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Cognitive reserve and its correlates in child and adolescent offspring of patients diagnosed with schizophrenia or bipolar disorder

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Abstract

Aim

To analyze cognitive reserve (CR) in child and adolescent offspring of patients diagnosed with schizophrenia (SZ-off) or bipolar disorder (BD-off) and compare them with a group of community controls (CC-off). We also aimed to investigate whether there was an association between CR and clinical and neuropsychological variables according to group.

Methods

The study included 46 SZ-off, 105 BD-off and 102 CC-off. All participants completed assessments regarding CR and clinical, neuropsychological and psychosocial functioning. CR was measured with a proxy based on premorbid intelligence, parental occupational level, educational attainment, developmental milestones and sociability. The clinical assessment included the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime, the Semi-structured Interview for Prodromal Syndromes, and the Global Assessment Functioning scale. The neuropsychological assessment included measures of executive functioning, attention, verbal memory, working memory and processing speed.

Results

SZ-off showed a lower level of CR compared to BD-off and CC-off, while BD-off showed an intermediate level of CR between SZ-off and CC-off. Moreover, an association between higher CR and less lifetime psychopathology, fewer prodromal psychotic symptoms, higher psychosocial functioning, and a higher working memory score was observed in all groups, but it was stronger in SZ-off.

Conclusions

CR seemed to be associated with psychopathology, clinical symptoms, psychosocial functioning, and some cognitive functions. SZ-off appeared to benefit more from a higher CR, therefore it could be considered a protective factor against the development of clinical symptomatology and cognitive impairment.

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Availability of data and material

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

The authors of this report would like to thank the following organizations for their kind support: the Instituto de Salud Carlos III (INT19/0021), the Catalonia Government, the ERDF Funds from the European Commission, “A way of making Europe” and CIBERSAM. The authors would also like to thank the families who participated in this study.

Funding

This study was supported by the Spanish Ministry of Health, Instituto de Salud Carlos III (INT19/0021; PI070066; PI1100683; PI151500467; PI17/00741; PI18/00696), Fundació Marato TV3 (091630), the Catalonia Government (2017SGR881), PERIS (SLT006/17/00346), co-financed by ERDF Funds from the European Commission, “A way of making Europe”, CIBERSAM. GS has received funding from the Instituto de Salud Carlos III—Fondos FEDER "una manera de hacer Europa" (PI1800976), the Fundació Clínic Recerca Biomèdica (Ajut a la Recerca Pons Bartran 2018) and the Alicia Koplowitz Foundation (AKOPLOWITZ20_004). CT is funded by the Spanish Ministry of Economy and Competitiveness, ISCIII, through a ‘Miguel Servet’ postdoctoral contract (CPI14/00175) and a Miguel Servet II (CPII19/00018). These institutions had no further role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

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Author notes

  1. Josefina Castro-Fornieles and Elena de la Serna contributed equally to this work.

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170., 08036, Barcelona, Spain

    Patricia Camprodon-Boadas, Gisela Sugranyes, Inmaculada Baeza, Daniel Ilzarbe, Josefina Castro-Fornieles & Elena de la Serna

  2. Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain

    Patricia Camprodon-Boadas, Roger Borras & Clemente García-Rizo

  3. Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain

    Gisela Sugranyes, Dolores Moreno, Inmaculada Baeza, Clemente García-Rizo, Carla Torrent, Josefina Castro-Fornieles & Elena de la Serna

  4. Institut d´Investigació Biomèdica August Pi iSunyer, IDIBAPS, Barcelona, Spain

    Mireia Rosa-Justicia, Gisela Sugranyes, Inmaculada Baeza, Daniel Ilzarbe, Carla Torrent & Josefina Castro-Fornieles

  5. Department of Medicine, University of Barcelona, Barcelona, Spain

    Patricia Camprodon-Boadas, Inmaculada Baeza, Daniel Ilzarbe, Carla Torrent & Josefina Castro-Fornieles

  6. Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain

    Dolores Moreno, Covadonga Martínez Díaz-Caneja, Mirian Ayora, Jessica Merchan & Nuria Martín

  7. Barcelona Bipolar and Depressive Unit, Institute of Neurosciences, Barcelona, Spain

    Carla Torrent

  8. Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic, Barcelona, Spain

    Clemente García-Rizo

  9. Department of Child and Adolescent Psychiatry, Hospital Universitario Sureste, Madrid, Spain

    Dolores Moreno

Authors
  1. Patricia Camprodon-Boadas
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  2. Mireia Rosa-Justicia
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  3. Gisela Sugranyes
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  6. Daniel Ilzarbe
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  7. Covadonga Martínez Díaz-Caneja
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  14. Josefina Castro-Fornieles
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  15. Elena de la Serna
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Contributions

ES, JC, IB, GS and DM designed the study and wrote the protocol. PC, DI, MR, DM, CM, MA, JM and NM collected data. CT and CG identified patients with SZ or BD in adult psychiatry units who had child or adolescent offspring. PC managed the literature searches. ES, PC and RB undertook statistical analysis. PC wrote the first draft of the manuscript. JC and ES contributed to earlier versions of the manuscript. All authors contributed to and have approved the final version of the manuscript.

Corresponding author

Correspondence to Elena de la Serna.

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Conflict of interest

Dr. Baeza has received honoraria or travel support to attend conferences from Angelini, Janssen and Otsuka-Lundbeck. Dr. Sugranyes has received funding from the Fundació Clínic Recerca Biomèdica (Ajut a la Recerca Pons Bartran), the Brain and Behaviour Research Foundation (NARSAD Young Investigator Award NARSAD17_YIG_02B), the Spanish Ministry of Health, Instituto de Salud Carlos III «Health Research Fund» fondos FEDER “Otra manera de hacer Europa” (PI18/00976), and the Alicia Koplowitz Foundation (AKOPLOWITZ20_004). The other authors do not report conflicts of interest.

Ethics approval

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant institutional committee on human experimentation and with Helsinki Declaration of 1964 and its later amendments.

Consent to participate

Informed consent to participate in the study was obtained from all participants (or their parent or legal guardian in the case of children under 12).

Consent for publication

Not applicable.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 141 KB)

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Camprodon-Boadas, P., Rosa-Justicia, M., Sugranyes, G. et al. Cognitive reserve and its correlates in child and adolescent offspring of patients diagnosed with schizophrenia or bipolar disorder. Eur Child Adolesc Psychiatry 32, 1463–1473 (2023). https://doi.org/10.1007/s00787-022-01957-0

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