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Søndergaard A, Gregersen M, Wilms M, Brandt JM, Hjorthøj C, Ohland J, Rohd SB, Hemager N, Andreassen AK, Knudsen CB, Veddum L, Krantz MF, Greve A, Bliksted V, Mors O, Lykkegaard K, Krustrup P, Thorup AE, Nordentoft M. Inflammatory markers, somatic complaints, use of medication and health care in 11-year-old children at familial high risk of schizophrenia or bipolar disorder compared with population-based controls. The Danish High Risk and Resilience Study - via 11. Nord J Psychiatry 2024; 78:507-517. [PMID: 38923920 DOI: 10.1080/08039488.2024.2369145] [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: 11/04/2023] [Revised: 05/12/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE Patients with schizophrenia or bipolar disorder are at increased risk of somatic illnesses and have more somatic complaints compared with the general population. Schizophrenia and bipolar disorder are highly heritable. Already during childhood, children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BD) are at increased risk of psychiatric disorders and cognitive and social impairments. Knowledge about physical conditions is sparse. MATERIALS AND METHODS Through blood tests (n = 293), interviews, and questionnaires, we assessed inflammatory markers, somatic complaints, medication - and health care use in 11-year-old children at FHR-SZ, FHR-BD, and population-based controls (PBC). RESULTS Children at FHR-SZ had higher concentrations of leucocytes (mean 6.41, SD 0.73) compared with PBC (mean 5.78, SD 0.27, p = 0.005) and of neutrophilocytes (FHR-SZ: mean 3.11, SD 1.32, PBC: mean 2.70, SD 0.96, p = 0.024). Compared with PBC (26.6%), more children at FHR-SZ (40.5%, p = 0.007) reported somatic complaints. So did caregivers and teachers to children at FHR-BD. Somatic complaints, higher concentrations of leucocytes, and neutrophilocytes were associated with lower levels of physical activity. Children at FHR-BD with psychiatric disorders reported more somatic complaints compared with those without. CONCLUSION Children at FHR-SZ had higher concentrations of leucocytes and neutrophilocytes than PBC. Children at FHR-SZ or FHR-BP displayed more somatic complaints than controls. Our study highlights rarely explored disadvantage of being born to parents with schizophrenia or bipolar disorder. To enhance understanding of how physical conditions in childhood may interplay with later transition to mental disorders in children at FHR-SZ and FHR-BD, further research is needed.
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Affiliation(s)
- Anne Søndergaard
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Maja Gregersen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Martin Wilms
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Julie Marie Brandt
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Carsten Hjorthøj
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Ohland
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Nicoline Hemager
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Research Unit of Psychiatry (Odense), Department of Clinical Research, University of Southern, Denmark
| | - Vibeke Bliksted
- Research Unit of Psychiatry (Odense), Department of Clinical Research, University of Southern, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Research Unit of Psychiatry (Odense), Department of Clinical Research, University of Southern, Denmark
| | | | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anne E Thorup
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, 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, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Stephens RL, Leavitt I, Cornea E, Jarskog LF, Gilmore JH. Early cognitive development and psychopathology in children at familial high risk for schizophrenia. Schizophr Res 2024; 271:262-270. [PMID: 39068878 DOI: 10.1016/j.schres.2024.07.034] [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: 01/12/2024] [Revised: 07/10/2024] [Accepted: 07/13/2024] [Indexed: 07/30/2024]
Abstract
Schizophrenia is a neurodevelopmental disorder associated with deficits in cognitive development and childhood psychopathology. Previous studies have focused on older children and the few studies of early childhood have yielded inconsistent findings. We studied cognitive development and psychopathology in children at familial high risk (FHR) of schizophrenia and matched controls from 1 to 6 years and hypothesized that FHR children would show consistent deficits across cognitive and behavioral measures in early childhood. STUDY DESIGN Cognitive development in children at high familial risk for schizophrenia or schizoaffective disorder (n = 33) and matched healthy controls (n = 66) was assessed at 1 and 2 years with the Mullen Scales of Early Learning, and at 4 and 6 years with the Stanford Binet Intelligence Scales, BRIEF-P/BRIEF and CANTAB. Psychopathology was assessed at 4 and 6 years with the BASC-2. General linear models were used to examine differences on outcome scores, and chi-square analyses were used to explore differences in the proportion of "at risk" or "below average" score profiles. STUDY RESULTS FHR children scored significantly lower than controls on Mullen Composite at age 2, and demonstrated broad deficits in IQ, executive function and working memory and 4 and 6 years. FHR children were also rated as significantly worse on most items of the BASC-2 at ages 4 and 6. CONCLUSIONS Children at FHR for schizophrenia demonstrate abnormal cognitive development and psychopathology at younger ages than previously detected, suggesting that early detection and intervention needs to be targeted to very early childhood.
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Affiliation(s)
- Rebecca L Stephens
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Isabel Leavitt
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Emil Cornea
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - L Fredrik Jarskog
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - John H Gilmore
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
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Maybery D, Grant A, Piché G, Yates S, Ruud T, Dunkley-Smith A, Davidson G. Summarising Quantitative Outcomes in Parental Mental Illness Research. Int J Ment Health Nurs 2024. [PMID: 39020472 DOI: 10.1111/inm.13385] [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: 03/14/2024] [Accepted: 06/19/2024] [Indexed: 07/19/2024]
Abstract
A quarter of all children grow up in a family where a parent experiences a mental illness (FaPMI). Research activity in this area is growing rapidly and it is now critical to better understand the extant knowledge in the field. This scoping review of quantitative FaPMI literature parallels a qualitative literature review and a series of Delphi studies with key stakeholders (e.g. lived experience and clinicians), that is part of a larger program of research to achieve consensus regarding the direction of FaPMI research; including making recommendations about outcomes and measures. The programme of research aims to promote and facilitate greater comparison and learning across studies and settings. Initially this scoping review summarises the quality and focus (e.g. country and sampling) of 50 quantitative studies from 2000 to 2023 and then classifies studies according to outcomes for parents, children and families. Six to eleven years were the most common child sample group and girls were slightly underrepresented (49/51) and parents were 88% mothers. Analogous parent and child outcomes were; mental illness/psychopathology, wellbeing, mental health literacy, trauma and stressful experiences, coping, help seeking/service need, within family relationships and supports, outside family relationships and supports. Additional outcomes for parents were; parenting skills, parent competence and parenting stress and for children in relation to their; cognitive functioning and caregiving. The family related outcomes were the within and outside family relationships and supports. Since 2000 there have been 136 different survey instruments employed with approximately 80% used in only one study. This suggests that the broader goals of the program of research are warranted as there is a need for less heterogeneity in measures used. Suggested areas for future research include a sampling focus on fathers, economic evaluations of programs, parent mental health literacy, trauma, genetics and integrating well-being concepts into research designs. Child research should focus on mental health literacy, the level and impact of caring responsibilities, assessing past trauma and the roles of close family and external supports.
