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Masias Bruns M, Ramirez-Mahaluf JP, Valli I, Ortuño M, Ilzarbe D, de la Serna E, Navarro OP, Crossley NA, González Ballester MÁ, Baeza I, Piella G, Castro-Fornieles J, Sugranyes G. Altered Temporal Dynamics of Resting-State Functional Magnetic Resonance Imaging in Adolescent-Onset First-Episode Psychosis. Schizophr Bull 2024; 50:418-426. [PMID: 37607335 PMCID: PMC10919773 DOI: 10.1093/schbul/sbad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND Dynamic functional connectivity (dFC) alterations have been reported in patients with adult-onset and chronic psychosis. We sought to examine whether such abnormalities were also observed in patients with first episode, adolescent-onset psychosis (AOP), in order to rule out potential effects of chronicity and protracted antipsychotic treatment exposure. AOP has been suggested to have less diagnostic specificity compared to psychosis with onset in adulthood and occurs during a period of neurodevelopmental changes in brain functional connections. STUDY DESIGN Seventy-nine patients with first episode, AOP (36 patients with schizophrenia-spectrum disorder, SSD; and 43 with affective psychotic disorder, AF) and 54 healthy controls (HC), aged 10 to 17 years were included. Participants underwent clinical and cognitive assessments and resting-state functional magnetic resonance imaging. Graph-based measures were used to analyze temporal trajectories of dFC, which were compared between patients with SSD, AF, and HC. Within patients, we also tested associations between dFC parameters and clinical variables. STUDY RESULTS Patients with SSD temporally visited the different connectivity states in a less efficient way (reduced global efficiency), visiting fewer nodes (larger temporal modularity, and increased immobility), with a reduction in the metabolic expenditure (cost and leap size), relative to AF and HC (effect sizes: Cohen's D, ranging 0.54 to.91). In youth with AF, these parameters did not differ compared to HC. Connectivity measures were not associated with clinical severity, intelligence, cannabis use, or dose of antipsychotic medication. CONCLUSIONS dFC measures hold potential towards the development of brain-based biomarkers characterizing adolescent-onset SSD.
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Affiliation(s)
- Mireia Masias Bruns
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan Pablo Ramirez-Mahaluf
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Isabel Valli
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María Ortuño
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Ilzarbe
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Olga Puig Navarro
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Nicolas A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Miguel Ángel González Ballester
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Inmaculada Baeza
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Gemma Piella
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Gisela Sugranyes
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
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2
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Andreassen AK, Lambek R, Greve A, Hemager N, Knudsen CB, Veddum L, Birk M, Søndergaard A, Brandt JM, Gregersen M, Falkenberg-Krantz M, Spang KS, Ohland J, Burton BK, Jepsen JRM, Thorup AAE, Nordentoft M, Mors O, Bliksted VF. The development in rating-based executive functions in children at familial high risk of schizophrenia or bipolar disorder from age 7 to age 11: the Danish high risk and resilience study. Eur Child Adolesc Psychiatry 2024; 33:549-560. [PMID: 36881155 DOI: 10.1007/s00787-023-02177-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/23/2023] [Indexed: 03/08/2023]
Abstract
Executive functions (EF) deficits are well documented in children at familial high risk of schizophrenia (FHR-SZ), and to a lesser degree in children at familial high risk of bipolar disorder (FHR-BP). The aim of this study was to assess EF development in preadolescent children at FHR-SZ, FHR-BP and population-based controls (PBC) using a multi-informant rating scale. A total of 519 children (FHR-SZ, n = 201; FHR-BP, n = 119; PBC, n = 199) participated at age 7, at age 11 or at both time points. Caregivers and teachers completed the Behavior Rating Inventory of Executive Functions (BRIEF). The developmental pattern from age 7 to age 11, did not differ between groups. At age 11, caregivers and teachers rated children at FHR-SZ as having widespread EF deficits. A higher proportion of children at FHR-SZ had clinically significant scores on the General executive composite (GEC) and all BRIEF indices compared to PBC. According to the caregivers, children at FHR-BP had significantly more EF deficits than PBC on 9 out of 13 BRIEF scales, whereas according to teachers, they only had significantly more deficits on one subdomain (Initiate). Likewise, caregivers rated a significantly higher proportion of children at FHR-BP above the clinical cut-off on the GEC and Metacognition index, compared to PBC, whereas there were no significant differences according to teachers. This study highlights the relevance of including multi-informant rating scales in the assessment of EF in children at FHR-SZ and FHR-BP. The results imply a need to identify children at high risk who would benefit from targeted intervention.
