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Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies

Published online by Cambridge University Press:  11 May 2012

L. J. Seidman ,
S. Cherkerzian ,
J. M. Goldstein ,
J. Agnew-Blais ,
M. T. Tsuang  and
S. L. Buka
L. J. Seidman*
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA, USA
S. Cherkerzian
Affiliation:
Department of Psychiatry, Harvard Medical School, Division of Women's Health, Connors Center for Women's Health and Gender Biology, Boston, MA, USA
J. M. Goldstein
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Division of Women's Health, Connors Center for Women's Health and Gender Biology, Boston, MA, USA
J. Agnew-Blais
Affiliation:
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
M. T. Tsuang
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA, USA Department of Psychiatry, Center for Behavior Genomics and Institute of Genomic Medicine, University of CaliforniaSan Diego, La Jolla, CA, USA Veterans Medical Research Foundation, San Diego, CA, USA
S. L. Buka
Affiliation:
Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA, USA Department of Community Health, Brown University, Providence, RI, USA
*
*Address for correspondence: L. J. Seidman, Ph.D., Massachusetts Mental Health Center, Neuropsychology Laboratory, Commonwealth Research Center, 5th Floor, 75 Fenwood Road, Boston, MA 02115, USA. (Email: lseidman@bidmc.harvard.edu)
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Abstract

Background

Persons developing schizophrenia (SCZ) manifest various pre-morbid neuropsychological deficits, studied most often by measures of IQ. Far less is known about pre-morbid neuropsychological functioning in individuals who later develop bipolar psychoses (BP). We evaluated the specificity and impact of family history (FH) of psychosis on pre-morbid neuropsychological functioning.

Method

We conducted a nested case-control study investigating the associations of neuropsychological data collected systematically at age 7 years for 99 adults with psychotic diagnoses (including 45 SCZ and 35 BP) and 101 controls, drawn from the New England cohort of the Collaborative Perinatal Project (CPP). A mixed-model approach evaluated full-scale IQ, four neuropsychological factors derived from principal components analysis (PCA), and the profile of 10 intelligence and achievement tests, controlling for maternal education, race and intra-familial correlation. We used a deviant responder approach (<10th percentile) to calculate rates of impairment.

Results

There was a significant linear trend, with the SCZ group performing worst. The profile of childhood deficits for persons with SCZ did not differ significantly from BP. Neuropsychological impairment was identified in 42.2% of SCZ, 22.9% of BP and 7% of controls. The presence of psychosis in first-degree relatives (FH+) significantly increased the severity of childhood impairment for SCZ but not for BP.

Conclusions

Pre-morbid neuropsychological deficits are found in a substantial proportion of children who later develop SCZ, especially in the SCZ FH+ subgroup, but less so in BP, suggesting especially impaired neurodevelopment underlying cognition in pre-SCZ children. Future work should assess genetic and environmental factors that explain this FH effect.

Keywords

Bipolar psychosisneurocognitionpre-morbidschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 1 , January 2013 , pp. 119 - 131
Copyright
Copyright © Cambridge University Press 2012

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