© 2000 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Childhood Cognitive Functioning in Schizophrenia Patients and Their Unaffected Siblings: A Prospective Cohort Study
Department of Psychology, University of California Los Angeles, CA
Department of Psychiatry, University of Pennsylvania Philadelphia, PA
Department of Psychiatry, University of Pennsylvania Philadelphia, PA
Professor of Psychology in Psychiatry and Chief of the Center for Mental Health Policy Research, Department of Psychiatry, University of Pennsylvania Philadelphia, PA
Department of Psychiatry, University of Utrecht Utrecht, The Netherlands
Department of Psychology, University of Pennsylvania
Reprint requests should be sent to Prof. T.D. Cannon, University of California, Los Angeles, Dept. of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095–1563; e-mail: cannon{at}psych.ucla.edu
While it is known that children of schizophrenia parents perform more poorly on tests of cognitive functioning than children of normal parents, less certain is the degree to which such deficits predict schizophrenia outcome, whether cognitive functioning deteriorates during childhood in preschizophrenia individuals, and whether nongenetic etiologic factors (such as obstetric complications) contribute to these deficits. In the present study, 72 patients with schizophrenia or schizoaffective disorder, 63 of their siblings not diagnosed with schizophrenia, and 7,941 controls with no diagnosis were ascertained from a birth cohort whose members had been evaluated with standardized tests of cognitive functioning at 4 and 7 years of age. Adult psychiatric morbidity was ascertained via a longitudinal treatment data base indexing regional public health service utilization, and diagnoses were made by review of all pertinent medical records according to DSM-IV criteria. Both the patients with schizophrenia and their unaffected siblings performed significantly worse than the nonpsychiatric controls (but did not differ from each other) on verbal and nonverbal cognitive tests at 4 and 7 years of age. Preschizophrenia cases and their siblings were increasingly overrepresented across decreasing quartiles of the performance distributions. There was not significant intra-individual decline, and there were no significant relationships between obstetric complications and test performance among the preschizophrenia subjects. These results suggest that during the period from age 4 to age 7 years, premorbid cognitive dysfunction in schizophrenia represents a relatively stable indicator of vulnerability deriving from primarily genetic (and/or shared environmental) etiologic influences.
Keywords: Schizophrenia / cognition / premorbid functioning / genetics
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