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Affiliation(s)
- Anna Krogh Andreassen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Aja Greve
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
| | - Christina Bruun Knudsen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lotte Veddum
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Merete Birk
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Marie Brandt
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg-Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
| | - Katrine Søborg Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Birgitte Klee Burton
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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3
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Andreassen AK, Lambek R, Hemager N, Knudsen CB, Veddum L, Carlsen AH, Bundgaard AF, Søndergaard A, Brandt JM, Gregersen M, Krantz MF, Burton BK, Jepsen JRM, Thorup AAE, Nordentoft M, Mors O, Bliksted VF, Greve A. Working memory heterogeneity from age 7 to 11 in children at familial high risk of schizophrenia or bipolar disorder- The Danish High Risk and Resilience Study. J Affect Disord 2023; 332:318-326. [PMID: 37059192 DOI: 10.1016/j.jad.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Despite the genetic overlap between bipolar disorder and schizophrenia, working memory impairments are mainly found in children of parents with schizophrenia. However, working memory impairments are characterized by substantial heterogeneity, and it is unknown how this heterogeneity develops over time. We used a data-driven approach to assess working memory heterogeneity and longitudinal stability in children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP). METHODS Based on the performances on four working memory tasks by 319 children (FHR-SZ, N = 202, FHR-BP, N = 118) measured at age 7 and 11, latent profile transition analysis was used to test for the presence of subgroups, and the stability of subgroup membership over time. Population-based controls (VIA 7, N = 200, VIA 11, N = 173) were included as a reference group. The working memory subgroups were compared based on caregiver- and teacher ratings of everyday working memory function, and dimensional psychopathology. RESULTS A model with three subgroups characterized by different levels of working memory function (an impaired subgroup, a mixed subgroup, and an above average subgroup) best fitted the data. The impaired subgroup had the highest ratings of everyday working memory impairments and psychopathology. Overall, 98 % (N = 314) stayed in the same subgroup from age 7 to 11. CONCLUSION Persistent working memory impairments are present in a subset of children at FHR-SZ and FHR-BP throughout middle childhood. Attention should be given to these children, as working memory impairments influence daily life, and may serve as a vulnerability marker of transition to severe mental illness.
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Affiliation(s)
- Anna Krogh Andreassen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark.
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Denmark
| | - Christina Bruun Knudsen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark
| | - Lotte Veddum
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark
| | - Anders Helles Carlsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; Research Unit, Research Unit, Aarhus University Hospital Psychiatry, Denmark
| | | | - Anne Søndergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Marie Brandt
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Denmark
| | - Birgitte Klee Burton
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Denmark; Center for Clinical Interventions and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital - Metal Health Services CPH, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark
| | - Aja Greve
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark
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4
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Knudsen CB, Greve AN, Jepsen JRM, Lambek R, Andreassen AK, Veddum L, Brandt JM, Gregersen M, Krantz MF, Søndergaard A, Carlsen AH, Steffensen NL, Bundgaard AF, Burton BK, Thorup AAE, Nordentoft M, Mors O, Bliksted VF, Hemager N. Neurocognitive Subgroups in Children at Familial High-risk of Schizophrenia or Bipolar disorder: Subgroup Membership Stability or Change From Age 7 to 11-The Danish High Risk and Resilience Study. Schizophr Bull 2023; 49:185-195. [PMID: 36200864 PMCID: PMC9810011 DOI: 10.1093/schbul/sbac134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND HYPOTHESIS Subgroups with distinct levels of neurocognitive functioning exist in children of parents with schizophrenia or bipolar disorder. However, studies investigating the temporal stability of subgroup membership are currently lacking. We hypothesized that a minority of children at familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) would transition to a different neurocognitive subgroup from age 7 to 11 and that most transitions would be to a more impaired subgroup. STUDY DESIGN Latent profile analysis was used to identify subgroups at two assessments (age 7 and 11) based on the performance of 320 children at FHR-SZ or FHR-BP across eight neurocognitive functions. Temporal stability in subgroup membership was evaluated with latent profile transition analysis. Population-based controls (age 7, n = 199; age 11, n = 178) were included as a reference group. Children transitioning to a more impaired subgroup were compared with nontransitioning children on sex, FHR-status, global functioning, and psychopathology. STUDY RESULTS At both assessment points, we identified three subgroups based on neurocognitive performance: a moderately-severely impaired, a mildly impaired, and an above-average subgroup. A total of 12.8% of children transitioned to a different subgroup, of which the majority (85.2%) moved to a more impaired subgroup. Parental diagnosis of schizophrenia, but neither parental diagnosis of bipolar disorder, global functioning at age 7, psychopathology, nor sex significantly differentiated children transitioning to a more impaired subgroup from nontransitioning children. CONCLUSIONS During pre-adolescence, neurocognitive developmental lag is associated with being at FHR-SZ. Close attention to these children's neurocognitive development is indicated.
