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School performance from primary education in the adolescent offspring of parents with schizophrenia and bipolar disorder– a national, register-based study

Published online by Cambridge University Press:  14 December 2017

Anne Ranning ,
Thomas Laursen ,
Esben Agerbo ,
Anne Thorup ,
Carsten Hjorthøj ,
Jens Richardt Møllegaard Jepsen  and
Merete Nordentoft
Anne Ranning*
Affiliation:
Psychiatric Research Centre, Mental Health Center Copenhagen, Copenhagen, Capital Region of Denmark iPsych – The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
Thomas Laursen
Affiliation:
iPsych – The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark National Center for Register-Based Research, Aarhus University, Denmark
Esben Agerbo
Affiliation:
iPsych – The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark National Center for Register-Based Research, Aarhus University, Denmark
Anne Thorup
Affiliation:
Psychiatric Research Centre, Mental Health Center Copenhagen, Copenhagen, Capital Region of Denmark iPsych – The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark Child and Adolescent Mental Health Center, Copenhagen, Capital Region of Denmark
Carsten Hjorthøj
Affiliation:
Psychiatric Research Centre, Mental Health Center Copenhagen, Copenhagen, Capital Region of Denmark iPsych – The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
Jens Richardt Møllegaard Jepsen
Affiliation:
Child and Adolescent Mental Health Center, Copenhagen, Capital Region of Denmark Center for Neuropsychiatric Schizophrenia Research, Psychiatric Centre Glostrup, Glostrup, Denmark Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen, Denmark.
Merete Nordentoft
Affiliation:
Psychiatric Research Centre, Mental Health Center Copenhagen, Copenhagen, Capital Region of Denmark iPsych – The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
*
Author for correspondence: Anne Ranning, E-mail: Anne.ranning@regionh.dk
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Abstract

Background

Schizophrenia (SZ) and bipolar disorder (BP) are causes of severe disability worldwide and parents’ severe mental illness (SMI) is associated with childhood adversity, and socio-emotional and cognitive problems in children. Yet, how parental BP and SZ affect educational attainment in offspring is still unclear.

Method

We included all children (N = 684.248) born and living in Denmark between 1986 and 1996 and their parents. Our follow-up lasted from 1986 until children's graduation in 2014. The main outcome variable was their school grades following their primary education. School outcomes were divided into four categories: not graduated, low-grade point average (GPA), medium GPA and high GPA. We then performed a multiple logistic regression with medium GPA as the reference category, with the children of parents without SZ or BP as the reference group.

Results

Children of parents with SZ faced higher odds than their peers of not graduating primary education (OR 2.6), along with low GPA (odds ratios (OR) 1.6) and lower odds for a high GPA (OR 0.7). Moreover, it was the children of mothers rather than fathers with BP who had higher odds of not graduating primary education (OR 1.6). Lastly, child placement was associated with lower grades and lower graduation rates, and outcomes for children of parents with SMI were favorable compared with other children placed in care.

Conclusion

For children, parental SZ is associated with lower grades and lower chances for graduating primary education. In contrast, the children of parents with BP were indistinguishable from the reference group regarding school grades. This signifies that specificity of parental severe mental illness is important in relation to educational achievement of children.

Keywords

School performanceparental mental illnessprimary educationschizophreniabipolar disorderepidemiology
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 12 , September 2018 , pp. 1993 - 2000
Copyright
Copyright © Cambridge University Press 2017 

