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Stark I, Rast JE, Lundberg M, Döring N, Ohlis A, Idring Nordström S, Rai D, Magnusson C. Completion of Upper Secondary Mainstream School in Autistic Students in Sweden. J Autism Dev Disord 2024:10.1007/s10803-024-06470-8. [PMID: 39017805 DOI: 10.1007/s10803-024-06470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
Higher education is an increasingly necessary achievement to attain employment. However, even in cases where a student has the academic skills to succeed, educational environments may not support students across all other domains necessary for education success, including social and communication needs. This is especially true for students with disabilities and autistic students, where the rate of completion of non-compulsory education is unknown. We used the Stockholm Youth Cohort (children aged 0-17 years from 2001 to 2011), a total population cohort (N = 736,180) including 3,918 autistic individuals, to investigate the association between autism without intellectual disability and completion of upper secondary education. We assessed the impact of sex and co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) on this association. By age 20 years (the expected age of completion), 68% of autistic students and 91% of non-autistic students admitted to upper secondary education had completed. In logistic regression models adjusted for student demographics, autistic students had almost five-fold higher odds of not completing secondary school (OR 4.90, 95% CI 4.56 5.26) compared to their non-autistic peers. Autistic students with ADHD had particularly high odds of non-completion of upper secondary school. Autistic students without intellectual disability attending mainstream education are substantially less likely to complete upper secondary education as compared to their peers. These findings have implications for the appraisal of how inclusive school policies serve autistic students' academic and social needs, ultimately addressing population health and independent living.
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Affiliation(s)
- Isidora Stark
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jessica E Rast
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Michael Lundberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Nora Döring
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Ohlis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | | | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
- Bristol Autism Spectrum Service, Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Cecilia Magnusson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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Takami Lageborn C, Zhou M, Boman M, Sjölander A, Larsson H, D'Onofrio BM, Pettersson E, Lichtenstein P, Landén M. Childhood and adolescence outcomes in offspring to parents with bipolar disorder: the impact of lifetime parental comorbidity, parental sex, and bipolar subtype. J Child Psychol Psychiatry 2024. [PMID: 38527491 DOI: 10.1111/jcpp.13982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Offspring of parents with bipolar disorder have increased risks of their own psychopathology. However, a large-scale survey of psychiatric, somatic, and adverse social outcomes up to adulthood, which could aid in prioritizing and tailoring prevention, is lacking. It also remains to clarify how risks are modified by other parental factors. METHODS Swedish population registers were linked to compare offspring having (N = 24,788) and not having (N = 247,880) a parent with bipolar disorder with respect to psychiatric diagnoses and psychotropic medication, birth-related and somatic conditions, social outcomes, accidents, suicide attempts, and mortality. Individuals were followed until age 18. We estimated the influence of lifetime parental psychiatric comorbidity, bipolar disorder subtype, and sex on outcomes. RESULTS Children of parents with bipolar disorder had 2-3 times higher risks of all psychiatric diagnoses, except for bipolar disorder, for which the risk was 11-fold. Significantly increased risks were also found for several somatic conditions, low school grades, criminal behavior, victimization, accidents, and suicidal behavior. Adjusting for lifetime parental psychiatric comorbidity attenuated most associations. Offspring of a parent with bipolar disorder type 2 had statistically significantly higher risks of attention deficit hyperactivity disorder, respiratory tract conditions, and accidents compared with offspring of a parent with bipolar disorder type 1. Offspring of mothers with bipolar disorder had higher risks of several psychiatric diagnoses, respiratory tract conditions, low school grades, and accidents compared with offspring of fathers with bipolar disorder. Having two parents with bipolar disorder entailed the highest risks of psychiatric outcomes in offspring. CONCLUSIONS Early intervention and family support are particularly warranted for the offspring of a parent with bipolar disorder in the presence of lifetime parental psychiatric comorbidity, when the parent has bipolar disorder type 2, or when the mother or both parents have bipolar disorder.
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Affiliation(s)
| | - Mengping Zhou
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Boman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Bete T, Misgana T, Nigussie K, Aliye K, Abdeta T, Wedaje D, Hunduma G, Assefa A, Tesfaye D, Asfaw H, Amano A, Tariku M, Dereje J, Ali T, Mohammed F, Demissie M, Mohammed A, Hayru N, Assefa B, Wilfong T, Alemu D. Depressive disorder, bipolar disorder, and associated factors among adults, in the Eastern part of Ethiopia. BMC Psychiatry 2024; 24:17. [PMID: 38172755 PMCID: PMC10763018 DOI: 10.1186/s12888-023-05466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Depressive disorder is one of the severe and common mental illnesses in the general population. Bipolar disorder is a severe, persistent mental illness associated with significant morbidity and mortality. However, there is a paucity of data on the prevalence of depressive disorder, and bipolar disorder in our study area. OBJECTIVE This study aimed to assess the prevalence of depressive and bipolar disorders among adults in Kersa, Haramaya, and Harar Health and Demographic Surveillance Sites in Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 1,416 participants. A multi-stage sampling was employed to select the participants. DSM-5 diagnostic criteria was used to assess depressive disorder and bipolar disorder. Data was collected using a standard questionnaire. Data were entered into Epi-Data 3.1 and analyzed using SPSS version 26. Both binary and multivariate logistic regression analyses were done. Those with a p-value < 0.05 in the final model were considered statistically significant. RESULTS The overall prevalence of depressive and bipolar disorders among our study participants was 6.7% (95% CI: 5.40, 8.20) and 2.1% (95% CI: (1.40, 3.00), respectively. The independent predictors of depressive disorder included a family history of mental illness, chronic medical illnesses, unemployment, low educational status, divorced or widowed, poor social support, and current alcohol use or khat chewing. Single, males, divorced or widowed, and current consumers of alcohol were independent predictors for bipolar disorder. CONCLUSIONS AND RECOMMENDATION The results of our investigation showed that bipolar illness and depression were significant public health issues. It was shown that although bipolar disorder is highly prevalent in the society, depression is a widespread concern. As a result, it is imperative that the relevant body grow and enhance the provision of mental health services. Furthermore, research on the effects and burdens of bipolar disorder in the community is required.
