Bipolar Affective Disorder Research Articles

Perceived cognitive loss, symptomology, and psychological well-being with bipolar disorder

BackgroundAdults with bipolar disorder (BD) commonly present with cognitive deficits. Many also report subjective or perceived cognitive failures. For this study, we identified four distinct clusters of adults with BD on the basis of both BD symptoms (depression and hypo/mania) and perceived cognitive errors (i.e., forgetfulness, distractibility, false triggering). We hypothesized that participants reporting more BD symptoms and cognitive errors would report lower psychological well-being (i.e., self-efficacy, life scheme, life satisfaction). A second objective was to determine if and how clusters differed in terms of BD related factors (e.g., subtypes, sleep, medications) and sociodemographic differences such as age of participants. From the BADAS (Bipolar Affective Disorder and older Adults) Study, we identified 281adults with BD (M = 44.27 years of age, range 19–81), recruited via social media. ResultsAll clusters significantly differed across all grouping variables except symptoms of hypo/mania due to low frequency. Across clusters, perceived cognitive failures and BD symptoms increased in lockstep; that is, those reporting more cognitive errors also reported significantly higher symptoms of both depression and hypo/mania. As hypothesized, they also reported significantly lower psychological well-being.ConclusionsAge did not significantly differ across clusters in contrast to existing research in which cognitive loss is objectively measured. That is, perceived cognitive errors are significantly associated with lower psychological well-being for both young and older adults with BD.

Bipolar Mood Disorder in Older Age Individuals

Since geriatric individuals are a rapidly growing segment of the population, the number of patients with bipolar mood disorder is increasing gradually. Treatment options become more difficult as a result of increasing organic diseases and comorbid psychiatric disorders with increasing age, and the treatment of geriatric bipolar mood disorder patients can be more complex than that of younger patients, considering the sensitivity to side effects due to pharmacological treatments. The aim of this study is to present the prevalence of bipolar mood disorder in the older age group, the symptoms affecting them, and the current status of comorbid disorders by collecting information from the studies in the related literature. It is of critical importance examining the neurodegeneration of bipolar mood disorder in more detail in future studies. With more interventional studies, it will be possible to support organic diseases and psychiatric comorbidities that occur with advancing age. Local studies on the treatment protocols will help to reduce the burden created on patients.

No Evidence Support Quetiapine in Treatment of Adolescent Bipolar Depression

Quetiapine, an atypical antipsychotic with established efficacy in the treatment of schizophrenia, shows efficacy in the treatment of acute mania and depression associated with bipolar disorder. Quetiapine, either as monotherapy or in combination with lithium or divalproex sodium, is generally well tolerated and effective in reducing manic symptoms in adult and adolescent patients with acute bipolar mania, and is approved for use in adults for this indication. As monotherapy, the drug is also effective in reducing depressive symptoms in patients with bipolar depression. It is associated with a low incidence of Extrapyramidal Symptom (EPS)-related adverse events and low EPS ratings in bipolar disorder. Quetiapine thus shows potential in the treatment of bipolar depression, and represents a useful agent for the treatment of acute bipolar mania. But for children and adolescent, quetiapine show no difference to placebo. The both RCT and evidence-based medicine study indicate that quetiapine have no efficacy for children and adolescent bipolar depression.

Analisis Psikospiritual Fenomena Relapse Bagi Kelompok ODGPZ di Loka Rehabilitasi BNN Deli Serdang Tahun 2024

Relapse is a relapse behavior that repeatedly occurs after undergoing rehabilitation characterized by the emergence of addictive mindsets, behaviors and actions after the withdrawal period. Drug cases create a sense of dependence caused by several factors, namely family factors, social factors, employment factors, psychological factors and spiritual factors. That's why the case causes uncontrolled emotions of wanting to collect. The focus of the research is to analyze in depth the psychospiritual of ODGPZ who experience continuous relapse in the Rehabilitation Workshop. The term psychospiritual refers to psychology and spirituality where the psychological dimension affects the spiritual experience and the spiritual dimension can affect psychology. Spirituality and psychology include the search for identity which raises various questions that can cause problems in oneself that make oneself anxious, depressed, unstable mood and feeling like they have no purpose in life. Psychospirituality is used as a tool or analytical knife for counselors to dismantle spiritual problems experienced by counselors and see patterns of relapsed behavior. The purpose of the study was to determine the pattern of relapse behavior for the ODGPZ group and analyze the pattern of relapse behavior using a psychospiritual perspective at the BNN Deli Serdang Rehabilitation Workshop. This study uses a qualitative research methodology with a case study method to clients who have experienced relapse. Data collection techniques were obtained by initial observation, interviews and documentation. The results of the analysis showed that the pattern of relapse behavior by ODGPZ was extraordinary enjoyment, suggestions from ODGPZ friends, increasing the spirit of activity, escaping from problems, and pressure and stigma from society. After the pattern was analyzed using a psychospiritual lens, the author found that there were clients who still found it difficult to refuse offers from ODGPZ friends, there were errors in interpreting the theological message of the Bible text, all problems were solved with drugs, finding meaning and purpose in life and social change. Therefore, psychospirituality is closely related to the intellectual and emotional of the individual which affects the mindset and behavior of individuals, especially drug user.

