Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-24T16:16:50.370Z Has data issue: false hasContentIssue false
  • English
  • Français

Pre-morbid IQ in mental disorders: a Danish draft-board study of 7486 psychiatric patients

Published online by Cambridge University Press:  06 August 2009

A. Urfer-Parnas ,
E. Lykke Mortensen ,
D. Sæbye  and
J. Parnas
A. Urfer-Parnas*
Affiliation:
University Department of Psychiatry, Hvidovre Hospital, Hvidovre, Denmark
E. Lykke Mortensen
Affiliation:
Institute of Public Health and Centre for Healthy Aging, University of Copenhagen, Denmark
D. Sæbye
Affiliation:
Institute of Preventive Medicine, Centre for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
J. Parnas*
Affiliation:
University Department of Psychiatry, Hvidovre Hospital, Hvidovre, Denmark Danish National Research Foundation's Centre for Subjectivity Research, University of Copenhagen, Denmark
*
*Address for correspondence: A. Urfer-Parnas, M.D.,Department of Psychiatry, Hvidovre Hospital, Brøndbyøstervej 160, 2605Brøndby, Denmark. (Email: annickurferparnas@dadlnet.dk)
*Address for correspondence: A. Urfer-Parnas, M.D.,Department of Psychiatry, Hvidovre Hospital, Brøndbyøstervej 160, 2605Brøndby, Denmark. (Email: annickurferparnas@dadlnet.dk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Longitudinal studies indicate that future schizophrenia patients exhibit lower IQ than healthy controls. Recent studies suggest that future patients with other mental illnesses obtain lower pre-morbid IQ. The aims of this study were to compare pre-morbid IQ among five diagnostic categories and normal controls, to examine the distribution of pre-morbid IQ, and to investigate the relationship between pre-morbid IQ and risk of mental illness.

Method

A total of 7486 individuals hospitalized with psychiatric disease and 20 531 controls. IQ was measured at the draft board and hospital diagnoses [schizophrenia (Sz), non-schizophrenic, non-affective psychoses (NSAP), affective (AD), personality (PD) and neurotic/stress disorders (ND)] were followed up to ages 43–54 years. Individuals hospitalized ⩽1 year after appearing before the draft board were excluded.

Results

All future patients obtained significantly lower pre-morbid IQ than controls (3–7 IQ points), AD had the highest IQ and PD the lowest. In each diagnostic category, decreasing IQ was associated with an increasing risk of becoming a patient [odds ratios (ORs) 0.5–2.5 over the full IQ spectrum]. IQ distributions was nearly normal and uni-modal.

Conclusions

IQ deficits in each diagnostic category may reflect different functional patterns and temporal vicissitudes of the specific pathogenetic processes involved in different mental disorders.