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Affiliation(s)
- Tilahun Bete
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Tadesse Misgana
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kemal Aliye
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Abdeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawud Wedaje
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gari Hunduma
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abduselam Assefa
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdulkarim Amano
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jerman Dereje
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fethia Mohammed
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mekdes Demissie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmed Mohammed
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nejiba Hayru
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Birhanu Assefa
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tara Wilfong
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Seo A, Chang AY. A systematic review of the social impact of diseases in Nordic countries. Scand J Public Health 2024:14034948231217365. [PMID: 38166481 DOI: 10.1177/14034948231217365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
BACKGROUND We review the literature on the social impacts of diseases, defined as the social consequences of having a disease on the people around the patient, such as spouses, caregivers and offspring. The two objectives of this study are to summarise the social outcomes commonly associated with diseases and to compare the social impact across a range of diseases. METHODS A systematic review of the social impact of disease in Nordic countries was conducted using PubMed, PsycINFO and Google Scholar (PROSPERO registration number CRD42022291796). All articles that met the inclusion criteria were reviewed. We tabulated all outcomes and diseases studied, and synthesised the evidence based on the perspectives of patients, spouse/caregiver and offspring. RESULTS A total of 135 studies met the eligibility criteria, covering 76 diseases and 39 outcomes. From the patient's perspective, diseases impact divorce and marriage rates, social functioning, likelihood of committing a crime and being a victim of crime. From the caregiver's perspective, diseases affect their health-related quality of life and physical and psychological health. From the offspring's perspective, diseases impact their development, health and social adversities in later life. Diseases generally had negative social impacts, but there were some diseases associated with positive impacts. CONCLUSIONS The review provides a useful summary and gross comparison of the social impact of different diseases. The social impact of diseases can be large and significant. Thus, it should be considered when policymakers are setting priorities across disease areas.
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Affiliation(s)
- Ahreum Seo
- Department of Public Health, University of Southern Denmark, Denmark
| | - Angela Y Chang
- Danish Institute for Advanced Study, University of Southern Denmark, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Denmark
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Sidorchuk A, Brander G, Pérez-Vigil A, Crowley JJ, Larsson H, Lichtenstein P, Mataix-Cols D, Nordsletten AE. One versus two biological parents with mental disorders: Relationship to educational attainment in the next generation. Psychol Med 2023; 53:7025-7041. [PMID: 36545765 PMCID: PMC10719631 DOI: 10.1017/s0033291722003506] [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: 05/18/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Both maternal and, separately, paternal mental illness are associated with diminished academic attainment among children. However, the differential impacts of diagnostic type and degree of parental burden (e.g. one v. both parents affected) on these functional outcomes are unknown. METHODS Using the Swedish national patient (NPR) and multi-generation (MGR) registers, 2 226 451 children (1 290 157 parental pairs), born 1 January 1973-31 December 1997, were followed through 31 December 2013. Diagnostic status of all cohort members was defined for eleven psychiatric disorders, and families classed by exposure: (1) parents affected with any disorder, (2) parents affected with a disorder group (e.g. neuropsychiatric disorders), and (3) parents affected with a specific disorder (e.g. ADHD). Pairs were further defined as 'unaffected,' 'single-affected,', or 'dual-affected.' Among offspring, the study evaluated fulfillment of four academic milestones, from compulsory (primary) school through University (college). Sensitivity analyses considered the impact of child's own mental health, as well as parental education, on main effects. RESULTS Marked reductions in the odds of achievement were observed, emerging at the earliest levels of schooling for both single-affected [adjusted odds ratio (aOR), 0.50; 95% CI 0.49-0.51] and dual-affected (aOR 0.29, 95% CI 0.28-0.30) pairs and persisting thereafter [aOR range (single), 0.52-0.65; aOR range (dual), 0.30-0.40]. This pattern was repeated for analyses within diagnosis/diagnostic group. Main results were robust to adjustment for offspring mental health and parent education level. CONCLUSIONS Parental mental illness is associated with profound reductions in educational attainment in the subsequent generation, with children from dual-affected families at uniquely high risk.
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Affiliation(s)
- Anna Sidorchuk
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Gustaf Brander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala Universitet, Uppsala, Sweden
| | - Ana Pérez-Vigil
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - James J. Crowley
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro Universitet, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Ashley E. Nordsletten
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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6
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Helmink FGL, Vandeleur CL, Preisig M, Gunput STG, Hillegers MHJ, Mesman E. Functional outcomes across development in offspring of parents with bipolar disorder. J Affect Disord 2023; 340:490-505. [PMID: 37467795 DOI: 10.1016/j.jad.2023.07.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 05/26/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Whereas the risk and course of psychopathology in offspring of parents with bipolar disorder (BD) have been the primary focus of high-risk offspring studies to date, functional outcomes have not been given much attention. We present a systematic review of functional outcomes and quality of life (QoL) across development in offspring of parents with BD and aim to explore the role of offspring psychopathology in these outcomes. METHOD We searched Embase, MEDLINE, PsycINFO, Web of Science, Cochrane Central, and Google Scholar from inception to June 24, 2022, for studies referring to functional outcomes (global, social, academic or occupational) or QoL in offspring of parents with BD. RESULTS From the 6470 records identified, 39 studies were retained (global = 17; social = 17; school = 16; occupational = 3; QoL = 5), including 13 studies that examined multiple domains. For all domains, high heterogeneity was found in study methods and quality. Only 56 % of studies adjusted for offspring psychopathology, impeding interpretation. Global and social functioning generally seemed to be impaired among older offspring (>16 years). Academic performance appeared to be unaffected. School behavior, occupational functioning, and QoL showed mixed results. Offspring psychopathology is associated with social functioning, but the relationship of offspring psychopathology with other domains is less clear. CONCLUSION Studies on functional outcome in offspring of parents with BD show predominantly mixed results. Inconsistent adjustment of psychopathology and age limits conclusive interpretation. Functional outcomes should be prioritized as research topics in high-risk studies and the potential associations between familial risk status, offspring psychopathology, and age may inform prevention strategies.
