Burton Birgitte Klee, Thorup Anne A E, Jepsen Jens Richardt, Poulsen Gry, Ellersgaard Ditte, Spang Katrine S, Christiani Camilla Jerlang, Hemager Nicoline, Gantriis Ditte, Greve Aja, Mors Ole, Nordentoft Merete, Plessen Kerstin Jessica
Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
Lancet Psychiatry. 2017 May;4(5):400-408. doi: 10.1016/S2215-0366(17)30103-7. Epub 2017 Mar 23.
Owing to the genetic overlap between schizophrenia and bipolar disorder, we aimed to assess domain-specific motor aberrations and disorder specificity among 7-year-old children with a familial risk of schizophrenia or bipolar disorder by comparing children in familial risk groups with each other and with children not in these risk groups.
In the Danish High Risk and Resilience Study, we established a cohort of 7-year-old children with no, one, or two parents with schizophrenia or bipolar disorder in Denmark between Jan 1, 2013, and Jan 31, 2016. We matched children of parents diagnosed with schizophrenia to children of parents without schizophrenia on the basis of their home address, age, and sex. Even though we did not match children of parents with bipolar disorder directly to controls because of resource constraints, we only recruited children into the three groups who did not differ in terms of age, sex, and urbanicity. We investigated motor function in children using the Movement Assessment Battery for Children-Second Edition. Motor function raters were masked to participants' clinical risk status during assessments. We assessed the effects of familial risk group in a mixed-model analysis with repeated measures with an unstructured variance component matrix.
We studied 514 children (198 [39%] children of parents with schizophrenia, 119 [23%] of parents with bipolar disorder, and 197 [38%] of parents without schizophrenia or bipolar disorder). Children of parents with schizophrenia showed impaired motor performance compared with those of parents without in the subdomains of manual dexterity (mean difference -1·42 [95% CI -2·08 to -0·77]; p<0·0001) and balance (-1·38 [-2·03 to -0·72]; p<0·0001), but not of aiming and catching (-0·39 [-0·97 to 0·19]; p=0·18). Children of parents with bipolar disorder did not show any significant difference in motor performance to children of parents without in the subdomains of manual dexterity (-0·69 [-1·44 to 0·07]; p=0·08), balance (-0·68 [-1·44 to 0·08]; p=0·08), and aiming and catching (-0·36 [-1·03 to 0·31]; p=0·29). Comparison of familial risk groups of mental disorders revealed no significant differences in the subdomains of manual dexterity (-0·74 [-1·49 to 0·02]; p=0·06), balance (-0·70 [-1·46 to 0·06]; p=0·07), or aiming and catching (-0·03 [-0·70 to 0·63]; p=0·92).
Motor abnormalities in children with a familial risk of schizophrenia are specific at 7 years of age with respect to fine motor function and balance, but non-specific with respect to familial risk of bipolar disorder. Clinicians should be aware of motor symptoms and refer children with definite motor problems (below the fifth percentile) to a child physiotherapist.
Mental Health Services of the Capital Region of Denmark, Aarhus University, and the Lundbeck Foundation Initiative for Integrative Psychiatric Research.
由于精神分裂症和双相情感障碍之间存在基因重叠，我们旨在通过比较有精神分裂症或双相情感障碍家族风险的7岁儿童与无此类风险的儿童，评估特定领域的运动异常情况以及疾病特异性。
在丹麦高危与复原力研究中，我们于2013年1月1日至2016年1月31日期间，在丹麦建立了一个由7岁儿童组成的队列，这些儿童的父母中没有、有一位或有两位患有精神分裂症或双相情感障碍。我们根据家庭住址、年龄和性别，将被诊断患有精神分裂症的父母的子女与没有精神分裂症的父母的子女进行匹配。尽管由于资源限制，我们没有将患有双相情感障碍的父母的子女直接与对照组匹配，但我们只招募了在年龄、性别和城市化程度方面没有差异的三组儿童。我们使用儿童运动评估量表第二版来研究儿童的运动功能。在评估过程中，运动功能评估人员对参与者的临床风险状态不知情。我们在一个具有重复测量的混合模型分析中，使用非结构化方差成分矩阵来评估家族风险组的影响。
我们研究了514名儿童（198名[39%]父母患有精神分裂症的儿童，119名[23%]父母患有双相情感障碍的儿童，以及197名[38%]父母没有精神分裂症或双相情感障碍的儿童）。与父母没有精神分裂症的儿童相比，父母患有精神分裂症的儿童在手部灵巧性（平均差异-1.42[95%置信区间-2.08至-0.77]；p<0.0001）和平衡（-1.38[-2.03至-0.72]；p<0.0001）子领域的运动表现受损，但在瞄准和接球方面没有受损（-0.39[-0.97至0.19]；p=0.18）。父母患有双相情感障碍的儿童在手部灵巧性（-0.69[-1.44至0.07]；p=0.08）、平衡（-0.68[-1.44至0.08]；p=0.08）和瞄准和接球（-0.36[-1.03至0.31]；p=0.29）子领域的运动表现与父母没有双相情感障碍的儿童没有显著差异。精神障碍家族风险组之间的比较显示，在手部灵巧性（-0.74[-1.49至0.02]；p=0.06）、平衡（-0.70[-1.46至0.06]；p=0.07）或瞄准和接球（-0.03[-0.70至0.63]；p=0.92）子领域没有显著差异。
有精神分裂症家族风险的儿童在7岁时，其精细运动功能和平衡方面的运动异常具有特异性，但在双相情感障碍家族风险方面不具有特异性。临床医生应注意运动症状，并将有明确运动问题（低于第五百分位数）的儿童转介给儿童物理治疗师。
丹麦首都地区精神卫生服务局、奥胡斯大学和伦贝克综合精神病学研究基金会倡议。
