Krantz Mette Falkenberg, Ellersgaard Ditte, Andersen Klaus Kaae, Hemager Nicoline, Christiani Camilla, Spang Katrine Søborg, Burton Birgitte Klee, Gregersen Maja, Søndergaard Anne, Greve Aja, Gantriis Ditte Lou, Ohland Jessica, Mortensen Preben Bo, Werge Thomas, Nudel Ron, Wang Yunpeng, Hougaard David M, Plessen Kerstin Jessica, Bliksted Vibeke, Jepsen Jens Richardt Møllegaard, Thorup Anne A E, Mors Ole, Nordentoft Merete
CORE - Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. sal., 2900 Hellerup, Denmark.
Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 København N., Denmark.
Schizophr Bull Open. 2022 Jan 27;3(1):sgac010. doi: 10.1093/schizbullopen/sgac010. eCollection 2022 Jan.
Children with familial high-risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) are frequently affected in a range of domains known to be precursors of severe mental illness. No previous studies have gathered known precursors to examine whether they distribute evenly across familial high risk (FHR) children or if they cluster among a smaller group. Since such examination holds the potential to identify high and low risk of severe mental illness groups, we aimed to cluster FHR and control children affected to various degrees.
In The Danish High Risk and Resilience Study VIA 7, a clinical cohort study, 514 7-year-old children with FHR-SZ or FHR-BP and matched controls were assessed in domains of motor function, neurocognition, emotional control, behavior, social cognition, self-perception, language, psychotic experiences, and psychopathology, and grouped using cluster analysis. Associations between clusters and parents' level of education, functioning, caregiver status, child's level of stimulation and support in the home, and polygenic risk scores were examined.
A total of four groups including one of broadly affected children were identified. The broadly affected group was represented 4-5-fold (18.1%) amongst FHR-SZ children and 2-3-fold (10.2%) amongst FHR-BP children, compared to controls (4.1%) ( < .001), and the broadly affected group had lower levels of caregiver functioning ( < .001) and stimulation and support at home ( < .001).
Precursors of severe mental illness distribute unevenly among FHR children; while approximately half are not affected in any domains, the other half are affected to various degrees. Targeted support towards the affected groups is indicated.
患有精神分裂症家族高风险（FHR-SZ）或双相情感障碍（FHR-BP）的儿童在一系列已知为严重精神疾病先兆的领域中经常受到影响。以前没有研究收集过已知的先兆来检查它们是否在家族高风险（FHR）儿童中均匀分布，或者它们是否聚集在较小的群体中。由于这种检查有可能识别出严重精神疾病的高风险和低风险群体，我们旨在对受不同程度影响的FHR儿童和对照儿童进行聚类。
在丹麦高风险与复原力研究VIA 7（一项临床队列研究）中，对514名患有FHR-SZ或FHR-BP的7岁儿童及匹配的对照儿童在运动功能、神经认知、情绪控制、行为、社会认知、自我认知、语言、精神病体验和精神病理学等领域进行评估，并使用聚类分析进行分组。研究了聚类与父母教育水平、功能、照顾者状态、儿童在家中受到的刺激和支持水平以及多基因风险评分之间的关联。
共识别出四组，其中包括一组广泛受影响的儿童。与对照组（4.1%）相比，广泛受影响的组在FHR-SZ儿童中占比高4-5倍（18.1%），在FHR-BP儿童中占比高2-3倍（10.2%）（P<0.001），且该组照顾者功能水平较低（P<0.001），在家中受到的刺激和支持也较少（P<0.001）。
严重精神疾病的先兆在FHR儿童中分布不均；约一半儿童在任何领域均未受影响，另一半则受到不同程度的影响。需要对受影响群体提供有针对性的支持。