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Affiliation(s)
- Fleur G L Helmink
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Caroline L Vandeleur
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Esther Mesman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
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Bell MF, Segal L, Dennison S, Kinner SA, Dawe S, Spittal MJ, Preen DB. Numeracy and literacy attainment of children exposed to maternal incarceration and other adversities: A linked data study. J Sch Psychol 2023; 100:101241. [PMID: 37689438 DOI: 10.1016/j.jsp.2023.101241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/20/2023] [Accepted: 07/27/2023] [Indexed: 09/11/2023]
Abstract
Parental incarceration has been associated with educational disadvantages for children, such as lower educational attainment, increased grade retention, and truancy and suspensions. However, children exposed to parental incarceration often experience other adversities that are also associated with educational disadvantage; the contribution of these co-occurring adversities has not been considered in previous research. This study aimed to investigate the educational outcomes of children exposed to (a) maternal incarceration alone and (b) maternal incarceration plus other adversities (i.e., maternal mental illness and/or child protective services [CPS] contact). We used linked administrative data for a sample of children whose mothers were incarcerated during the children's childhood (i.e., from the time of mother's pregnancy through the child's 18th birthday; n = 3828) and a comparison group of children whose mothers had not been incarcerated (n = 9570). Multivariate multinomial logistic regressions examined the association between exposure to the three adversities (i.e., maternal incarceration, maternal mental illness, and child CPS contact) and above or below average reading and numeracy attainment in Grades 3, 5, 7 and 9. At all grade levels, children exposed to maternal incarceration alone and those exposed to maternal incarceration plus other adversities had increased odds of below average numeracy and reading attainment and decreased odds of above average numeracy and reading attainment compared to children without any of the recorded exposures. Children exposed to maternal incarceration and CPS contact and those exposed to all three adversities had increased odds of below average reading and numeracy attainment compared to children exposed to maternal incarceration alone. The findings highlight the complex needs of children of incarcerated mothers that must be considered when designing and delivering educational support programs. These children would benefit from the implementation of multi-tiered, trauma-informed educational and clinical services.
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Affiliation(s)
- Megan F Bell
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia.
| | - Leonie Segal
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia.
| | - Susan Dennison
- School of Criminology and Criminal Justice, Griffith University, Mt Gravatt, Queensland, Australia; Griffith Criminology Institute, Griffith University, Mt Gravatt, Queensland, Australia.
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Mt Gravatt, Queensland, Australia; Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, New South Wales, Australia; Mater Research Institute-UQ, University of Queensland, South Brisbane, Queensland, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Sharon Dawe
- School of Psychology, Griffith University, Mt Gravatt, Queensland, Australia.
| | - Matthew J Spittal
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
| | - David B Preen
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia.
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Nordmo M, Kleppestø T, Sunde HF, Flatø M, Demange P, Torvik FA. The association between parental internalizing disorders and child school performance. NPJ SCIENCE OF LEARNING 2023; 8:34. [PMID: 37670035 PMCID: PMC10480151 DOI: 10.1038/s41539-023-00182-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 08/18/2023] [Indexed: 09/07/2023]
Abstract
Parents play a crucial role in children's lives. Despite high prevalences of anxiety and depression, we do not know how these disorders among parents associate with child school performance in Norway. We use regression models to estimate associations between parental mental disorders and child school performance, while adjusting for some social and genetic confounders. Parental anxiety and depression were assessed from administrative registers of government funded health service consultations for all individuals in Norway with children born between 1992 and 2002. School performance was assessed as standardized grade point average at the end of compulsory education when children are 16 years old. Associations were also considered in samples of adoptees and among differentially affected siblings. We find that 18.8% of children have a parent with an anxiety or depression diagnosis from primary care during the last three years of compulsory education (yearly prevalence: 11.5%). There is a negative association between these parental mental disorders and child school outcomes (z = 0.43). This association was weakened, but statistically significant among differentially exposed siblings (z = 0.04), while disappearing in adoptee children. Many children experience that their parents have anxiety or depression and receive a diagnosis from primary care. On average, these children have lower school performance. The association is attenuated when comparing differentially exposed siblings and disappears in adoptee children. These results have a poor fit with the hypothesis that parental internalizing is an influential causal factor in determining children's educational success.
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Affiliation(s)
- Magnus Nordmo
- Department of Educational Science, University of South-Eastern Norway, Notodden, Norway.
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Thomas Kleppestø
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Hans Fredrik Sunde
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Martin Flatø
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Perline Demange
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fartein Ask Torvik
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Nielsen SS, Mikkelsen LJ, Quaade N, Gladstone TRG, Beardslee WR, Bonnemose K, Rosenberg NK, Hjorthøj C, Thorup AAE, Nordentoft M, Ranning A. A study protocol for the randomized controlled trial SAFIR FAMILY TALK: a selective primary preventive intervention vs. service as usual for children of parents with mental illness. Trials 2023; 24:291. [PMID: 37087437 PMCID: PMC10122450 DOI: 10.1186/s13063-023-07256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/14/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Children of parents with mental illness have an increased risk of developing mental illness themselves throughout their lifespan. This is due to genetic factors but also environmental disadvantages during childhood associated with parental mental illness. Selective primary preventive interventions for the children are recommended to mitigate risk factors and strengthen protective factors, but large-scale, longitudinal studies are needed. This study aims to investigate the effect of the Family Talk Preventive Intervention in a cohort of children and their parents with mental illness. METHODS The study is a randomized controlled trial with 286 planned families with at least one parent with any mental illness and at least one child aged 7 to 17 years. It will be carried out in the mental healthcare system in the Capital Region of Denmark. Families will be referred from hospitals and municipalities. The children and parents will be assessed at baseline and then randomized and allocated to either the Family Talk Preventive Intervention or service as usual. The intervention group will be assigned to Family Talk Preventive Intervention, a manualized programme consisting of ~ seven sessions for the family, including psychoeducation about parental mental illness and resilience in children, stimulating dialogue between family members and creating a common family narrative. The study period for both groups will be 12 months. Follow-up assessments will be conducted after 4 months and 12 months. The primary outcomes are the children's level of functioning, parental sense of competence and family functioning. DISCUSSION Given the prevalence of transgenerational transmission of mental illness, a systematic approach to prevention is needed in the mental healthcare setting. This study provides valuable knowledge on the Family Talk Preventive Intervention with a large sample size, inclusion of any parental mental illness and examination of the primary outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT05615324. Registered on 26 October 2022. Retrospectively registered.