Evaluating the effectiveness of a multi-component lifestyle therapy program versus psychological therapy for managing mood disorders (HARMON-E): protocol of a randomised non-inferiority trial

BackgroundMood disorders, including unipolar and bipolar depression, contribute significantly to the global burden of disease. Psychological therapy is considered a gold standard non-pharmacological treatment for managing these conditions; however, a growing body of evidence also supports the use of lifestyle therapies for these conditions. Despite some clinical guidelines endorsing the application of lifestyle therapies as a first-line treatment for individuals with mood disorders, there is limited evidence that this recommendation has been widely adopted into routine practice. A key obstacle is the insufficient evidence on whether lifestyle therapies match the clinical and cost effectiveness of psychological therapy, particularly for treating those with moderate to severe symptoms. The HARMON-E Trial seeks to address this gap by conducting a non-inferiority trial evaluating whether a multi-component lifestyle therapy program is non-inferior to psychological therapy on clinical and cost-effectiveness outcomes over 8-weeks for adults with major depressive disorder and bipolar affective disorder.MethodsThis trial uses an individually randomised group treatment design with computer generated block randomisation (1:1). Three hundred and seventy-eight adults with clinical depression or bipolar affective disorder, a recent major depressive episode, and moderate-to-severe depressive symptoms are randomised to receive either lifestyle therapy or psychological therapy (adjunctive to any existing treatments, including pharmacotherapies). Both therapy programs are delivered remotely, via a secure online video conferencing platform. The programs comprise an individual session and six subsequent group-based sessions over 8-weeks. All program aspects (e.g. session duration, time of day, and communications between participants and facilitators) are matched except for the content and program facilitators. Lifestyle therapy is provided by a dietitian and exercise physiologist focusing on four pillars of lifestyle (diet, physical activity, sleep, and substance use), and the psychological therapy program is provided by two psychologists using a cognitive behavioural therapy approach. Data collection occurs at baseline, 8-weeks, 16-weeks, and 6 months with research assistants blinded to allocation. The primary outcome is depressive symptoms at 8 weeks, measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) (minimal clinically important difference = 1.6). A pre-specified within-trial economic evaluation will also be conducted.DiscussionShould lifestyle therapy be found to be as clinically and cost effective as psychological therapy for managing mood disorders, this approach has potential to be considered as an adjunctive treatment for those with moderate to severe depressive symptoms.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12622001026718, registered 22nd July 2022.Protocol version: 4.14, 26/06/2024

A Bayesian analysis of heart rate variability changes over acute episodes of bipolar disorder

Bipolar disorder (BD) involves autonomic nervous system dysfunction, detectable through heart rate variability (HRV). HRV is a promising biomarker, but its dynamics during acute mania or depression episodes are poorly understood. Using a Bayesian approach, we developed a probabilistic model of HRV changes in BD, measured by the natural logarithm of the Root Mean Square of Successive RR interval Differences (lnRMSSD). Patients were assessed three to four times from episode onset to euthymia. Unlike previous studies, which used only two assessments, our model allowed for more accurate tracking of changes. Results showed strong evidence for a positive lnRMSSD change during symptom resolution (95.175% probability of positive direction), though the sample size limited the precision of this effect (95% Highest Density Interval [−0.0366, 0.4706], with a Region of Practical Equivalence: [-0.05; 0.05]). Episode polarity did not significantly influence lnRMSSD changes.

Longitudinal course of inflammatory-cognitive subgroups across first treatment severe mental illness and healthy controls.

