How do joint measures of premorbid cognitive ability and familial cognitive aptitude (FCA) reflect risk for a diversity of psychiatric and substance use disorders? To address this question, we examined, using Cox models, the predictive effects of school achievement (SA) measured at age 16 and FCA-assessed from SA in siblings and cousins, and educational attainment in parents-on risk for 12 major psychiatric syndromes in 1 140 608 Swedes born 1972-1990. Four developmental patterns emerged. In the first, risk was predicted jointly by low levels of SA and high levels of FCA-that is a level of SA lower than would be predicted from the FCA. This pattern was strongest in autism spectrum disorders and schizophrenia, and weakest in bipolar illness. In these disorders, a pathologic process seems to have caused cognitive functioning to fall substantially short of familial potential. In the second pattern, seen in the internalizing conditions of major depression and anxiety disorders, risk was associated with low SA but was unrelated to FCA. Externalizing disorders-drug abuse and alcohol use disorders-demonstrated the third pattern, in which risk was predicted jointly by low SA and low FCA. The fourth pattern, seen in eating disorders, was directly opposite of that observed in externalizing disorders with risk associated with high SA and high FCA. When measured together, adolescent cognitive ability and FCA identified four developmental patterns leading to diverse psychiatric disorders. The value of cognitive assessments in psychiatric research can be substantially increased by also evaluating familial cognitive potential.

中文翻译：

---

青春期认知能力和家族认知能力对重大精神疾病风险的共同影响：四种潜在疾病途径的描述。

病前认知能力和家族性认知能力（FCA）的联合测量如何反映出多种精神病和药物滥用疾病的风险？为了解决这个问题，我们使用Cox模型研究了在16岁时测量的学业成绩（SA）的预测效果以及通过SA对兄弟姐妹和堂兄弟姐妹进行的FCA评估的预测效果，以及父母对12种主要精神病综合征风险的教育程度。 1140608瑞典人，1972年至1990年出生。出现了四种发展模式。首先，低水平的SA和高水平的FCA共同预测了风险-SA的水平低于FCA的预测。这种模式在自闭症谱系障碍和精神分裂症中最强，而在躁郁症中最弱。在这些疾病中 病理过程似乎已经导致认知功能大大缺乏家族潜力。在第二种模式中，从重度抑郁症和焦虑症的内在条件来看，风险与低SA相关，但与FCA无关。外在的疾病-药物滥用和酒精滥用-表现出第三种模式，其中低SA和FCA共同预测风险。在饮食失调中观察到的第四种模式与在具有高SA和高FCA风险的外在性失调中观察到的模式正好相反。一起衡量时，青春期认知能力和FCA确定了导致多种精神疾病的四种发展模式。