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Affiliation(s)
- Signe S Nielsen
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | - Lisbeth J Mikkelsen
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | - Nikolaj Quaade
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | | | | | - Katrina Bonnemose
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | | | - Carsten Hjorthøj
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne A E Thorup
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen, Capital Region of Denmark, Denmark
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Ranning
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark.
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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10
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Rajagopal VM, Ganna A, Coleman JRI, Allegrini A, Voloudakis G, Grove J, Als TD, Horsdal HT, Petersen L, Appadurai V, Schork A, Buil A, Bulik CM, Bybjerg-Grauholm J, Bækvad-Hansen M, Hougaard DM, Mors O, Nordentoft M, Werge T, Mortensen PB, Breen G, Roussos P, Plomin R, Agerbo E, Børglum AD, Demontis D. Genome-wide association study of school grades identifies genetic overlap between language ability, psychopathology and creativity. Sci Rep 2023; 13:429. [PMID: 36624241 PMCID: PMC9829693 DOI: 10.1038/s41598-022-26845-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Cognitive functions of individuals with psychiatric disorders differ from that of the general population. Such cognitive differences often manifest early in life as differential school performance and have a strong genetic basis. Here we measured genetic predictors of school performance in 30,982 individuals in English, Danish and mathematics via a genome-wide association study (GWAS) and studied their relationship with risk for six major psychiatric disorders. When decomposing the school performance into math and language-specific performances, we observed phenotypically and genetically a strong negative correlation between math performance and risk for most psychiatric disorders. But language performance correlated positively with risk for certain disorders, especially schizophrenia, which we replicate in an independent sample (n = 4547). We also found that the genetic variants relating to increased risk for schizophrenia and better language performance are overrepresented in individuals involved in creative professions (n = 2953) compared to the general population (n = 164,622). The findings together suggest that language ability, creativity and psychopathology might stem from overlapping genetic roots.
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Affiliation(s)
- Veera M Rajagopal
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.
- Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark.
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark.
| | - Andrea Ganna
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- Broad Institute, Cambridge, USA
| | - Jonathan R I Coleman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- National Institute of Health Research Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Trust, London, UK
| | - Andrea Allegrini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Georgios Voloudakis
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jakob Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Thomas D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Henriette T Horsdal
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- The National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Liselotte Petersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- The National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
| | - Vivek Appadurai
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Institute of Biological Psychiatry, Mental Health Services of Copenhagen, Copenhagen, Denmark
| | - Andrew Schork
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Institute of Biological Psychiatry, Mental Health Services of Copenhagen, Copenhagen, Denmark
- Neurogenomics Division, The Translational Genomics Research Institute (TGEN), Phoenix, AZ, USA
| | - Alfonso Buil
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Institute of Biological Psychiatry, Mental Health Services of Copenhagen, Copenhagen, Denmark
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Marie Bækvad-Hansen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Mental Health Services in The Capital Region of Denmark, Copenhagen, Denmark
- Department Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Institute of Biological Psychiatry, Mental Health Services of Copenhagen, Copenhagen, Denmark
- Department Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- National Institute of Health Research Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Trust, London, UK
| | - Panos Roussos
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Robert Plomin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark
- Centre for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Ditte Demontis
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.
- Center for Genome Analysis and Personalized Medicine, Aarhus, Denmark.
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark.
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11
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Academic performance in adolescent offspring of mothers with prenatal and perinatal psychiatric hospitalizations: A register-based, data linkage, cohort study. Psychiatry Res 2023; 319:114946. [PMID: 36463723 DOI: 10.1016/j.psychres.2022.114946] [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: 07/07/2022] [Revised: 10/12/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND This is the first study to investigate the longitudinal association between prenatal and perinatal psychiatric hospitalizations and academic achievements in adolescent offspring. METHODS We conducted an administrative health data-based cohort study of 168, 528 mother-offspring pairs using linked data obtained from health and educational registries in New South Wales, Australia. Prenatal and perinatal maternal psychiatric diagnosis was measured by using ICD-10. The National Assessment Program for Literacy and Numeracy (NAPLAN) was used to assess the educational performance of the offspring. Logistic regression model was used to explore the association. Multivariate models were adjusted for maternal sociodemographic characteristics such as age at birth, marital status, educational status, and occupational status, maternal diabetes and chronic hypertension, maternal smoking during pregnancy, birth weight, and language spoken at home. RESULTS The findings show that after adjusting for important covariates adolescent offspring of mothers with prenatal and perinatal psychiatric hospitalizations were more likely to perform below the national minimum standard in all domains of academic performance at age 14 years, when compared with the offspring of mothers without such hospitalizations, with the highest odds for numeracy (OR = 2.88; 95% CI: 2.50-3.31) followed by reading (OR = 2.08; 95% CI: 1.81-2.38), spelling (OR = 1.74; 95% CI: 1.51-2.01), and writing (OR = 1.56; 95% CI: 1.34-1.80). There was significant gender interaction such that males were more likely to experience lower rates of academic performance than females in all academic domains. Lower academic achievements were observed among offspring of mothers with all major groupings of psychiatric disorders, with a higher risk for severe psychiatric disorders followed by mental disorders due to substance use or medical conditions. CONCLUSION In sum, maternal prenatal and perinatal psychiatric hospitalizations are associated with lower academic achievements in adolescent offspring, with a stronger effect on the academic performance of male offspring. Early intervention strategies that aim to enhance educational performance in the exposed offspring are needed.
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12
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Early-life factors associated with increased risk of disability pension in the national real-world schizophrenia FACE-SZ cohort study. Eur Arch Psychiatry Clin Neurosci 2022; 272:1379-1384. [PMID: 35333961 DOI: 10.1007/s00406-021-01364-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/24/2021] [Indexed: 11/03/2022]
Abstract
Among severe psychiatric disorders, schizophrenia has one of the highest impacts on professional and personal functioning with important indirect costs including disability pension allowance for the patients with the more severe forms of schizophrenia. To explore early-life factors associated with disability pension in schizophrenia. 916 patients were consecutively recruited at a national level in 10 expert centers and received a comprehensive standardized evaluation. Their disability pension status and early-life variables were reported from medical records and validated scales. Eight factors were explored: age, male sex, parental history of severe mental illness, childhood trauma exposure, education level, childhood ADHD, early age at schizophrenia onset and duration of untreated psychosis. 739 (80.7%) participants received a disability pension. In the multivariate model, early age at schizophrenia onset and low education level were associated with disability pension independently of age and sex while no significant association was found for parent history of severe mental illness, childhood trauma, childhood ADHD or duration of untreated psychosis. Low education level and early age at schizophrenia onset seem the best predictors of increased risk of disability pension in schizophrenia.