Keywords

Affective disordercognitive functionintelligencepersonality disorderschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 4 , April 2010 , pp. 547 - 556
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bilder, RM, Reiter, G, Bates, J, Lencz, T, Szeszko, P, Goldman, RS, Robinson, D, Lieberman, JA, Kane, JM (2006). Cognitive development in schizophrenia: follow-back from the first episode. Journal of Clinical and Experimental Neuropsychology 28, 270–282.CrossRefGoogle ScholarPubMed
Burgess, JW (1992). Neurocognitive impairment in dramatic personalities: histrionic, narcissistic, borderline, and antisocial disorders. Psychiatry Research 42, 283–290.CrossRefGoogle ScholarPubMed
Coid, JW (1999). Aetiological risk factors for personality disorders. British Journal of Psychiatry 174, 530–538.CrossRefGoogle ScholarPubMed
David, AS, Malmberg, A, Brandt, L, Allebeck, P, Lewis, G (1997). IQ and risk for schizophrenia: a population-based cohort study. Psychological Medicine 27, 1311–1323.CrossRefGoogle ScholarPubMed
David, AS, Zammit, S, Lewis, G, Dalman, C, Allebeck, P (2008). Impairments in cognition across the spectrum of psychiatric disorders: evidence from a Swedish conscript cohort. Schizophrenia Bulletin 34, 1035–1041.CrossRefGoogle ScholarPubMed
Davidson, M, Reichenberg, A, Rabinowitz, J, Weiser, M, Kaplan, Z, Mark, M (1999). Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. American Journal of Psychiatry 156, 1328–1335.CrossRefGoogle ScholarPubMed
Fearon, P, Murray, RM (2002). Intellectual function and schizophrenia. British Journal of Psychiatry 181, 276–277.CrossRefGoogle ScholarPubMed
Gale, RG, Deary, IJ, Boyle, SH, Barefoot, J, Mortensen, LH, Batty, D (2009). Cognitive ability in early adulthood and risk of 5 specific psychiatric disorders in middle age. The Vietman experience study. Archives General of Psychiatry 65, 1410–1418.CrossRefGoogle Scholar
Goldberg, TE, Gold, JM, Greenberg, R, Griffin, S, Schulz, SC, Pickar, D, Kleinman, JE, Weinberger, DR (1993). Contrasts between patients with affective disorders and patients with schizophrenia on a neuropsychological test battery. American Journal of Psychiatry 150, 1355–1362.Google ScholarPubMed
Green, MF (2006). Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. Journal of Clinical Psychiatry 67, 36–42.Google ScholarPubMed
Heinrichs, RW, Zakzanis, KK (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426–445.CrossRefGoogle ScholarPubMed
Hill, SK, Keshavan, MS, Thase, ME, Sweeney, JA (2004). Neuropsychological dysfunction in antipsychotic-naive first-episode unipolar psychotic depression. American Journal of Psychiatry 161, 996–1003.CrossRefGoogle ScholarPubMed
Jørgensen, A, Teasdale, TW, Parnas, J, Schulsinger, F, Schulsinger, H, Mednick, SA (1987). The Copenhagen high-risk project: the diagnosis of maternal schizophrenia and its relation to offspring diagnosis. British Journal of Psychiatry 151, 753–757.CrossRefGoogle Scholar
Jones, P, Rodgers, B, Murray, RM, Marmot, M (1994). Child developmental risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet 344, 1398–1402.CrossRefGoogle ScholarPubMed
Kandel, E, Mednick, SA, Kirkegaard-Sorensen, L, Hutching, B, Knop, J, Rosenberg, R, Schhulsinger, F (1988). IQ as a protective factor for subjects at high risk for antisocial behavior. Journal of Consulting and Clinical Psychology 56, 224–226.CrossRefGoogle ScholarPubMed
Kessing, LV (1998). Validity of diagnoses and other register data in patients with affective disorder. European Psychiatry 13, 342–345.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demier, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
Koenen, KC, Moffitt, TE, Roberts, AL, Martin, LT, Kubzansky, L, Harrington, HL, Poulton, R, Caspi, A (2009). Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis. American Journal of Psychiatry 166, 50–57.CrossRefGoogle ScholarPubMed
Kremen, WS, Buka, SL, Seidman, LJ, Goldstein, JM, Koren, D, Tsuang, MT (1998). IQ decline during childhood and adult psychotic symptoms in a community sample: a 19-year longitudinal study. American Journal of Psychiatry 155, 672–677.CrossRefGoogle Scholar
Kremen, WS, Koenen, KC, Boake, C, Purcell, S, Eisen, SA, Franz, CE, Tsuang, MT, Lyons, MJ (2007). Pretrauma cognitive ability and risk for posttraumatic stress disorder. Archives of General Psychiatry 64, 361–368.CrossRefGoogle ScholarPubMed
McIntosh, AM, Harrison, LK, Forrester, K, Lawrie, SM, Johnstone, EC (2005). Neuropsychological impairments in people with schizophrenia or bipolar disorder and their unaffected relatives. British Journal of Psychiatry 186, 378–385.CrossRefGoogle ScholarPubMed
Mohamed, S, Paulsen, JS, O'Leary, D, Arndt, S, Andreasen, N (1999). Generalized cognitive deficits in schizophrenia: a study of first-episode patients. Archives of General Psychiatry 56, 749–754.CrossRefGoogle ScholarPubMed
