TY - JOUR

T1 - Mental disorders in preadolescent children at familial high-risk of schizophrenia or bipolar disorder

T2 - a four-year follow-up study The Danish High Risk and Resilience Study, VIA 11

AU - Gregersen, Maja

AU - Sondergaard, Anne

AU - Brandt, Julie Marie

AU - Ellersgaard, Ditte

AU - Rohd, Sinnika Birkehoj

AU - Hjorthøj, Carsten

AU - Ohland, Jessica

AU - Krantz, Mette Falkenberg

AU - Wilms, Martin

AU - Andreassen, Anna Krogh

AU - Knudsen, Christina Bruun

AU - Veddum, Lotte

AU - Greve, Aja

AU - Bliksted, Vibeke

AU - Mors, Ole

AU - Clemmensen, Lars

AU - Jepsen, Jens Richardt Møllegaard

AU - Nordentoft, Merete

AU - Hemager, Nicoline

AU - Thorup, Anne Amalie Elgaard

PY - 2022

Y1 - 2022

N2 - BackgroundChildren at familial high-risk of schizophrenia and bipolar disorder have an elevated prevalence of mental disorders but studies of children within a narrow age range are lacking and there are few conjoint studies of these two groups. Knowledge on their mental health is important for prevention and early intervention.MethodsThe authors examined mental disorders and global functioning in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP) compared with population-based controls. In a longitudinal cohort study, 450 children (FHR-SZ, n = 171; FHR-BP, n = 104; controls, n = 175), were assessed for Axis I disorders at baseline and four-year follow-up (mean age 11.9, SD 0.2) with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children and for global functioning with Children’s Global Assessment Scale.ResultsCumulative incidence of Any Axis I disorder was elevated by age 11 in children at FHR-SZ (54.4%, OR 3.0, 95% CI 1.9–4.7, p < .001) and children at FHR-BP (52.9%, OR 2.8, 95% CI 1.7–4.7, p < .001) compared with controls (28.6%). Children at FHR-SZ and FHR-BP had higher rates of affective disorders (OR 4.4, 95% CI 1.4–13.5, p = .009; OR 5.1, 95% CI 1.6–16.4, p = .007), anxiety disorders (OR 2.1, 95% CI 1.1–4.0, p = .02; OR 3.0, 95% CI 1.5–6.1, p = .002), and stress and adjustment disorders (OR 3.3, 95% CI 1.4–7.5, p = .006; OR 5.3, 95% CI 2.2–12.4, p < .001). Disruptive behavior disorders (OR 2.8, 95% CI 1.0–7.3, p = .04) and ADHD (OR 2.9, 95% CI 1.6–5.3, p < .001) were elevated in children at FHR-SZ. Both FHR groups had lower global functioning than controls. Cumulative incidence of disorders increased equally across the three groups from early childhood to preadolescence and level of functioning did not change differentially.ConclusionsChildren at FHR-SZ and FHR-BP have an elevated prevalence of mental disorders and poorer functioning than controls. Vulnerability in children at FHR manifests early and remains stable throughout childhood. Early attention toward their mental health and identification of those in need of intervention is warranted.

AB - BackgroundChildren at familial high-risk of schizophrenia and bipolar disorder have an elevated prevalence of mental disorders but studies of children within a narrow age range are lacking and there are few conjoint studies of these two groups. Knowledge on their mental health is important for prevention and early intervention.MethodsThe authors examined mental disorders and global functioning in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP) compared with population-based controls. In a longitudinal cohort study, 450 children (FHR-SZ, n = 171; FHR-BP, n = 104; controls, n = 175), were assessed for Axis I disorders at baseline and four-year follow-up (mean age 11.9, SD 0.2) with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children and for global functioning with Children’s Global Assessment Scale.ResultsCumulative incidence of Any Axis I disorder was elevated by age 11 in children at FHR-SZ (54.4%, OR 3.0, 95% CI 1.9–4.7, p < .001) and children at FHR-BP (52.9%, OR 2.8, 95% CI 1.7–4.7, p < .001) compared with controls (28.6%). Children at FHR-SZ and FHR-BP had higher rates of affective disorders (OR 4.4, 95% CI 1.4–13.5, p = .009; OR 5.1, 95% CI 1.6–16.4, p = .007), anxiety disorders (OR 2.1, 95% CI 1.1–4.0, p = .02; OR 3.0, 95% CI 1.5–6.1, p = .002), and stress and adjustment disorders (OR 3.3, 95% CI 1.4–7.5, p = .006; OR 5.3, 95% CI 2.2–12.4, p < .001). Disruptive behavior disorders (OR 2.8, 95% CI 1.0–7.3, p = .04) and ADHD (OR 2.9, 95% CI 1.6–5.3, p < .001) were elevated in children at FHR-SZ. Both FHR groups had lower global functioning than controls. Cumulative incidence of disorders increased equally across the three groups from early childhood to preadolescence and level of functioning did not change differentially.ConclusionsChildren at FHR-SZ and FHR-BP have an elevated prevalence of mental disorders and poorer functioning than controls. Vulnerability in children at FHR manifests early and remains stable throughout childhood. Early attention toward their mental health and identification of those in need of intervention is warranted.

KW - Child and adolescent psychiatry

KW - familial high-risk

KW - psychopathology

KW - schizophrenia

KW - bipolar disorder

U2 - 10.1111/jcpp.13548

DO - 10.1111/jcpp.13548

M3 - Journal article

C2 - 34918345

VL - 63

SP - 1046

EP - 1056

JO - Journal of Child Psychology & Psychiatry

JF - Journal of Child Psychology & Psychiatry

SN - 0021-9630

IS - 9

ER -