The Impact of Parental Bipolar Disorder on Children

This chapter reviews the impact of parental bipolar disorder on offspring across risk, mechanisms, and interventions. Owing to high heritability, children of affected parents constitute a high-risk group, with elevated rates of bipolar spectrum, depressive, anxiety, attention-deficit/hyperactivity disorder (ADHD), and behavioral disorders. Beyond genetics, parenting quality, family conflict, illness duration, childhood trauma, and stressful life events contribute to onset and recurrence. High-risk offspring show dimensional psychopathology such as mood lability and anxiety/depression, neurocognitive deficits in attention, memory, and executive function, and neurobiological alterations in frontolimbic circuitry and white-matter integrity. Emerging tools such as risk calculators and early interventions including psychoeducation, family-focused therapy, cognitive-behavioral therapy/Interpersonal and Social Rhythm Therapy (CBT/IPSRT), and sleep-rhythm strategies show promise, while pharmacologic prevention evidence remains limited, highlighting the need for longitudinal trials.