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Poor sleep in children predicts mental and physical disorders later in life. Identifying and changing modifiable factors associated with sleep problems in young children may improve their health trajectory. Our aim was to establish whether overprotective parenting was associated with problems sleeping in children. Parents of children aged 2-6 years completed questionnaires about their own anxiety, parenting style, and about their children's sleep. We obtained 307 reports on 197 children from 240 parents. Using mixed-effects linear regression, we found that maternal (beta = 0.26, 95% CI 0.11 to 0.41, p = 0.001) and paternal (beta = 0.35, 95% CI 0.17 to 0.53, p < 0.001) overprotection were associated with impaired sleep in children. This relationship remained unchanged when controlling for parental anxiety. Decreasing parents' overprotection may improve children's sleep, and reduce the risk of physical and mental disorders later in their life.
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Trastornos del Inicio y del Mantenimiento del Sueño , Trastornos del Sueño-Vigilia , Niño , Preescolar , Padre , Humanos , Masculino , Responsabilidad Parental , Padres , SueñoRESUMEN
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) and lower cognitive ability have been linked with increased likelihood of exposure to adversity. We hypothesized that these associations may be partly due to genetic factors. METHODS: We calculated polygenic scores for ADHD and intelligence and assessed psychopathology and general cognitive ability in a sample of 297 youth aged 5-27 years enriched for offspring of parents with mood and psychotic disorders. We calculated an adversity score as a mean of 10 indicators, including socio-economic disadvantage, childhood maltreatment and bullying. We tested the effects of polygenic scores, externalizing symptoms and IQ on adversity scores using mixed-effects linear regression. RESULTS: Externalizing symptoms and general cognitive ability showed expected positive and negative relationships with adversity, respectively. Polygenic scores for intelligence were unrelated to adversity, but polygenic scores for ADHD were associated with adversity (ß = 0.23, 95% CI 0.13 to 0.34, p < .0001). ADHD polygenic scores uniquely explained 4.0% of variance in adversity score. The relationship between polygenic scores for ADHD and adversity was independently significant among individuals with (ß = 0.49, 95% CI 0.25 to 0.75, p < .0001) and without (ß = 0.14, 95% CI 0.02 to 0.26, p = .022) ADHD. CONCLUSIONS: A genetic score indexing liability to ADHD was associated with exposure to adversity in early life. Previously observed associations between externalizing symptoms, lower cognitive ability and adversity may be partially attributed to genetic liability to ADHD.
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Experiencias Adversas de la Infancia , Trastorno por Déficit de Atención con Hiperactividad/genética , Predisposición Genética a la Enfermedad , Trastornos Mentales/etiología , Trastornos Mentales/genética , Adolescente , Experiencias Adversas de la Infancia/psicología , Acoso Escolar , Niño , Femenino , Humanos , Inteligencia/genética , Control Interno-Externo , Masculino , Trastornos Mentales/fisiopatología , Trastornos Mentales/psicología , Herencia Multifactorial/genética , Psicopatología , Factores SocioeconómicosRESUMEN
BACKGROUND: Psychotic symptoms are common during childhood and adolescence and may indicate transdiagnostic risk of future psychiatric disorders. Lower visual memory ability has been suggested as a potential indicator of future risk of mental illness. The relationship between visual memory and clinician-confirmed definite psychotic symptoms in youth has not yet been explored. METHODS: We examined visual memory and psychotic symptoms among 205 participants aged 7-27 years in a cohort enriched for parental mood and psychotic disorders. We assessed visual memory using the Rey Complex Figure Test (RCFT) and psychotic symptoms using validated semi-structured interview measures. We tested the relationship between visual memory and psychotic symptoms using mixed-effects logistic regression. RESULTS: After accounting for age, sex, and family clustering, we found that psychotic symptoms were significantly associated with lower visual memory (OR = 1.80, 95% CI 1.06-3.06, p = 0.030). This result was unchanged after accounting for general cognitive ability. CONCLUSION: Lower visual memory performance is associated with psychotic symptoms among youth, regardless of general cognitive ability. This finding may inform future targeted early interventions.
