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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Correction to: 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; 50:230. [PMID: 37738434 DOI: 10.1093/schbul/sbad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Burton BK, Andersen KK, Greve AN, Hemager N, Spang KS, Ellersgaard D, Christiani CJ, Gantriis D, Gregersen M, Søndergaard A, Jepsen JRM, Bliksted VF, Mors O, Plessen KJ, Nordentoft M, Thorup AAE. Sex differences across developmental domains among children with a familial risk of severe mental disorders. Psychol Med 2023; 53:3628-3643. [PMID: 35156599 DOI: 10.1017/s0033291722000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sex differences in brain structure and neurodevelopment occur in non-clinical populations. We investigated whether sex had a similar effect on developmental domains amongst boys and girls with a familial risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and controls. METHODS Through Danish registries, we identified 522 7-year-old children (242 girls) with FHR-SZ, FHR-BP, and controls. We assessed their performance within the domains of neurocognition, motor function, language, social cognition, social behavior, psychopathology, and home environment. RESULTS FHR-SZ boys compared with FHR-SZ girls had a higher proportion of disruptive behavior and attention-deficit hyperactivity disorder (ADHD) and exhibited lower performance in manual dexterity, balance, and emotion recognition. No sex differences were found between boys and girls within FHR-BP group. Compared with controls, both FHR-SZ boys and FHR-SZ girls showed impaired processing speed and working memory, had lower levels of global functioning, and were more likely to live in an inadequate home environment. Compared with control boys, FHR-SZ boys showed impaired manual dexterity, social behavior, and social responsiveness, and had a higher proportion of ADHD and disruptive behavior disorder diagnoses. Stress and adjustment disorders were more common in FHR-BP boys compared with control boys. We found no differences between FHR-BP girls and control girls. CONCLUSIONS Impairment within neurodevelopmental domains associated within FHR-SZ boys v. FHR-SZ girls was most evident among boys, whereas no sex differences were found within the FHR-BP group (FHR-BP boys v. FHR-BP girls). FHR-SZ boys exhibited the highest proportion of early developmental impairments.
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Affiliation(s)
- Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Klaus Kaae Andersen
- Danish Cancer Society Research Center, Statistics and Pharmacoepidemiology, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Aja N Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
| | - Nicoline Hemager
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark
| | - Katrine S Spang
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Ditte Ellersgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark
| | - Camilla J Christiani
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Ditte Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
| | - Maja Gregersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark
| | - Anne Søndergaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark
| | - Jens Richardt M Jepsen
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark
- Centre for Neuropsychiatric Schizophrenia Research & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Hospital Centre Glostrup, Ndr. Ringvej 29-67, 2600 Glostrup, Denmark
| | - Vibeke Fuglsang Bliksted
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Avenue d'Echallens 9, CH-1004 Lausanne, Switzerland
| | - Merete Nordentoft
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark
| | - Anne A E Thorup
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Gentofte Hospitalsvej 3A, 1st floor, 2900 Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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