(PS2-87) Tracing the Trajectory: A Scoping Review of Longitudinal Studies on Pediatric Bipolar Disorder and Offspring of Bipolar Parents

Abstract Text:

Objectives: Bipolar disorder (BD) is a serious mental health condition with strong heritability. While research on youth BD onset and progression has grown, most reviews are over a decade old or focus on highly specific analyses. To address these gaps, we conducted a scoping review of longitudinal studies examining two groups: children diagnosed with BD (“bottom-up” design) and children at high-risk for heritability from a first-degree relative (“top-down” design). This review compared study locations, sample ages, diagnostic assessments, follow-up durations, outcomes, and other key factors.

Methods: We systematically searched ten databases using the PRISMA framework. Duplicates were removed in EndNote, and Covidence was used for two rounds of screening. The primary study for each cohort was identified as the first publication providing baseline sample and diagnostic details. Baseline characteristics were extracted from primary studies, while outcomes and follow-up data were sourced from the latest publications containing the largest portion of the original sample.

Results: Database searches yielded 1,532 results, with 883 imported into Covidence. After exclusions, 18 publications remained: five affected youth, 11 high-risk (HR), and two mixed cohorts. Birth cohorts, RCTs, cross-sectional, retrospective studies, and those with a mean intake age over 18 were excluded. The most commonly used diagnostic tools were the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) for youth and the Structured Clinical Interview for DSM Disorders (SCID) for parents. Mean intake age was 12 years (range: 1–21) and mean follow-up duration was 12.5 years (up to 25). Across included high-risk studies, 12.8% of HR offspring developed a bipolar spectrum disorder (BSD), and HR offspring overall had greater risk for mood disorders than controls.

Conclusions: To date, this review provides the most updated and comprehensive analysis of longitudinal studies on youth with or at high-risk for BD. These studies uniquely track the progression of BD and its common comorbidities from early childhood to early adulthood, benefiting researchers and clinicians alike.