Bipolar (BD) and schizophrenia (SCZ) share many elements including age of onset, family history patterns, and premorbid symptomology. Individuals who develop bipolar psychosis (BP) have even more in common with those who develop SCZ. However, until recently, few studies have examined how cognitive impairment in childhood/adolescence differs between individuals who later develop SCZ compared to those who go on to develop BP and BD. To examine these early risk factors in more depth, Larry J. Seidman of the Department of Psychiatry at Harvard Medical School in Massachusetts recently conducted a study using data from 99 individuals with either BP or SCZ, and data from 101 nonpsychotic control participants. He assessed their IQs and cognitive abilities with data from school tests when they were seven years old and also looked at family history to determine its influence on future psychosis.
Seidman discovered that although BD, BP, and SCZ all shared some early risk factors, the participants with SCZ had more severe cognitive impairments and memory and attention deficits in childhood than the BD or BP participants. Family history significantly increased the risk for psychosis in all of the participants, but most in those who developed SCZ. The participants with BD had the lowest levels of cognitive impairment and academic difficulties in childhood, followed closely by those who later developed BP. Seidman hopes that the results of this study will provide educators with pertinent information that can be used to identify children most at risk for future psychotic problems. He also feels that having this information could prevent children from being misdiagnosed with other issues that could mimic premorbid conditions, such as defiance issues or attention deficit hyperactivity (ADHD). In conclusion, Seidman said that children with neuropsychological impairments, especially those with a family history of psychosis, should be closely monitored and targeted for early identification of SCZ, BP, and even BD. He added, “Future work should assess genetic and environmental factors that explain this FH [family history] effect.”
Seidman, L. J., et al. (2013). Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies. Psychological Medicine 43.1 (2013): 119-31.ProQuest. Web.
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