While inflammation is associated with cognitive impairment in severe mental illnesses (SMI), there is substantial heterogeneity and evidence of transdiagnostic subgroups across schizophrenia (SZ) and bipolar (BD) spectrum disorders. There is however, limited knowledge about the longitudinal course of this relationship. Systemic inflammation (C-Reactive Protein, CRP) and cognition (nine cognitive domains) was measured from baseline to 1 year follow-up in first treatment SZ and BD (n = 221), and healthy controls (HC, n = 220). Linear mixed models were used to evaluate longitudinal changes separately in CRP and cognitive domains specific to diagnostic status (SZ, BD, HC). Hierarchical clustering was applied on the entire sample to investigate the longitudinal course of transdiagnostic inflammatory-cognitive subgroups. There were no case-control differences or change in CRP from baseline to follow-up. We confirm previous observations of case-control differences in cognition at both time-points and domain specific stability/improvement over time regardless of diagnostic status. We identified transdiagnostic inflammatory-cognitive subgroups at baseline with differing demographics and clinical severity. Despite improvement in cognition, symptoms and functioning, the higher inflammation - lower cognition subgroup (75% SZ; 48% BD; 38% HC) had sustained inflammation and lower cognition, more symptoms, and lower functioning (SMI only) at follow-up. This was in comparison to a lower inflammation - higher cognition subgroup (25% SZ, 52% BD, 62% HC), where SMI participants showed cognitive functioning at HC level with a positive clinical course. Our findings support heterogenous and transdiagnostic inflammatory-cognitive subgroups that are stable over time, and may benefit from targeted interventions.

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Clinical and dynamic features of bipolar affective disorder in patients with chronic coronary artery disease

Introduction. Currently, the study of comorbidity, which is characteristic of the clinical picture of modern patients, is relevant. This also applies to psychiatric disorders in cardiovascular diseases, which are common, affect social functioning and determine the clinical and biological characteristics of patients and prognosis. Bipolar disorder and coronary heart disease are one example of such a comorbidity. Recent evidence suggests that up to 40% of patients with bipolar disorder die from cardiovascular disease.Aim: To study the frequency of bipolar disorders and their clinical and dynamic features in patients with chronic coronary artery disease with the assessment of seven-year survival rates.Material and Methods. Patients with confirmed chronic coronary artery disease, aged 35–70 years, living in Tomsk and the Tomsk Region: the main group (with identified mood disorders, diagnosed by a psychiatrist, n = 262) and the comparison group (without mood or other mental disorders, n = 291). The Hamilton Depression Scale for Seasonal Affective Disorders was used to assess depressive symptoms. The survival tables and Kaplan – Meier methods were used to assess survival, survival curves were compared using the Mantel – Cox logrank test.Results. The frequency of bipolar disorder among hospitalized patients with chronic coronary artery disease was three times higher than that in the population. Depressive symptoms in bipolar disorder did not differ clinically from those in other mood disorders. The prognostic signs indicating the risk of bipolar disorder include: family history with mental disorders, atypical specification of depression, earlier age of onset of depression, high multimorbidity with mental (anxiety disorders, dependence syndrome due to alcohol, nicotine) and physical diseases. According to a retrospective assessment, coronary artery disease in half of the cases developed against the background of bipolar disorder. During the 7-year follow-up period, the number of cases of bipolar disorder doubled compared to the beginning of the study. Patients with bipolar disorder had more frequent acute myocardial infarction and had clinically more significant functional classes of angina pectoris and heart failure.Conclusion. During the 7-year follow-up period, the number of patients with bipolar disorder doubled. Patients with this comorbidity had an unfavorable prognosis in terms of survival (62.5%) compared with individuals without mood disorders.

Hypomanic symptoms in major depressive disorder: Prognostic impact and treatment issues

