Abstract
BackgroundSevere mental illnesses like schizophrenia and bipolar disorder are known to be diseases that to some extent, but not entirely can be understood genetically. The dominating hypothesis is that these disorders should be understood in a neurodevelopmental perspective where genes and environment as well as gene-environment-interactions contribute to the risk of developing the disease. We aim to analyse the influences of genetic risk and environmental factors in a population of 520 7-year-old children with either 0, 1 or 2 parents diagnosed with schizophrenia spectrum psychosis or bipolar disorder on mental health and level of functioning. We hypothesize that a larger proportion of children growing up with an ill parent will display abnormal or delayed development, behavioural problems or psychiatric symptoms compared to the healthy controls.Methods/designWe are establishing a cohort of 520 7-year-old children and both their parents for a comprehensive investigation with main outcome measures being neurocognition, behaviour, psychopathology and neuromotor development of the child. Parents and children are examined with a comprehensive battery of instruments and are asked for genetic material (saliva or blood) for genetic analyses. The participants are recruited via Danish registers to ensure representativity. Data from registers concerning social status, birth complications, somatic illnesses and hospitalization are included in the database. Psychological and relational factors like emotional climate in the family, degree of stimulation and support in the home and attachment style are also investigated.DiscussionData collection started January 1, 2013, and is successfully ongoing. By Aug 2015 424 families are included. About 20 % of the invited families decline to participate, equal for all groups.
Highlights
Schizophrenia and bipolar disorder are among the most severe and disabling mental disorders, influencing both patients, relatives and society [1]
The aims of the Danish High Risk and Resilience Study-VIA 7 are: 1) to analyse the influences of familial risk and environmental factors, including rearing conditions in childhood among a population of 7-year-old children with either 0, 1 or 2 parents diagnosed with schizophrenia spectrum psychosis or bipolar disorder, especially focusing on psychopathology, cognition, neuromotor, and psychosocial development; 2) to identify early risk markers of schizophrenia and bipolar disorder to establish a basis for future primary preventive interventions in the premorbid phase; 3) to get an overview of the kind and the intensity of help and support that the families have received from the community from the time when the child was born until the age of 7
Optimal designs for investigating gene-environment interactions The high risk approach Theoretically, optimal designs for investigating interaction between environmental and genetic risk factors in childhood and adolescence with respect to development of schizophrenia or bipolar disorder, would be randomized clinical studies with the individuals being exposed to poor environmental conditions, or adoption or twin studies
Summary
Schizophrenia and bipolar disorder are among the most severe and disabling mental disorders, influencing both patients, relatives and society [1]. It has recently been shown that mental diseases like schizophrenia, major depression and bipolar disorder may be quite closely related genetically, meaning that there is a considerable genetic overlap between the three different diagnoses [2]. We aim to analyse the influences of genetic risk and environmental factors in a population of 520 7-year-old children with either 0, 1 or 2 parents diagnosed with schizophrenia spectrum psychosis or bipolar disorder on mental health and level of functioning. One of its major contributions was to show that schizophrenia was at least partly familial It was one of the first studies to show the specific impairments in these children at high risk in domains of e.g. neuromotor development, behaviour, cognition and emotional problems [9, 10]. They may have been quite severely ill and impaired by their psychotic symptoms in the early years of the children’s lives
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