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Affiliation(s)
- Darryl Maybery
- School of Rural Health, Monash University, Melbourne, Victoria, Australia
| | - Anne Grant
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Geneviève Piché
- Département de Psychologie et de Psychoéducation, Université du Québec en Outaouais, Saint-Jerome, Quebec, Canada
| | | | - Torleif Ruud
- Akershus University Hospital, Oslo, Norway
- Clinic for Health Services Research and Psychiatry, University of Oslo, Oslo, Norway
| | - Addy Dunkley-Smith
- School of Rural Health, Monash University, Melbourne, Victoria, Australia
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
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Shestiperov A, Grinstein-Cohen O, Lindell D, Irani E, Kagan I. Lived experiences: Growing up with a seriously mentally ill parent. J Nurs Scholarsh 2024; 56:357-370. [PMID: 38168092 DOI: 10.1111/jnu.12955] [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: 10/03/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. DESIGN This study used an interpretive phenomenological design. METHODS Participants were invited to voluntarily participate in the study through a call posted on social media. Semi-structured interviews were conducted with 30 adults (age range, 20-55 years) who grew up with a parent with serious mental illness. The interviews were recorded and transcribed, and inductive thematic analysis was used to identify main and overarching themes. RESULTS The overarching theme of transition from childhood survival to adulthood survival emerged and included four main themes: (1) a traumatic childhood, (2) perceived control, (3) resilience and general self-efficacy, and (4) adult quality of life. A traumatic childhood consisted of experiences of neglect and abuse, while participants used perceived control to achieve personal growth, self-care, and care of others. Resilience and general self-efficacy emerged during the transition to adulthood and helped participants further their social status and strengthen family bonds. Lastly, adult quality of life was described as being disturbed by feelings of loneliness and being burdensome, stemming from an inherent tendency to rely solely on themselves, leading to trust issues and mental health complications. Therefore, these adults found it difficult to reach out and get help or treatment for their concerns, as they initially did not want to appear dysfunctional or in need. CONCLUSION This study has illuminated the lived experiences of a specific, vulnerable population that has not been intentionally explored until now. To delve into these experiences, we employed a distinctive qualitative approach, merging the interpretive phenomenological perspective with an inductive thematic analysis. This allowed for rich insight with a relatively large group of participants and enabled an in-depth exploration within this methodological framework. Consequently, this study constitutes a notable contribution to the extant body of knowledge, exploring the intricacies of personal growth and its impact on participants' quality of life. It uncovers the essence of resilience and general self-efficacy, revealing how these elements intertwine with the negative results observed. However, the study findings emphasize the need for healthcare professionals, including nurses and other caregivers, to be mindful of the long-lasting effects of the adverse experiences of children of patients with serious mental illness. Prioritizing active clinical assessment and implementing tailored interventions to address such children's specific needs and difficulties across different developmental stages is imperative. Such comprehensive and targeted approaches are crucial in providing appropriate support and promoting the well-being of these individuals. CLINICAL RELEVANCE Enhanced clinical attention in holistic psychiatric care is crucial for individuals and their relatives, especially children. Comprehensive assessments of children and adults raised by seriously mentally ill parents can enable tailored and preventive interventions, positively impacting overall quality of life.
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Affiliation(s)
- Alexander Shestiperov
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Recanati School for Community Health Professions, BE'ER SHEVA, Israel
- Merhavim-Mental Health Center, Beer-Yaakov, Israel
| | - Orli Grinstein-Cohen
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Recanati School for Community Health Professions, BE'ER SHEVA, Israel
| | - Deborah Lindell
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Ilya Kagan
- Ashkelon Academic College, Ashkelon, Israel
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Gjøde ICT, Laursen TM, Müller AD, Ranning A, Moszkowicz M, Hemager N, Speyer H, Hjorthøj C, Nordentoft M, Thorup AAE. Association of maternal and paternal personality disorders with risk of mental disorders in children: A nationwide, register-based cohort study of 1,406,965 children. Acta Psychiatr Scand 2024; 149:195-206. [PMID: 38145901 DOI: 10.1111/acps.13648] [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: 06/21/2023] [Revised: 11/25/2023] [Accepted: 12/10/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Knowledge of the association between parental personality disorders and mental disorders in children is limited. To examine the association between parental personality disorders and the risk of mental disorders in offspring. METHODS We linked Danish health registers to create a cohort of children born from January 1, 1995, to December 31, 2016. Children were followed until their 18th birthday, diagnosis set, emigration, death, or December 31, 2016. Parental personality disorders according to the International Classification of Diseases (ICD) Eighth or 10th Revision. Poisson regression analyses were used to estimate the incidence risk ratio (IRR) and cumulative incidence of ICD 10th mental disorders in offspring (age 0-17). RESULTS The study cohort included 1,406,965 children. For girls, maternal or paternal personality disorder (MPD/PPD) was associated with mental disorders: MPD girls (IRR, 2.74; 95% CI, 2.59-2.89) and PPD girls (IRR, 2.10; 95% CI, 1.94-2.27). Likewise, the risk was increased for both MPD boys (IRR, 2.44; 95% CI, 2.33-2.56) and PPD boys (IRR, 2.04; 95% CI, 1.91-2.18). For girls and boys combined, exposure to two parents with a personality disorder was associated with the highest risk (IRR, 3.69; 95% CI, 3.15-4.33). At age 18, the cumulative incidence of any mental disorder in children of one or two parents with a personality disorder was 34.1% (95% CI, 33.0-35.1), which was twice the cumulative incidence of mental disorders in nonexposed children (15.2% [95% CI, 15.1-15.3]). CONCLUSION Children of parents with a personality disorder were at a 2 to 3.5 times higher risk of mental disorders compared with nonexposed offspring. Possible mechanisms of transmission of mental disorders from parent to child involve genetic, environmental, and gene-environment pathways. More research into these mechanisms and research into preventive interventions is warranted.
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Affiliation(s)
- Ida Christine Tholstrup Gjøde
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Thomas Munk Laursen
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Anne Dorothee Müller
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Ranning
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Mala Moszkowicz
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Nicoline Hemager
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Helene Speyer
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Mental Health Services in Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Carsten Hjorthøj
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
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Setiaman N, Mesman E, van Haren N, Hillegers M. Emerging psychopathology and clinical staging in adolescent offspring of parents with bipolar disorder or schizophrenia-A longitudinal study. Bipolar Disord 2024; 26:58-70. [PMID: 37328951 DOI: 10.1111/bdi.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Offspring of parents with bipolar disorder (BDo) and schizophrenia (SZo) are at increased risk for these disorders and general psychopathology. Little is known about their (dis)similarities in risk and developmental trajectories during adolescence. A clinical staging approach may help define the developmental course of illness. METHODS The Dutch Bipolar and Schizophrenia Offspring Study is a unique cross-disorder and prospective cohort study, established in 2010. In total, 208 offspring (58 SZo, 94 BDo, and 56 control offspring [Co]) and their parents participated. Offspring were 13.2 years (SD = 2.5; range: 8-18 years) at baseline and 17.1 years (SD = 2.7) at follow-up (88.5% retention rate). Psychopathology was assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version, and Achenbach System of Empirically Based Assessment parent-, self- and teacher-reports. Groups were compared on (1) the presence of categorical psychopathology, (2) timing and development of psychopathology using a clinical staging perspective, and (3) dimensional psychopathology using a multi-informant approach. RESULTS SZo and BDo showed more categorical psychopathology and (sub)clinical symptoms, as compared to Co. SZo have, compared to BDo, an increased risk for developmental disorders, a younger age of onset, and more (sub)clinical symptoms of the mood and behavioral spectrum as reported by multiple informants. CONCLUSIONS Our study shows that the phenotypical risk profile overlaps between SZo and BDo, although an earlier onset of developmental psychopathology was found specifically in SZo, suggesting of a potentially different ethiopathophysiology. Longer follow-up and future studies are needed.
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Affiliation(s)
- Nikita Setiaman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Esther Mesman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Neeltje van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
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7
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Aagaard K, Møllegaard Jepsen JR, Sevelsted A, Horner D, Vinding R, Rosenberg JB, Brustad N, Eliasen A, Mohammadzadeh P, Følsgaard N, Hernández-Lorca M, Fagerlund B, Glenthøj BY, Rasmussen MA, Bilenberg N, Stokholm J, Bønnelykke K, Ebdrup BH, Chawes B. High-dose vitamin D3 supplementation in pregnancy and risk of neurodevelopmental disorders in the children at age 10: A randomized clinical trial. Am J Clin Nutr 2024; 119:362-370. [PMID: 38072183 DOI: 10.1016/j.ajcnut.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Vitamin D deficiency in pregnancy may increase the risk of autism and attention deficit hyperactivity disorder (ADHD). OBJECTIVE The objective of this study was to estimate the effect of vitamin D3 supplementation in pregnancy on risk of autism and ADHD. DESIGN This randomized clinical trial was part of the COpenhagen Prospective Study on Neuro-PSYCHiatric Development (COPYCH) project nested within the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) cohort comprising a population-based sample of 700 healthy mother-child pairs enrolled at week 24 of pregnancy. Maternal 25-hydroxy-vitamin D (25(OH)D) was measured at inclusion and 623 mothers were randomized 1:1 to either high-dose (2800 IU/d) or standard dose (400 IU/d) vitamin D3 until 1 wk postpartum (315 received high-dose, 308 standard dose). At age 10, diagnoses and symptom load of autism and ADHD, respectively, were established using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. RESULTS The psychopathologic evaluation was completed by 591 children aged 10 y, and 16 children (2.7%) were diagnosed with autism and 65 (11.0%) with ADHD. Hereof, 496 children participated in the vitamin D3 trial (246 received high-dose, 250 standard dose). Of these, 12 children (2.4%) were diagnosed with autism and 58 (11.7%) with ADHD. Higher maternal preintervention 25(OH)D levels were associated with a decreased risk of autism [odd ratio (OR) per 10 nmol/L: 0.76 (0.59,0.97); P = 0.034], lower autistic symptom load [β per 10 nmol/L: -0.03 (-0.05,0.00); P = 0.024), and decreased risk of ADHD diagnosis (OR per 10 nmol/L: 0.88 (0.78,0.99); P = 0.033]. High-dose vitamin D3 supplementation was not associated with risk of autism or ADHD. CONCLUSIONS Higher maternal preintervention 25(OH)D was associated with a decreased risk of autism, lower autistic symptom load, and decreased risk of ADHD diagnosis, but high-dose vitamin D3 supplementation in pregnancy had no effect on risk of autism and ADHD. This trial was registered at clinicaltrials.gov as NCT00856947.