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Affiliation(s)
- Christina Bruun Knudsen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Aja Neergaard Greve
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center, Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Anna Krogh Andreassen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Veddum
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Julie Marie Brandt
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Helles Carlsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
| | - Nanna Lawaetz Steffensen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Anette Faurskov Bundgaard
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
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5
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Valli I, De la Serna E, Segura AG, Pariente JC, Calvet-Mirabent A, Borras R, Ilzarbe D, Moreno D, Martín-Martínez N, Baeza I, Rosa-Justicia M, Garcia-Rizo C, Díaz-Caneja CM, Crossley NA, Young AH, Vieta E, Mas S, Castro-Fornieles J, Sugranyes G. Genetic and Structural Brain Correlates of Cognitive Subtypes Across Youth at Family Risk for Schizophrenia and Bipolar Disorder. J Am Acad Child Adolesc Psychiatry 2023; 62:74-83. [PMID: 35710081 DOI: 10.1016/j.jaac.2022.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/21/2022] [Accepted: 06/06/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Cognitive impairment is an important feature of schizophrenia (SZ) and bipolar disorder (BP) with severity across the two disorders characterized by significant heterogeneity. Youth at family risk for SZ and BP were clustered based on cognitive function and examined in terms of the clinical, genetic, and brain imaging correlates of cluster membership. METHOD One hundred sixty participants, 32 offspring of patients with SZ, 59 offspring of patients with BP and 69 offspring of healthy control parents underwent clinical and cognitive assessments, genotyping and structural MRI. K-means clustering was used to group family risk participants based on cognitive measures. Clusters were compared in terms of cortical and subcortical brain measures as well as polygenic risk scores. RESULTS Participants were grouped in 3 clusters with intact, intermediate, and impaired cognitive performance. The intermediate and impaired clusters had lower total brain surface area compared with the intact cluster, with prominent localization in frontal and temporal cortices. No between-cluster differences were identified in cortical thickness and subcortical brain volumes. The impaired cluster also had poorer psychosocial functioning and worse PRS-COG compared with the other 2 clusters and with offspring of healthy control parents, while there was no significant between-cluster difference in terms of PRS-SZ and PRS-BP. PRS-COG predicted psychosocial functioning, yet this effect did not appear to be mediated by an effect of PRS-COG on brain area. CONCLUSION Stratification based on cognition may help to elucidate the biological underpinnings of cognitive heterogeneity across SZ and BP risk.
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Affiliation(s)
- Isabel Valli
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London.
| | - Elena De la Serna
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain
| | | | - Jose C Pariente
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Roger Borras
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Ilzarbe
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain
| | - Dolores Moreno
- Institute of Neuroscience, Hospital Clínic Barcelona, Spain; Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nuria Martín-Martínez
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
| | - Mireia Rosa-Justicia
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Clemente Garcia-Rizo
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nicolas A Crossley
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London; Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Allan H Young
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, United Kingdom
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
| | - Sergi Mas
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Spain
| | - Josefina Castro-Fornieles
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
| | - Gisela Sugranyes
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
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6
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Knudsen CB, Hemager N, Greve AN, Lambek R, Andreassen AK, Veddum L, Brandt JM, Gregersen M, Krantz MF, Søndergaard A, Steffensen NL, Birk M, Stadsgaard HB, Ohland J, Burton BK, Jepsen JRM, Thorup AAE, Nordentoft M, Mors O, Bliksted VF. Neurocognitive Development in Children at Familial High Risk of Schizophrenia or Bipolar Disorder. JAMA Psychiatry 2022; 79:589-599. [PMID: 35385060 PMCID: PMC8988021 DOI: 10.1001/jamapsychiatry.2022.0465] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
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.
