{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:29:31Z","timestamp":1784867371871,"version":"3.55.0"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2020-01175"],"award-info":[{"award-number":["2020-01175"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Avtal om L\u00e4karutbildning och Forskning"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Hypothesis<\/jats:title>\n                  <jats:p>To clarify whether the familial liability to psychosis associated with bipolar disorder (BD) is nonspecific or has a greater effect on risk for psychosis in cases with prominent mood symptoms and\/or a remitting course.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Design<\/jats:title>\n                  <jats:p>We examined, in 984 809 offspring raised in intact families in Sweden, born 1980\u20131996 and followed-up through 2018, by multivariable Cox proportional hazards regression, risk in offspring of parents with BD for 7 psychotic disorders: Psychotic MD (PMD), psychotic BD (PBD), schizoaffective disorder (SAD), acute psychoses, psychosis NOS, delusional disorder (DD) and schizophrenia (SZ). Diagnoses were obtained from national registers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Results<\/jats:title>\n                  <jats:p>In the offspring of BD parents, the hazard ratios (HR) for these 7 disorders formed an inverted U-shaped curve, rising from 2.98 for PMD, to peak at 4.49 for PBD and 5.25 for SAD, and then declining to a HR of 3.48 for acute psychoses and 3.22 for psychosis NOS, to a low of 2.19 for DD and 2.33 for SZ. A similar pattern of risks was seen in offspring of mothers and fathers affected with BD and in offspring predicted from age at onset in their BD parent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The BD-associated risk for psychosis impacts most strongly on mood disorders, moderately on episodic psychotic syndromes, and least on chronic psychotic disorders. These results support prior clinical studies suggesting a qualitative difference in the familial substrate for psychosis occurring in BD and SZ.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/schbul\/sbad097","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T15:15:15Z","timestamp":1689261315000},"page":"157-165","source":"Crossref","is-referenced-by-count":2,"title":["The Nature of the Familial Risk for Psychosis in Bipolar Disorder"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8689-6570","authenticated-orcid":false,"given":"Kenneth S","family":"Kendler","sequence":"first","affiliation":[{"name":"Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond, VA , USA"},{"name":"Department of Psychiatry, Virginia Commonwealth University , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Abrahamsson","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University , Malm\u00f6 , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-5015","authenticated-orcid":false,"given":"Jan","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University , Malm\u00f6 , Sweden"},{"name":"Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8031-279X","authenticated-orcid":false,"given":"Kristina","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University , Malm\u00f6 , Sweden"},{"name":"Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"2023122814530424500_CIT0001","volume-title":"Psychiatrie: Ein Lehrbuch fur Studirende und Aerzte","author":"Kraepelin","year":"1899","edition":"6"},{"key":"2023122814530424500_CIT0002","article-title":"Psychiatry, A Textbook for Students and Physicians (Translation of the 6th Edition of Psychiatrie-Translator Volume 2-Sabine Ayed)","volume-title":"Clinical Psychiatry","author":"Kraepelin","year":"1990"},{"issue":"4","key":"2023122814530424500_CIT0003","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s11920-000-0069-4","article-title":"Prevalence and description of psychotic features in bipolar mania","volume":"2","author":"Dunayevich","year":"2000","journal-title":"Curr Psychiatry Rep."},{"issue":"8","key":"2023122814530424500_CIT0004","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1176\/appi.ajp.158.8.1258","article-title":"The familial aggregation of psychotic symptoms in bipolar disorder pedigrees","volume":"158","author":"Potash","year":"2001","journal-title":"Am J Psychiatry."},{"issue":"2","key":"2023122814530424500_CIT0005","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1038\/mp.2013.132","article-title":"Specificity of psychosis, mania and major depression in a contemporary family study","volume":"19","author":"Vandeleur","year":"2014","journal-title":"Mol Psychiatry."},{"key":"2023122814530424500_CIT0006","first-page":"1","article-title":"A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses","volume":"194","author":"Perris","year":"1966","journal-title":"Acta Psychiatr Scand Suppl."