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Memoria/fisiología , Estimulación Luminosa/métodos , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Percepción Visual/fisiología , Adolescente , Adulto , Niño , Cognición/fisiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Affective lability, defined as the propensity to experience excessive and unpredictable changes in mood, has been proposed as a potential transdiagnostic predictor of major mood and psychotic disorders. A parental diagnosis of bipolar disorder has been associated with increased affective lability in offspring. However, the association between affective lability and family history of other mood and psychotic disorders has not been examined. We measured affective lability using the self- and parent-reported Children's Affective Lability Scale in a cohort of 320 youth aged 6-17 years, including 137 offspring of a parent with major depressive disorder, 68 offspring of a parent with bipolar disorder, 24 offspring of a parent with schizophrenia, and 91 offspring of control parents. We tested differences in affective lability between groups using mixed-effects linear regression. Offspring of a parent with major depressive disorder (ß = 0.46, 95% CI 0.17-0.76, p = 0.002) or bipolar disorder (ß = 0.47, 95% CI 0.12-0.81, p = 0.008) had significantly higher affective lability scores than control offspring. Affective lability did not differ significantly between offspring of a parent with schizophrenia and offspring of control parents. Our results suggest that elevated affective lability during childhood is a marker of familial risk for mood disorders.
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Trastorno Bipolar/psicología , Hijo de Padres Discapacitados/psicología , Trastorno Depresivo Mayor/psicología , Trastornos Psicóticos/psicología , Psicología del Esquizofrénico , Adolescente , Adulto , Niño , Estudios de Cohortes , Femenino , Humanos , MasculinoRESUMEN
BackgroundIt has been suggested that offspring of parents with bipolar disorder are at increased risk for disruptive mood dysregulation disorder (DMDD), but the specificity of this association has not been established.AimsWe examined the specificity of DMDD to family history by comparing offspring of parents with (a) bipolar disorder, (b) major depressive disorder and (c) a control group with no mood disorders.MethodWe established lifetime diagnosis of DMDD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children for DSM-5 in 180 youth aged 6-18 years, including 58 offspring of parents with bipolar disorder, 82 offspring of parents with major depressive disorder and 40 control offspring.ResultsDiagnostic criteria for DMDD were met in none of the offspring of parents with bipolar disorder, 6 of the offspring of parents with major depressive disorder and none of the control offspring. DMDD diagnosis was significantly associated with family history of major depressive disorder.ConclusionsOur results suggest that DMDD is not specifically associated with a family history of bipolar disorder and may be associated with parental depression.
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Trastorno Bipolar , Hijo de Padres Discapacitados/psicología , Trastorno Depresivo Mayor , Trastornos del Humor/epidemiología , Adolescente , Canadá/epidemiología , Niño , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVE: This study aimed to examine differences in the clinical presentation of very-early-onset (VEO) and early-onset (EO) bipolar disorder (BD) not fully explored previously. METHODS: We selected two groups of subjects with BD from the Maritime Bipolar Registry based on age at onset of first major mood episode (VEO with onset prior to age 15 years; EO ranging from 15 to 18 years) and compared them with a reference group (onset after 18 years of age). There were 363 subjects (240 with bipolar I disorder and 123 with bipolar II disorder; mean age 44.2 ± 12.8 (SD) years), with 41 subjects in the VEO and 95 in the EO groups. RESULTS: In comparison with the EO and reference groups, more subjects in the VEO group developed major depression as an index episode (88% for the VEO group versus 61% for the EO group and 54% for the reference group), and had an unremitting clinical course (65% versus 42% and 42%, respectively), rapid cycling (54% versus 34% and 28%, respectively), and comorbid attention-deficit hyperactivity disorder (17% versus 1% and 3%, respectively); a higher proportion of the VEO group had first-degree relatives with affective disorders compared with the EO and reference groups (0.41 versus 0.32 and 0.29, respectively), and they had lower scores on the Global Assessment of Functioning scale (mean scores of 64 versus 70 and 70). Overall, the EO group was similar to the reference group on most measures, except for increased suicidal behavior VEO 53%, EO 44% and reference group 25%). The results of polychotomous logistic regression also support the view that VEO BD represents a rather specific subtype of BD. CONCLUSIONS: Our results suggest the recognized correlates of early-onset BD may be driven by subjects at the lowest end of the age at onset spectrum.