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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

  • L. J. Seidman (a1) (a2) (a3), S. Cherkerzian (a4), J. M. Goldstein (a2) (a3) (a4), J. Agnew-Blais (a5), M. T. Tsuang (a1) (a2) (a3) (a6) (a7) and S. L. Buka (a3) (a8)...

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.

Copyright

Corresponding author

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

  • L. J. Seidman (a1) (a2) (a3), S. Cherkerzian (a4), J. M. Goldstein (a2) (a3) (a4), J. Agnew-Blais (a5), M. T. Tsuang (a1) (a2) (a3) (a6) (a7) and S. L. Buka (a3) (a8)...

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