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Affiliation(s)
- Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - David Horner
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Rebecca Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Julie Bøjstrup Rosenberg
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Nicklas Brustad
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Anders Eliasen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Health Technology, Section for Bioinformatics, Technical University of Denmark
| | - Parisa Mohammadzadeh
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Nilofar Følsgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - María Hernández-Lorca
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Section of Food, Microbiology and Fermentation, Department of Food Science, University of Copenhagen
| | - Niels Bilenberg
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Section of Food, Microbiology and Fermentation, Department of Food Science, University of Copenhagen
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Søndergaard A, Gregersen M, Wilms M, Brandt JM, Hjorthøj C, Ohland J, Rohd SB, Hemager N, Andreassen AK, Knudsen CB, Veddum L, Krantz MF, Greve A, Bliksted V, Mors O, Valmaggia L, Thorup AE, Nordentoft M. Exploring the relationship between attributional style measured in virtual reality and bullying among children at familial high risk of schizophrenia or bipolar disorder compared with controls. Schizophr Res 2024; 264:354-361. [PMID: 38219411 DOI: 10.1016/j.schres.2024.01.004] [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: 10/08/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Children of parents with severe mental illness report bullying more often compared with controls. We hypothesized that deviations in attributional styles may explain the increased prevalence of bullying experiences. We aimed to assess real-time responses to standardized ambiguous social situations, bullying experiences by children, their primary caregivers, and teachers, and to investigate potential associations between attributional styles and bullying. METHOD The study included 465 children aged 11-12, born to parents with schizophrenia, N =179, bipolar disorder, N = 105, or population-based controls, N = 181. Attributional style was evaluated using virtual reality environments depicting ambiguous social everyday situations. We created a tailored assessment since no suitable assessments were found. Bullying was assessed through self-reports and reports from primary caregivers and teachers. RESULTS We observed no group differences in the attributional style of the children. Reports from children, primary caregivers, and teachers revealed that compared with controls, children born to parents with schizophrenia were more likely to perceive bullying victimization, with high consistency among reports. No associations were found between bullying reports and attributional style. CONCLUSIONS Children of parents with schizophrenia consistently experienced more bullying, as reported by the children themselves, primary caregivers, and teachers. No differences in attributional style were found, indicating that attributional style did not explain the increased prevalence of bullying reports. While it cannot be ruled out that our virtual environments were insufficient to trigger a sense of social exclusion, the results suggest that the observed differences in reported bullying are genuine and not a result of the child's attributional style.
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Affiliation(s)
- Anne Søndergaard
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
| | - Maja Gregersen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Martin Wilms
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Julie Marie Brandt
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Carsten Hjorthøj
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; University of Copenhagen, Department of Public Health, Section of Epidemiology, Copenhagen, Denmark
| | - Jessica Ohland
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Nicoline Hemager
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Vibeke Bliksted
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lucia Valmaggia
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Anne E Thorup
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, 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, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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9
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Larsen KM, Madsen KS, Ver Loren van Themaat AH, Thorup AAE, Plessen KJ, Mors O, Nordentoft M, Siebner HR. Children at Familial High risk of Schizophrenia and Bipolar Disorder Exhibit Altered Connectivity Patterns During Pre-attentive Processing of an Auditory Prediction Error. Schizophr Bull 2024; 50:166-176. [PMID: 37379847 PMCID: PMC10754183 DOI: 10.1093/schbul/sbad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND AND HYPOTHESIS Individuals with schizophrenia or bipolar disorder have attenuated auditory mismatch negativity (MMN) responses, indicating impaired sensory information processing. Computational models of effective connectivity between brain areas underlying MMN responses show reduced connectivity between fronto-temporal areas in individuals with schizophrenia. Here we ask whether children at familial high risk (FHR) of developing a serious mental disorder show similar alterations. STUDY DESIGN We recruited 67 children at FHR for schizophrenia, 47 children at FHR for bipolar disorder as well as 59 matched population-based controls from the Danish High Risk and Resilience study. The 11-12-year-old participants engaged in a classical auditory MMN paradigm with deviations in frequency, duration, or frequency and duration, while we recorded their EEG. We used dynamic causal modeling (DCM) to infer on the effective connectivity between brain areas underlying MMN. STUDY RESULTS DCM yielded strong evidence for differences in effective connectivity among groups in connections from right inferior frontal gyrus (IFG) to right superior temporal gyrus (STG), along with differences in intrinsic connectivity within primary auditory cortex (A1). Critically, the 2 high-risk groups differed in intrinsic connectivity in left STG and IFG as well as effective connectivity from right A1 to right STG. Results persisted even when controlling for past or present psychiatric diagnoses. CONCLUSIONS We provide novel evidence that connectivity underlying MMN responses in children at FHR for schizophrenia and bipolar disorder is altered at the age of 11-12, echoing findings that have been found in individuals with manifest schizophrenia.
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Affiliation(s)
- Kit Melissa Larsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Anna Hester Ver Loren van Themaat
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark
- Department of Psychiatry, Service of Child and Adolescent Psychiatry, University Medical Center, University of Lausanne, Switzerland
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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Hagstrøm J, Nielsen T, Sørensen ME, Aagaard K, Arendt Rasmussen M, Rosenberg JB, Mohammadzadeh P, Sevelsted A, Hernández-Lorca M, Fagerlund B, Rydkjær J, Pagsberg AK, Kaufman J, Ebdrup BH, Bilenberg N, Jepsen JRM. Dimensional profiling of psychopathology in children and adolescents based on the K-SADS-PL and an analysis of the construct validity of two ADHD symptom dimensions. Nord J Psychiatry 2024; 78:71-78. [PMID: 37755235 DOI: 10.1080/08039488.2023.2262997] [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: 04/12/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES The traditional view on psychiatric disorders as categorical and distinct is being challenged by perspectives emphasizing the relevance of dimensional and transdiagnostic assessment. However, most diagnostic instruments are based on a categorical view with a threshold-approach to disease classification. METHODS We here describe algorithms for dimensionalizing the psychopathological ratings of the widely used diagnostic interview for children and adolescents, the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL). We further evaluate the criterion-related construct validity of the dimensionalized attention-deficit/hyperactivity disorder (ADHD) scales using Rasch models in a sample of 590 children (mean age 10.29 (.36), 49% girls). RESULTS The algorithms generate scores of current symptom load, i.e., the sum of clinician-rated symptoms within each disorder assessed with the interview. We found support for counting symptoms of inattention and hyperactivity/impulsivity, respectively, but not for a single combined ADHD scale. CONCLUSIONS The algorithms constitute an initial step in creating a framework for clinician-rated dimensional analyses of symptoms derived from the K-SADS-PL, but future studies are needed to further evaluate the construct validity of the remaining scales and the reliability and clinical utility of the method. We believe that our proposed algorithms offer a novel method of dimensional psychopathological assessment, which can be applied in multiple branches of child and adolescent psychiatry.