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno Bipolar , Adolescente , Adulto , Edad de Inicio , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/epidemiología , Trastorno Bipolar/psicología , Canadá/epidemiología , Comorbilidad , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/epidemiología , Trastorno Depresivo Mayor/psicología , Familia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Humor/diagnóstico , Trastornos del Humor/epidemiología , Trastornos del Humor/psicología , Escalas de Valoración Psiquiátrica , PsicopatologíaRESUMEN
BACKGROUND: Severe mental illness (SMI), including schizophrenia, bipolar disorder and severe depression, is responsible for a substantial proportion of disability in the population. This article describes the aims and design of a research study that takes a novel approach to targeted prevention of SMI. It is based on the rationale that early developmental antecedents to SMI are likely to be more malleable than fully developed mood or psychotic disorders and that low-risk interventions targeting antecedents may reduce the risk of SMI. METHODS/DESIGN: Families Overcoming Risks and Building Opportunities for Well-being (FORBOW) is an accelerated cohort study that includes a large proportion of offspring of parents with SMI and embeds intervention trials in a cohort multiple randomized controlled trial (cmRCT) design. Antecedents are conditions of the individual that are distressing but not severely impairing, predict SMI with moderate-to-large effect sizes and precede the onset of SMI by at least several years. FORBOW focuses on the following antecedents: affective lability, anxiety, psychotic-like experiences, basic symptoms, sleep problems, somatic symptoms, cannabis use and cognitive delay. Enrolment of offspring over a broad age range (0 to 21 years) will allow researchers to draw conclusions on a longer developmental period from a study of shorter duration. Annual assessments cover a full range of psychopathology, cognitive abilities, eligibility criteria for interventions and outcomes. Pre-emptive early interventions (PEI) will include skill training for parents of younger children and courses in emotional well-being skills based on cognitive behavioural therapy for older children and youth. A sample enriched for familial risk of SMI will enhance statistical power for testing the efficacy of PEI. DISCUSSION: FORBOW offers a platform for efficient and unbiased testing of interventions selected according to best available evidence. Since few differences exist between familial and 'sporadic' SMI, the same interventions are likely to be effective in the general population. Comparison of short-term efficacy of PEI on antecedents and the long term efficacy for preventing the onset of SMI will provide an experimental test of the etiological role of antecedents in the development of SMI.
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Intervención Médica Temprana/métodos , Familia , Trastornos Mentales/diagnóstico , Trastornos Mentales/prevención & control , Índice de Severidad de la Enfermedad , Adolescente , Niño , Hijo de Padres Discapacitados/psicología , Preescolar , Terapia Cognitivo-Conductual/métodos , Estudios de Cohortes , Familia/psicología , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Trastornos Mentales/psicología , Factores de Riesgo , Adulto JovenRESUMEN
Major depressive, bipolar, or psychotic disorders are preceded by earlier manifestations in behaviours and experiences. We present a synthesis of evidence on associations between person-level antecedents (behaviour, performance, psychopathology) in childhood, adolescence, or early adulthood and later onsets of major depressive disorder, bipolar disorder, or psychotic disorder based on prospective studies published up to September 16, 2022. We screened 11,342 records, identified 460 eligible publications, and extracted 570 risk ratios quantifying the relationships between 52 antecedents and onsets in 198 unique samples with prospective follow-up of 122,766 individuals from a mean age of 12.4 to a mean age of 24.8 for 1522,426 person years of follow-up. We completed meta-analyses of 12 antecedents with adequate data. Psychotic symptoms, depressive symptoms, anxiety, disruptive behaviors, affective lability, and sleep problems were transdiagnostic antecedents associated with onsets of depressive, bipolar, and psychotic disorders. Attention-deficit/hyperactivity and hypomanic symptoms specifically predicted bipolar disorder. While transdiagnostic and diagnosis-specific antecedents inform targeted prevention and help understand pathogenic mechanisms, extensive gaps in evidence indicate potential for improving early risk identification.
