Dickson Hannah, Cullen Alexis E, Reichenberg Abraham, Hodgins Sheilagh, Campbell Desmond D, Morris Robin G, Laurens Kristin R
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom.
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom.
J Psychiatr Res. 2014 Mar;50:92-9. doi: 10.1016/j.jpsychires.2013.12.003. Epub 2013 Dec 18.
Adults with schizophrenia present cognitive impairments, as do individuals at ultra-high risk for the disorder, youth with relatives with schizophrenia spectrum disorders, and children with antecedents of schizophrenia. The present study aimed to determine if impairments in childhood differed depending on the definition of risk and/or on the degree of relatedness to an affected individual, and if impairments were explained by IQ. Four groups of children aged 9-12 years were studied: (1) 13 children with ≥1 first-degree or ≥2 second-degree affected relatives (high familial loading: FHx(H)); (2) 14 with ≥1 affected second-degree relative (lower familial loading: FHx(L)); (3) 32 with well-replicated antecedents of schizophrenia (ASz); and (4) 45 typically-developing (TD) children with neither a positive family history nor antecedents. Compared to TD children, both FHx(H) and ASz children exhibited significantly poorer verbal comprehension, scholastic achievement, and verbal working memory, while FHx(H) children additionally displayed significantly lower full-scale IQ, and verbal memory and executive function impairments. After adjusting statistical analyses for IQ, group differences were attenuated. Relative to TD children, FHx(L) children showed no significant differences in performance. The results imply that impairments in verbal comprehension, scholastic achievement, and verbal working memory may index vulnerability for schizophrenia among children with affected relatives with the disorder and among those with multiple antecedents of the disorder who have no affected relatives. More accurate identification of children at-risk for schizophrenia and the specific deficits that they present provides opportunities for interventions such as cognitive remediation that may impact the development of the illness.
精神分裂症成年患者存在认知障碍，处于该疾病超高风险的个体、有精神分裂症谱系障碍亲属的青少年以及有精神分裂症前驱史的儿童也存在认知障碍。本研究旨在确定儿童期的认知障碍是否因风险定义和/或与受影响个体的亲缘程度不同而有所差异，以及这些障碍是否可以用智商来解释。研究了四组9至12岁的儿童：（1）13名有≥1名一级或≥2名二级受影响亲属的儿童（高家族负荷：FHx(H)）；（2）14名有≥1名二级受影响亲属的儿童（低家族负荷：FHx(L)）；（3）32名有充分证实的精神分裂症前驱史的儿童（ASz）；以及（4）45名既无阳性家族史也无前驱史的正常发育儿童（TD）。与TD儿童相比，FHx(H)组和ASz组儿童的语言理解、学业成绩和语言工作记忆明显较差，而FHx(H)组儿童的全量表智商、语言记忆和执行功能障碍也明显更低。在对智商进行统计分析调整后，组间差异有所减弱。相对于TD儿童，FHx(L)组儿童在表现上没有显著差异。结果表明，语言理解、学业成绩和语言工作记忆方面的障碍可能表明患有该疾病的亲属的儿童以及没有受影响亲属但有该疾病多种前驱史的儿童患精神分裂症的易感性。更准确地识别精神分裂症高危儿童及其所呈现的特定缺陷，为认知康复等可能影响疾病发展的干预措施提供了机会。
