Executive functions in 7-year-old children of parents with schizophrenia or bipolar disorder compared with controls: The Danish High Risk and Resilience Study—VIA 7, a population-based cohort study

2020 ◽  
Author(s):  
Katrine Søborg Spang ◽  
Ditte Ellersgaard ◽  
Nicoline Hemager ◽  
Camilla Jerlang Christiani ◽  
Birgitte Klee Burton ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
High Risk ◽  
Executive Functions ◽  
Population Based ◽  
Risk And Resilience

scholarly journals Critical Predictors for the Early Detection of Conversion From Unipolar Major Depressive Disorder to Bipolar Disorder: Nationwide Population-Based Retrospective Cohort Study (Preprint)

2019 ◽  
Author(s):  
Ya-Han Hu ◽  
Kuanchin Chen ◽  
I-Chiu Chang ◽  
Cheng-Che Shen
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Cohort Study ◽  
High Risk ◽  
Retrospective Cohort ◽  
Risk Group ◽  
Population Based ◽  
Major Depressive ◽  
Risk Stratification Model

BACKGROUND Unipolar major depressive disorder (MDD) and bipolar disorder are two major mood disorders. The two disorders have different treatment strategies and prognoses. However, bipolar disorder may begin with depression and could be diagnosed as MDD in the initial stage, which may later contribute to treatment failure. Previous studies indicated that a high proportion of patients diagnosed with MDD will develop bipolar disorder over time. This kind of hidden bipolar disorder may contribute to the treatment resistance observed in patients with MDD. OBJECTIVE In this population-based study, our aim was to investigate the rate and risk factors of a diagnostic change from unipolar MDD to bipolar disorder during a 10-year follow-up. Furthermore, a risk stratification model was developed for MDD-to-bipolar disorder conversion. METHODS We conducted a retrospective cohort study involving patients who were newly diagnosed with MDD between January 1, 2000, and December 31, 2004, by using the Taiwan National Health Insurance Research Database. All patients with depression were observed until (1) diagnosis of bipolar disorder by a psychiatrist, (2) death, or (3) December 31, 2013. All patients with depression were divided into the following two groups, according to whether bipolar disorder was diagnosed during the follow-up period: converted group and nonconverted group. Six groups of variables within the first 6 months of enrollment, including personal characteristics, physical comorbidities, psychiatric comorbidities, health care usage behaviors, disorder severity, and psychotropic use, were extracted and were included in a classification and regression tree (CART) analysis to generate a risk stratification model for MDD-to-bipolar disorder conversion. RESULTS Our study enrolled 2820 patients with MDD. During the follow-up period, 536 patients were diagnosed with bipolar disorder (conversion rate=19.0%). The CART method identified five variables (kinds of antipsychotics used within the first 6 months of enrollment, kinds of antidepressants used within the first 6 months of enrollment, total psychiatric outpatient visits, kinds of benzodiazepines used within one visit, and use of mood stabilizers) as significant predictors of the risk of bipolar disorder conversion. This risk CART was able to stratify patients into high-, medium-, and low-risk groups with regard to bipolar disorder conversion. In the high-risk group, 61.5%-100% of patients with depression eventually developed bipolar disorder. On the other hand, in the low-risk group, only 6.4%-14.3% of patients with depression developed bipolar disorder. CONCLUSIONS The CART method identified five variables as significant predictors of bipolar disorder conversion. In a simple two- to four-step process, these variables permit the identification of patients with low, intermediate, or high risk of bipolar disorder conversion. The developed model can be applied to routine clinical practice for the early diagnosis of bipolar disorder.

scholarly journals The Danish High Risk and Resilience Study – VIA 7 - a cohort study of 520 7-year-old children born of parents diagnosed with either schizophrenia, bipolar disorder or neither of these two mental disorders