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Trastorno Bipolar , Trastorno Depresivo Mayor , Trastornos Psicóticos , Humanos , Trastornos Psicóticos/epidemiología , Trastorno Bipolar/epidemiología , Trastorno Depresivo Mayor/epidemiología , Estudios Prospectivos , Adolescente , Adulto Joven , NiñoRESUMEN
BACKGROUND: Virtual care may improve access to healthcare and may be well suited to digitally connected youth, but experts caution that privacy and technology barriers could perpetuate access inequities. Success of virtual care will depend on its alignment with patient preferences. However, information on preferences for virtual and in-person healthcare is missing, especially for youth. We sought to quantify preferences for and barriers to virtual versus in-person mental and physical healthcare in youth and their parents, including in vulnerable segments of the population such as families with a parent with severe mental illness (SMI). METHODS: Participants were 219 youth and 326 parents from the Families Overcoming Risks and Building Opportunities for Wellbeing cohort from Canada, of which 61% of youth had at least one parent with SMI. Participants were interviewed about healthcare preferences and access to privacy/technology between October 2021 and December 2022. RESULTS: Overall, youth reported a preference for in-person mental (66.6%) and physical healthcare (74.7%) versus virtual care or no preference, and to a somewhat lesser degree, so did their parents (48.0% and 53.9%). Half of participants reported privacy/technology barriers to virtual care, with privacy being the most common barrier. Preferences and barriers varied as a function of parent SMI status, socioeconomic status and rural residence. CONCLUSIONS: The majority of youth and parents in this study prefer in-person healthcare, and the preference is stronger in youth and in vulnerable segments of the population. Lack of privacy may be a greater barrier to virtual care than access to technology.
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Instituciones de Salud , Trastornos Mentales , Humanos , Adolescente , Canadá/epidemiología , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Padres , Prioridad del PacienteAsunto(s)
Agonistas de Receptores Adrenérgicos alfa 2/uso terapéutico , Trastorno del Espectro Autista/tratamiento farmacológico , Guanfacina/uso terapéutico , Problema de Conducta/psicología , Agresión/psicología , Trastorno del Espectro Autista/psicología , Niño , Preparaciones de Acción Retardada , Humanos , Conducta Impulsiva , Masculino , Conducta Autodestructiva/tratamiento farmacológico , Conducta Autodestructiva/psicología , Resultado del TratamientoRESUMEN
OBJECTIVE: Family history is an established risk factor for mental illness. The authors sought to investigate whether polygenic scores (PGSs) can complement family history to improve identification of risk for major mood and psychotic disorders. METHODS: Eight cohorts were combined to create a sample of 1,884 participants ages 2-36 years, including 1,339 offspring of parents with mood or psychotic disorders, who were prospectively assessed with diagnostic interviews over an average of 5.1 years. PGSs were constructed for depression, bipolar disorder, anxiety, attention deficit hyperactivity disorder (ADHD), schizophrenia, neuroticism, subjective well-being, p factor, and height (as a negative control). Cox regression was used to test associations between PGSs, family history of major mental illness, and onsets of major mood and psychotic disorders. RESULTS: There were 435 onsets of major mood and psychotic disorders across follow-up. PGSs for neuroticism (hazard ratio=1.23, 95% CI=1.12-1.36), schizophrenia (hazard ratio=1.15, 95% CI=1.04-1.26), depression (hazard ratio=1.11, 95% CI=1.01-1.22), ADHD (hazard ratio=1.10, 95% CI=1.00-1.21), subjective well-being (hazard ratio=0.90, 95% CI=0.82-0.99), and p factor (hazard ratio=1.14, 95% CI=1.04-1.26) were associated with onsets. After controlling for family history, neuroticism PGS remained significantly positively associated (hazard ratio=1.19, 95% CI=1.08-1.31) and subjective well-being PGS remained significantly negatively associated (hazard ratio=0.89, 95% CI=0.81-0.98) with onsets. CONCLUSIONS: Neuroticism and subjective well-being PGSs capture risk of major mood and psychotic disorders that is independent of family history, whereas PGSs for psychiatric illness provide limited predictive power when family history is known. Neuroticism and subjective well-being PGSs may complement family history in the early identification of persons at elevated risk.