BackgroundMixed depression (MXD), defined as (hypo)manic symptoms occurring within major depressive episodes, is common in both bipolar and unipolar disorders, but its prognostic and treatment implications remain unclear. This study aimed to examine the relationship between hypomanic symptoms, treatment response and remission of suicidal thoughts. MethodsWe analyzed 1243 adults with major depressive disorder (MDD), recruited for a naturalistic study on treatment-resistant depression. Data were gathered cross-sectionally and retrospectively through structured interviews and clinical rating scales including the Young Mania Rating Scale (YMRS) and Montgomery-Asberg Depression Rating Scale (MADRS); statistical analyses were performed using univariate and multivariate methods. ResultsHypomanic symptoms were present in 651 patients (45 %), while 307 patients (25 %) responded to treatment. Both treatment responders (p < 0.0001) and those who achieved remission from suicide ideation (p = 0.0085) showed lower hypomanic (YMRS) scores. Multivariate analysis showed that hypomanic symptoms were negatively linked to treatment response (O.R. 0.71–0.87), while bipolar spectrum markers such as age at illness onset (O.R. 1.00–1.03) and MDD recurrence (O.R. 0.47–0.89) predicted remission from suicidal thoughts. Medications commonly used to treat bipolar disorder showed some benefits, with dopamine/serotonin antagonists improving suicide ideation (p < 0.0001) and mood stabilizers being associated with reduced hypomanic symptoms (p = 0.0003). LimitationsThe study lacked prospective clinical assessments and treatment randomization. ConclusionHypomanic symptoms are common in unipolar depression; their assessment is essential to identify challenging-to-treat cases and select the best pharmacological options.

Audit of Lithium Monitoring in a Mental Health for Older Persons (Dublin North City Central) Service

Abstract Background Lithium is a psychotropic medication used for the treatment of bipolar affective disorder and augmentation for treatment resistant depression. Lithium monitoring is essential due to the narrow therapeutic range of serum lithium and the potential for toxicity. Other medications with similar risk profiles, such as warfarin, have established monitoring programmes. Older adults receiving lithium therapy are at an increased risk of adverse events, given the prevalence of medical co-morbidities and changing pharmacokinetics. The authors of this audit identified the lack of formalized lithium monitoring programme in the Mental Health Service for Older Persons (MHSOP). The aim of this audit to compare monitoring practices in the MHSOP against the current gold standard Irish Medication Safety Network (IMSN) for Prescribing and Monitoring of Lithium Therapy. Methods A survey of all community medical charts identifying patients attending the service receiving lithium therapy was completed. Data collected pertained to diagnosis, treating consultant, lithium dose, if the patient received educational material, compliance with ECG and blood monitoring. Results The MHSOP active case load was 682 patients, 14 patients were prescribed lithium therapy. Cycle 1 of the audit demonstrated poor compliance of lithium monitoring against the gold standard. A lithium pack was inserted in patient files to prompt all clinicians to follow the recommended standardized monitoring of lithium therapy as per the IMSN guidelines. In cycle 2 of the audit there was an improvement in recording blood monitoring across the patient group. Conclusion The audit demonstrated improvement in compliance with international guidelines following the intervention. It was recommended that a formalized Lithium Clinic was a needed resource for the MHSOP. The lithium monitoring pack will continue to be added to clinical files, included in Non-Hospital Consultant (NCHD) induction and multi - disciplinary teaching sessions. It is proposed that the audit be repeated in one year to longitudinally assess compliance.

Homoeopathy in bipolar affective disorder: A review of research evidence

Homoeopathy in bipolar affective disorder: A review of research evidence

The importance of oxidative stress in the pathogenesis and treatment of bipolar affective disorder: a review of the literature

Introduction: Bipolar affective disorder (BD), also known as manic-depressive illness, is a chronic and recurrent psychiatric disorder characterised by significant mood disturbances. It is one of the leading causes of disability worldwide and is associated with a high risk of suicide. Recent studies highlight the role of oxidative stress (OS) in the pathogenesis of BD. The body's pro/antioxidant imbalance adversely affects cellular and molecular processes. Aim: The aim of this review is to synthesise the current state of knowledge on the role of OS in the aetiology and course of BD, including key biomarkers and potential therapeutic interventions. Methods: A review of the scientific literature was conducted, including articles published between 2000 and 2024. Searches were conducted in PubMed, Scopus and Web of Science databases, using the following keywords: 'bipolar disorder', 'oxidative stress', 'antioxidants', 'biomarkers', 'mitochondrial dysfunction', 'redox homeostasis', 'treatment'. Results: Results indicate that patients with BD have elevated levels of OS markers, including increased lipid peroxidation, altered antioxidant enzyme activity and impaired redox homeostasis. Treatment with lithium and other mood stabilisers may modulate levels of OS markers, which is one potential mechanism of drug action. However, inconclusive data suggest the need for further research to clarify the relationship between OS and BD. Conclusions: OS plays an important role in the pathophysiology of BD, offering potential directions for therapeutic interventions. Understanding the complex interactions between OS and BD may lead to the development of more targeted therapies aimed at reducing oxidative damage and improving patient health. Keywords: oxidative stress, bipolar affective disorder, redox, lipid peroxidation, protein damage, antioxidants, lithium