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13
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Ayano G, Lin A, Dachew BA, Tait R, Betts K, Alati R. The impact of parental mental health problems on the educational outcomes of their offspring: Findings from the Raine Study. Aust N Z J Psychiatry 2022; 56:510-524. [PMID: 34227415 DOI: 10.1177/00048674211025633] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES There is limited evidence on the impact of parental mental health problems on offspring's educational outcomes. We investigated the impact of maternal anxiety and depressive symptoms, as well as paternal emotional problems on the educational outcomes of their adolescent and young adult offspring. METHODS We used data from a longitudinal birth cohort recruited between 1989 and 1991 in Australia (the Raine Study). The Depression, Anxiety and Stress Scale was used to assess maternal depressive and anxiety symptoms, and a self-reported question was used to measure paternal mental health problems. Both were assessed when the offspring was aged 10 years. Outcomes included offspring's self-reported education attainment-not completing year 10 at age 17, not attending tertiary education at ages 17 and 22 and primary caregiver's reports of offspring's academic performance at age 17. RESULTS A total of 1033, 1307 and 1364 parent-offspring pairs were included in the final analysis exploring the association between parental mental health problems and offspring's academic performance at school, completing year 10 and attending tertiary education, respectively. After adjusting for potential confounders, the offspring of mothers with anxiety symptoms were 3.42 times more likely than the offspring of mothers without anxiety symptoms to have poor or below-average academic performance (odds ratio = 3.42; 95% confidence interval = [1.31, 8.92]) and more than 2 times more likely to not attend tertiary education (odds ratio = 2.55; 95% confidence interval = [1.10, 5.5.88]) and not to have completed year 10 (odds ratio = 2.13; 95% confidence interval = [1.04, 4.33]). We found no significant associations between maternal depressive symptoms or paternal emotional problems and offspring educational attainment. CONCLUSION Maternal anxiety symptoms, but not depression and paternal emotional problems, are associated with poor educational attainment and achievement in adolescent offspring. The findings highlight that efforts to improve the outcomes of offspring of mothers with anxiety could focus on educational attainment.
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Affiliation(s)
- Getinet Ayano
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Berihun Assefa Dachew
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Robert Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Kim Betts
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Rosa Alati
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Institute of Social Science Research, The University of Queensland, Brisbane, QLD, Australia
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14
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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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15
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Cognitive reserve and its correlates in child and adolescent offspring of patients diagnosed with schizophrenia or bipolar disorder. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01957-0. [PMID: 35175425 DOI: 10.1007/s00787-022-01957-0] [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: 05/18/2021] [Accepted: 02/06/2022] [Indexed: 11/03/2022]
Abstract
AIM To analyze cognitive reserve (CR) in child and adolescent offspring of patients diagnosed with schizophrenia (SZ-off) or bipolar disorder (BD-off) and compare them with a group of community controls (CC-off). We also aimed to investigate whether there was an association between CR and clinical and neuropsychological variables according to group. METHODS The study included 46 SZ-off, 105 BD-off and 102 CC-off. All participants completed assessments regarding CR and clinical, neuropsychological and psychosocial functioning. CR was measured with a proxy based on premorbid intelligence, parental occupational level, educational attainment, developmental milestones and sociability. The clinical assessment included the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime, the Semi-structured Interview for Prodromal Syndromes, and the Global Assessment Functioning scale. The neuropsychological assessment included measures of executive functioning, attention, verbal memory, working memory and processing speed. RESULTS SZ-off showed a lower level of CR compared to BD-off and CC-off, while BD-off showed an intermediate level of CR between SZ-off and CC-off. Moreover, an association between higher CR and less lifetime psychopathology, fewer prodromal psychotic symptoms, higher psychosocial functioning, and a higher working memory score was observed in all groups, but it was stronger in SZ-off. CONCLUSIONS CR seemed to be associated with psychopathology, clinical symptoms, psychosocial functioning, and some cognitive functions. SZ-off appeared to benefit more from a higher CR, therefore it could be considered a protective factor against the development of clinical symptomatology and cognitive impairment.
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Morozov P, Bekker R, Bykov Y. Cariprazine's Potential in Improving Social Dysfunction in Patients With Schizophrenia: A Perspective. Front Psychiatry 2022; 13:868751. [PMID: 35573354 PMCID: PMC9091654 DOI: 10.3389/fpsyt.2022.868751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
Social dysfunction is one of the most debilitating aspects of schizophrenia. Treatment of this complex phenomenon, constituted by negative, cognitive, and affective symptoms, has been difficult with the available pharmacological agents, hence it represents an unmet medical need. Cariprazine, a novel, third-generation antipsychotic with a unique mechanism of action has been proven to sufficiently alleviate negative, cognitive, and affective symptoms of schizophrenia. These characteristics make this compound a valid candidate for addressing social dysfunction too. In this perspective, we argue that cariprazine can be viewed as a "socializing drug" that has the ability to improve the patient's functionality and ultimately their quality of life. Data from animal research, clinical trials, an observational study, and patient cases are provided.