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Affiliation(s)
- Julie Hagstrøm
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Tine Nielsen
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Applied Research in Education and Social Science, UCL University College, Odense, Denmark
| | - Mikkel E Sørensen
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
| | - Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Julie B Rosenberg
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Parisa Mohammadzadeh
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - María Hernández-Lorca
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
| | - Jacob Rydkjær
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
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Köhler-Forsberg O, Ge F, Hauksdóttir A, Thordardottir EB, Ásbjörnsdóttir K, Rúnarsdóttir H, Tómasson G, Jakobsdóttir J, Guðmundsdóttir B, Björnsson AS, Sigurðsson E, Aspelund T, Valdimarsdottir UA. Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study. Br J Psychiatry 2024; 224:6-12. [PMID: 37850429 PMCID: PMC10751941 DOI: 10.1192/bjp.2023.128] [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: 05/06/2023] [Revised: 07/07/2023] [Accepted: 08/30/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder. AIMS The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder. METHOD Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder. RESULTS Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately. CONCLUSION Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.
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Affiliation(s)
- Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Denmark; and Department of Clinical Medicine, Aarhus University, Denmark
| | - Fenfen Ge
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland; and Mental Health Services, Landspitali, The National University Hospital of Iceland, Iceland
| | | | - Harpa Rúnarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Gunnar Tómasson
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Berglind Guðmundsdóttir
- Faculty of Medicine, University of Iceland, Iceland; and Mental Health Services, Landspitali, The National University Hospital of Iceland, Iceland
| | | | | | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Unnur A. Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Sweden; and Harvard T.H. Chan School of Public Health, USA
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12
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Rosenberg JB, Richardt Møllegaard Jepsen J, Mohammadzadeh P, Sevelsted A, Vinding R, Sørensen ME, Horner D, Aagaard K, Fagerlund B, Brix S, Følsgaard N, Schoos AMM, Stokholm J, Chawes B, Pantelis C, Dalsgaard S, Glenthøj BY, Bilenberg N, Bønnelykke K, Ebdrup BH. Maternal inflammation during pregnancy is associated with risk of ADHD in children at age 10. Brain Behav Immun 2024; 115:450-457. [PMID: 37914103 DOI: 10.1016/j.bbi.2023.10.023] [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: 06/05/2023] [Revised: 09/04/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Maternal inflammation during pregnancy may affect early neurodevelopment in offspring as suggested by preclinical and register data. However, clinical evidence for risk of aberrant neurodevelopment later in childhood is scarce. In the population-based COPSAC2010 mother-child cohort, we investigated associations between maternal inflammation levels during pregnancy and the risk of a diagnosis of ADHD as well as the load of ADHD symptoms in the children at age 10. METHODS The COPSAC2010 cohort consists of 700 mother-child pairs followed prospectively since pregnancy week 24.Maternal high-sensitivity C-Reactive Protein (hs-CRP) level at week 24 of gestation was investigated in relation to child neurodevelopment by age 10 using logistic and linear regression models with extensive confounder adjustment, including socioeconomic status and maternal polygenic risk of ADHD. The children completed a comprehensive examination of neurodevelopment including categorical (i.e., diagnostic) and dimensional (i.e., symptom load) psychopathology using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL) and parental rated ADHD-Rating Scale (ADHD-RS). RESULTS A total of 604 (86 %) of the 700 children in the COPSAC2010 cohort participated in the COPSYCH visit at age 10. Sixty-five (10.8 %) fulfilled a research diagnosis of ADHD (16 girls and 49 boys). Higher maternal hs-CRP level in pregnancy at week 24 (median 5.4 mg/L) was significantly associated with increased risk for a diagnosis of ADHD, adjusted OR 1.40, 95 %CI (1.16-1.70), p = 0.001. Additionally, higher maternal hs-CRP was associated with increased ADHD symptom load in the entire cohort, reflected by ADHD-RS raw scores. DISCUSSION These clinical data demonstrated a robust association of prenatal maternal inflammation assessed by hs-CRP with a diagnosis of ADHD by age 10. Moreover, maternal inflammation was associated with ADHD symptom load in the complete cohort. Identifying inflammation as an important marker will provide a potential target for future increased awareness and prevention during pregnancy thereby ultimately improving neurodevelopmental outcomes in children.
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Affiliation(s)
- Julie B Rosenberg
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Jens Richardt Møllegaard Jepsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Parisa Mohammadzadeh
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Rebecca Vinding
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Mikkel E Sørensen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - David Horner
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Brix
- DTU, Department of Biotechnology and Biomedicine, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Nilofar Følsgaard
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Ann-Marie M Schoos
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Pediatrics, Slagelse Hospital, Slagelse, Denmark; Department of Food Science, University of Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Søren Dalsgaard
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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13
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Gregersen M, Ellersgaard D, Søndergaard A, Christiani C, Hemager N, Spang KS, Burton BK, Uddin MJ, Ohland J, Gantriis D, Greve A, Hjorthøj C, Mors O, Plessen KJ, Nordentoft M, Clemmensen L, Jepsen JRM, Thorup AAE. Attachment representations in 7-year-old children at familial high risk of schizophrenia or bipolar disorder: Associations with mental disorders and daily functioning: The Danish High Risk and Resilience Study, VIA 7-A population-based cohort study. Scand J Psychol 2023; 64:776-783. [PMID: 37309265 DOI: 10.1111/sjop.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Attachment quality may affect psychological functioning. However, evidence on attachment representations and their correlates in children born to parents with schizophrenia and bipolar disorder is sparse. METHODS We compared attachment representations in a Danish sample of 482 children aged 7 years at familial high risk of schizophrenia, bipolar disorder, and population-based controls and examined associations between attachment and mental disorders and daily functioning. Attachment representations were examined with the Story Stem Assessment Profile (SSAP). Mental disorders were ascertained in diagnostic interviews. Daily functioning was assessed with the Children's Global Assessment Scale. RESULTS We found no between-group differences in attachment. Higher levels of secure attachment were associated with decreased risk of concurrent mental disorders in the schizophrenia high-risk group. Higher levels of insecure and disorganized attachment were associated with increased risk of mental disorders across the cohort. Higher levels of secure and insecure attachment were associated with better and poorer daily functioning, respectively. In the current study, results regarding defensive avoidance could not be reported due to methodological limitations. CONCLUSION Familial high risk of schizophrenia (FHR-SZ) or bipolar disorder is not associated with less secure or more insecure attachment at age 7. Insecure and disorganized attachment representations index risk of mental disorders and poorer functioning. Secure attachment may be a protective factor against mental disorders in children at FHR-SZ. Validation of the SSAP is needed.