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References

Agnew-Blais, J and Seidman, LJ (2013) Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and qualitative review. Cognitive Neuropsychiatry 18, 44–82. doi: 10.1080/13546805.2012.676309.Google Scholar
Aldridge, J (2009) Pictures of young caring. Criminal Justice Matters 78(1), 38–40. doi: 10.1080/09627250903385289.Google Scholar
Balanzá-Martínez, V, Rubio, C, Selva-Vera, G, Martinez-Aran, A, Sánchez-Moreno, J, Salazar-Fraile, J et al. (2008) Neurocognitive endophenotypes (Endophenocognitypes) from studies of relatives of bipolar disorder subjects: a systematic review. Neuroscience and Biobehavioral Reviews 32(8), 1426–1438. doi: 10.1016/j.neubiorev.2008.05.019.Google Scholar
Berlin, M, Vinnerljung, B and Hjern, A (2011) School performance in primary school and psychosocial problems in young adulthood among care leavers from long term foster care. Children and Youth Services Review Elsevier Ltd 33(12), 2489–2497. doi: 10.1016/j.childyouth.2011.08.024.Google Scholar
Björkenstam, C, Weitoft, GR, Hjern, A, Nordström, P, Hallqvist, J and Ljung, R (2011) School grades, parental education and suicide--a national register-based cohort study. Journal of Epidemiology and Community Health 65(11), 993–998. doi: 10.1136/jech.2010.117226.Google Scholar
Bora, E, Yucel, M and Pantelis, C (2009) Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. Journal of Affective Disorders. Elsevier B.V., 113(1–2), 1–20. doi: 10.1016/j.jad.2008.06.009.Google Scholar
Cannon, M, Jones, P, Huttunen, MO, Tanskanen, A, Huttunen, T, Rabe-Hesketh, S et al. (1999) School performance in Finnish children and later development of schizophrenia: a population-based longitudinal study. Archives of General Psychiatry 56(5), 457–463. doi: 10.1001/archpsyc.56.5.457.Google Scholar
Deary, IJ, Strand, S, Smith, P and Fernandes, C (2007) Intelligence and educational achievement. Intelligence 35(1), 13–21. doi: 10.1016/j.intell.2006.02.001.Google Scholar
Duffy, A (2007) Temperament, life events, and psychopathology among the offspring of bipolar parents. Bipolar Disorders 16, 222–228. doi: 10.1007/s00787-006-0592-x.Google Scholar
Farahati, F, Marcotte, DE and Wilcox-Gök, V (2003) The effects of parent's psychiatric disorders on children's high school dropout. Economics of Education Review 22(2), 167–178. doi: 10.1016/S0272-7757(02)00031-6.Google Scholar
Hameed, MA, and Lewis, AJP (2016) Offspring of parents with schizophrenia. Harvard Review of Psychiatry 24(2), 104–117. doi: 10.1097/HRP.0000000000000072.Google Scholar
Jundong, J, Kuja-Halkola, R, Hultman, C, Långström, N, D'Onofrio, BM and Lichtenstein, P (2012) Poor school performance in offspring of patients with schizophrenia: what are the mechanisms?. Psychological Medicine 42(1), 111–123. doi: 10.1017/S0033291711001127.Google Scholar
Krapohl, E, Rimfeld, K, Shakeshaft, NG, Trzaskowski, M and Mcmillan, A (2014) The high heritability of educational achievement reflects many genetically influenced traits, not just intelligence. Proceedings of the National Academy of Sciences of the United States of America 111(42), 15273–15278. doi: 10.1073/pnas.1408777111.Google Scholar
Lin, A, Di Prinzio, P, Young, D, Jacoby, P, Whitehouse, A, Waters, F et al. (2017) Academic performance in children of mothers with schizophrenia and other severe mental illness, and risk for subsequent development of psychosis: a population-based study. Schizophrenia Bulletin 43(1), 205–213. doi: 10.1093/schbul/sbw042.Google Scholar
Liu, CH, Keshavan, MS, Tronick, E and Seidman, LJ (2015) Perinatal risks and childhood premorbid indicators of later psychosis: next steps for early psychosocial interventions. Schizophrenia Bulletin 41(4), 801–816. doi: 10.1093/schbul/sbv047.Google Scholar
MacCabe, JH, Lambe, MP, Cnattingius, S, Sham, PC, David, AS, Reichenberg, A et al. (2010) Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study. British Journal of Psychiatry 196(2), 109–115. doi: 10.1192/bjp.bp.108.060368.Google Scholar
MacCabe, JH, Lambe, MP, Cnattingius, S, Torrång, A, Björk, C, Sham, PC et al. (2008) Scholastic achievement at age 16 and risk of schizophrenia and other psychoses: a national cohort study. Psychological Medicine 38(8), 1133–1140. doi: 10.1017/S0033291707002048.Google Scholar
Maziade, M, Rouleau, N, Gingras, N, Boutin, P, Paradis, ME, Jomphe, V et al. (2009) Shared neurocognitive dysfunctions in young offspring at extreme risk for schizophrenia or bipolar disorder in eastern quebec multigenerational families. Schizophrenia Bulletin 35(5), 919–930. doi: 10.1093/schbul/sbn058.Google Scholar
Mordoch, E and Hall, WA (2008) Children's perceptions of living with a parent with a mental illness: finding the rhythm and maintaining the frame. Qualitative Health Research 18, 1127–1144. doi: 10.1177/1049732308320775.Google Scholar
Mors, O, Perto, GP and Mortensen, PB (2011) The danish psychiatric central research register. Scandinavian Journal of Public Health 39(Suppl. 7), 54–57.Google Scholar
