Parental Mental Health Disorders Increase Offspring Risk of Mental Health Disorders

1. The risk of developing the same or any mental health disorder was increased in offspring of parents with a mental health disorder.

2. The age of onset of bipolar, depressive, and psychotic disorders was 5, 6, and 16 years old, respectively in the offspring of parents with a MHD, with risk increasing until the age of 30.

Evidence Rating Level: 1 (Excellent)

The inheritance of mental health disorders (MHD) from parent to offspring has been well documented. In particular, the risk for psychosis and bipolar disorder is so high that the offspring of parents with these diagnoses are targeted early with intervention. To implement early intervention, clinicians rely on risk and age of onset of the illness. Previous studies have only focused on major depressive, psychotic, and bipolar disorders leaving a gap in literature with respect to other MHDs. Furthermore, research has only focused on the risk of developing the same MHD as the parent.

This meta-analysis used studies published until September 2022 which investigated the risk of developing MHDs in offspring of parents with a MHD. 211 studies were identified which compared 3,172,115 offspring with a MH diagnosis to a control group of 20,428,575. Inclusion criteria required studies which looked at parent-offspring groups with one or more MH diagnoses confirmed using the DSM or ICD. 10 groups were defined: psychotic, bipolar, depressive, anxiety, substance use, borderline personality, attention deficit/hyperactivity, disruptive, obsessive-compulsive, and eating disorders. Low quality study designs like case reports, and cases without a DSM or ICD diagnosis were excluded. The primary outcome measured the risk of developing MHDs in offspring of parents with MHDs.

The risk of developing any MHD was increased in offspring of parents with anxiety, psychotic, bipolar, depressive, or substance use disorders. The risk of developing the same MHD was increased in offspring of parents with ADHD, psychosis, bipolar, substance use, depressive, eating, and anxiety disorders. The age of onset of bipolar, depressive, and psychotic disorders was 5, 6, and 16 years old, respectively, with risk increasing until the mid-20s to 30. One limitation of this meta-analysis is that few studies looked at lower socioeconomic groups which affects the generalizability of the study, and potentially overlooks a high-risk sub-group. Furthermore, the study did not address the onset age of other MHDs. Nevertheless, this meta-analysis shows the need for proactive MH screening, and implementation of early interventions in this population to reduce the risk of developing MHDs.

Click here to read this study in World Psychiatry

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