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The relationship of family characteristics and bipolar disorder using causal-pie models

Published online by Cambridge University Press:  15 April 2020

Y.-C. Chen ,
C.-F. Kao ,
M.-K. Lu ,
Y.-K. Yang ,
S.-C. Liao ,
F.-L. Jang ,
W.J. Chen ,
R.-B. Lu  and
P.-H. Kuo
Y.-C. Chen
Affiliation:
Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
C.-F. Kao
Affiliation:
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
M.-K. Lu
Affiliation:
Department of Health, Jia Nan Mental Hospital, Tainan, Taiwan
Y.-K. Yang
Affiliation:
Department of Psychiatry, National Cheng Kung University and Hospital, Tainan, Taiwan
S.-C. Liao
Affiliation:
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
F.-L. Jang
Affiliation:
Department of Psychiatry, Chi Mei Medicine Center, Tainan, Taiwan
W.J. Chen
Affiliation:
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
R.-B. Lu
Affiliation:
Department of Psychiatry, National Cheng Kung University and Hospital, Tainan, Taiwan
P.-H. Kuo*
Affiliation:
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
*
*Corresponding author. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Rm521, No 17, Xuzhou Rd, Taipei 100, Taiwan. Tel.: +886 2 3366 8015; fax: +886 2 2351 1955. E-mail address:phkuo@ntu.edu.tw (P.-H. Kuo).
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Abstract

Many family characteristics were reported to increase the risk of bipolar disorder (BPD). The development of BPD may be mediated through different pathways, involving diverse risk factor profiles. We evaluated the associations of family characteristics to build influential causal-pie models to estimate their contributions on the risk of developing BPD at the population level. We recruited 329 clinically diagnosed BPD patients and 202 healthy controls to collect information in parental psychopathology, parent-child relationship, and conflict within family. Other than logistic regression models, we applied causal-pie models to identify pathways involved with different family factors for BPD. The risk of BPD was significantly increased with parental depression, neurosis, anxiety, paternal substance use problems, and poor relationship with parents. Having a depressed mother further predicted early onset of BPD. Additionally, a greater risk for BPD was observed with higher numbers of paternal/maternal psychopathologies. Three significant risk profiles were identified for BPD, including paternal substance use problems (73.0%), maternal depression (17.6%), and through poor relationship with parents and conflict within the family (6.3%). Our findings demonstrate that different aspects of family characteristics elicit negative impacts on bipolar illness, which can be utilized to target specific factors to design and employ efficient intervention programs.

Keywords

Bipolar disorderPsychopathologyAge of onsetCausal-pieFamily relationship
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 1 , January 2014 , pp. 36 - 43
Copyright
Copyright © 2013 Elsevier Masson SAS

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Footnotes

1

Yu-Chu Chen and Chung-Feng Kao contributed equally to the paper as first authors.

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