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Abstract
ObjectiveNeurocognitive dysfunctions analogous to those of adult patients have been detected in children at risk of schizophrenia and bipolar disorder. This led to the following developmental question: Do IQ and memory impairments exhibit different developmental courses from childhood to young adulthood in terms of stability or fluctuations?MethodsIn a high risk sample, we used a step by step sampling approach to narrow-down the early disease mechanisms. Upstream, we started with a 20-year follow-up of 48 densely affected multigenerational kindreds, including 1500 clinically characterized adult members. We then identified 400 adult members affected by a DSM-IV schizophrenia or bipolar disorder. Downstream, we finally focused on 65 offspring (of an affected parent) aged 7 to 22, who were administered a neuropsychological battery. We then constructed cross-sectional trajectories that were compared to those of controls.ResultsThe childhood IQ deficit displayed a stability until young adulthood. The delay in visual memory exhibited a non-linear two-stage trajectory: a lagging period during childhood followed by a recuperation period from adolescence until adulthood, as supported by a significant Group x Age Periods interaction. No data suggested deterioration between 7 and 22.ConclusionIn these offspring at genetic risk, the developmental trajectory of global IQ impairment may not apply to specific domains of cognition such as episodic memory. Different cognitive dysfunctions would mark different developmental courses. The shape of the trajectories might itself have a meaning and provide empirical leads for targeting the right dysfunction at the right time in future prevention research.
Highlights
Neuropsychological deficits have been documented in schizophrenia and may be at the core of pathological processes
A first observation was a moderate delay at 7–12 years for the two tests (Effect Size; Effect sizes (ES) = 2.66 and 2.52 respectively for RCFTIR and RCFTDR) which tended to increase in young adolescence (ES = 21.52 and 21.53)
The second observation for visual memory was that the difference between groups decreased from their peak during adolescence to young adulthood for the two tests ending closer to normal controls
Summary
Neuropsychological deficits have been documented in schizophrenia and may be at the core of pathological processes. Patients with schizophrenia have pronounced impairments in general intelligence level (IQ), verbal memory and processing speed, with large effect sizes of 1.0 and higher [1,2,3,4,5,6,7]. Cognitive deficits precede the appearance of adult disease [8] and children or adolescents (from 3 to 21 years old) who develop schizophrenia usually present a deficit of 5–9 points in global IQ [9,10,11,12]. Many studies confirmed a further decline of 5–8 points of IQ in adult schizophrenic patients who have a IQ impairment that is around twice as large as that in childhood [13,14]. Most of the longitudinal studies on cognitive impairments were centered on IQ [15,16] and few studies measured other cognitive domains such as memory [17,18,19]
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