Melatonin receptor agonists in neurodegenerative diseases and psychiatric disorders

Neurodegenerative and psychiatric diseases remain a therapeutic challenge. Mental illnesses such as depression and bipolar affective disorder lead to disruption of the diurnal rhythm of melatonin secretion and disruption of the sleep-wake axis. The use of new melatonergic drugs has received special attention in recent years. Selective melatoninergic M1 and M2 receptor agonists (tasimelteon, ramelteon) show a more favorable metabolic profile, better regulation of circadian rhythms, and effects on total sleep time and sleep quality compared to the already well-studied melatonin. In addition, these drugs show no addictive potential. Agomelatine, through its action on M1 and M2 receptors, as well as serotonergic 5-HT2C and 5-HT2B receptors, exhibits antidepressant, normothymic, and neuroprotective effects, providing primary therapy or adjunctive treatment.

Cariprazine in Psychiatry: A Comprehensive Review of Efficacy, Safety, and Therapeutic Potential.

This article provides a comprehensive review of recent developments regarding a new atypical antipsychotic drug - cariprazine - considering the mechanism of action, efficacy, safety, and promising therapeutic option for various psychiatric disorders, including schizophrenia and bipolar disorder, therapy of addictions, and treatment in the pediatric population. Its distinct pharmacological profile, characterized by partial agonism at dopamine D2 and D3 receptors, as well as serotonin receptors - 5HT1A with a preference for the D3 receptor - sets it apart from other antipsychotics. The unique mechanism of action contributes to cariprazine's positive impact on negative symptoms in schizophrenia and an antidepressant effect. Its relatively low risk of adverse effects, such as sedation, metabolic issues, and hypotension, enhances its tolerability. In bipolar affective disorder, cariprazine exhibits effectiveness in managing both depressive and manic episodes. Ongoing research in pediatric populations suggests potential benefits in schizophrenia, bipolar I disorder, and autism spectrum disorder, but further research is necessary to establish safety and efficacy. Moreover, cariprazine shows promise in addiction therapy, particularly with coexisting psychiatric disorders. Continued research and clinical exploration may discover additional insights, broadening its use in diverse patient populations. This article aims to review the role of cariprazine, a dopamine D2/D3 and serotonin 5-HT1A receptor partial agonist, in the management of psychotic illnesses, including schizophrenia, bipolar disorder, addiction therapy, and pediatric treatment.

Case report: nephrons, neurons and too much urine — the highs and lows of lithium-associated arginine vasopressin resistance (AVR) in bipolar affective disorder (BPAD)

Case report: nephrons, neurons and too much urine — the highs and lows of lithium-associated arginine vasopressin resistance (AVR) in bipolar affective disorder (BPAD)

Distinct Effects of Major Affective Disorder Diagnoses and Suicidal Symptom Severity on Inhibitory Control Function and Proinflammatory Cytokines: Single-Site Analysis of 800 Adolescents and Adults.

Inhibitory control function and proinflammatory cytokines play a role in the pathomechanisms underlying major affective disorders and suicidal behavior. However, the distinct or interactive effects of major affective disorders and suicidal symptom severity on inhibitory control function and proinflammatory cytokines remain unclear. This study included 287 patients with bipolar disorder, 344 with major depressive disorder, and 169 healthy controls. We categorized the participants into 3 groups based on Montgomery-Åsberg Depression Rating Scale (MADRS) item 10 (suicidal symptoms) score: 0, 2 or 3, and ≥4. The participants completed the go/no-go task and the measurements for C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) levels. Errors in the go/no-go task were associated with suicidality (P = .040), regardless of the severity of suicidal symptoms and diagnosis. An elevated CRP level was especially associated with a Montgomery-Åsberg Depression Rating Scale item 10 score ≥4 (P = .001). An increased TNF-α level could distinguish bipolar disorder from major depressive disorder (P < .001). Our study indicated the distinct effects of major affective disorder diagnosis and suicide symptom severity on inhibitory control function and CRP and TNF-α levels. Importantly, individuals with the poorest inhibitory control function and highest CRP levels had more severe suicidal symptoms.