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Affiliation(s)
- Christina Bruun Knudsen
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Child and Adolescent Mental Health Center, Copenhagen University Hospital–Mental Health Services, Copenhagen, Denmark
| | - Aja Neergaard Greve
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Anna Krogh Andreassen
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Veddum
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Julie Marie Brandt
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Child and Adolescent Mental Health Center, Copenhagen University Hospital–Mental Health Services, Copenhagen, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nanna Lawaetz Steffensen
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | - Merete Birk
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | | | - Jessica Ohland
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Copenhagen University Hospital–Mental Health Services, Copenhagen, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Child and Adolescent Mental Health Center, Copenhagen University Hospital–Mental Health Services, Copenhagen, Denmark,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center, Glostrup, Copenhagen University Hospital–Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Child and Adolescent Mental Health Center, Copenhagen University Hospital–Mental Health Services, Copenhagen, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital–Psychiatry, Aarhus, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research–iPSYCH, Aarhus, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
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7
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Hemager N, Christiani CJ, Thorup AAE, Spang KS, Ellersgaard D, Burton BK, Gregersen M, Greve AN, Wang Y, Nudel R, Mors O, Plessen KJ, Nordentoft M, Jepsen JRM. Neurocognitive heterogeneity in 7-year-old children at familial high risk of schizophrenia or bipolar disorder: The Danish high risk and resilience study - VIA 7. J Affect Disord 2022; 302:214-223. [PMID: 35085674 DOI: 10.1016/j.jad.2022.01.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies of neurocognitive heterogeneity in young children at familial high-risk of bipolar disorder (FHR-BP) or schizophrenia (FHR-SZ) are important to investigate inter-individual neurocognitive differences. We aimed to identify neurocognitive subgroups, describe prevalence of FHR-BP or FHR-SZ children herein, and examine risk ratios (RR) compared with controls. METHODS In a population-based cohort of 514 7-year-old children (197 FHR-SZ, 118 FHR-BP, and 199 matched controls) we used hierarchical cluster analyses to identify subgroups across 14 neurocognitive indices. RESULTS Three neurocognitive subgroups were derived: A Mildly Impaired (30%), Typical (51%), and Above Average subgroup (19%). The Mildly Impaired subgroup significantly underperformed controls (Cohen d = 0.11-1.45; Ps < 0.001) except in set-shifting (P = .84). FHR-SZ children were significantly more prevalent in the Mildly Impaired subgroup; FHR-BP children were more so in the Above Average subgroup (X2 (2, N = 315) = 9.64, P < .01). 79.7% FHR-BP and 64.6% FHR-SZ children demonstrated typical or above average neurocognitive functions. Neurocognitive heterogeneity related significantly to concurrent functioning, psychopathology severity, home environment adequacy, and polygenic scores for schizophrenia (Ps <. 01). Compared with controls, FHR-SZ and FHR-BP children had a 93% (RR, 1.93; 95% CI, 1.40-2.64) and 8% (RR, 1.08; 95% CI, 0.71-1.66) increased risk of Mildly Impaired subgroup membership. LIMITATIONS Limitations include the cross-sectional design and smaller FHR-BP sample size. CONCLUSIONS Identification of neurocognitive heterogeneity in preadolescent children at FHR-BP or FHR-SZ may ease stigma and enable pre-emptive interventions to enhance neurocognitive functioning and resilience to mental illness in the impaired sub-population.
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Affiliation(s)
- Nicoline Hemager
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
| | - Camilla Jerlang Christiani
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Anne Amalie Elgaard Thorup
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Katrine Søborg Spang
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Ditte Ellersgaard
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Maja Gregersen
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ron Nudel
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Mental Health Center Sct. Hans, Mental Health Services, Institute of Biological Psychiatry, Capital Region of Denmark, Roskilde, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne, Lausanne, Switzerland
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Gentoftevej 15, 4th floor, Copenhagen, Hellerup 2900, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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