{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:48:56Z","timestamp":1793191736712,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2013,10,9]],"date-time":"2013-10-09T00:00:00Z","timestamp":1381276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Children of parents with bipolar disorder (BD) are at heightened risk for developing mood and other psychiatric disorders. We proposed to evaluate the environment of families with at least one parent with BD type I (BDF) with affected offspring (aBDF) and unaffected offspring (uBDF) compared with control families without a history of DSM-IV Axis I disorder (CF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>We used the Family Environment Scale (FES) to evaluate 47 BDF (aBDF + uBDF) and 30 CF. Parents were assessed through the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Diagnosis of the offspring was determined through the Schedule for Affective Disorders and Schizophrenia for School-Age Children\/Present and Lifetime Version (K-SADS-PL) interview.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were statistically significant differences between aBDF, uBDF and CF in cohesion ( p = 0.003), intellectual-cultural orientation ( p = 0.01), active-recreational orientation ( p = 0.007), conflict ( p = 0.001), control ( p = 0.01), moral-religious emphasis ( p = 0.01) and organization ( p = 0.001). The aBDF showed higher levels of control ( p = 0.02) when compared to the uBDF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Families with a BD parent presented more dysfunctional interactions among members. Moreover, the presence of BD or other psychiatric disorders in the offspring of parents with BD is associated with higher levels of control. These results highlight the relevance of psychosocial interventions to improve resilience and family interactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004867413506754","type":"journal-article","created":{"date-parts":[[2013,10,10]],"date-time":"2013-10-10T15:43:14Z","timestamp":1381419794000},"page":"1051-1057","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Dysfunctional family environment in affected versus unaffected offspring of parents with bipolar disorder"],"prefix":"10.1177","volume":"47","author":[{"given":"Guilherme S","family":"Ferreira","sequence":"first","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina RL","family":"Moreira","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Kleinman","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmir CGP","family":"Nader","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo Carram\u00e3o","family":"Gomes","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria A","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Center for the Support of Research in Applied Neuroscience \u2013 N\u00facleo de Apoio \u00e0 Pesquisa em Neuroci\u00eancia Aplicada (NAPNA), University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana C Almeida","family":"Rocca","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Center for the Support of Research in Applied Neuroscience \u2013 N\u00facleo de Apoio \u00e0 Pesquisa em Neuroci\u00eancia Aplicada (NAPNA), University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Nicoletti","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jair C","family":"Soares","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo F","family":"Busatto","sequence":"additional","affiliation":[{"name":"Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Center for the Support of Research in Applied Neuroscience \u2013 N\u00facleo de Apoio \u00e0 Pesquisa em Neuroci\u00eancia Aplicada (NAPNA), University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beny","family":"Lafer","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila C","family":"Caetano","sequence":"additional","affiliation":[{"name":"Bipolar Research Program, Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Center for the Support of Research in Applied Neuroscience \u2013 N\u00facleo de Apoio \u00e0 Pesquisa em Neuroci\u00eancia Aplicada (NAPNA), University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"},{"name":"Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, 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