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Trastorno Bipolar , Trastornos Psicóticos , Esquizofrenia , Humanos , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/genética , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/genética , Trastorno Bipolar/psicología , Esquizofrenia/diagnóstico , Esquizofrenia/genética , Padres , Factores de RiesgoRESUMEN
Importance: Although anxiety disorders are known to run in families, the relative contribution of genes and environment is unclear. Patterns of sex-specific transmission of anxiety may point to different pathways in how parents pass anxiety disorders down to their children; however, the association of parent and offspring sex with the transmission of anxiety disorders has not been previously studied. Objective: To examine whether the transmission of anxiety from parents to children is sex specific. Design, Setting, and Participants: This cross-sectional family study recruited participants from the general population (enriched for familial risk of mood disorders) in Nova Scotia, Canada, from February 1, 2013, to January 31, 2020. Exposures: Anxiety disorder in the same-sex or opposite-sex parent. Main Outcomes and Measures: Semistructured interviews were used to establish lifetime diagnoses of anxiety disorder in parents and offspring. The association between anxiety disorder in the same-sex or opposite-sex parent and anxiety disorders in the offspring was tested with logistic regression. Results: A total of 398 offspring (203 female offspring with a mean [SD] age of 11.1 [3.7] years and 195 male offspring with a mean [SD] age of 10.6 [3.1] years) of 221 mothers and 237 fathers participated in the study. Anxiety disorders in the same-sex parent (odds ratio [OR], 2.85; 95% CI, 1.52-5.34; P = .001) were associated with increased rates of anxiety disorders in the offspring, whereas anxiety disorders in the opposite-sex parent (OR, 1.51; 95% CI, 0.81-2.81; P = .20) were not. Sharing a household with a same-sex parent without anxiety was associated with lower rates of offspring anxiety (OR, 0.38; 95% CI, 0.22-0.67; P = .001), but the presence of an opposite-sex parent without anxiety was not (OR, 0.96; 95% CI, 0.56-1.63; P = .88). Conclusions and Relevance: In this cross-sectional study of families, an association between the same-sex parent's anxiety disorder and anxiety disorders in offspring suggests an environmental mechanism, such as modeling. Future studies should establish whether treating parents' anxiety may protect their children from developing an anxiety disorder.
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Trastornos de Ansiedad , Padres , Trastornos de Ansiedad/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos del Humor/epidemiología , MadresRESUMEN
Severe mental illness (SMI) refers to impairing and frequently chronic disorders that are difficult to treat. Lower cognitive performance early in life may be a manifestation of risk for SMI. Visual memory has been highlighted as a potential cognitive predictor of future risk of developing bipolar disorder and schizophrenia. We examined visual memory in 214 participants (mean age = 12.62, SD = 4.49) using the Rey Complex Figure Test (RCFT). Our sample included 37 offspring with no parental history of mental illness, 103 offspring with parental history of non-severe mental illness (NSMI), and 74 offspring with parental history of SMI. We tested the effects of family history of mental illness on visual memory using mixed-effects linear regression. After accounting for age, sex, and family clustering, we found that as severity of parental mental illness increases, offspring visual memory performance decreases significantly (b = -3.58, 95% CI -6.79 to -0.37, p = 0.029). We found that severity of parental mental illness predicts visual memory ability. This finding may help identify youth most at risk of developing mental illness and thus inform future interventions.
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Activities may be modifiable factors that moderate the risk and resilience in the development of mental health and illness. Youth who spend more time using screens are more likely to have poor mental health. Conversely, time spent engaged in active behaviors (i.e., physical activity, socializing and reading) is associated with better mental health. The choice of activities may be important in offspring of parents with mental illness, who are at increased risk for developing mental disorders. Among 357 youth of the FORBOW (Families Overcoming Risks and Building Opportunities for Well-being) cohort aged 6-21, we examined whether parental diagnosis of mental illness (i.e., major depressive disorder, schizophrenia and bipolar disorder) and current levels of depression influenced the amount of time their offspring spent using screens and engaging in active behaviors. Parental history of mental illness and higher levels of current depression in mothers were associated with less time spent engaged in active behaviors and more time spent using screens. Creating opportunities and incentives for active behaviors may redress the balance between youth with and without a familial history of mental illness.