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Affiliation(s)
- Maja Gregersen
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Ditte Ellersgaard
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Camilla Christiani
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Nicoline Hemager
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark
| | - Katrine Søborg Spang
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark
| | - Birgitte Klee Burton
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark
- University of Copenhagen - Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Roskilde, Denmark
| | - Md Jamal Uddin
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Jessica Ohland
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Ditte Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Carsten Hjorthøj
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital, Lausanne, Switzerland
| | - Merete Nordentoft
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- University of Copenhagen - Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Lars Clemmensen
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE - Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, 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
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Centre, Copenhagen, Denmark
- University of Copenhagen - Faculty of Health and Medical Sciences, Copenhagen, Denmark
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14
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Gregersen M, Møllegaard Jepsen JR, Marie Brandt J, Søndergaard A, Birkehøj Rohd S, Veddum L, Bruun Knudsen C, Krogh Andreassen A, Klee Burton B, Hjorthøj C, Falkenberg Krantz M, Neergaard Greve A, Bliksted V, Mors O, Nordentoft M, Elgaard Thorup AA, Hemager N. Suicidal Ideation and Non-Suicidal Self-Injury Following Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder-The Danish High Risk and Resilience Study, VIA 11. Schizophr Bull 2023; 49:1602-1613. [PMID: 37171862 PMCID: PMC10686355 DOI: 10.1093/schbul/sbad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND HYPOTHESIS Suicide is a leading cause of death in youth and is often preceded by suicidal ideation (SI) and non-suicidal self-injury (NSSI). Identifying early markers of risk for SI and NSSI could improve timely identification of at-risk individuals. STUDY DESIGN Children (mean age 11.9, SD 0.2) at familial high risk of schizophrenia (N = 171), or bipolar disorder (N = 104), and controls (N = 174) were assessed for psychotic experiences (PE), SI, NSSI, and Axis I mental disorders in face-to-face interviews in early and middle childhood (age 7 and 11). STUDY RESULTS Having 2 types of early childhood PE predicted middle childhood SI after accounting for previous SI, NSSI, and mental disorders (OR 2.8, 95% CI 1.1-6.9; P = .03). Two PE predicted NSSI (OR 3.0, 95% CI 1.2-7.7; P = .02) in excess of previous SI, NSSI, mental disorders, and familial risk. Persistent and incident PE predicted SI (OR 3.2, 95% CI, 1.1-8.8; P = .03; OR 3.8, 95% CI, 1.3-11.5; P = .02) in the fully adjusted model. Nineteen percent of children with persistent PE reported middle childhood SI vs 3.8% of those who never reported PE. In children with early childhood mental disorders, those who reported 2 PE had 4.4-fold increased odds of later SI (95% CI, 1.2-16.7; P = .03) after adjustments. PE were nondifferentially associated with outcomes across familial risk groups. CONCLUSIONS Early childhood PE index elevated risk for subsequent SI and NSSI beyond what can be attributed to presence of mental disorders. Mental health screenings and clinical assessments should include early childhood PE.
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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
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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, Skejby, 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, Skejby, 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, Skejby, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Roskilde, 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
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Aja Neergaard Greve
- 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, Skejby, Denmark
| | - Vibeke Bliksted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, 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, Skejby, 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
| | - Anne Amalie Elgaard Thorup
- 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
- 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
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
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15
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Krantz MF, Frederiksen H, Hjorthøj C, Søndergaard A, Brandt JM, Rohd SB, Veddum L, Steffensen NL, Knudsen CB, Andreasen AK, Hemager N, Burton BK, Gregersen M, Greve AN, Ohland J, Bliksted V, Mors O, Thorup AA, Juul A, Nordentoft M. Pubertal timing, sex hormone levels, and associations between early life adversity and accelerated development amongst 11-year-old children of parents with schizophrenia or bipolar disorder and controls: The Danish high risk and Resilience study via 11. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100204. [PMID: 37664528 PMCID: PMC10470414 DOI: 10.1016/j.cpnec.2023.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023] Open
Abstract
Background Children of parents with severe mental illness have several known risk factors for altered pubertal timing. Pubertal timing is important for children's physical and emotional development. We aimed to examine pubertal timing and associations between pubertal timing, early life adversity and child problem behavior including psychiatric diagnoses among children of parents with schizophrenia or bipolar disorder and controls. Methods Self-reported Tanner stage (mean age 11.9, range 10.87-12.67), sex hormone levels, home environment, placement out of home, and problem behavior including psychiatric diagnoses of children at familial high-risk (FHR) of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP) and population-based controls (PBC) were assessed. Results A total of 465 children participated in the study (Tanner assessment N = 417, sex hormones N = 293). Assessed with self-reported Tanner, no difference in pubertal timing was found between groups (p = 0.09). Hormone levels did not differ between groups except for inhibin B (mean (SD) = 55.86 (29.13) pg/mL for FHR-SZ girls vs 84.98 (47.98) pg/mL) for PBC girls (p < 0.001)) and for follicle stimulating hormone (FSH) (mean (SD) = 5.82 (1.45) U/L for FHR-BP girls vs 4.54 (1.68) U/L for PBC girls (p < 0.001)). FHR children who were placed out of home (17 children, 3.8% of participants) had higher Tanner stages than those living at home (p < 0.001). Timing was not associated with level of problem behavior or psychiatric diagnoses. Conclusions FHR children did not differ from controls in pubertal timing. Early life adversity assessed as placement out of home may be associated with accelerated pubertal timing among children of parents with schizophrenia or bipolar disorder.
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Affiliation(s)
- Mette Falkenberg Krantz
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
| | - Carsten Hjorthøj
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Denmark
| | - Anne Søndergaard
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Clinical Medicine, 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, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Lotte Veddum
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Nanna Lawaetz Steffensen
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Christina Bruun Knudsen
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Anna Krogh Andreasen
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Nicoline Hemager
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Research Unit at Child and Adolescent Mental Health Center Copenhagen, Capital Region of Denmark, Denmark
| | - Birgitte Klee Burton
- Research Unit at Child and Adolescent Mental Health Center Copenhagen, Capital Region of Denmark, Denmark
| | - Maja Gregersen
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Aja Neergaard Greve
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Jessica Ohland
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Vibeke Bliksted
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Ole Mors
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- The Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Denmark
| | - Anne A.E. Thorup
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Research Unit at Child and Adolescent Mental Health Center Copenhagen, Capital Region of Denmark, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
- iPSYCH -The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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16
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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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17
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Hernández-Lorca M, Sevelsted A, Jepsen JRM, Pedersen CET, Rosenberg JB, Mohammadzadeh P, Rasmussen MA, Sørensen ME, Bilenberg N, Glenthøj B, Fagerlund B, Chawes B, Stokholm J, Vinding RK, Ebdrup BH, Bønnelykke K. COVID-19 lockdown, genetic ADHD susceptibility, and mental health in 10- year-old children. Psychiatry Res 2023; 329:115481. [PMID: 37776756 DOI: 10.1016/j.psychres.2023.115481] [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: 07/17/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
Previous studies report that the COVID-19 lockdown had an impact on the mental health of the pediatric population. In this study, we harness the deep neuropsychiatric phenotyping of the population-based COPSAC2010 (n = 700) cohort at age 10 to study the impact of the COVID-19 lockdown on mental health outcomes with focus on the role of the genetic vulnerability to attention-deficit/hyperactivity disorder (ADHD), in the form of polygenic risk scores (PRS). A total of 593 children were examined between 2019 and 2021, resulting in two groups of different children, those evaluated before the lockdown (n = 230) and those evaluated after (n = 363). Children assessed after the lockdown presented higher odds of being diagnosed with ADHD and had significantly higher scores in most neuropsychiatric scales, particularly in subscales pertaining to behavior and attention problems. We observed a significant interaction between the lockdown and ADHD PRS on several neuropsychiatric dimensions, with a large post-lockdown increase in children with a high PRS, while there was little to no pre-post difference in children with low PRS. These results indicate mental health consequences of the lockdown in children and suggest that genetically susceptible individuals are more affected by such stressors in childhood.
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Affiliation(s)
- María Hernández-Lorca
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark.
