Impact of psychotic symptoms on cognitive functioning in child and adolescent psychiatric inpatients with severe mood disorders

McCarthy, James B.; Weiss, Shira R.; Segovich, Kristin T.; Barbot, Baptiste

doi:10.1016/j.psychres.2016.07.049

Cited by 16 publications

(10 citation statements)

References 57 publications

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“…This is consistent with the observation that IQ deficits are greater in adults with schizophrenia SZ compared to adults with BD (Bora and Ozerdem, 2017), and that it is the severity rather than the profile of cognitive deficits that differentiates these two disorders in adulthood (Vöhringer et al, 2013). Furthermore, greater severity of IQ deficits in people with BD has been linked to the presence of psychotic symptoms (McCarthy et al, 2016;Tsitsipa and Fountoulakis, 2015), whilst individuals with BD who had a manic psychosis had higher SZ-PRS scores compared to those with BD and no history of psychosis (Markota et al, 2018). These studies, in conjunction with our findings, suggest that both cognitive deficits and presence of psychotic phenomena in people with BD are primarily driven by risk SNPs that are shared across BD and schizophreniaSZ.…”

Section: Interpreting Findings In the Context Of Previous Worksupporting

confidence: 87%

Investigating associations between genetic risk for bipolar disorder and cognitive functioning in childhood

Mistry

Escott‐Price

Florio

et al. 2019

Journal of Affective Disorders

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Introduction Identifying phenotypic manifestations of genetic risk for bipolar disorder (BD) in childhood could increase our understanding of aetiological mechanisms. Aims To examine whether BD genetic risk is associated with childhood (age 8 years) cognitive function. Methods Using data from the Avon Longitudinal Study of Parents and Children, we examined associations between polygenic risk scores for BD (BD-PRS) derived using Psychiatric Genomics Consortium summary data at p-thresholds (P T) 0.01 (primary) and 0.5 (secondary) and several cognitive domains (sample sizes 5,613 to 5,936). We also examined whether associations were due to SNPs that have shared risk effects on schizophrenia (SZ). 2 Results At P T 0.01, the BD-PRS was associated with poorer executive functioning (ß=-0.03, 95%CI-0.06,-0.01; p=0.013), and, more weakly with poorer processing speed (ß =-0.02, 95%CI-0.05, 0.02; p=0.075). Evidence of association with both poorer processing speed (p=0.016) and performance IQ (p=0.018) was stronger at P T 0.5. Associations with performance IQ and processing speed were primarily driven by genetic effects that are shared with schizophrenia SZ risk, but there was some evidence of bipolar-specific genetic effects on childhood executive functioning. Limitations The BD-PRS still explains only a small proportion of the variance for BD which will have reduced power to detect associations. Conclusions Genetic risk for BD manifests as impaired cognition in childhood, and this is driven by risk SNPs that are also shared with schizophrenia SZ genetic risk. Further elucidation of which cognitive domains are most affected by genetic risk for BD could help understanding of aetiology and improve prediction of BD.

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Section: Interpreting Findings In the Context Of Previous Worksupporting

confidence: 87%

Investigating associations between genetic risk for bipolar disorder and cognitive functioning in childhood

Mistry

Escott‐Price

Florio

et al. 2019

Journal of Affective Disorders

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“…Although we did not assess mechanisms by which psychosis negatively affects the course of BDP, psychosis has been associated with cognitive and biological changes in the brain. For example, BDP+ youths demonstrated lower IQs and greater working memory deficits than BDP− youths, and adults with BDP+ had diminished suppression of the P50 auditory evoked potential and higher dopamine‐2 receptors' density in the basal ganglia compared to BDP− . These findings may represent a common physiological mechanism associated with the vulnerability to psychosis in people with BD, and may suggest that the presence of psychosis in BD represents a unique subtype of the disorder .…”

Section: Discussionmentioning

confidence: 94%

“…For example, Hua and colleagues assessed 226 youths with BD, and showed that BDP+ youths had higher rates of comorbid psychopathology, family history of psychosis, and poorer overall functioning in multiple domains, than youths with BDP− . McCarthy and colleagues assessed the cognitive correlates of psychosis in 43 youths with BD, and showed that BDP+ youths have lower IQs and greater working memory deficits than BDP− youths . Caetano and colleagues showed that psychotic symptoms in youths with BD were associated with more suicidal ideation and plans and psychiatric hospitalizations .…”

Section: Discussionmentioning

confidence: 99%

“…4 McCarthy and colleagues assessed the cognitive correlates of psychosis in 43 youths with BD, and showed that BDP+ youths have lower IQs and greater working memory deficits than BDP− youths. 6 Caetano and colleagues showed that psychotic symptoms in youths with BD were associated with more suicidal ideation and plans and psychiatric hospitalizations. 8 Finally, although not consistently, the adult BD literature has also reported that the presence of psychosis in patients with BD is associated with poor course and outcome.…”

Section: Schizoaffective Disorder and Schizophreniamentioning

confidence: 99%

“…Three cross-sectional studies reported that, compared to BD youths without psychosis (BDP−), BDP+ youths showed significantly lower intelligence quotient (IQ), and more suicidal ideation, psychiatric hospitalizations, family history of anxiety disorders, and suicide attempts. [6][7][8] The only existing longitudinal study showed that, in comparison with BDP− youths, BDP+ youths had higher rates of comorbid psychopathology, family history of psychosis, and poorer overall functioning in multiple domains. 4 Based on these results, the authors suggested that BDP+ might be considered a separate subtype of BD.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal course and risk factors associated with psychosis in bipolar youths

et al. 2019

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Objectives To compare the longitudinal clinical course of youths with bipolar disorder (BD) spectrum with lifetime (past, intake, and/or follow‐up) psychosis (BDP+) to youths with BD without lifetime psychosis (BDP−). Also, to identify risk factors associated with increased risk of first onset of psychosis during prospective follow‐up. Method Bipolar disorder youths (BDP+ = 137, BDP− = 233), aged 7‐17 years old, were followed on average every 7 months for 11.7 years and were evaluated using standardized instruments. Data were analyzed using linear and generalized linear models for the full sample, as well as for youths who developed first period of psychosis (n = 55). Results After adjusting for confounders, BDP+ youths with one, and in particular ≥2 lifetime psychotic episodes, had higher rates and more severe mood and anxiety symptoms, higher rates of suicidality, psychiatric hospitalizations, and sexual/physical abuse, and poorer psychosocial functioning than BDP− youths. Even before the first onset of psychosis during follow‐up, BDP+ youths showed more psychopathology and had more family history of psychiatric illness than those who never developed psychosis. First‐onset psychosis was associated with low socioeconomic status (SES), living with one parent, bipolar disorder type one and type two, comorbid anxiety, history of hospitalizations, and family history of mania and suicidality. Conclusion BDP+ is associated with poor prognosis and worse clinical picture, even before the onset of psychosis, indicating the need for prompt identification and treatment of these youths. Studies aimed to treat acute symptoms of psychosis, as well as prevent the onset of psychosis, including risk factors amenable to change, are warranted.

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Psychological interventions for psychosis in adolescents

Datta

Daruvala

Kumar

2020

Cochrane Database of Systematic Reviews

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Impact of psychotic symptoms on cognitive functioning in child and adolescent psychiatric inpatients with severe mood disorders

Cited by 16 publications

References 57 publications

Investigating associations between genetic risk for bipolar disorder and cognitive functioning in childhood

Investigating associations between genetic risk for bipolar disorder and cognitive functioning in childhood

Longitudinal course and risk factors associated with psychosis in bipolar youths

Psychological interventions for psychosis in adolescents

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