},{"issue":"5","key":"2023122814530424500_CIT0007","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1001\/archpsyc.60.5.497","article-title":"The heritability of bipolar affective disorder and the genetic relationship to unipolar depression","volume":"60","author":"McGuffin","year":"2003","journal-title":"Arch Gen Psychiatry."},{"issue":"9","key":"2023122814530424500_CIT0008","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1001\/archpsyc.1993.01820210033004","article-title":"A pilot Swedish twin study of affective illness, including hospital- and population-ascertained subsamples","volume":"50","author":"Kendler","year":"1993","journal-title":"Arch Gen Psychiatry."},{"issue":"8","key":"2023122814530424500_CIT0009","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1001\/jamapsychiatry.2020.0223","article-title":"An extended swedish national adoption study of bipolar disorder illness and cross-generational familial association with schizophrenia and major depression","volume":"77","author":"Kendler","year":"2020","journal-title":"JAMA Psychiatry."},{"issue":"5618","key":"2023122814530424500_CIT0010","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/268327a0","article-title":"Adoption study supporting genetic transmission in manic--depressive illness","volume":"268","author":"Mendlewicz","year":"1977","journal-title":"Nature."},{"issue":"1","key":"2023122814530424500_CIT0011","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/ajmg.c.20013","article-title":"Family, twin, and adoption studies of bipolar disorder","volume":"123C","author":"Smoller","year":"2003","journal-title":"Am J Med Genet C Semin Med Genet."},{"issue":"6","key":"2023122814530424500_CIT0012","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1038\/s41588-021-00857-4","article-title":"Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology","volume":"53","author":"Mullins","year":"2021","journal-title":"Nat Genet."},{"issue":"9","key":"2023122814530424500_CIT0013","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1038\/ng.2711","article-title":"Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs","volume":"45","author":"Lee","year":"2013","journal-title":"Nat Genet."},{"issue":"6395","key":"2023122814530424500_CIT0014","first-page":"1313","article-title":"Analysis of shared heritability in common disorders of the brain","volume":"360","author":"Brainstorm","year":"2018","journal-title":"Science."},{"issue":"11","key":"2023122814530424500_CIT0015","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1176\/appi.ajp.21101051","article-title":"Charting the landscape of genetic overlap between mental disorders and related traits beyond genetic correlation","volume":"179","author":"Hindley","year":"2022","journal-title":"Am J Psychiatry."},{"key":"2023122814530424500_CIT0016","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1176\/appi.ajp.22010003","article-title":"Polygenic risk and episode polarity among individuals with bipolar disorder","volume":"180","author":"Hasseris","year":"2023","journal-title":"Am J Psychiatry."},{"issue":"1","key":"2023122814530424500_CIT0017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41398-018-0242-3","article-title":"Association of schizophrenia polygenic risk score with manic and depressive psychosis in bipolar disorder","volume":"8","author":"Markota","year":"2018","journal-title":"Transl Psychiatry."},{"issue":"7","key":"2023122814530424500_CIT0018","first-page":"1705","article-title":"Schizophrenia working group of the psychiatric genomics consortium. electronic address drve, bipolar d, schizophrenia working group of the psychiatric genomics c. genomic dissection of bipolar disorder and schizophrenia, including 28 subphenotypes","volume":"173","author":"Bipolar","year":"2018","journal-title":"Cell."},{"issue":"1","key":"2023122814530424500_CIT0019","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1001\/jamapsychiatry.2017.3485","article-title":"Association between schizophrenia-related polygenic liability and the occurrence and level of mood-incongruent psychotic symptoms in bipolar disorder","volume":"75","author":"Allardyce","year":"2018","journal-title":"JAMA Psychiatry"},{"issue":"11","key":"2023122814530424500_CIT0020","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1001\/jamapsychiatry.2022.2873","article-title":"Risk for mood, anxiety, and psychotic disorders in individuals at high and low genetic liability for bipolar disorder and major depression","volume":"79","author":"Kendler","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"2023122814530424500_CIT0021","first-page":"343","volume-title":"Further evidence for age of onset being an indicator for severity of bipolar disorder","author":"Schulze","year":"2002"},{"key":"2023122814530424500_CIT0022","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1176\/ajp.145.2.221","article-title":"Adolescent versus adult onset of mania","volume":"145","author":"McGlashan","year":"1988","journal-title":"Am J Psychiatry."