The Open Neuropsychopharmacology Journal
Family Illness History, Obstetric Complications and Age
of Onset in Bipolar Patients
Selim M. El-Badri, Heather C. Ashton, I. Nicol Ferrier and P.
Brian Moore Pp 11-15
The study examined the relationship between obstetric complications,
genetic risk and age of illness onset in bipolar disorder.
Thirty DSM-IV bipolar I patients in remission (ages 21-39yr, mean
30.7 ± 6.1yr.) and twenty seven healthy controls (ages 19-39yr,
mean 27.7 ± 7.0yr.) were investigated using structured interview,
life chart and pregnancy and birth complications questionnaire.
Family history, pregnancy and birth complications and age of illness
onset were collected. Comparisons were made between patients and
controls and also between patient groups with age of illness onset
before and after the age of 21 years.
Obstetric complications were more common in patients (effect size=
0.48) than controls but this was not significant statistically (Fisher’s
exact test, p=0.13). There was a non-significant excess in early
onset patients. Family histories of mood disorder were found in
22 out of 30 bipolar subjects, but rates in early and late onset
groups did not differ (p=0.35).
The study failed to find evidence of either increased rates of obstetric
complications in bipolar disorder patients or of a link between
age of illness onset and a family history of mood disorders. The
power of the study was limited by a sample size and difficulties
in obtaining unequivocal obstetric data. The finding is in agreement
with a recent metanalysis. The large effect size indicates that
larger study of obstetric complications in bipolar disorder subjects
is justified, looking particularly for subgroups for which there
may be an association between complications and clinical variables.