| | - Astrid Sevelsted
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Casper-Emil T Pedersen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark
| | - Julie B Rosenberg
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Parisa Mohammadzadeh
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Morten Arendt Rasmussen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Science, Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Erlang Sørensen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health, Mental Health Services in the Region of Southern Denmark, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Bo Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark; Faculty of Science, Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Rebecca Kofod Vinding
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR) & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital - Herlev and Gentofte, Gentofte, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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18
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Uher R, Pavlova B, Radua J, Provenzani U, Najafi S, Fortea L, Ortuño M, Nazarova A, Perroud N, Palaniyappan L, Domschke K, Cortese S, Arnold PD, Austin JC, Vanyukov MM, Weissman MM, Young AH, Hillegers MH, Danese A, Nordentoft M, Murray RM, Fusar‐Poli P. Transdiagnostic risk of mental disorders in offspring of affected parents: a meta-analysis of family high-risk and registry studies. World Psychiatry 2023; 22:433-448. [PMID: 37713573 PMCID: PMC10503921 DOI: 10.1002/wps.21147] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
The offspring of parents with mental disorders are at increased risk for developing mental disorders themselves. The risk to offspring may extend transdiagnostically to disorders other than those present in the parents. The literature on this topic is vast but mixed. To inform targeted prevention and genetic counseling, we performed a comprehensive, PRISMA 2020-compliant meta-analysis. We systematically searched the literature published up to September 2022 to retrieve original family high-risk and registry studies reporting on the risk of mental disorders in offspring of parents with any type of mental disorder. We performed random-effects meta-analyses of the relative risk (risk ratio, RR) and absolute risk (lifetime, up to the age at assessment) of mental disorders, defined according to the ICD or DSM. Cumulative incidence by offspring age was determined using meta-analytic Kaplan-Meier curves. We measured heterogeneity with the I2 statistic, and risk of bias with the Quality In Prognosis Studies (QUIPS) tool. Sensitivity analyses addressed the impact of study design (family high-risk vs. registry) and specific vs. transdiagnostic risks. Transdiagnosticity was appraised with the TRANSD criteria. We identified 211 independent studies that reported data on 3,172,115 offspring of parents with psychotic, bipolar, depressive, disruptive, attention-deficit/hyperactivity, anxiety, substance use, eating, obsessive-compulsive, and borderline personality disorders, and 20,428,575 control offspring. The RR and lifetime risk of developing any mental disorder were 3.0 and 55% in offspring of parents with anxiety disorders; 2.6 and 17% in offspring of those with psychosis; 2.1 and 55% in offspring of those with bipolar disorder; 1.9 and 51% in offspring of those with depressive disorders; and 1.5 and 38% in offspring of those with substance use disorders. The offspring's RR and lifetime risk of developing the same mental disorder diagnosed in their parent were 8.4 and 32% for attention-deficit/hyperactivity disorder; 5.8 and 8% for psychosis; 5.1 and 5% for bipolar disorder; 2.8 and 9% for substance use disorders; 2.3 and 14% for depressive disorders; 2.3 and 1% for eating disorders; and 2.2 and 31% for anxiety disorders. There were 37 significant transdiagnostic associations between parental mental disorders and the RR of developing a different mental disorder in the offspring. In offspring of parents with psychosis, bipolar and depressive disorder, the risk of the same disorder onset emerged at 16, 5 and 6 years, and cumulated to 3%, 19% and 24% by age 18; and to 8%, 36% and 46% by age 28. Heterogeneity ranged from 0 to 0.98, and 96% of studies were at high risk of bias. Sensitivity analyses restricted to prospective family high-risk studies confirmed the pattern of findings with similar RR, but with greater absolute risks compared to analyses of all study types. This study demonstrates at a global, meta-analytic level that offspring of affected parents have strongly elevated RR and lifetime risk of developing any mental disorder as well as the same mental disorder diagnosed in the parent. The transdiagnostic risks suggest that offspring of parents with a range of mental disorders should be considered as candidates for targeted primary prevention.
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Affiliation(s)
- Rudolf Uher
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Barbara Pavlova
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Umberto Provenzani
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Sara Najafi
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Maria Ortuño
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Anna Nazarova
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Nader Perroud
- Service of Psychiatric Specialties, Department of PsychiatryUniversity Hospitals of GenevaGenevaSwitzerland
- Department of PsychiatryUniversity of GenevaGenevaSwitzerland
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of PsychiatryMcGill UniversityMontrealQBCanada
- Robarts Research InstituteWestern UniversityLondonONCanada
- Department of Medical BiophysicsWestern UniversityLondonONCanada
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Samuele Cortese
- School of Psychology, and Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- Solent NHS TrustSouthamptonUK
- Division of Psychiatry and Applied PsychologyUniversity of NottinghamNottinghamUK
- Hassenfeld Children's Hospital at NYU LangoneNew YorkNYUSA
| | - Paul D. Arnold
- Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryALCanada
| | - Jehannine C. Austin
- Departments of Psychiatry and Medical GeneticsUniversity of British ColumbiaVancouverBCCanada
| | - Michael M. Vanyukov
- Departments of Pharmaceutical Sciences, Psychiatry, and Human GeneticsUniversity of PittsburghPittsburghPAUSA
| | - Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
- Division of Translational EpidemiologyNew York State Psychiatric InstituteNew YorkNYUSA
- Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Allan H. Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Manon H.J. Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus University Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre and Department of Child and Adolescent PsychiatryInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and DepressionSouth London and Maudsley NHS Foundation TrustLondonUK
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health ServicesCapital Region of DenmarkCopenhagenDenmark
- Department of Clinical Medicine, Faculty of Health SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Paolo Fusar‐Poli
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- Early Psychosis: Intervention and Clinical‐detection (EPIC) lab, Department of Psychosis StudiesKing's College LondonLondonUK
- Outreach and Support in South‐London (OASIS) NHS Foundation Trust, South London and Maudsley NHS Foundation TrustLondonUK
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19
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Veddum L, Greve AN, Gregersen M, Andreassen AK, Knudsen CB, Brandt JM, Krantz MF, Søndergaard A, Burton BK, Jepsen JRM, Hemager N, Werge T, Thorup AAE, Nordentoft M, Mors O, Nudel R. A study of the genetic architecture of social responsiveness in families with parental schizophrenia or bipolar disorder and population-based controls. Psychiatry Res 2023; 326:115280. [PMID: 37339530 DOI: 10.1016/j.psychres.2023.115280] [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: 02/27/2023] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/22/2023]
Abstract
Twin-studies of social responsiveness have reported moderate to high heritabilities, but studies using parent-child data are lacking. Additionally, social impairments have been suggested as a vulnerability marker for schizophrenia and bipolar disorder, but the heritability of social responsiveness in this context is unknown. This study is part of the Danish High Risk and Resilience Study - VIA, comprising families with one parent with schizophrenia (n = 202) or bipolar disorder (n = 120) and population-based controls (PBC, n = 200). Social responsiveness was assessed with The Social Responsiveness Scale, Second Edition (SRS-2). Heritability was estimated from variance components, and a polygenic risk score (PRS) for autism spectrum disorder (ASD) was calculated to assess the genetic relationship between ASD and SRS-2. SRS-2 heritability was moderate to high and significantly different from zero in all groups when the children were rated by the primary caregiver. With teacher ratings, the heritability was lower and only significant in the full cohort and PBC. We found no significant association between SRS-2 and PRS for ASD. Our study confirms that social responsiveness is heritable, but that heritability estimates are affected by the child-respondent relation and familial risk of mental illness. This has implications for clinical practice and research using SRS-2 and provides insight on the familial transmission of mental illness.
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Affiliation(s)
- Lotte Veddum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
| | - Aja Neergaard Greve
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Maja Gregersen
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Anna Krogh Andreassen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Christina Bruun Knudsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark; The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Julie Marie Brandt
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Mette Falkenberg Krantz
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark
| | - Anne Søndergaard
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark; Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Denmark
| | - Jens Richardt Møllegaard Jepsen
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center, Copenhagen University Hospital, Mental Health Services Copenhagen, Denmark
| | - Nicoline Hemager
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark
| | - Thomas Werge
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Mental Health Services Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Child and Adolescent Mental Health Center, Research Unit, Capital Region of Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Merete Nordentoft
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Institute of Clinical Medicine, Denmark
| | - Ole Mors
- The Psychosis Research Unit, Aarhus University Hospital Skejby, Psychiatry, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Ron Nudel
- iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen, Denmark.
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20
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Buckley V, Young AH, Smith P. Child and adolescent anxiety as a risk factor for bipolar disorder: A systematic review of longitudinal studies. Bipolar Disord 2023; 25:278-288. [PMID: 36949612 DOI: 10.1111/bdi.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVES Several studies have suggested that anxiety disorders in childhood and adolescence often precede the onset of bipolar disorder. We therefore systematically reviewed the relationship between child and adolescent anxiety and later bipolar disorder. METHODS Online databases (Medline [for Ovid], EMBASE and PsychINFO) were searched for original, peer-reviewed studies examining the relationship between child and adolescent anxiety and later bipolar disorder. Studies in both community samples and bipolar offspring samples were included. RESULTS A total of 16 studies were included in the review. The results were broadly consistent and revealed that child and adolescent anxiety disorders are associated with later bipolar disorder in community samples. In bipolar offspring, child and adolescent anxiety disorders are a marker of increased risk and predict the onset of bipolar disorder and other major mood disorders. CONCLUSIONS There is evidence that anxiety disorders in childhood and adolescence increase the risk of later bipolar disorder. Anxiety disorders may be a useful target for early intervention in those at high-risk of bipolar disorder.