},{"issue":"2","key":"2023122814530424500_CIT0023","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1176\/appi.ajp.157.2.213","article-title":"Phenomenology and outcome of subjects with early-and adult-onset psychotic mania","volume":"157","author":"Carlson","year":"2000","journal-title":"Am J Psychiatry."},{"key":"2023122814530424500_CIT0024","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1176\/ajp.139.5.602","article-title":"The\u201c atypical\u201d clinical picture of adolescent mania","volume":"139","author":"Ballenger","year":"1982","journal-title":"Am J Psychiatry."},{"key":"2023122814530424500_CIT0025","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1176\/ajp.140.11.1523","article-title":"Age at onset and number of psychotic symptoms in bipolar I and schizoaffective disorder","volume":"140","author":"Rosen","year":"1983","journal-title":"Am J Psychiatry."},{"key":"2023122814530424500_CIT0026","volume-title":"A language and environment for statistical computing (Version 4.2.1) [computer program]","year":"2022"},{"key":"2023122814530424500_CIT0027","volume-title":"SAS\/STAT\u00ae Online Documentation, Version 9.4","author":"SAS Institute I","year":"2012"},{"key":"2023122814530424500_CIT0028","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/BF02865610","article-title":"Uber Erblichkeitsbeziehungen in der Psychiatrie","volume":"13","author":"Schuppius","year":"1912","journal-title":"Zeitschrift f\u00fcr die gesamte Neurologie und Psychiatrie"},{"key":"2023122814530424500_CIT0029","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/BF02897039","article-title":"Psychiatrische familienforschungen","volume":"21","author":"Wittermann","year":"1913","journal-title":"Zeitschrift f\u00fcr die gesamte Neurologie und Psychiatrie"},{"issue":"8","key":"2023122814530424500_CIT0030","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1001\/archpsyc.1985.01790310032004","article-title":"Psychiatric illness in first-degree relatives of schizophrenic and surgical control patients. A family study using DSM-III criteria","volume":"42","author":"Kendler","year":"1985","journal-title":"Arch Gen Psychiatry."},{"issue":"10","key":"2023122814530424500_CIT0031","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1001\/archpsyc.1982.04290100031006","article-title":"A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands","volume":"39","author":"Gershon","year":"1982","journal-title":"Arch Gen Psychiatry."},{"issue":"4","key":"2023122814530424500_CIT0032","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1176\/ajp.142.4.447","article-title":"A family study of schizophrenic and normal control probands: implications for the spectrum concept of schizophrenia","volume":"142","author":"Baron","year":"1985","journal-title":"Am J Psychiatry."},{"issue":"8","key":"2023122814530424500_CIT0033","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1001\/archpsyc.1993.01820200059006","article-title":"The Roscommon Family Study. II. The risk of nonschizophrenic nonaffective psychoses in relatives","volume":"50","author":"Kendler","year":"1993","journal-title":"Arch Gen Psychiatry."},{"key":"2023122814530424500_CIT0034","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1177\/0957154X9200301207","article-title":"The manifestations of insanity by Emil Kraepelin [1920], translated and with an introduction by Beer D (Classic Text No. 12)","volume":"3","author":"Kraepelin","year":"1992","journal-title":"Hist Psychiatry."},{"issue":"1","key":"2023122814530424500_CIT0035","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1038\/s41380-021-01232-9","article-title":"\u201cManifestations of insanity\u201d: Kraepelin\u2019s final views on psychiatric nosology in their historical context","volume":"27","author":"Heckers","year":"2022","journal-title":"Mol Psychiatry."},{"issue":"2","key":"2023122814530424500_CIT0036","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1034\/j.1600-0447.2003.00105.x","article-title":"Anomalies of subjective experience in schizophrenia and psychotic bipolar illness","volume":"108","author":"Parnas","year":"2003","journal-title":"Acta Psychiatr Scand."},{"issue":"1","key":"2023122814530424500_CIT0037","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/schbul\/sbt121","article-title":"Schizophrenia and the sense of self","volume":"40","author":"Moe","year":"2014","journal-title":"Schizophr Bull."