Background

Cognitive impairment is a feature of severe mental illness (SMI; schizophrenia, bipolar disorder, major depressive disorder). Psychotic forms of SMI may be associated with greater cognitive impairment, but it is unclear if this differential impairment pre-dates illness onset or whether it reflects a consequence of the disorder. To establish if there is a developmental impairment related to familial risk of psychotic SMI, we investigated cognition in offspring of parents with psychotic and non-psychotic SMI.

Method

Participants included 360 children and youth (mean age 11.10, SD 4.03, range 6–24), including 68 offspring of parents with psychotic SMI, 193 offspring of parents with non-psychotic SMI, and 99 offspring of control parents. The cognitive battery assessed a range of functions using standardized tests and executive function tasks from the Cambridge Automated Neuropsychological Test Battery.

Results

Compared to controls, offspring of parents with psychotic SMI performed worse on overall cognition (β = −0.32; p < 0.001) and 6 of 15 cognitive domains, including verbal intelligence, verbal working memory, processing speed, verbal learning and memory, verbal fluency, and sustained attention. Offspring of parents with non-psychotic SMI performed worse than controls on 3 of the 15 domain specific cognitive tests, including verbal intelligence, visual memory and decision-making.

Conclusions

Widespread mild-to-moderate cognitive impairments are present in young offspring at familial risk for transdiagnostic psychotic SMI. Offspring at familial risk for non-psychotic SMI showed fewer and more specific impairments in the domains of verbal intelligence, visual memory and decision-making.

中文翻译：

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患有精神病和非精神病的严重精神疾病父母的后代认知。

背景

认知障碍是严重精神疾病（SMI；精神分裂症，躁郁症，重度抑郁症）的特征。精神病性SMI可能与更大的认知障碍有关，但尚不清楚这种差异性障碍是否早于疾病发作或是否反映了疾病的后果。为了确定是否存在与精神病性SMI家族风险有关的发育障碍，我们调查了患有精神病性和非精神病性SMI的父母的后代认知。

方法

参加者包括360名儿童和青少年（平均年龄11.10，SD 4.03，范围6-24），包括68名患有精神病性SMI的父母的后代，193名非精神病性SMI的父母的后代和99名对照父母的后代。认知电池使用标准化测试和剑桥自动神经心理测试电池的执行功能任务评估了一系列功能。

结果

与对照组相比，患有精神病性SMI的父母的后代在整体认知上表现较差（β= -0.32；p  <0.001），并且在15个认知领域中有6个表现较差，包括语言智力，语言工作记忆，处理速度，语言学习和记忆，语言流利性，并持续关注。非精神病性SMI父母的后代在15个领域特定的认知测验中有3个表现不如对照组，这些测验包括言语智力，视觉记忆和决策能力。

结论

在具有经转诊性精神病性SMI家族风险的年轻后代中，存在着广泛的轻度至中度认知障碍。具有非精神病性SMI家族风险的后代在言语智力，视觉记忆和决策领域表现出越来越少的特异性损伤。