Peer-reviewed article

Emotional and behavioral problems in the offspring of parents with schizophrenia or bipolar disorder: a controlled comparative study.

Balatacı U, Ay B, Tarhan R, Ay A · 9 Sept 2026

Abstract

Objective This study aimed to compare emotional and behavioral problems in the offspring of parents with schizophrenia, the offspring of parents with bipolar disorder, and healthy controls using the Child Behavior Checklist for ages 6-18 years (CBCL/6-18). Methods This cross-sectional controlled study was conducted in the Child and Adolescent Psychiatry Outpatient Clinic of Karabük Training and Research Hospital. The sample included 62 children and adolescents aged 6-18 years: 21 offspring of parents with schizophrenia, 20 offspring of parents with bipolar disorder, and 21 healthy controls. Parental diagnoses were established according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and confirmed with the Structured Clinical Interview for DSM-5. Emotional and behavioral problems were assessed using CBCL/6-18 T-scores. Group comparisons were performed using one-way analysis of variance and chi-square tests, with Bonferroni correction applied for multiple CBCL comparisons. Multivariable linear regression analysis was used to identify factors independently associated with total problems scores. Results The groups did not differ significantly in age, sex, or educational status. Compared with healthy controls, both clinical groups had higher rates of previous child psychiatry visits and less favorable family-related sociodemographic characteristics. After Bonferroni correction, significant group differences remained for withdrawn/depressed, anxious/depressed, internalizing problems, aggressive behavior, externalizing problems, social problems, attention problems, and total problems. In these domains, both offspring groups scored significantly higher than controls, whereas the schizophrenia and bipolar disorder groups did not significantly differ from one another. In adjusted regression analysis, both schizophrenia-group status and bipolar-disorder-group status remained independently associated with higher total problems scores. Conclusion Offspring of parents with schizophrenia or bipolar disorder show elevated emotional and behavioral problems compared with healthy controls, supporting the importance of early screening and family-oriented preventive interventions.