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Affiliation(s)
- Vanessa Buckley
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, DeCrespigny Park, London, SE5 8AF, UK
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21
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Knudsen CB, Hemager N, Jepsen JRM, Gregersen M, Greve AN, Andreassen AK, Veddum L, Brandt JM, Krantz MF, Søndergaard A, Burton BK, Thorup AAE, Nordentoft M, Lambek R, Mors O, Bliksted VF. Early Childhood Neurocognition in Relation to Middle Childhood Psychotic Experiences in Children at Familial High Risk of Schizophrenia or Bipolar Disorder and Population-Based Controls: The Danish High Risk and Resilience Study. Schizophr Bull 2023; 49:756-767. [PMID: 36548470 PMCID: PMC10154705 DOI: 10.1093/schbul/sbac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND HYPOTHESIS Familial high-risk (FHR) studies examining longitudinal associations between neurocognition and psychotic experiences are currently lacking. We hypothesized neurocognitive impairments at age 7 to be associated with increased risk of psychotic experiences from age 7 to 11 in children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) and population-based controls (PBC), and further, impaired functioning in some neurocognitive functions to be associated with greater risk of psychotic experiences in children at FHR-SZ or FHR-BP relative to PBC. STUDY DESIGN Neurocognition was assessed at age 7 (early childhood) and psychotic experiences from age 7 to 11 (middle childhood) in 449 children from the Danish High Risk and Resilience Study. The neurocognitive assessment covered intelligence, processing speed, attention, visuospatial and verbal memory, working memory, and set-shifting. Psychotic experiences were assessed through face-to-face interviews with the primary caregiver and the child. STUDY RESULTS Set-shifting impairments at age 7 were associated with greater risk of psychotic experiences from age 7 to 11 in children at FHR-SZ. Children at FHR-BP and PBC showed no differential associations. Working memory and visuospatial memory impairments were related to increased risk of psychotic experiences across the cohort. However, adjusting for concurrent psychopathology attenuated these findings. CONCLUSIONS Early childhood neurocognitive impairments are risk markers of middle childhood psychotic experiences, of which impaired set-shifting appears to further increase the risk of psychotic experiences in children at FHR-SZ. More research is needed to examine longitudinal associations between neurocognitive impairments and psychotic experiences in FHR samples.
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Affiliation(s)
- Christina Bruun Knudsen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Børglumvej 5, 1st floor, 8240 Risskov, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center, Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
| | - Aja Neergaard Greve
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Anna Krogh Andreassen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Børglumvej 5, 1st floor, 8240 Risskov, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Veddum
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Børglumvej 5, 1st floor, 8240 Risskov, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Julie Marie Brandt
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital – Psychiatry Region Zealand, Roskilde, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Børglumvej 5, 1st floor, 8240 Risskov, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
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Abstract
Bipolar disorders (BDs) are recurrent and sometimes chronic disorders of mood that affect around 2% of the world's population and encompass a spectrum between severe elevated and excitable mood states (mania) to the dysphoria, low energy, and despondency of depressive episodes. The illness commonly starts in young adults and is a leading cause of disability and premature mortality. The clinical manifestations of bipolar disorder can be markedly varied between and within individuals across their lifespan. Early diagnosis is challenging and misdiagnoses are frequent, potentially resulting in missed early intervention and increasing the risk of iatrogenic harm. Over 15 approved treatments exist for the various phases of bipolar disorder, but outcomes are often suboptimal owing to insufficient efficacy, side effects, or lack of availability. Lithium, the first approved treatment for bipolar disorder, continues to be the most effective drug overall, although full remission is only seen in a subset of patients. Newer atypical antipsychotics are increasingly being found to be effective in the treatment of bipolar depression; however, their long term tolerability and safety are uncertain. For many with bipolar disorder, combination therapy and adjunctive psychotherapy might be necessary to treat symptoms across different phases of illness. Several classes of medications exist for treating bipolar disorder but predicting which medication is likely to be most effective or tolerable is not yet possible. As pathophysiological insights into the causes of bipolar disorders are revealed, a new era of targeted treatments aimed at causal mechanisms, be they pharmacological or psychosocial, will hopefully be developed. For the time being, however, clinical judgment, shared decision making, and empirical follow-up remain essential elements of clinical care. This review provides an overview of the clinical features, diagnostic subtypes, and major treatment modalities available to treat people with bipolar disorder, highlighting recent advances and ongoing therapeutic challenges.
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Affiliation(s)
- Fernando S Goes
- Precision Medicine Center of Excellence in Mood Disorders, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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23
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Knudsen CB, Greve AN, Jepsen JRM, Lambek R, Andreassen AK, Veddum L, Brandt JM, Gregersen M, Krantz MF, Søndergaard A, Carlsen AH, Steffensen NL, Bundgaard AF, Burton BK, Thorup AAE, Nordentoft M, Mors O, Bliksted VF, Hemager N. Neurocognitive Subgroups in Children at Familial High-risk of Schizophrenia or Bipolar disorder: Subgroup Membership Stability or Change From Age 7 to 11-The Danish High Risk and Resilience Study. Schizophr Bull 2023; 49:185-195. [PMID: 36200864 PMCID: PMC9810011 DOI: 10.1093/schbul/sbac134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND HYPOTHESIS Subgroups with distinct levels of neurocognitive functioning exist in children of parents with schizophrenia or bipolar disorder. However, studies investigating the temporal stability of subgroup membership are currently lacking. We hypothesized that a minority of children at familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) would transition to a different neurocognitive subgroup from age 7 to 11 and that most transitions would be to a more impaired subgroup. STUDY DESIGN Latent profile analysis was used to identify subgroups at two assessments (age 7 and 11) based on the performance of 320 children at FHR-SZ or FHR-BP across eight neurocognitive functions. Temporal stability in subgroup membership was evaluated with latent profile transition analysis. Population-based controls (age 7, n = 199; age 11, n = 178) were included as a reference group. Children transitioning to a more impaired subgroup were compared with nontransitioning children on sex, FHR-status, global functioning, and psychopathology. STUDY RESULTS At both assessment points, we identified three subgroups based on neurocognitive performance: a moderately-severely impaired, a mildly impaired, and an above-average subgroup. A total of 12.8% of children transitioned to a different subgroup, of which the majority (85.2%) moved to a more impaired subgroup. Parental diagnosis of schizophrenia, but neither parental diagnosis of bipolar disorder, global functioning at age 7, psychopathology, nor sex significantly differentiated children transitioning to a more impaired subgroup from nontransitioning children. CONCLUSIONS During pre-adolescence, neurocognitive developmental lag is associated with being at FHR-SZ. Close attention to these children's neurocognitive development is indicated.
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Affiliation(s)
- Christina Bruun Knudsen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Aja Neergaard Greve
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center, Glostrup, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Anna Krogh Andreassen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Veddum
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Julie Marie Brandt
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Helles Carlsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
| | - Nanna Lawaetz Steffensen
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Anette Faurskov Bundgaard
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
| | - Vibeke Fuglsang Bliksted
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research – iPSYCH, Aarhus, Denmark
- CORE – Copenhagen Research Centre for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
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24
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Premorbid adjustment associates with cognitive and functional deficits in individuals at ultra-high risk of psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:79. [PMID: 36207320 PMCID: PMC9547050 DOI: 10.1038/s41537-022-00285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 08/03/2022] [Indexed: 11/05/2022]
Abstract
Premorbid social and academic adjustment are important predictors of cognitive and functional performance in schizophrenia. Whether this relationship is also present in individuals at ultra-high risk (UHR) for psychosis is the focus of the present study. Using baseline data from a randomised clinical trial (N = 146) this study investigated associations between premorbid adjustment and neuro- and social cognition and functioning in UHR individuals aged 18–40 years. Patients were evaluated with the Premorbid Adjustment Scale (PAS) comprising a social and an academic domain. Using validated measures neurocognition was assessed in the domains of processing speed, executive function, attention, verbal learning and memory, visual learning and memory, and working memory along with estimated IQ. Social cognitive domains assessed were theory of mind, emotion recognition, and attributional bias. Functional assessment comprised the domains of social- and role functioning, functional capacity, and quality of life. Linear regression analyses revealed poor premorbid academic adjustment to be associated with poorer performance in processing speed, working memory, attention, full scale IQ, and verbal IQ. Poor premorbid social adjustment was associated with theory of mind deficits. Additionally, both premorbid adjustment domains were associated with social- and role functioning and quality of life. Corroborating evidence from schizophrenia samples, our findings indicate poor premorbid adjustment to correlate with deficits in specific cognitive and functional domains in UHR states. Early premorbid adjustment difficulties may therefore indicate a poor cognitive and functional trajectory associated with significant impairments in early and established psychotic disorders suggesting targets for primary intervention.
