The Challenge of Heritability in Bipolar Research Posted on May 2, 2006 Family members with mental illness can effect data quality, states David A. Axelson (bio).

Bipolar disorder is a genetic and family illness, and so I mean, it’s highly heritable, that with schizophrenia, is it’s probably the most heritable of serious mental illnesses, so it runs in families. And family members, often times a parent has bipolar disorder or a parent has a parent, has a grandparent with bipolar disorder, or there’s another child with a significant mental illness. And so that all pulls on the family resources. It makes it more and more difficult to engage folks into studies because a study takes time and commitment from the child and family. And you know, if dad is having major mood fluctuations and having trouble at work or mom, the same way, you know, they’re not going to be able to come in for appointments as regularly as you would like, or they’re not going to have four hours to sit with you to go through the history of the child for the past six months. So it really impacts on the feasibility and quality of the data. And you really have to make sure what you’re doing is going to match the family needs, because on the other hand, if you only take kids from intact families whose parents are doing well, you’ve got a very skewed view of your population, and you’re not really actually then looking at the illness. You’re looking at sort of one subset of the – of folks with this illness, and you’re not going to be really generalizing to what’s really going to be helpful for people.

And when parents are suffering their own illness, it colors their own report of their child’s, perception of how their child is doing. And it also puts you – it really impacts the child’s overall course, too. They’re stressed out when their parent’s doing poorly, that really has a big impact on them. And it can be hard as, you know, being the treating person or the person helping or assessing a child and seeing a parent suffer and doing poorly, and it’s a delicate line of telling somebody, “Gee, this seems like you’re really struggling, too. Are you getting your help?” things like that, doing that in a delicate way that’s going to be supportive without pejorative or sort of labeling is a challenge.

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