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Affiliation(s)
- Petr Morozov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Roman Bekker
- Ben-Gurion University of the Negev, Beersheba, Israel
| | - Youri Bykov
- Stavropol State Medical University, Stavropol, Russia
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Fekadu W, Craig TK, Kebede D, Medhin G, Fekadu A. Multidimensional and intergenerational impact of Severe Mental Disorders. EClinicalMedicine 2021; 41:101151. [PMID: 34632353 PMCID: PMC8488481 DOI: 10.1016/j.eclinm.2021.101151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Severe Mental Disorders (SMDs) affect multiple generations although this is poorly studied. The aim of this study was to investigate the intergenerational and multidimensional impacts of SMD in rural Ethiopia. METHODS This comparative study was nested within an existing population-based cohort study. We collected data from a total 5762 family members of 532 households (266 households with at least one family member with SMD and 266 sex and age matched mentally well controls from the neighborhood) in 2019. The main outcomes were multidimensional poverty, mortality, food insecurity, and family satisfaction. FINDINGS Multidimensional poverty Index was higher in the households of persons with SMD (74·44%) than the comparison households (38·35%). School attendance was lower in children of people with SMD (63·28%) than children of the comparisons (78·08%). The median years of schooling was also lower among children of people with SMD than the controls. This lower attendance was also true among siblings of people with SMD (35·52%) than the comparisons (49·33%). Over the course of 20 years, family members who have a person with SMD in their household had 23% increased risk of death compared to family members who did not have a person with SMD in their household. Severe food insecurity was also higher in the SMD households (20·68%) than the comparison (13·53%) while family satisfaction was lower. INTERPRETATION Families of people with SMD experience pervasive multidimensional and intergenerational impacts. Interventions should consider the broader family social and healthcare needs of the broader family.
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Affiliation(s)
- Wubalem Fekadu
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Corresponding author at: Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Tom K.J. Craig
- Department of Health Services and Population Research, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Derege Kebede
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Abebaw Fekadu
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development Therapeutic Studies for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, United Kingdom
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18
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Bager L, Munk Laursen T, Skipper N, Agerbo E. School performance of children whose parents suffered torture and war-a register-based study in Denmark. Eur J Public Health 2021; 31:749-755. [PMID: 34458911 DOI: 10.1093/eurpub/ckab108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Young refugees and descendants of refugees have different preconditions for learning than their peers without refugee background. Children growing up in families where parents have suffered torture and war trauma may represent a particularly vulnerable group. This study investigates whether children of torture survivors living in Denmark achieved different test scores throughout primary and secondary school compared to children of non-traumatized parents. METHODS Using data from a national school test programme, tests from Grades 2-8 were compared for children whose parents had been treated for torture and war trauma as to their peers. Referral to specialized rehabilitation clinics was used to identify the traumatized parent group. The mean score difference was estimated using multilevel linear regression, and outcomes were measured within groups of parental region of origin to allow for region-specific effects. The odds of missing a test were also estimated with multilevel logistic regression. RESULTS The study included 854 467 children [median age (interquartile range) =12 (3.3)] of which 7809 were children of the trauma-exposed parents. The analysis revealed that children of torture survivors achieved test scores between -6% (95% CI: -0.13, 0.00) and -38% (95% CI: -0.44, -0.32) of a standard deviation compared to children of non-traumatized parents, adjusted for the main effect of region of origin. They were also more likely to miss a test [OR=4.95 (95% CI: 4.30, 5.71)]. CONCLUSIONS The findings indicate that risk factors for poorer school performance cluster in children of traumatized refugee parents, and reveal the possible adverse educational effects of trauma across generations.
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Affiliation(s)
- Line Bager
- Department of Economics and Business Economics, NCRR, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Thomas Munk Laursen
- Department of Economics and Business Economics, NCRR, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.,Department of Economics and Business Economics, iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Department of Economics and Business Economics, CIRRAU, Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Niels Skipper
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- Department of Economics and Business Economics, NCRR, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.,Department of Economics and Business Economics, iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Department of Economics and Business Economics, CIRRAU, Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
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19
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Nordentoft M, Jeppesen P, Thorup AAE. Prevention in the mental health field should be implemented synergically at different levels. World Psychiatry 2021; 20:230-231. [PMID: 34002513 PMCID: PMC8129867 DOI: 10.1002/wps.20856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pia Jeppesen
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- Copenhagen Research Center for Mental Health, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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20
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Maj M, van Os J, De Hert M, Gaebel W, Galderisi S, Green MF, Guloksuz S, Harvey PD, Jones PB, Malaspina D, McGorry P, Miettunen J, Murray RM, Nuechterlein KH, Peralta V, Thornicroft G, van Winkel R, Ventura J. The clinical characterization of the patient with primary psychosis aimed at personalization of management. World Psychiatry 2021; 20:4-33. [PMID: 33432763 PMCID: PMC7801854 DOI: 10.1002/wps.20809] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medica-tion is prescribed, with second-generation antipsychotics usually preferred to first-generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence-based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves "recovery-oriented", it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient's needs in terms of employment, housing, self-care, social relationships and education, and offers a focus on identity, meaning and resilience.
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Affiliation(s)
- Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Jim van Os
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marc De Hert
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, LVR-Klinikum Düsseldorf, and WHO Collaborating Center on Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Philip D Harvey
- Division of Psychology, Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge and Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Dolores Malaspina
- Department of Psychiatry and Neuroscience, Ichan Medical School at Mount Sinai, New York, NY, USA
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Jouko Miettunen
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Robin M Murray
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Keith H Nuechterlein
- Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine, and Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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21
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Chen J, Chen X, Leung SS, Tsang HW. Potential impacts, alleviating factors, and interventions for children of a parent with schizophrenia: A scoping review. CHILDREN AND YOUTH SERVICES REVIEW 2021. [DOI: 10.1016/j.childyouth.2020.105751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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22
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Marsman A, Pries LK, ten Have M, de Graaf R, van Dorsselaer S, Bak M, Kenis G, Lin BD, Luykx JJ, Rutten BPF, Guloksuz S, van Os J. Do Current Measures of Polygenic Risk for Mental Disorders Contribute to Population Variance in Mental Health? Schizophr Bull 2020; 46:1353-1362. [PMID: 33259628 PMCID: PMC7707067 DOI: 10.1093/schbul/sbaa086] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The polygenic risk score (PRS) allows for quantification of the relative contributions of genes and environment in population-based studies of mental health. We analyzed the impact of transdiagnostic schizophrenia PRS and measures of familial and environmental risk on the level of and change in general mental health (Short-Form-36 mental health) in the Netherlands Mental Health Survey and Incidence Study-2 general population sample, interviewed 4 times over a period of 9 years, yielding 8901 observations in 2380 individuals. Schizophrenia PRS, family history, somatic pain, and a range of environmental risks and social circumstances were included in the regression model of level of and change in mental health. We calculated the relative contribution of each (group of) risk factor(s) to the variance in (change in) mental health. In the combined model, familial and environmental factors explained around 17% of the variance in mental health, of which around 5% was explained by age and sex, 30% by social circumstances, 16% by pain, 22% by environmental risk factors, 24% by family history, and 3% by PRS for schizophrenia (PRS-SZ). Results were similar, but attenuated, for the model of mental health change over time. Childhood trauma and gap between actual and desired social status explained most of the variance. PRS for bipolar disorder, cross-disorder, and depression explained less variance in mental health than PRS-SZ. Polygenic risk for mental suffering, derived from significance-testing in massive samples, lacks impact in analyses focusing on prediction in a general population epidemiological setting. Social-environmental circumstances, particularly childhood trauma and perceived status gap, drive most of the attributable variation in population mental health.