Mortensen, EL, Reinisch, JM, Teasdale, TW (1989). Intelligence as measured by WAIS and a military draft board group test. Scandinavian Journal of Psychology 30, 315–318.CrossRefGoogle Scholar
Mortensen, EL, Sørensen, HJ, Jensen, HE, Reinish, JM, Mednick, SA (2005). IQ and mental disorder in young men. British Journal of Psychiatry 187, 407–415.CrossRefGoogle ScholarPubMed
Munk-Jørgensen, P (1985). The schizophrenia diagnosis in Denmark. A register-based investigation. Acta Psychiatrica Scandinavica 72, 266–273.CrossRefGoogle Scholar
Munk-Jørgensen, P, Mortensen, PB (1997). The Danish Psychiatric Central Register. Danish Medical Bulletin 44, 82–84.Google ScholarPubMed
Osuji, IJ, Cullum, CM (2005). Cognition in bipolar disorder. Psychiatric Clinics of North America 28, 427–441.CrossRefGoogle ScholarPubMed
Ott, SL, Spinelli, S, Rock, D, Roberts, S, Amminger, GP, Erlenmeyer-Kimling, L (1998). The New York High Risk Project: social and general intelligence in children at risk for schizophrenia. Schizophrenia Research 31, 1–11.CrossRefGoogle ScholarPubMed
Pantelis, C, YÛcel, M, Wood, SJ, Velakoulis, D, Sun, D, Berger, G, Stuart, GW, Yung, A, Phillips, L, McGorry, PD (2005). Structural brain imaging for multiple pathological processes at different stages of brain development in schizophrenia. Schizophrenia Bulletin 31, 672–696.CrossRefGoogle ScholarPubMed
Parnas, J, Cannon, M, Schulsinger, F, Mednick, SA (1995). Early predictors of onset and course of schizophrenia: results from the Copenhagen High-Risk Study. In Search for the Causes of Schizophrenia, vol. III (ed. Häfner, H. and Gattaz, W. F.), pp. 67–86. Springer Verlag: Berlin.CrossRefGoogle Scholar
Parnas, J, Teasdale, TW (1987). A matched-paired comparison of treated versus untreated schizophrenia spectrum cases: a high-risk population study. Acta Psychiatrica Scandinavica 75, 44–50.CrossRefGoogle Scholar
Rabinowitz, J, Reichenberg, A, Weiser, M, Mark, M, Kaplan, Z, Davidson, M (2000). Cognitive and behavioral functioning in men with schizophrenia both before and shortly after first admission to hospital. British Journal of Psychiatry 177, 26–32.CrossRefGoogle ScholarPubMed
Rappaport, JL, Addington, AM (2005). The neurodevelopmental model of schizophrenia: update 2005. Molecular Psychiatry 10, 434–449.CrossRefGoogle Scholar
Reichenberg, A, Weiser, M, Caspi, A, Knobler, HY, Lubin, G, Harvey, P, Rabinowitz, J, Davidson, M (2006). Premorbid intellectual functioning and risk of schizophrenia and spectrum disorders. Journal of Clinical and Experimental Neuropsychology 28, 193–207.CrossRefGoogle ScholarPubMed
Reichenberg, A, Weiser, M, Rabinowitz, J, Caspi, A, Schmeidler, J, Mordechal, M, Zeev, K, Davidson, M (2002). A population-based cohort study of premorbid intellectual, language, and behavioral functioning in patients with schizophrenia, schizoaffective disorder, and nonpsychotic bipolar disorder. American Journal of Psychiatry 159, 2027–2035.CrossRefGoogle ScholarPubMed
Reichenberg, A, Weiser, M, Rapp, MA, Rabinowitz, J, Caspi, A, Schmeidler, J, Knobler, HY, Lubin, G, Nahon, D, Harvey, PD, Davidson, M (2005). Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia. Archives of General Psychiatry 62, 1297–1304.CrossRefGoogle ScholarPubMed
Ruocco, AC (2005). The neuropsychology of the borderline personality disorder: a meta-analysis and review. Psychiatry Research 137, 191–202.CrossRefGoogle ScholarPubMed
Seidman, LJ, Buka, SL, Goldstein, JM, Tsuang, MT (2006). Intellectual decline in schizophrenia: evidence from a prospective birth cohort 28 year follow-up study. Journal of Clinical and Experimental Neuropsychology 28, 225–242.CrossRefGoogle ScholarPubMed
Teasdale, TW, Owen, DR (1989). Continuing secular increase in intelligence and a stable prevalence of high intelligence level. Intelligence 13, 255–262.CrossRefGoogle Scholar
Tiihonen, J, Haukka, J, Henriksson, M, Cannon, M, Kieseppä, T, Ilmo, L, Sinivuo, J, Lönnqvist, J (2005). Premorbid intellectual functioning in bipolar disorder and schizophrenia: results from a cohort study of male conscripts. American Journal of Psychiatry 162, 1904–1910.CrossRefGoogle ScholarPubMed
van Os, J, Jones, P, Lewis, G, Wadsworth, M, Murray, R (1997). Developmental precursors of affective illness in a general population birth cohort. Archives of General Psychiatry 54, 625–631.CrossRefGoogle Scholar
Walker, NP, McConville, PM, Hunter, D, Deary, IJ, Whalley, LJ (2002). Childhood mental ability and lifetime psychiatric contact: a 66-year follow-up study of the 1932 Scottish Mental Ability Survey. Intelligence 30, 233–245.CrossRefGoogle Scholar
Woodberry, KA, Anthony, GJ, Seidman, LJ (2008). Premorbid IQ in schizophrenia: a meta-analytic review. American Journal of Psychiatry 165, 579–587.CrossRefGoogle ScholarPubMed
Zammit, S, Allebeck, P, David, AS, Dalman, C, Hemmingsson, T, Lundberg, I, Lewis, G (2004). A longitudinal study of premorbid IQ score and risk for developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Archives of General Psychiatry 61, 354–360.CrossRefGoogle ScholarPubMed