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Trastorno Bipolar/psicología , Hijo de Padres Discapacitados/psicología , Trastorno Depresivo Mayor/psicología , Ejercicio Físico/psicología , Psicología del Esquizofrénico , Tiempo de Pantalla , Adolescente , Trastorno Bipolar/epidemiología , Niño , Estudios de Cohortes , Trastorno Depresivo Mayor/epidemiología , Ejercicio Físico/fisiología , Femenino , Humanos , Masculino , Padres/psicología , Esquizofrenia/epidemiología , Autoinforme , Adulto JovenRESUMEN
OBJECTIVE: Bipolar disorders (BD) have a strong genetic underpinning, yet no biological vulnerability markers for BD have yet been identified. To test whether amygdala or hippocampal volumes represent an endophenotype for BD, we measured mesiotemporal volumes in young affected and unaffected relatives of patients with BD (high-risk design). METHOD: High-risk participants (aged 15 to 30 years) were recruited from families multiply affected with BD. They included 20 affected and 26 unaffected offspring of parents with primary mood disorders, matched by age and sex with 31 control subjects without a personal or family history of psychiatric disorders. Amygdala and hippocampal volumes were measured on 1.5 Tesla 3-dimensional anatomical magnetic resonance images using standard methods. RESULTS: We found comparable amygdala and hippocampal volumes among unaffected relatives, affected high-risk patients, and control subjects. The exclusion of 6 medicated patients did not change the results. There were no differences between participants with family history of BD I, compared with participants with family history of BD II, or between subjects with family history of BD with psychotic symptoms, compared with subjects with family history of BD without psychotic symptoms. CONCLUSIONS: Hippocampal and amygdala volume abnormalities were absent in unaffected and affected relatives of patients with BD and thus did not meet criteria for endophenotype.
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Amígdala del Cerebelo/patología , Trastorno Bipolar/patología , Hipocampo/patología , Adolescente , Adulto , Estudios Transversales , Familia , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Tamaño de los Órganos , Fenotipo , Factores de Riesgo , Adulto JovenRESUMEN
Background: The greater presence of neurodevelopmental antecedants may differentiate schizophrenia from bipolar disorders (BD). Machine learning/pattern recognition allows us to estimate the biological age of the brain from structural magnetic resonance imaging scans (MRI). The discrepancy between brain and chronological age could contribute to early detection and differentiation of BD and schizophrenia. Methods: We estimated brain age in 2 studies focusing on early stages of schizophrenia or BD. In the first study, we recruited 43 participants with first episode of schizophrenia-spectrum disorders (FES) and 43 controls. In the second study, we included 96 offspring of bipolar parents (48 unaffected, 48 affected) and 60 controls. We used relevance vector regression trained on an independent sample of 504 controls to estimate the brain age of study participants from structural MRI. We calculated the brain-age gap estimate (BrainAGE) score by subtracting the chronological age from the brain age. Results: Participants with FES had higher BrainAGE scores than controls (F(1, 83) = 8.79, corrected P = .008, Cohen's d = 0.64). Their brain age was on average 2.64 ± 4.15 years greater than their chronological age (matched t(42) = 4.36, P < .001). In contrast, participants at risk or in the early stages of BD showed comparable BrainAGE scores to controls (F(2,149) = 1.04, corrected P = .70, η2 = 0.01) and comparable brain and chronological age. Conclusions: Early stages of schizophrenia, but not early stages of BD, were associated with advanced BrainAGE scores. Participants with FES showed neurostructural alterations, which made their brains appear 2.64 years older than their chronological age. BrainAGE scores could aid in early differential diagnosis between BD and schizophrenia.
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Trastorno Bipolar/diagnóstico por imagen , Aprendizaje Automático , Imagen por Resonancia Magnética/métodos , Trastornos Psicóticos/diagnóstico por imagen , Esquizofrenia/diagnóstico por imagen , Adolescente , Adulto , Factores de Edad , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Riesgo , Adulto JovenRESUMEN
BACKGROUND: Basic symptoms, defined as subjectively perceived disturbances in thought, perception and other essential mental processes, have been established as a predictor of psychotic disorders. However, the relationship between basic symptoms and family history of a transdiagnostic range of severe mental illness, including major depressive disorder, bipolar disorder and schizophrenia, has not been examined. AIMS: We sought to test whether non-severe mood disorders and severe mood and psychotic disorders in parents is associated with increased basic symptoms in their biological offspring. METHOD: We measured basic symptoms using the Schizophrenia Proneness Instrument - Child and Youth Version in 332 youth aged 8-26 years, including 93 offspring of control parents, 92 offspring of a parent with non-severe mood disorders, and 147 offspring of a parent with severe mood and psychotic disorders. We tested the relationships between parent mental illness and offspring basic symptoms in mixed-effects linear regression models. RESULTS: Offspring of a parent with severe mood and psychotic disorders (B = 0.69, 95% CI 0.22-1.16, P = 0.004) or illness with psychotic features (B = 0.68, 95% CI 0.09-1.27, P = 0.023) had significantly higher basic symptom scores than control offspring. Offspring of a parent with non-severe mood disorders reported intermediate levels of basic symptoms, that did not significantly differ from control offspring. CONCLUSIONS: Basic symptoms during childhood are a marker of familial risk of psychopathology that is related to severity and is not specific to psychotic illness. DECLARATION OF INTEREST: None.
