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Gregersen M, Søndergaard A, Brandt JM, Ellersgaard D, Rohd SB, Hjorthøj C, Ohland J, Krantz MF, Wilms M, Andreassen AK, Knudsen CB, Veddum L, Greve A, Bliksted V, Mors O, Clemmensen L, Møllegaard Jepsen JR, Nordentoft M, Hemager N, Thorup AAE. Mental disorders in preadolescent children at familial high-risk of schizophrenia or bipolar disorder - a four-year follow-up study: The Danish High Risk and Resilience Study, VIA 11: The Danish High Risk and Resilience Study, VIA 11. J Child Psychol Psychiatry 2022; 63:1046-1056. [PMID: 34918345 DOI: 10.1111/jcpp.13548] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Children at familial high-risk of schizophrenia and bipolar disorder have an elevated prevalence of mental disorders but studies of children within a narrow age range are lacking and there are few conjoint studies of these two groups. Knowledge on their mental health is important for prevention and early intervention. METHODS The authors examined mental disorders and global functioning in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP) compared with population-based controls. In a longitudinal cohort study, 450 children (FHR-SZ, n = 171; FHR-BP, n = 104; controls, n = 175), were assessed for Axis I disorders at baseline and four-year follow-up (mean age 11.9, SD 0.2) with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children and for global functioning with Children's Global Assessment Scale. RESULTS Cumulative incidence of Any Axis I disorder was elevated by age 11 in children at FHR-SZ (54.4%, OR 3.0, 95% CI 1.9-4.7, p < .001) and children at FHR-BP (52.9%, OR 2.8, 95% CI 1.7-4.7, p < .001) compared with controls (28.6%). Children at FHR-SZ and FHR-BP had higher rates of affective disorders (OR 4.4, 95% CI 1.4-13.5, p = .009; OR 5.1, 95% CI 1.6-16.4, p = .007), anxiety disorders (OR 2.1, 95% CI 1.1-4.0, p = .02; OR 3.0, 95% CI 1.5-6.1, p = .002), and stress and adjustment disorders (OR 3.3, 95% CI 1.4-7.5, p = .006; OR 5.3, 95% CI 2.2-12.4, p < .001). Disruptive behavior disorders (OR 2.8, 95% CI 1.0-7.3, p = .04) and ADHD (OR 2.9, 95% CI 1.6-5.3, p < .001) were elevated in children at FHR-SZ. Both FHR groups had lower global functioning than controls. Cumulative incidence of disorders increased equally across the three groups from early childhood to preadolescence and level of functioning did not change differentially. CONCLUSIONS Children at FHR-SZ and FHR-BP have an elevated prevalence of mental disorders and poorer functioning than controls. Vulnerability in children at FHR manifests early and remains stable throughout childhood. Early attention toward their mental health and identification of those in need of intervention is warranted.
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Affiliation(s)
- Maja Gregersen
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Marie Brandt
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Ellersgaard
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark
| | - Carsten Hjorthøj
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Ohland
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark
| | - Mette Falkenberg Krantz
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Wilms
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Vibeke Bliksted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lars Clemmensen
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Merete Nordentoft
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Hemager
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
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Nieto L, Domínguez-Martínez T, Rosel-Vales M, Saracco-Alvarez R, Celada-Borja C, Rascón-Gasca ML. Clinical and Functional Differences Between Mexican Youth at Clinical High Risk for Psychosis and With Familial High Risk. Front Psychol 2022; 13:911030. [PMID: 35859823 PMCID: PMC9289544 DOI: 10.3389/fpsyg.2022.911030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Few studies have explored the differences in clinical psychopathology between youth at high risk for psychosis and those at familial high risk for psychosis. This study seeks to describe and compare the sociodemographic, clinical, and functional characteristics of At-Risk Mental State (ARMS) for psychosis youth and those with a first- or second-degree relative with psychosis (Familial High-Risk: FHR) in a Mexican sample. Twenty-one ARMS individuals and 21 with FHR were evaluated for sociodemographic characteristics, psychopathological symptoms, and functional impairment. ARMS individuals were significantly younger, had fewer years of schooling, and were more likely to be male than those in the FHR group. Groups did not differ as regards marital status or occupation. The ARMS group showed greater severity of prodromal symptoms, schizotypal personality traits, and general psychopathology than the FHR group. In addition, they reported more premorbid adjustment deficit from early adolescence than the FHR group. Current overall social and role functioning was significantly lower in the ARMS group. Findings are consistent with ARMS studies from other countries. First- or second-degree relatives of patients with psychosis should be considered a vulnerable group as they display several symptoms of general psychopathology and may experience social adjustment problems in their adult lives. The lack of early detection and intervention psychosis programs in Mexico underlines the need to prioritize the development of preventive strategies to help close the care gap.
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Affiliation(s)
- Lourdes Nieto
- Division of Epidemiological and Psychosocial Research, Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
- *Correspondence: Lourdes Nieto,
| | - Tecelli Domínguez-Martínez
- Division of Epidemiological and Psychosocial Research, Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mauricio Rosel-Vales
- Schizophrenia Clinic, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Ricardo Saracco-Alvarez
- Department of Clinical Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Cesar Celada-Borja
- Schizophrenia Clinic, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - María Luisa Rascón-Gasca
- Division of Epidemiological and Psychosocial Research, Department of Social Sciences in Health, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
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Taylor JH, Asabere N, Calkins ME, Moore TM, Tang SX, Xavier RM, Merikangas AK, Wolf DH, Almasy L, Gur RC, Gur RE. Characteristics of youth with reported family history of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort. Schizophr Res 2020; 216:104-110. [PMID: 31883930 PMCID: PMC7239716 DOI: 10.1016/j.schres.2019.12.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/23/2019] [Accepted: 12/19/2019] [Indexed: 12/22/2022]
Abstract
Little is known about the impact of family history of psychosis on youth from community samples. To fill this gap, we compared youth with a first-degree relative with psychosis spectrum symptoms (i.e. family history of psychosis spectrum symptoms, FHPS) to youth without FHPS in a cross-sectional analysis of the Philadelphia Neurodevelopmental Cohort (PNC). The PNC is a racially diverse community sample of 9498 youth ages 8-21 years old, of whom 8928 completed the Family Interview for Genetic Studies to determine FHPS status. Polygenic risk score for schizophrenia (PRSS) was available for a subsample of 4433 European Americans. FHPS youth (n = 489) constituted 5.5% of the analytic sample. After adjusting for environmental risk factors (sociodemographic variables and traumatic stressful events), FHPS youth had lower functioning on the Children's Global Assessment Scale and elevated psychosis spectrum, mood, externalizing, and fear symptoms compared to non-FHPS youth (all p < .001). In the European-American subsample, FHPS status was associated with poorer functioning and greater symptom burden in all four psychopathology domains (all p < .001), even after covarying for PRSS. Thus, ascertaining FHPS is important because it is uniquely associated with symptoms and functional impairment in community youth beyond PRS-S and the environmental risk factors we investigated. Future research identifying environmental causes of FHPS-associated impairment could inform the development of interventions for the broad array of symptoms observed in FHPS youth.
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Affiliation(s)
- Jerome H Taylor
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
| | - Nana Asabere
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Monica E Calkins
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyler M Moore
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Sunny X Tang
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Rose Mary Xavier
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alison K Merikangas
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel H Wolf
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Almasy
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Raquel E Gur
- Lifespan Brain Institute, Children's Hospital of Philadelphia Department of Child and Adolescent Psychiatry and Behavioral Sciences, Perelman School of Medicine Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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