},{"issue":"1","key":"2023122814530424500_CIT0038","article-title":"First rank symptoms for schizophrenia","author":"Soares-Weiser","year":"2015","journal-title":"Cochrane Database Sys Rev"},{"key":"2023122814530424500_CIT0039","volume-title":"The Genetics of Mood Disorders.","author":"Tsuang","year":"1990"},{"key":"2023122814530424500_CIT0040","first-page":"153","article-title":"Diagnostic and classification tradition of mental disorders in the 20th century in Scandinavia","volume-title":"Sources and Traditions of Classification in Psychiatry","author":"Bech","year":"1990"},{"issue":"Dec","key":"2023122814530424500_CIT0041","first-page":"1047","article-title":"Diagnosis and prognosis of schizophrenia","volume":"53","author":"Langfeldt","year":"1960","journal-title":"Proc R Soc Med"},{"key":"2023122814530424500_CIT0042","volume-title":"Psychogenic psychoses","author":"Wimmer","year":"2003"},{"key":"2023122814530424500_CIT0043","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1600-0447.1958.tb03526.x","article-title":"Clinical and genetic studies on benign schizophreniform psychosis based on follow-up","volume":"33","author":"Welner","year":"1958","journal-title":"Acta Psychiatr et Neurol Scand"},{"key":"2023122814530424500_CIT0044","volume-title":"The Schizophreniform States","author":"Langfeldt","year":"1939"},{"key":"2023122814530424500_CIT0045","volume-title":"Paranoid and Paranoiac Psychoses","author":"Retterstol","year":"1966"},{"issue":"10","key":"2023122814530424500_CIT0046","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1017\/S0033291706008385","article-title":"Recurrence risks for schizophrenia in a Swedish national cohort","volume":"36","author":"Lichtenstein","year":"2006","journal-title":"Psychol Med."},{"issue":"4","key":"2023122814530424500_CIT0047","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1080\/08039480701414932","article-title":"Mortality among persons with schizophrenia in Sweden: an epidemiological study","volume":"61","author":"Fors","year":"2007","journal-title":"Nord J Psychiatry."},{"issue":"5","key":"2023122814530424500_CIT0048","doi-asserted-by":"crossref","first-page":"e141","DOI":"10.1371\/journal.pmed.0020141","article-title":"A systematic review of the prevalence of schizophrenia","volume":"2","author":"Saha","year":"2005","journal-title":"PLoS Med."},{"key":"2023122814530424500_CIT0049","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12888-015-0578-7","article-title":"An evaluation of variation in published estimates of schizophrenia prevalence from 1990\u20142013: a systematic literature review","volume":"15","author":"Simeone","year":"2015","journal-title":"BMC Psychiatry"},{"issue":"6","key":"2023122814530424500_CIT0050","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1600-0447.2011.01747.x","article-title":"Validity of bipolar disorder hospital discharge diagnoses: file review and multiple register linkage in Sweden","volume":"124","author":"Sellgren","year":"2011","journal-title":"Acta Psychiatr Scand."},{"issue":"1","key":"2023122814530424500_CIT0051","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/08039480500360906","article-title":"Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses","volume":"59","author":"Ekholm","year":"2005","journal-title":"Nord J Psychiatry."},{"issue":"10","key":"2023122814530424500_CIT0052","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1001\/archpsyc.1982.04290100043007","article-title":"Assortative mating for psychiatric disorders and psychological traits","volume":"39","author":"Merikangas","year":"1982","journal-title":"Arch Gen Psychiatry."},{"issue":"6","key":"2023122814530424500_CIT0053","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1017\/S0033291798007326","article-title":"Assortative mating for major psychiatric diagnoses in two population- based samples","volume":"28","author":"Maes","year":"1998","journal-title":"Psychol Med."},{"issue":"4","key":"2023122814530424500_CIT0054","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/acps.12686","article-title":"A systematic review and meta-analysis of prospective transition from major depression to bipolar disorder","volume":"135","author":"Ratheesh","year":"2017","journal-title":"Acta Psychiatr Scand."}],"container-title":["Schizophrenia Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article-pdf\/50\/1\/157\/54915363\/sbad097.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article-pdf\/50\/1\/157\/54915363\/sbad097.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T14:54:02Z","timestamp":1703775242000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/schizophreniabulletin\/article\/50\/1\/157\/7223753"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,13]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,7,13]]},"published-print":{"date-parts":[[2024,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/schbul\/sbad097","relation":{},"ISSN":["0586-7614","1745-1701"],"issn-type":[{"value":"0586-7614","type":"print"},{"value":"1745-1701","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,1]]},"published":{"date-parts":[[2023,7,13]]}}}