Neurocognitive Development in Children at Familial High Risk of Schizophrenia or Bipolar Disorder

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Christina Bruun Knudsen
  • Nicoline Hemager, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen, Københavns Universitet
  • ,
  • Aja Neergaard Greve
  • Rikke Lambek
  • Anna Krogh Andreassen
  • Lotte Veddum
  • Julie Marie Brandt, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen, Københavns Universitet
  • ,
  • Maja Gregersen, Københavns Universitet, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen
  • ,
  • Mette Falkenberg Krantz, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen, Københavns Universitet
  • ,
  • Anne Søndergaard, Københavns Universitet, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen
  • ,
  • Nanna Lawaetz Steffensen
  • Merete Birk
  • Henriette Brockdorff Stadsgaard
  • Jessica Ohland, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen
  • ,
  • Birgitte Klee Burton, Københavns Universitet
  • ,
  • Jens Richardt Møllegaard Jepsen, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Mental Health Centre Copenhagen, Københavns Universitet
  • ,
  • Anne Amalie Elgaard Thorup, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, IT University of Copenhagen
  • ,
  • Merete Nordentoft, Københavns Universitet, Mental Health Centre Copenhagen, iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research
  • ,
  • Ole Mors
  • Vibeke Fuglsang Bliksted

Importance: Neurocognitive impairments exist in children at familial high risk (FHR) of schizophrenia and bipolar disorder. Studies on preadolescent developmental courses of neurocognition are important to describe shared and distinct neurodevelopmental pathways in these groups.

Objective: To assess the development in specific neurocognitive functions from age 7 to 11 years in children at FHR of schizophrenia or bipolar disorder compared with children in a population-based control (PBC) group.

Design, Setting, and Participants: The Danish High Risk and Resilience Study is a prospective, longitudinal, cohort study that collected data from January 1, 2013, to January 31, 2016 (phase 1), and from March 1, 2017, to June 30, 2020 (phase 2). Data were collected at 2 university hospitals in Denmark, and participants included 520 children at FHR of schizophrenia or bipolar disorder along with a PBC group matched with the group of children at FHR of schizophrenia by age, sex, and municipality.

Exposures: Parental schizophrenia, bipolar disorder, or neither.

Main Outcomes and Measures: Neurocognitive functioning was assessed with validated tests of intelligence, processing speed, attention, memory, verbal fluency, and executive functioning. Multilevel mixed-effects linear regression models with maximum likelihood estimation were used to estimate neurocognitive development from age 7 to 11 years.

Results: At 4-year follow-up, a total of 451 children (mean [SD] age; 11.9 [0.2] years; 208 girls [46.1%]) underwent neurocognitive testing. There were a total of 170 children at FHR of schizophrenia (mean [SD] age, 12.0 [0.3]; 81 girls [47.7%]), 103 children at FHR of bipolar disorder (mean [SD] age, 11.9 [0.2] years; 45 girls [43.7%]), and 178 children in the PBC group (mean [SD] age, 11.9 [0.2] years; 82 girls [46.1%]). At either age 7 or 11 years or at both assessments, 520 children participated in the neurocognitive assessment and were therefore included in the analyses. When correcting for multiple comparisons, no statistically significant time × group interactions were observed across the 3 groups. Compared with the PBC group at 4-year follow-up, children at FHR of schizophrenia showed significant neurocognitive impairment in 7 of 24 neurocognitive measures (29.2%; Cohen d range, 0.29-0.37). Compared with children at FHR of bipolar disorder, children at FHR of schizophrenia had significant neurocognitive impairment in 5 of 24 measures (20.8%; Cohen d range, 0.29-0.38). Children at FHR of bipolar disorder and those in the PBC group did not differ significantly.

Conclusions and Relevance: In this cohort study, findings suggest that neurocognitive maturation was comparable across groups of children at FHR of schizophrenia or bipolar disorder compared with PBCs from age 7 to 11 years. Compared with the PBC group, children at FHR of schizophrenia demonstrated widespread, stable, neurocognitive impairments during this period, whereas children at FHR of bipolar disorder showed no neurocognitive impairments, which may indicate distinct neurodevelopmental pathways in children at FHR of schizophrenia and bipolar disorder.

OriginalsprogEngelsk
TidsskriftJAMA Psychiatry
Vol/bind79
Nummer6
Sider (fra-til)589-599
Antal sider11
ISSN0003-990X
DOI
StatusUdgivet - jun. 2022

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