Andreassen Anna Krogh, Lambek Rikke, Hemager Nicoline, Knudsen Christina Bruun, Veddum Lotte, Carlsen Anders Helles, Bundgaard Anette Faurskov, Søndergaard Anne, Brandt Julie Marie, Gregersen Maja, Krantz Mette Falkenberg, Burton Birgitte Klee, Jepsen Jens Richardt Møllegaard, Thorup Anne Amalie Elgaard, Nordentoft Merete, Mors Ole, Bliksted Vibeke Fuglsang, Greve Aja
Psychosis Research Unit, Aarhus University Hospital Psychiatry, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark.
Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.
J Affect Disord. 2023 Jul 1;332:318-326. doi: 10.1016/j.jad.2023.04.011. Epub 2023 Apr 12.
Despite the genetic overlap between bipolar disorder and schizophrenia, working memory impairments are mainly found in children of parents with schizophrenia. However, working memory impairments are characterized by substantial heterogeneity, and it is unknown how this heterogeneity develops over time. We used a data-driven approach to assess working memory heterogeneity and longitudinal stability in children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP).
Based on the performances on four working memory tasks by 319 children (FHR-SZ, N = 202, FHR-BP, N = 118) measured at age 7 and 11, latent profile transition analysis was used to test for the presence of subgroups, and the stability of subgroup membership over time. Population-based controls (VIA 7, N = 200, VIA 11, N = 173) were included as a reference group. The working memory subgroups were compared based on caregiver- and teacher ratings of everyday working memory function, and dimensional psychopathology.
A model with three subgroups characterized by different levels of working memory function (an impaired subgroup, a mixed subgroup, and an above average subgroup) best fitted the data. The impaired subgroup had the highest ratings of everyday working memory impairments and psychopathology. Overall, 98 % (N = 314) stayed in the same subgroup from age 7 to 11.
Persistent working memory impairments are present in a subset of children at FHR-SZ and FHR-BP throughout middle childhood. Attention should be given to these children, as working memory impairments influence daily life, and may serve as a vulnerability marker of transition to severe mental illness.
尽管双相情感障碍和精神分裂症之间存在基因重叠，但工作记忆损害主要见于精神分裂症患者的子女。然而，工作记忆损害具有显著的异质性，且这种异质性如何随时间发展尚不清楚。我们采用数据驱动的方法来评估精神分裂症（FHR-SZ）或双相情感障碍（FHR-BP）家族高危儿童的工作记忆异质性和纵向稳定性。
基于319名儿童（FHR-SZ组202名，FHR-BP组118名）在7岁和11岁时四项工作记忆任务的表现，采用潜在剖面转换分析来检验亚组的存在情况以及亚组成员身份随时间的稳定性。以基于人群的对照组（7岁时200名，11岁时173名）作为参照组。根据照顾者和教师对日常工作记忆功能及维度精神病理学的评分对工作记忆亚组进行比较。
一个具有三个亚组（以不同水平的工作记忆功能为特征，即受损亚组、混合亚组和高于平均水平亚组）的模型最符合数据。受损亚组在日常工作记忆损害和精神病理学方面的评分最高。总体而言，98%（N = 314）的儿童从7岁到11岁一直处于同一亚组。
在整个童年中期，FHR-SZ和FHR-BP儿童中的一部分存在持续的工作记忆损害。应关注这些儿童，因为工作记忆损害会影响日常生活，且可能作为向严重精神疾病转变的易感性标志物。
