Executive functions in 7-year-old children of parents with schizophrenia or bipolar disorder compared with controls: The
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Executive functions in 7‑year‑old children of parents with schizophrenia or bipolar disorder compared with controls: The Danish High Risk and Resilience Study—VIA 7, a population‑based cohort study Katrine Søborg Spang1,2,3 · Ditte Ellersgaard2,4 · Nicoline Hemager1,2,3 · Camilla Jerlang Christiani2,3,4 · Birgitte Klee Burton1,2,3 · Aja Neergaard Greve2,5 · Ditte Gantriis2,5 · Jessica Ohland2,4 · Marianne Giørtz Pedersen2,9,10 · Ole Mors2,5 · Merete Nordentoft2,3,4 · Kerstin J. Plessen1,2,8 · Carsten Obel6 · Jens Richardt Møllegaard Jepsen1,2,4,7 · Anne A. E. Thorup1,2,3 Received: 26 February 2020 / Accepted: 18 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Cognitive impairments are strongly associated with schizophrenia (SZ) and bipolar disorder (BP) with executive functions (EF) impairments as a likely key feature. Studies of everyday behavior rated EF in young children at familial high risk of SZ (FHR-SZ) are scarce and, to our knowledge, non-existent in young children at familial high risk of BP (FHR-BP). We aimed to compare everyday behavior-rated EF of FHR-SZ, FHR-BP, and control children. A nationwide population-based cohort of 522 7-year-old children with parents diagnosed with either SZ (N = 202) or BP (N = 120) and matched controls (N = 200) were recruited using the Danish national registries. The children’s EF were assessed with the Behavior Rating Inventory of Executive Functions questionnaire rated by primary caregivers and teachers. According to primary caregiver assessments, FHR-SZ children displayed widespread EF impairments and had an odds ratio of 3.7 (2.0–6.9) of having clinically significant global EF impairments compared to controls. FHR-BP children were most severely impaired regarding EF related to emotional control and had an odds ratio of 2.5 (1.2–5.1) of clinically significant global EF impairments compared to controls. Teacher assessments were overall comparable to primary caregiver assessments but teachers rated more difficulties in the FHR-SZ group than primary caregivers. Already at age 7, children with a parental history of SZ or BP displayed significant impairments of EF in everyday-life situations. FHR-SZ children displayed widespread significant impairments of EF, whereas FHR-BP children were most severely impaired on emotional control. Clinicians should be aware of potential EF impairments in FHR children. Keywords Schizophrenia · Bipolar disorder · Familial high risk · Executive function Abbreviations BP Bipolar disorder BRIEF Behavior rating inventory of executive function EF Executive functions FHR Familial high risk GEC Global executive composite SZ Schizophrenia
* Katrine Søborg Spang [email protected]; [email protected]
Introduction Cognitive impairments are well established in schizophrenia (SZ) and an association is strongly suggested between bipolar disorder (BP) and cognitive impairments [1–3]. Furthermore, a significant overlap of cognitive impairments of SZ and BP is suggested
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