A Comparative Analysis of the Frequency of Bipolar Spectrum Disorder in Patients with and Without Psoriasis

Background: Psoriasis is a chronic disease that significantly negatively affects a patient’s quality of life. Based on etiopathological characteristics, there is strong evidence of susceptibility to psychological disorders, such as depression and bipolar disorder, in patients suffering from psoriasis. Objectives: We investigated the frequency of bipolar spectrum disorders in psoriasis patients compared to healthy controls in a selected population in Iran. Methods: This case-control study was conducted on two sample groups, with and without psoriasis (50 people in each group). The statistical population included all individuals referred to Shohadaye Tajrish and Taleghani Hospitals of Shahid Beheshti University of Medical Sciences, selected using the available method and assigned to two groups in 2023. The participants were examined for the presence of bipolar spectrum disorders using the Mood Disorder Questionnaire (MDQ) and the Bipolar Spectrum Diagnostic Scale (BSDS). Results: According to the MDQ questionnaire, the frequency rates of bipolar disorder in the patients and controls were 20% and 40%, respectively, with no significant difference between the groups (P = 0.108). Based on the BSDS, the frequency of bipolar disorder in the two groups, with and without psoriasis, was estimated to be 25% and 32.1%, respectively, with no significant difference (P = 0.226). The rate of major depressive disorders was also 22% and 26%, with no significant difference (P = 0.640). Conclusions: Among Iranian patients with psoriasis, the presence of the disease may not be associated with an increased risk of bipolar spectrum disorders.

Pervasive findings of directional selection realize the promise of ancient DNA to elucidate human adaptation.

We present a method for detecting evidence of natural selection in ancient DNA time-series data that leverages an opportunity not utilized in previous scans: testing for a consistent trend in allele frequency change over time. By applying this to 8433 West Eurasians who lived over the past 14000 years and 6510 contemporary people, we find an order of magnitude more genome-wide significant signals than previous studies: 347 independent loci with >99% probability of selection. Previous work showed that classic hard sweeps driving advantageous mutations to fixation have been rare over the broad span of human evolution, but in the last ten millennia, many hundreds of alleles have been affected by strong directional selection. Discoveries include an increase from ∼0% to ∼20% in 4000 years for the major risk factor for celiac disease at HLA-DQB1 ; a rise from ∼0% to ∼8% in 6000 years of blood type B; and fluctuating selection at the TYK2 tuberculosis risk allele rising from ∼2% to ∼9% from ∼5500 to ∼3000 years ago before dropping to ∼3%. We identify instances of coordinated selection on alleles affecting the same trait, with the polygenic score today predictive of body fat percentage decreasing by around a standard deviation over ten millennia, consistent with the "Thrifty Gene" hypothesis that a genetic predisposition to store energy during food scarcity became disadvantageous after farming. We also identify selection for combinations of alleles that are today associated with lighter skin color, lower risk for schizophrenia and bipolar disease, slower health decline, and increased measures related to cognitive performance (scores on intelligence tests, household income, and years of schooling). These traits are measured in modern industrialized societies, so what phenotypes were adaptive in the past is unclear. We estimate selection coefficients at 9.9 million variants, enabling study of how Darwinian forces couple to allelic effects and shape the genetic architecture of complex traits.

Familial coaggregation of major psychiatric disorders and neurodevelopmental disorders among first-degree relatives of individuals with generalized anxiety disorder

BackgroundAnxiety disorders, major psychiatric disorders (e.g., schizophrenia and major affective disorders), and neurodevelopmental disorders (e.g., autism and attention-deficit/hyperactivity disorder [ADHD]) may cluster together within families. However, whether the first-degree relatives (FDRs) of individuals with generalized anxiety disorder (GAD) are at an elevated risk of neurodevelopmental or major psychiatric disorders remains unknown. MethodsWe identified 2,378,190 FDRs of patients with GAD and 9,512,760 birth year–matched and sex-matched controls from Taiwan's National Health Insurance Research Database. Neurodevelopmental disorders, including autism and ADHD, and major psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, and GAD, were identified. ResultsThe FDRs—parents, offspring, and siblings—of individuals with GAD were more likely to be diagnosed as having schizophrenia (relative risk: 1.22), bipolar disorder (1.36), major depressive disorder (1.29), autism (1.20), ADHD (1.52), obsessive–compulsive disorder (1.21), and GAD (1.61) than are the FDRs of individuals without GAD. ConclusionOur findings support the notion of a familial coaggregation between GAD, major psychiatric disorders, and neurodevelopmental disorders. Future studies should elucidate the definitive genetic etiology of this familial coaggregation.