Objectives: To prospectively investigate whether baseline clinical characteristics and medication exposure predict development of major depressive disorder or bipolar disorder in offspring of parents with bipolar disorder. Methods: Youth aged 9-20 years with at least one biological parent with bipolar disorder and no prior history of mood or psychotic episodes (n=93) were prospectively evaluated and treated naturalistically during the study. Participants were divided into two groups: converters, defined as those who met DSM-IV criteria for a mood episode during follow-up (n=19); or non-converters (n=74). Logistic regression models were used to investigate associations between baseline clinical variables and medication exposure during follow-up and risk of developing a first mood episode (conversion). Results: Multivariate regression analyses showed that baseline anxiety disorders and subsyndromal mood disorders were associated with increased risk of conversion during follow-up. Adding medication exposure to the multivariate model showed that exposure to antidepressants during follow-up was associated with increased risk of conversion. Conclusions: Caution should be used when treating bipolar offspring with anxiety and/or emerging depressive symptoms using antidepressant agents, given the increased risk of developing a major mood disorder.

中文翻译：

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双相情感障碍父母子女首次情绪发作的药物暴露和预测因素：一项前瞻性研究

目的：前瞻性调查基线临床特征和药物暴露是否能预测患有双相情感障碍的父母的后代患重度抑郁症或双相情感障碍。方法：在研究期间，前瞻性地评估和治疗 9-20 岁的年轻人，其至少有一个亲生父母患有双相情感障碍，并且没有情绪或精神病发作史（n = 93）。参与者被分为两组：转化者，定义为在随访期间符合 DSM-IV 情绪发作标准的人（n=19）；或非转化者 (n=74)。Logistic 回归模型用于研究基线临床变量与随访期间的药物暴露以及发生第一次情绪发作（转换）的风险之间的关联。结果：多变量回归分析表明，基线焦虑症和亚综合征情绪障碍与随访期间转换风险的增加有关。将药物暴露加入多变量模型表明，在随访期间暴露于抗抑郁药与转化风险增加有关。结论：考虑到发生严重情绪障碍的风险增加，在使用抗抑郁药治疗患有焦虑和/或新出现的抑郁症状的双相后代时应谨慎。