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. 2023 May 3;49(3):756-767.
doi: 10.1093/schbul/sbac198.

Early Childhood Neurocognition in Relation to Middle Childhood Psychotic Experiences in Children at Familial High Risk of Schizophrenia or Bipolar Disorder and Population-Based Controls: The Danish High Risk and Resilience Study

Christina Bruun Knudsen  1   2   3 , Nicoline Hemager  2   4   5 , Jens Richardt Møllegaard Jepsen  2   4   5   6 , Maja Gregersen  2   4 , Aja Neergaard Greve  7   2 , Anna Krogh Andreassen  1   2   3 , Lotte Veddum  1   2   3 , Julie Marie Brandt  2   4   8 , Mette Falkenberg Krantz  2   4   5 , Anne Søndergaard  2   4   8 , Birgitte Klee Burton  5   8   9 , Anne Amalie Elgaard Thorup  2   5   8 , Merete Nordentoft  2   4   8 , Rikke Lambek  10 , Ole Mors  7   2 , Vibeke Fuglsang Bliksted  1   2   3
Affiliations

Early Childhood Neurocognition in Relation to Middle Childhood Psychotic Experiences in Children at Familial High Risk of Schizophrenia or Bipolar Disorder and Population-Based Controls: The Danish High Risk and Resilience Study

Christina Bruun Knudsen et al. Schizophr Bull. .

Abstract

Background and hypothesis: Familial high-risk (FHR) studies examining longitudinal associations between neurocognition and psychotic experiences are currently lacking. We hypothesized neurocognitive impairments at age 7 to be associated with increased risk of psychotic experiences from age 7 to 11 in children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) and population-based controls (PBC), and further, impaired functioning in some neurocognitive functions to be associated with greater risk of psychotic experiences in children at FHR-SZ or FHR-BP relative to PBC.

Study design: Neurocognition was assessed at age 7 (early childhood) and psychotic experiences from age 7 to 11 (middle childhood) in 449 children from the Danish High Risk and Resilience Study. The neurocognitive assessment covered intelligence, processing speed, attention, visuospatial and verbal memory, working memory, and set-shifting. Psychotic experiences were assessed through face-to-face interviews with the primary caregiver and the child.

Study results: Set-shifting impairments at age 7 were associated with greater risk of psychotic experiences from age 7 to 11 in children at FHR-SZ. Children at FHR-BP and PBC showed no differential associations. Working memory and visuospatial memory impairments were related to increased risk of psychotic experiences across the cohort. However, adjusting for concurrent psychopathology attenuated these findings.

Conclusions: Early childhood neurocognitive impairments are risk markers of middle childhood psychotic experiences, of which impaired set-shifting appears to further increase the risk of psychotic experiences in children at FHR-SZ. More research is needed to examine longitudinal associations between neurocognitive impairments and psychotic experiences in FHR samples.

Keywords: cognitive functions; preadolescence; psychosis; severe mental illness.

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Figures

Fig. 1.
Fig. 1.
(A–H) Associations between neurocognitive function and psychotic experiences by familial high-risk (FHR) group. Note: Predicted probability of psychotic experiences as a function of performance on individual neurocognitive tests stratified by FHR group.
See this image and copyright information in PMC

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