Nijjar, R, Ellenbogen, MA and Hodgins, S (2016) Personality, coping, risky behavior, and mental disorders in the offspring of parents with bipolar disorder: a comprehensive psychosocial assessment. Journal of Affective Disorders. Elsevier 166, 315–323. doi: 10.1016/j.jad.2014.04.047.Google Scholar
Nordsletten, A, Larsson, H, Crowley, J, Almqvist, C, Lichtenstein, P and Mataix-cols, D (2016) Patterns of nonrandom mating within and across 11 major psychiatric disorders. JAMA Psychiatry 73(4), 354–361. doi: 10.1001/jamapsychiatry.2015.3192.Google Scholar
Pedersen, CB, Gotzsche, H, Moller, JO and Mortensen, PB (2006) The Danish Civil Registration System. A cohort of eight million persons. Danish Medical Bulletin 4, 451–459.Google Scholar
Ranning, A, Laursen, T, Hjorthøj, C, Thorup, A and Nordentoft, M (2015) Serious mental illness and disrupted caregiving for children – a nationwide, register-based cohort study. Journal of Clinical Psychiatry 76, 1006–1014.Google Scholar
Ranning, A, Laursen, TM, Thorup, A, Hjorthøj, C and Nordentoft, M (2016) Children of parents with serious mental illness: with whom do they grow up? – A prospective, population-based study. Journal of the American Academy of Child and Adolescent Psychiatry. Elsevier Inc 55(11), 953–961. doi: 10.1016/j.jaac.2016.07.776.Google Scholar
Schisterman, EF, Cole, SR and Platt, RW (2009) Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology 20(4), 488–495. doi: 10.1097/EDE.0b013e3181a819a1.Overadjustment.Google Scholar
Schizophrenia Research Consortium (2009) Common polygenic variation contributes to risk of schizophrenia that overlaps with bipolar disorder. Nature 460(6), 748–752. doi: 10.1038/jid.2014.371.Google Scholar
Seidman, LJ, Giuliano, AJ, Smith, W, Stone, WS, Glatt, SJ, Meyer, E et al. (2006) Neuropsychological functioning in adolescents and young adults at genetic risk for schizophrenia and affective psychoses: results from the harvard and hillside adolescent high risk studies. Schizophrenia Bulletin 32, 507–524. doi: 10.1093/schbul/sbj078.Google Scholar
Seidman, LJ and Nordentoft, M (2015) New targets for prevention of schizophrenia: is it time for interventions in the premorbid phase?. Schizophrenia Bulletin 41, 795–800. doi: 10.1093/schbul/sbv050.Google Scholar
Shen, H, Magnusson, C, Rai, D and Lundberg, M (2016) Associations of parental depression with child school performance at age 16 years in Sweden. JAMA Psychiatry 73(3), 239–246. doi: 10.1001/jamapsychiatry.2015.2917.Google Scholar
Statistics Denmark (2012) Quality Declaration for Children and Young People Receiving Social Benefits 2012. Available at http://www.dst.dk/en/Statistik/dokumentation/declarations/children-and-young-people-receiving-social-benefits.Google Scholar
The Ministry of Children Gender Equality Integration and Social Affairs (2013) Consolodation Act on Social Services (Serviceloven). The Ministry of Children, Gender Equality, Integration and Social Affairs. Available at http://www.restinformation.dk.Google Scholar
Tideman, E, Vinnerljung, B, Hintze, K and Isaksson, AA (2011) Improving foster children's school achievements: promising results from a Swedish intensive study. Adoption & Fostering 35(1), 44–56.Google Scholar
Tordön, R, Vinnerljung, B and Axelsson, U (2014) Improving foster children's school performance: a replication of the Helsingborg study. Adoption & Fostering 38(1), 37–48. doi: 10.1177/0308575913518003.Google Scholar
Trotta, A, Murray, RM and MacCabe, JH (2015) Do premorbid and post-onset cognitive functioning differ between schizophrenia and bipolar disorder? A systematic review and meta-analysis. Psychological Medicine 45(2), 381–394. doi: 10.1017/S0033291714001512.Google Scholar
Uher, R, Cumby, J, MacKenzie, LE, Morash-Conway, J, Glover, JM, Aylott, A et al. (2014) A familial risk enriched cohort as a platform for testing early interventions to prevent severe mental illness. BMC Psychiatry 14(1), 344. doi: 10.1186/s12888-014-0344-2.Google Scholar
Valiakalayil, A, Paulson, LA and Tibbo, P (2004) Burden in adolescent children of parents with schizophrenia. The Edmonton high risk project. Social Psychiatry and Psychiatric Epidemiology. Germany 39(7), 528–535. doi: 10.1007/s00127-004-0778-9.Google Scholar
Vandeleur, C, Rothen, S, Castelao, E and Vidal, S (2012) Mental disorders in offspring of parents with bipolar and major depressive disorders. Bipolar Disorders (14), 641–653. doi: 10.1111/j.1399-5618.2012.01048.x.Google Scholar
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W et al. (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin 38(4), 661–671.Google Scholar
Zammit, S, Allebeck, P, David, AS, Dalman, C, Hemmingsson, T, Lundberg, I et al. (2004) A longitudinal study of premorbid IQ score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Archives of General Psychiatry 61(4), 354–360. doi: 10.1001/archpsyc.61.4.354.Google Scholar
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