Intellectual functioning in schizophrenia: a marker of neurodevelopmental damage?

MacCabe, James H.; Murray, Robin M.

doi:10.1111/j.1365-2788.2004.00619.x

Cited by 16 publications

(11 citation statements)

References 36 publications

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“…The results showed that the presence of schizophrenia spectrum disorders was associated with lower intellectual functioning, whereas anxiety and mood disorders were not. This is consistent with findings from the general population showing that schizophrenia spectrum disorders are associated with broad cognitive impairments (59). …”

Section: Discussionsupporting

confidence: 92%

Psychiatric Disorders From Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results From the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome

Schneider

Debbané

Bassett

et al. 2014

AJP

700

740

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Objective Chromosome 22q11.2 deletion syndrome is a neurogenetic disorder associated with high rates of schizophrenia and other psychiatric conditions. The authors report what is to their knowledge the first large-scale collaborative study of rates and sex distributions of psychiatric disorders from childhood to adulthood in 22q11.2 deletion syndrome. The associations among psychopathology, intellect, and functioning were examined in a subgroup of participants. Method The 1,402 participants with 22q11.2 deletion syndrome, ages 6–68 years, were assessed for psychiatric disorders with validated diagnostic instruments. Data on intelligence and adaptive functioning were available for 183 participants ages 6 to 24 years. Results Attention deficit hyperactivity disorder (ADHD) was the most frequent disorder in children (37.10%) and was overrepresented in males. Anxiety disorders were more prevalent than mood disorders at all ages, but especially in children and adolescents. Anxiety and unipolar mood disorders were overrepresented in females. Psychotic disorders were present in 41% of adults over age 25. Males did not predominate in psychotic or autism spectrum disorders. Hierarchical regressions in the subgroup revealed that daily living skills were predicted by the presence of anxiety disorders. Psychopathology was not associated with communication or socialization skills. Conclusions To the authors' knowledge, this is the largest study of psychiatric morbidity in 22q11.2 deletion syndrome. It validates previous findings that this condition is one of the strongest risk factors for psychosis. Anxiety and developmental disorders were also prevalent. These results highlight the need to monitor and reduce the long-term burden of psychopathology in 22q11.2 deletion syndrome.

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Section: Discussionsupporting

confidence: 92%

Psychiatric Disorders From Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results From the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome

Schneider

Debbané

Bassett

et al. 2014

AJP

700

740

View full text Add to dashboard Cite

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“…The first and most commonly argued explanation is that the premorbid cognitive deficits in schizophrenia are a result of neurodevelopmental impairment. 7,8 The second suggestion is that the association between poor cognitive functioning and schizophrenia may be driven by socioeconomic factors: evidence for this includes the association of social factors with the risk for schizophrenia (urban birth, 9 migration, 10 and low socioeconomic status 11 ) and the observation that poor cognitive or educational performance in childhood has associations with a wide range of adult outcomes that are likely mediated by social processes such as cardiovascular disease and stroke, 12 premature mortality, 13 and nonpsychotic mental disorders. 14 The third suggestion is that the premorbid deficits in IQ found in schizophrenia reflect prodromal, rather than neurodevelopmental, processes.…”

mentioning

confidence: 99%

Decline in Cognitive Performance Between Ages 13 and 18 Years and the Risk for Psychosis in Adulthood

MacCabe¹,

Wicks²,

Löfving³

et al. 2013

JAMA Psychiatry

105

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“…Disruptive mood dysregulation disorder, proposed as an alternative diagnosis for these children, is problematic in that explosive temper is defined by frequency rather than severity of outbursts and it is difficult to define "mood between outbursts" (Galanter et al 2012). Moreover, it is not at all clear whether adding a comorbid diagnosis is more helpful than considering explosive temper and mood lability as subtype of ADHD denoted by a diagnostic specifier-coming full circle as it were and supported by convergent evidence that childhood ADHD is associated with psychotic and neurodevelopmental disorders (Hamshere et al 2013a;MacCabe and Murray 2004;Murray et al 2004). Nevertheless, this journey has been helpful in underscoring the importance of a comprehensive clinical assessment, which as in other areas of medicine should include collecting collateral history from multiple sources, distinguishing illness episodes from baseline functioning, and assessing symptoms in the context of the developmental history, family history, clinical course, treatment response and psychosocial context (Duffy et al 2018a).…”

Section: Discussionmentioning

confidence: 99%

Pre-pubertal bipolar disorder: origins and current status of the controversy

Duffy

Carlson

Dubicka

et al. 2020

Int J Bipolar Disord

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Background: Evidence from epidemiological, clinical and high-risk studies has established that the peak period of risk for onset of bipolar disorder spans late adolescence and early adulthood. However, the proposal of the existence of a pre-pubertal form of bipolar disorder manifesting in early childhood created substantial debate. In this narrative review, the literature and contributing factors pertaining to the controversy surrounding the proposed pre-pubertal bipolar disorder subtype are discussed. The resolution of the debate and lessons learned are highlighted. Main body: In the mid 1990s US researchers proposed that chronic irritability and explosive temper in pre-pubertal children with pre-existing ADHD and/or other learning and developmental disorders might represent a variant of mania. A number of factors contributed to this proposal including severely ill children with no diagnostic home given changes in the ADHD DSM diagnostic criteria and over-reliance on symptoms and structured interviews rather than on a clinical assessment incorporating developmental history, social context and clinical course. Prospective studies of children at high familial risk did not support the proposed pre-pubertal bipolar phenotype; but rather provided convergent evidence that bipolar disorder onset in adolescence and early adulthood not uncommonly preceded by sleep and internalizing symptoms and most often debuting as depression in adolescence (after puberty). Epidemiological studies of population and hospital discharge data provided evidence that the pre-pubertal bipolar phenotype was largely a US driven phenomenon. Conclusions: Psychiatric diagnosis is particularly challenging given the current lack of objective biomarkers. However, validity and utility of clinical diagnoses can be strengthened if all available predictive information is used to formulate a diagnosis. As in other areas of medicine, critical information required to make a valid diagnosis includes developmental history, clinical course, family history and treatment response-weighed against the known trajectories of classical disorders. Moreover, given that psychiatric disorders are in evolution over childhood and adolescence and symptoms, in of themselves, are often non-specific, a thorough clinical assessment incorporating collateral history and psychosocial context is paramount. Such an approach might have avoided or at least brought a more timely resolution to the debate on pre-pubertal mania.

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Intellectual functioning in schizophrenia: a marker of neurodevelopmental damage?

Cited by 16 publications

References 36 publications

Psychiatric Disorders From Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results From the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome

Psychiatric Disorders From Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results From the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome

Decline in Cognitive Performance Between Ages 13 and 18 Years and the Risk for Psychosis in Adulthood

Pre-pubertal bipolar disorder: origins and current status of the controversy

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