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Anne A. E. Thorup ◽  
Jens Richardt Jepsen ◽  
Ditte Vestbjerg Ellersgaard ◽  
Birgitte Klee Burton ◽  
Camilla Jerlang Christiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
High Risk ◽  
Mental Disorders ◽  
Risk And Resilience

scholarly journals Critical Predictors for the Early Detection of Conversion From Unipolar Major Depressive Disorder to Bipolar Disorder: Nationwide Population-Based Retrospective Cohort Study

10.2196/14278 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e14278 ◽  
Author(s):  
Ya-Han Hu ◽  
Kuanchin Chen ◽  
I-Chiu Chang ◽  
Cheng-Che Shen
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Cohort Study ◽  
High Risk ◽  
Retrospective Cohort ◽  
Risk Group ◽  
Population Based ◽  
Major Depressive ◽  
Risk Stratification Model

Background Unipolar major depressive disorder (MDD) and bipolar disorder are two major mood disorders. The two disorders have different treatment strategies and prognoses. However, bipolar disorder may begin with depression and could be diagnosed as MDD in the initial stage, which may later contribute to treatment failure. Previous studies indicated that a high proportion of patients diagnosed with MDD will develop bipolar disorder over time. This kind of hidden bipolar disorder may contribute to the treatment resistance observed in patients with MDD. Objective In this population-based study, our aim was to investigate the rate and risk factors of a diagnostic change from unipolar MDD to bipolar disorder during a 10-year follow-up. Furthermore, a risk stratification model was developed for MDD-to-bipolar disorder conversion. Methods We conducted a retrospective cohort study involving patients who were newly diagnosed with MDD between January 1, 2000, and December 31, 2004, by using the Taiwan National Health Insurance Research Database. All patients with depression were observed until (1) diagnosis of bipolar disorder by a psychiatrist, (2) death, or (3) December 31, 2013. All patients with depression were divided into the following two groups, according to whether bipolar disorder was diagnosed during the follow-up period: converted group and nonconverted group. Six groups of variables within the first 6 months of enrollment, including personal characteristics, physical comorbidities, psychiatric comorbidities, health care usage behaviors, disorder severity, and psychotropic use, were extracted and were included in a classification and regression tree (CART) analysis to generate a risk stratification model for MDD-to-bipolar disorder conversion. Results Our study enrolled 2820 patients with MDD. During the follow-up period, 536 patients were diagnosed with bipolar disorder (conversion rate=19.0%). The CART method identified five variables (kinds of antipsychotics used within the first 6 months of enrollment, kinds of antidepressants used within the first 6 months of enrollment, total psychiatric outpatient visits, kinds of benzodiazepines used within one visit, and use of mood stabilizers) as significant predictors of the risk of bipolar disorder conversion. This risk CART was able to stratify patients into high-, medium-, and low-risk groups with regard to bipolar disorder conversion. In the high-risk group, 61.5%-100% of patients with depression eventually developed bipolar disorder. On the other hand, in the low-risk group, only 6.4%-14.3% of patients with depression developed bipolar disorder. Conclusions The CART method identified five variables as significant predictors of bipolar disorder conversion. In a simple two- to four-step process, these variables permit the identification of patients with low, intermediate, or high risk of bipolar disorder conversion. The developed model can be applied to routine clinical practice for the early diagnosis of bipolar disorder.

Home environment of 11-year-old children born to parents with schizophrenia or bipolar disorder – a controlled, 4-year follow-up study: The Danish High Risk and Resilience Study – VIA 11

2021 ◽  
pp. 1-11
Author(s):  
Mette Falkenberg Krantz ◽  
Carsten Hjorthøj ◽  
Julie Marie Brandt ◽  
Åsa Kremer Prøsch ◽  
Sinnika Birkehøj Rohd ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Home Environment ◽  
Population Based ◽  
Risk And Resilience ◽  
Health Issues ◽  
Follow Up Study ◽  
Home Stimulation ◽  
At Home