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25
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Brandt JM, Hemager N, Gregersen M, Søndergaard A, Falkenberg Krantz M, Ohland J, Wilms M, Birkehøj Rohd S, Hjorthøj C, Veddum L, Bruun Knudsen C, Krogh Andreassen A, Greve A, Spang KS, Christiani CA, Ellersgaard D, Klee Burton B, Gantriis DL, Bliksted V, Mors O, Plessen KJ, Møllegaard Jepsen JR, Nordentoft M, Elgaard Thorup AA. Childhood trauma in children at familial high risk of schizophrenia or bipolar disorder: A longitudinal study. The Danish High Risk and Resilience Study - VIA 7 and VIA 11. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:875-894. [PMID: 35332530 DOI: 10.1111/bjc.12364] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Childhood trauma increases the risk of developing mental illness as does being born to parents with schizophrenia or bipolar disorder. We aimed to compare prevalence of lifetime childhood trauma among 11-year-old children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) compared with population-based controls (PBCs). DESIGN The study is a longitudinal, prospective cohort study of children at FHR-SZ, FHR-BP, and PBCs. METHODS A cohort of 512 children at FHR-SZ (N = 199), FHR-BP (N = 118), and PBCs (N = 195) were examined at baseline (mean age 7.8, SD 0.2) and 451 children at FHR-SZ (N = 172), FHR-BP (N = 104), and PBCs (N = 175) were examined at four-year follow-up (mean age 11.9, SD 0.2, retention rate 87.3%). Childhood trauma was measured with a semi-structured interview. RESULTS Children at FHR-BP had an elevated risk of exposure to any lifetime trauma (age 0-11 years) compared with PBCs (OR 2.082, 95%CI 1.223-3.545, p = .007) measured with binary logistic regression. One-way ANOVA revealed that both FHR-groups had a higher lifetime prevalence of exposure to a greater number of types of trauma compared with PBCs (FHR-SZ: observed mean: 1.53, 95%CI 1.29-1.77; FHR-BP: observed mean: 1.56, 95%CI 1.26-1.85; PBCs: observed mean: 0.99, 95%CI 0.82-1.17; p < .001). Binary logistic regression showed that the lifetime risk of exposure to interpersonal trauma (age 0-11 years) was elevated for both FHR-groups (FHR-SZ: OR 3.773, 95%CI 2.122-6.710, p < .001; FHR-BP: OR 3.602, 95%CI 1.913-6.783, p < .001). CONCLUSIONS Children at FHR-SZ and FHR-BP are at increased risk for being exposed to childhood trauma compared with PBCs. This study underscores the need for early detection, support, and prevention of childhood trauma in children at FHR-SZ and FHR-BP.
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Affiliation(s)
- Julie Marie Brandt
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, 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 Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, 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 Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Jessica Ohland
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Martin Wilms
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Sinnika Birkehøj Rohd
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Carsten Hjorthøj
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, 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, Skejby, 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, Skejby, 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, Skejby, Aarhus, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Aarhus, Denmark
| | - Katrine Søborg Spang
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Camilla Austa Christiani
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark
| | - Ditte Ellersgaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark
| | - Ditte Lou Gantriis
- 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, Skejby, 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, Skejby, 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, Skejby, Aarhus, Denmark
| | - Kerstin Jessica Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Jens Richardt Møllegaard Jepsen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark.,Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Hellerup, Denmark
| | - Merete Nordentoft
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Hellerup, 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.,Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen, Denmark
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26
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Thorup AAE, Hemager N, Bliksted VF, Greve AN, Ohland J, Wilms M, Rohd SB, Birk M, Bundgaard AF, Laursen AF, Jefsen OH, Steffensen NL, Andreassen AK, Veddum L, Knudsen CB, Enevoldsen M, Nymand M, Brandt JM, Søndergaard A, Carmichael L, Gregersen M, Krantz MF, Burton BK, Dietz M, Nudel R, Johnsen LK, Larsen KM, Meder D, Hulme OJ, Baaré WFC, Madsen KS, Lund TE, Østergaard L, Juul A, Kjær TW, Hjorthøj C, Siebner HR, Mors O, Nordentoft M. The Danish High-Risk and Resilience Study-VIA 15 - A Study Protocol for the Third Clinical Assessment of a Cohort of 522 Children Born to Parents Diagnosed With Schizophrenia or Bipolar Disorder and Population-Based Controls. Front Psychiatry 2022; 13:809807. [PMID: 35444571 PMCID: PMC9013818 DOI: 10.3389/fpsyt.2022.809807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/28/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Children born to parents with severe mental illness have gained more attention during the last decades because of increasing evidence documenting that these children constitute a population with an increased risk of developing mental illness and other negative life outcomes. Because of high-quality research with cohorts of offspring with familial risk and increased knowledge about gene-environment interactions, early interventions and preventive strategies are now being developed all over the world. Adolescence is a period characterized by massive changes, both in terms of physical, neurologic, psychological, social, and behavioral aspects. It is also the period of life with the highest risk of experiencing onset of a mental disorder. Therefore, investigating the impact of various risk and resilience factors in adolescence is important. METHODS The Danish High-Risk and Resilience Study started data collection in 2012, where 522 7-year-old children were enrolled in the first wave of the study, the VIA 7 study. The cohort was identified through Danish registers based on diagnoses of the parents. A total of 202 children had a parent diagnosed with schizophrenia, 120 children had a parent diagnosed with bipolar disorder, and 200 children had parents without these diagnoses. At age 11 years, all children were assessed for the second time in the VIA 11 study, with a follow-up retention rate of 89%. A comprehensive assessment battery covering domains of psychopathology, neurocognition, social cognition and behavior, motor development and physical health, genetic analyses, attachment, stress, parental functioning, and home environment was carried out at each wave. Magnetic resonance imaging scans of the brain and electroencephalograms were included from age 11 years. This study protocol describes the third wave of assessment, the VIA 15 study, participants being 15 years of age and the full, 3-day-long assessment battery this time including also risk behavior, magnetoencephalography, sleep, and a white noise paradigm. Data collection started on May 1, 2021. DISCUSSION We will discuss the importance of longitudinal studies and cross-sectional data collection and how studies like this may inform us about unmet needs and windows of opportunity for future preventive interventions, early illness identification, and treatment in the future.
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Affiliation(s)
- Anne Amalie Elgaard Thorup
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Vibeke Fuglsang Bliksted
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Martin Wilms
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Merete Birk
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anette Faurskov Bundgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Andreas Færgemand Laursen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Oskar Hougaard Jefsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Nanna Lawaetz Steffensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, 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 Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, 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 Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Enevoldsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Marie Nymand
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Julie Marie Brandt
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Anne Søndergaard
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Line Carmichael
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Maja Gregersen
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Roskilde, Denmark
| | - Martin Dietz
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Ron Nudel
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Line Korsgaard Johnsen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kit Melissa Larsen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Oliver James Hulme
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - William Frans Christiaan Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Radiography, Department of Technology, University College Copenhagen, Copenhagen, Denmark
| | - Torben Ellegaard Lund
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Leif Østergaard
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Anders Juul
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, Section 5064, University of Copenhagen, Copenhagen, Denmark
| | | | - Carsten Hjorthøj
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology University of Copenhagen, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Neurology, Hospital Bispebjerg, Copenhagen University, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
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