collected will continue, and many more papers will be written, based on these findings. It’s important to note that the study results already have and will continue to inform the scientific community and treating clinicians, for many years to come.
As the sun sets on the Pittsburgh Bipolar Offspring study, we would like to offer our sincere gratitude to all of the participants who agreed to be a part of the study and have remained with us for nearly 20 years! Without your ongoing participation we could not have gathered all of this important data, learned about the information detailed above, thus helping to improve the lives of people diagnosed with BP. Finally, we would like to thank the NIMH for the support of our work and the many staff who have, tirelessly, worked on the study over the last 2 decades. It is because of all of you that we have made such great strides in the area of bipolar research.
If you have any questions, please don’t hesitate to contact us: 1.888.377.5444 or email monkk@upmc.edu
*Mania/Hypomania-(less extreme than mania) includes elevated mood and/or unusually irritable, decreased need for sleep, increased energy level, more impulsive behavior, poor judgement and grandiose thinking