Abstract Background The home environment has a major impact on child development. Parental severe mental illness can pose a challenge to the home environment of a child. We aimed to examine the home environment of children of parents with schizophrenia or bipolar disorder and controls longitudinally through at-home assessments. Methods Assessments were conducted within The Danish High Risk and Resilience Study, a nationwide multi-center cohort study of children of parents with schizophrenia or bipolar disorder and population-based controls. The level of at-home stimulation and support was measured at age 7 (N = 508 children) and age 11 (N = 430 children) with the semi-structured HOME Inventory. Results from the 11-year follow-up study were analyzed and compared with 7-year baseline results to examine change across groups. Results At age 11, children of parents with schizophrenia and bipolar disorder had lower levels of stimulation and support than controls (mean (s.d.) = 46.16 (5.56), 46.87 (5.34) and 49.25 (4.37) respectively, p < 0.001). A higher proportion of children with parental schizophrenia or bipolar disorder lived in inadequate home environments at age 11, compared with controls (N (%) = 24 (15.0), 12 (12.2) and 6 (3.5) respectively, p < 0.003). The changes in home environment scores did not differ across groups from age 7 to age 11. Conclusions Assessed longitudinally from the children's age of 7 to 11, children of parents with schizophrenia or bipolar disorder had lower levels of stimulation and support in their homes than controls. Integrated support which can target practical, economic, social and health issues to improve the home environment is indicated.

Poster #S151 NEUROCOGNITIVE PROFILES IN 7-YEAR-OLD OFFSPRING OF PARENTS WITH SCHIZOPHRENIA OR BIPOLAR DISORDER. PART OF THE HIGH RISK AND RESILIENCE STUDY – VIA 7

2014 ◽  
Vol 153 ◽  
pp. S143-S144
Author(s):  
Nicoline Hemager ◽  
Jens Richardt Møllegaard Jepsen ◽  
Anne Amalie Elgaard Thorup ◽  
Camilla Austa Jerlang Christiani ◽  
Aja Neergaard Greve ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Risk And Resilience ◽  
Neurocognitive Profiles

scholarly journals Social Cognition, Language, and Social Behavior in 7-Year-Old Children at Familial High-Risk of Developing Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7—A Population-Based Cohort Study

2019 ◽  
Vol 45 (6) ◽  
pp. 1218-1230 ◽  
Author(s):  
Camilla Jerlang Christiani ◽  
Jens R M Jepsen ◽  
Anne Thorup ◽  
Nicoline Hemager ◽  
Ditte Ellersgaard ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Social Cognition ◽  
Social Behavior ◽  
High Risk ◽  
Social Functioning ◽  
Population Based ◽  
Social Responsiveness ◽  
Developmental Phase ◽  
Bonferroni Correction ◽  
Familial High Risk

Abstract Objective To characterize social cognition, language, and social behavior as potentially shared vulnerability markers in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP). Methods The Danish High-Risk and Resilience Study VIA7 is a multisite population-based cohort of 522 7-year-old children extracted from the Danish registries. The population-based controls were matched to the FHR-SZ children on age, sex, and municipality. The FHR-BP group followed same inclusion criteria. Data were collected blinded to familial high-risk status. Outcomes were social cognition, language, and social behavior. Results The analysis included 202 FHR-SZ children (girls: 46%), 120 FHR-BP children (girls: 46.7%), and 200 controls (girls: 46.5%). FHR-SZ children displayed significant deficits in language (receptive: d = −0.27, P = .006; pragmatic: d = −0.51, P < .001), social responsiveness (d = −0.54, P < .001), and adaptive social functioning (d = −0.47, P < .001) compared to controls after Bonferroni correction. Compared to FHR-BP children, FHR-SZ children performed significantly poorer on adaptive social functioning (d = −0.29, P = .007) after Bonferroni correction. FHR-BP and FHR-SZ children showed no significant social cognitive impairments compared to controls after Bonferroni correction. Conclusion Language, social responsiveness, and adaptive social functioning deficits seem associated with FHR-SZ but not FHR-BP in this developmental phase. The pattern of results suggests adaptive social functioning impairments may not be shared between FHR-BP and FHR-SZ in this developmental phase and thus not reflective of the shared risk factors for schizophrenia and bipolar disorder.

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