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Affiliation(s)
- Anne Marsman
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Margreet ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- FACT, Mondriaan Mental Health, Maastricht, The Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Bochao D Lin
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jurjen J Luykx
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Neurology, UMC Utrecht Brain Center, University Medical Centre Utrecht, Utrecht, The Netherlands
- GGNet Mental Health, Apeldoorn, The Netherlands
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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23
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Stark I, Liao P, Magnusson C, Lundberg M, Rai D, Lager A, Idring Nordström S. Qualification for upper secondary education in individuals with autism without intellectual disability: Total population study, Stockholm, Sweden. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:1036-1046. [PMID: 33246359 PMCID: PMC8111225 DOI: 10.1177/1362361320975929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study used the Stockholm Youth Cohort, a total population cohort (N = 364,957), to describe patterns and predictors of qualification for upper secondary education, defined by passing graduation grades in core compulsory school subjects in contemporary young individuals diagnosed with autism spectrum disorders without intellectual disability (n = 6138). At the expected age for graduation, 16 years, 29% (adjusted rate difference 95% confidence interval (28.0–30.0)) fewer autistic than non-autistic individuals were qualified for upper secondary education (57% and 86%, respectively). Comorbid attention-deficit hyperactivity disorder further increased this difference. Within the group of autistic students without intellectual disability, female sex and lower family income were associated with non-qualification for upper secondary education. The proportion of students with autism without intellectual disability who qualified for upper secondary education increased at age 20. These findings underline the need for improved support for students with a diagnosis of autism without intellectual disability in mainstream education.
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Affiliation(s)
| | - Peiwen Liao
- Karolinska Institutet, Sweden.,University of New South Wales (UNSW), Australia
| | | | | | | | - Anton Lager
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden
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24
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Dickson H, Hedges EP, Ma SY, Cullen AE, MacCabe JH, Kempton MJ, Downs J, Laurens KR. Academic achievement and schizophrenia: a systematic meta-analysis. Psychol Med 2020; 50:1949-1965. [PMID: 32684198 DOI: 10.1017/s0033291720002354] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cognitive impairments in childhood are associated with increased risk of schizophrenia in later life, but the extent to which poor academic achievement is associated with the disorder is unclear. METHODS Major databases were searched for articles published in English up to 31 December 2019. We conducted random-effects meta-analyses to: (1) compare general academic and mathematics achievement in youth who later developed schizophrenia and those who did not; (2) to examine the association between education level achieved and adult-onset schizophrenia; and, (3) compare general academic achievement in youth at-risk for schizophrenia and typically developing peers. Meta-regression models examined the effects of type of academic assessment, educational system, age at assessment, measurement of educational level attained, school leaving age, and study quality on academic achievement and education level among individuals with schizophrenia. RESULTS Meta-analyses, comprising data of over four million individuals, found that: (1) by age 16 years, those who later developed schizophrenia had poorer general academic (Cohen's d = -0.29, p ⩽ 0.0001) and mathematics achievement (d = -0.23, p = 0.01) than those who did not; (2) individuals with schizophrenia were less likely to enter higher education (odds ratio = 0.49, p ⩽ 0.0001); and, (3) youth reporting psychotic-like experiences and youth with a family history of schizophrenia had lower general academic achievement (d = -0.54, p ⩽ 0.0001; d = -0.39, p ⩽ 0.0001, respectively). Meta-regression analyses determined no effect modifiers. DISCUSSION Despite significant heterogeneity across studies, various routinely collected indices of academic achievement can identify premorbid cognitive dysfunction among individuals who are vulnerable for schizophrenia, potentially aiding the early identification of risk in the population.
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Affiliation(s)
- Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily P Hedges
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Shin Y Ma
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Johnny Downs
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kristin R Laurens
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Queensland University of Technology (QUT), School of Psychology and Counselling, and Institute of Health and Biomedical Innovation, Brisbane, QLD, Australia
- School of Psychiatry, University of New South Wales, NSW, Australia
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25
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Abstract
OBJECTIVE The impact of severe mental illnesses (SMIs) is not limited to the person with the illness but extends to their family members and the community where the patient comes from. In this review, we systematically analyse the available evidence of impacts of SMI on family members, including parents, grandparents, siblings, spouses and children. DATA SOURCES PubMed, PsycINFO, Embase and Global Index Medicus were searched from the inception of each database up to 9 November 2019. We also did manual searches of grey literature. ELIGIBILITY CRITERIA We included studies that assessed the impacts of SMI on any family member. We excluded studies in admitted clinics and acute wards to rule out the acute effect of hospitalisation. DATA EXTRACTION Two reviewers extracted data independently using the Cochrane handbook guideline for systematic reviews and agreed on the final inclusion of identified studies. RISK OF BIAS The quality of the included studies was assessed using effective public health practice project quality assessment tool for quantitative studies.The review protocol was registered in the PROSPERO database. RESULTS We screened a total of 12 107 duplicate free articles and included 39 articles in the review. The multidimensional impact of SMI included physical health problems (sleeplessness, headache and extreme tiredness.), psychological difficulties (depression and other psychological problems) and socioeconomic drift (less likely to marry and higher divorce rate and greater food insecurity). Impacts on children included higher mortality, poor school performance and nutritional problems. However, the quality of one in five studies was considered weak. CONCLUSIONS Our review indicated a high level of multidimensional impact across multiple generations. The serious nature of the impact calls for interventions to address the multidimensional and multigenerational impact of SMI, particularly in low/middle-income countries. Given the relatively high number of studies rated methodologically weak, more robust studies are indicated. PROSPERO REGISTRATION NUMBER CRD42018064123.