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OBJECTIVE: Bipolar disorders have a strong genetic underpinning. Little is known about biological predispositions that convey vulnerability for the illness. We searched for biological vulnerability markers using proton magnetic resonance spectroscopy (MRS) in both affected and unaffected participants at high genetic risk for bipolar disorder. METHODS: We recruited high-risk participants aged 15-30 years from families in which multiple members were affected with bipolar disorder. Our primary sample included 14 affected and 15 unaffected relatives of probands with bipolar I disorder. Our extended sample comprised 19 affected and 21 unaffected participants with a family history of either bipolar I or bipolar II disorders. We matched both samples by age and sex with 31 control participants without a personal or family history of psychiatric disorders. We performed single voxel proton MRS at 1.5 T in bilateral dorsal and ventral medial prefrontal cortices with correction for grey matter proportion. RESULTS: We found comparable levels of choline, creatine, myo-inositol and N-acetylaspartate among the groups in both samples. There were no differences between regions of the medial prefrontal cortex or between hemispheres for any of the metabolites in any of the samples. The exclusion of 5 participants taking medication did not change our results. CONCLUSION: Neurochemical changes in the medial prefrontal cortex that are measurable using proton MRS do not appear to be antecedent to the onset of mood disorders in genetically susceptible individuals.
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Trastorno Bipolar/genética , Adolescente , Adulto , Biomarcadores , Trastorno Bipolar/metabolismo , Trastorno Bipolar/psicología , Química Encefálica , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Masculino , Trastornos del Humor/metabolismo , Trastornos del Humor/psicología , Escalas de Valoración PsiquiátricaRESUMEN
BACKGROUND: Bipolar disorders (BD) have a strong genetic underpinning, yet no biological vulnerability markers for BD have been identified. Decreased volumes of subgenual cingulate (SGC) were replicated in familial bipolar patients. Presence of abnormality in unaffected subjects at genetic risk for an illness needs to be established before SGC volumes can be used as an endophenotype. This is the first study of SGC volumes in affected and unaffected subjects at familial risk for mood disorders. METHOD: High-risk participants were recruited from families multiply affected with BD. The high-risk sample included 13 affected and 13 unaffected offspring of bipolar I parents, who were matched by age and sex with 31 controls without a personal or family history of psychiatric disorders. The expanded sample consisted of 24 unaffected, 19 affected subjects all with a first or second degree relative suffering from BD I or II. The age range for all subjects was 15-30 years. Subgenual cingulate volumes were measured on 1.5 T 3D anatomical MRI images using standard methods. RESULTS: We found comparable SGC volumes among unaffected, affected offspring of BD I parents and controls. Likewise no SGC abnormalities were found in the expanded sample of subjects with BD I or II relatives. Left SGC volumes in all groups were smaller than right SGC volumes without laterality by group interaction. The exclusion of 5 medicated subjects did not change the results. LIMITATIONS: Cross sectional design, inclusion of both bipolar I and bipolar II probands. CONCLUSIONS: Subgenual cingulate volume abnormalities were absent in unaffected or affected relatives of bipolar patients and thus did not meet criteria for endophenotype.
Asunto(s)
Trastorno Bipolar/epidemiología , Trastorno Bipolar/psicología , Hijo de Padres Discapacitados/psicología , Hijo de Padres Discapacitados/estadística & datos numéricos , Giro del Cíngulo/anatomía & histología , Adolescente , Adulto , Trastorno Bipolar/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Factores de RiesgoRESUMEN
BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to drug-induced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. METHODS: We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6-21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. RESULTS: Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82-10.69; P = .001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. CONCLUSIONS: Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.