Neurocognitive heterogeneity in 7-year-old children at familial high risk of schizophrenia or bipolar disorder: The Danish high risk and resilience study - VIA 7

Nicoline Hemager, Camilla Jerlang Christiani, Anne Amalie Elgaard Thorup, Katrine Søborg Spang, Ditte Ellersgaard, Birgitte Klee Burton, Maja Gregersen, Aja Neergaard Greve, Yunpeng Wang, Ron Nudel, Ole Mors, Kerstin Jessica Plessen, Merete Nordentoft, Jens Richardt Møllegaard Jepsen

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Abstract

Background
Studies of neurocognitive heterogeneity in young children at familial high-risk of bipolar disorder (FHR-BP) or schizophrenia (FHR-SZ) are important to investigate inter-individual neurocognitive differences. We aimed to identify neurocognitive subgroups, describe prevalence of FHR-BP or FHR-SZ children herein, and examine risk ratios (RR) compared with controls.

Methods
In a population-based cohort of 514 7-year-old children (197 FHR-SZ, 118 FHR-BP, and 199 matched controls) we used hierarchical cluster analyses to identify subgroups across 14 neurocognitive indices.

Results
Three neurocognitive subgroups were derived: A Mildly Impaired (30%), Typical (51%), and Above Average subgroup (19%). The Mildly Impaired subgroup significantly underperformed controls (Cohen d = 0.11–1.45; Ps < 0.001) except in set-shifting (P = .84). FHR-SZ children were significantly more prevalent in the Mildly Impaired subgroup; FHR-BP children were more so in the Above Average subgroup (X2 (2, N = 315) = 9.64, P < .01). 79.7% FHR-BP and 64.6% FHR-SZ children demonstrated typical or above average neurocognitive functions. Neurocognitive heterogeneity related significantly to concurrent functioning, psychopathology severity, home environment adequacy, and polygenic scores for schizophrenia (Ps <. 01). Compared with controls, FHR-SZ and FHR-BP children had a 93% (RR, 1.93; 95% CI, 1.40–2.64) and 8% (RR, 1.08; 95% CI, 0.71–1.66) increased risk of Mildly Impaired subgroup membership.

Limitations
Limitations include the cross-sectional design and smaller FHR-BP sample size.

Conclusions
Identification of neurocognitive heterogeneity in preadolescent children at FHR-BP or FHR-SZ may ease stigma and enable pre-emptive interventions to enhance neurocognitive functioning and resilience to mental illness in the impaired sub-population.
Original languageEnglish
JournalJournal of Affective Disorders
Volume302
Pages (from-to)214-223
ISSN0165-0327
DOIs
Publication statusPublished - 2022

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