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Affiliation(s)
- Wubalem Fekadu
- Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Awoke Mihiretu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tom K J Craig
- Department of Health Services and Population Research, King's College London, London, London, UK
| | - Abebaw Fekadu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Center for Innovative Drug Development Therapeutic Studies for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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26
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Ingstrup KG, Laursen TM, Bergink V, Ranning A, Munk-Olsen T. Association of Timing of Onset of Maternal Mental Disorders With Completion of Primary Education in Offspring. JAMA Psychiatry 2019; 76:761-762. [PMID: 30892584 PMCID: PMC6583853 DOI: 10.1001/jamapsychiatry.2019.0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study examines the association between specific timing of maternal mental disorder onset and completion of primary education in offspring.
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Affiliation(s)
- Katja Glejsted Ingstrup
- Department of Economics and Business Economics, School of Business and Social Sciences, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Thomas Munk Laursen
- Department of Economics and Business Economics, School of Business and Social Sciences, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark,IPsych, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Veerle Bergink
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anne Ranning
- Psychiatric Research Center, Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Trine Munk-Olsen
- Department of Economics and Business Economics, School of Business and Social Sciences, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark,IPsych, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
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27
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Parnas J, Sandsten KE, Vestergaard CH, Nordgaard J. Schizophrenia and Bipolar Illness in the Relatives of University Scientists: An Epidemiological Report on the Creativity-Psychopathology Relationship. Front Psychiatry 2019; 10:175. [PMID: 31001153 PMCID: PMC6454109 DOI: 10.3389/fpsyt.2019.00175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/11/2019] [Indexed: 11/13/2022] Open
Abstract
A potential link between creativity and mental illness has been a longstanding topic for human studies and empirical research. The major problem is defining creativity and establishing its measurable indicators. A few high-quality epidemiological studies have been undertaken and point to a link between creativity and vulnerability to mental illness. Demonstrating such a shared vulnerability could expand our understanding of mental illnesses and open up new avenues of empirical research. In this epidemiological study, we defined scientists (academics) at the universities as individuals assumed to exhibit "more creativity" than the background population. In a register coupling with a population of 588,532 people, we examined successful university academics' first- and second-degree relatives for diagnosed mental disorders and compared those figures with controls from the background population controlling for educational level. The relatives of the academics had significantly increased risk of suffering from schizophrenia or bipolar disorder. For bipolar disorder, it is perhaps temperamental features and high energy levels that contribute to this association. In the case of schizophrenia, the mediating bridge may involve an amplification of human tendency to question the obvious and "taken-for-granted." Creativity and an increased risk for mental disorders seem to be linked by a shared vulnerability that is not manifested by clinical mental disorders in the academics.
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Affiliation(s)
- Josef Parnas
- Mental Health Center Glostrup, Broendby, Denmark.,Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark
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28
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Thorup AAE, Hemager N, Søndergaard A, Gregersen M, Prøsch ÅK, Krantz MF, Brandt JM, Carmichael L, Melau M, Ellersgaard DV, Burton BK, Greve AN, Uddin MJ, Ohland J, Nejad AB, Johnsen LK, Ver Loren van Themaat AH, Andreassen AK, Vedum L, Knudsen CB, Stadsgaard H, M. Jepsen JR, Siebner HR, Østergaard L, Bliksted VF, Plessen KJ, Mors O, Nordentoft M. The Danish High Risk and Resilience Study-VIA 11: Study Protocol for the First Follow-Up of the VIA 7 Cohort -522 Children Born to Parents With Schizophrenia Spectrum Disorders or Bipolar Disorder and Controls Being Re-examined for the First Time at Age 11. Front Psychiatry 2018; 9:661. [PMID: 30631284 PMCID: PMC6315161 DOI: 10.3389/fpsyt.2018.00661] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction: Offspring of parents with severe mental illness have an increased risk of developing mental illnesses themselves. Familial high risk cohorts give a unique opportunity for studying the development over time, both the illness that the individual is predisposed for and any other diagnoses. These studies can also increase our knowledge of etiology of severe mental illness and provide knowledge about the underlying mechanisms before illness develops. Interventions targeting this group are often proposed due to the potential possibility of prevention, but evidence about timing and content is lacking. Method: A large, representative cohort of 522 7-year old children born to parents with schizophrenia, bipolar disorder or controls was established based on Danish registers. A comprehensive baseline assessment including neurocognition, motor functioning, psychopathology, home environment, sociodemographic data, and genetic information was conducted from January 1, 2013 to January 31, 2016. This study is the first follow-up of the cohort, carried out when the children turn 11 years of age. By assessing the cohort at this age, we will evaluate the children twice before puberty. All instruments have been selected with a longitudinal perspective and most of them are identical to those used at inclusion into the study at age 7. A diagnostic interview, motor tests, and a large cognitive battery are conducted along with home visits and information from teachers. This time we examine the children's brains by magnetic resonance scans and electroencephalograms. Measures of physical activity and sleep are captured by a chip placed on the body, while we obtain biological assays by collecting blood samples from the children. Discussion: Findings from the VIA 7 study revealed large variations across domains between children born to parents with schizophrenia, bipolar and controls, respectively. This study will further determine whether the children at familial risk reveal delayed developmental courses, but catch up at age 11, or whether the discrepancies between the groups have grown even larger. We will compare subgroups within each of the familial high risk groups in order to investigate aspects of resilience. Data on brain structure and physical parameters will add a neurobiological dimension to the study.
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Affiliation(s)
- Anne A. E. Thorup
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Åsa Kremer Prøsch
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Mette F. Krantz
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Julie M. Brandt
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Line Carmichael
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Melau
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Ditte V. Ellersgaard
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte K. Burton
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
| | - Aja N. Greve
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Md Jamal Uddin
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Ayna B. Nejad
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Line K. Johnsen
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anna Hester Ver Loren van Themaat
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anna K. Andreassen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Lotte Vedum
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Christina B. Knudsen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Henriette Stadsgaard
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Jens Richardt M. Jepsen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience, Aarhus University, Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Vibeke F. Bliksted
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- Center of Functionally Integrative Neuroscience, Aarhus University, Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J. Plessen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Division of Adolescent and Child Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Ole Mors
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
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