New research presented at this year's International Early Psychosis Association (IEPA) meeting in Milan, Italy (20-22 October) shows that children born to one or both parents with schizophrenia or bipolar disorder are more likely to suffer mental health problems by age 7 years. The study is by Assistant Professor Anne Thorup and Professor Merete Nordentoft, Institute of Clinical Medicine, Faculty Health and Medical Science, University of Copenhagen, Denmark, and colleagues.
Familial high-risk studies are important and relevant and may represent a possible shortcut to learning more about early markers of illness, mental vulnerability and resilience. The Danish High Risk and Resilience Study - VIA 7 - is a prospective cohort study of 522 children aged 7 years at the start of the study, with 202 born to least one person diagnosed with schizophrenia (located using Danish registries), 120 of them born to least one parent diagnosed with bipolar disorder, and 200 of them born to parents without any of these diagnoses.
The results show children born to parents with schizophrenia or bipolar disorder score higher than controls using a tool called the child behaviour checklist (CBCL). This is a widely used questionnaire with more than 100 questions given to parents and teachers, that describes behavioural problems or signs of possible illness. A higher score represents more problems. Mean scores for children in the schizophrenia group were 27.2, the bipolar group 23.5, and control group 17.1.
There were also marked differences between the 3 groups concerning psychopathology, neuro-cognition, motor functioning and their home environment. Children born to parents with schizophrenia, and to a minor extent also bipolar disorder, were found to have increased risk for problems such as anxiety, attention deficit hyperactivity disorder (ADHD) and stress/adjustment disorder, and were also more likely to display neurocognitive problems or delays and to grow up in families were social status is lower and risk of adverse life events is higher.
Assistant Professor Thorup says: "Results from this first assessment in the VIA 7 study indicate that many children and families have unmet needs and problems. We plan to follow the children until age 11 years to conduct a new assessment before puberty. We do not know if the impaired children will catch up in neurocognitive areas or if their mental problems will be in remission, but since social aspects and environmental factors contribute significantly to child development ? and they were quite marked already at age 7 years - we are expecting similar or even worse results could be seen at age 11 years. At the same time, we are developing an early, integrated, specialised and family based intervention, called VIA family, to prevent or slow development of severe mental illness in individuals born to parents with schizophrenia or bipolar disorder."