2024
Depressive symptoms in youth before and during the covid-19 pandemic: longitudinal investigations of patterns dependent on age, sex, and family history of mental illness
2023
Depressive symptoms in youth before and during the covid-19 pandemic: longitudinal investigations of patterns dependent on age, sex, and family history of mental illness
The COVID-19 pandemic has brought with it growing concern about youth mental health. Many surveys have reported large increases in depressive symptoms during the pandemic with the highest increases being discussed in females. There are few studies that look at depressive symptoms before and during the pandemic among the same group of youth. Other studies have predicted that youth who have one or more parent living with mental illness may experience increased mental health difficulties during the pandemic. We wanted to know if depressive symptoms in youth have increased in youth and which youth may be experiencing the greatest increase.
To do this, we compared depressive symptoms before the pandemic and during the pandemic in FORBOW youth. Before the pandemic started, we had measured depressive symptoms in 412 youth aged 5-25 years old. We were then able to measure depressive symptoms again in 371 youth during the COVID-19 pandemic for a high follow-up rate of 90%.
We found a small overall increase in depressive symptoms among youth. The youth who experienced the largest increased in depressive symptoms were female youth who do not have a parent with mental illness. There was no change in depressive symptoms in male youth or youth who have one or more parents with mental illness.
Our results provide reassurance about the wellbeing of children of parents with mental illness during a period of restricted access to resources outside the family. The pandemic seems to have impacted youth in ways that were not expected leading to increased depressive symptoms in parts of the youth population that were previously considered to me at lower risk.
Howes Vallis, E., Stephens, M., Ross, B., Rempel, S., Howard, C., Liu, D., Villars, K., Mazurka, R., Cumby, J., Alda, M., Pavlova, B., Uher, R. (2023). Depressive Symptoms in Youth Before and During the COVID-19 Pandemic: Longitudinal Investigation of Patterns Dependent on Age, Sex, and Family History of Mental Illness. Psychological Medicine.
Click here for a link to the published article!
To do this, we compared depressive symptoms before the pandemic and during the pandemic in FORBOW youth. Before the pandemic started, we had measured depressive symptoms in 412 youth aged 5-25 years old. We were then able to measure depressive symptoms again in 371 youth during the COVID-19 pandemic for a high follow-up rate of 90%.
We found a small overall increase in depressive symptoms among youth. The youth who experienced the largest increased in depressive symptoms were female youth who do not have a parent with mental illness. There was no change in depressive symptoms in male youth or youth who have one or more parents with mental illness.
Our results provide reassurance about the wellbeing of children of parents with mental illness during a period of restricted access to resources outside the family. The pandemic seems to have impacted youth in ways that were not expected leading to increased depressive symptoms in parts of the youth population that were previously considered to me at lower risk.
Howes Vallis, E., Stephens, M., Ross, B., Rempel, S., Howard, C., Liu, D., Villars, K., Mazurka, R., Cumby, J., Alda, M., Pavlova, B., Uher, R. (2023). Depressive Symptoms in Youth Before and During the COVID-19 Pandemic: Longitudinal Investigation of Patterns Dependent on Age, Sex, and Family History of Mental Illness. Psychological Medicine.
Click here for a link to the published article!
will genetic test help predict mental health and illness?
Mental illness runs in families. The best available method to estimate an individual’s risk of mental illness is to look at their family history. However, family history information is limited, and it is not always known in full. It is also possible to estimate genetic predisposition to mental illness and other traits using polygenic scores. We calculated polygenic scores from blood and saliva samples from participants in our studies. We wanted to know if polygenic scores could help us identify which youth are at higher risk of developing mental illness.
We included data from 1884 youth participants from 8 studies from across the world, including 1339 offspring of parents with mood or psychotic disorders. We looked at whether polygenic scores could improve the prediction of mental illness among youth over family history information alone.
We found that youth with greater genetic predisposition to neuroticism were more likely to develop major mental illness by adulthood. We also found that youth with greater genetic predisposition to subjective well-being were less likely to develop major mental illness. Interestingly, genetic predisposition to various forms of mental illness did not improve prediction over family history information.
Our findings suggest that polygenic scores for neuroticism and subjective well-being may be used in combination with other information, including family history, to help us identify which youth are at higher risk for mental illness. This will be helpful, because those who are at the highest risk may also benefit most from childhood programs to strengthen mental health for the long-term.
Zwicker, A., Fullerton, J.M., Mullins, N., Rice, F, ... , Alda, M., Nurnberger, J. I., & Uher, R. (2023). Polygenic Scores and Onset of Major Mood or Psychotic Disorders Among Offspring of Affected Parents. Am J Psychiatry.
Click here for a link to the published article!
We included data from 1884 youth participants from 8 studies from across the world, including 1339 offspring of parents with mood or psychotic disorders. We looked at whether polygenic scores could improve the prediction of mental illness among youth over family history information alone.
We found that youth with greater genetic predisposition to neuroticism were more likely to develop major mental illness by adulthood. We also found that youth with greater genetic predisposition to subjective well-being were less likely to develop major mental illness. Interestingly, genetic predisposition to various forms of mental illness did not improve prediction over family history information.
Our findings suggest that polygenic scores for neuroticism and subjective well-being may be used in combination with other information, including family history, to help us identify which youth are at higher risk for mental illness. This will be helpful, because those who are at the highest risk may also benefit most from childhood programs to strengthen mental health for the long-term.
Zwicker, A., Fullerton, J.M., Mullins, N., Rice, F, ... , Alda, M., Nurnberger, J. I., & Uher, R. (2023). Polygenic Scores and Onset of Major Mood or Psychotic Disorders Among Offspring of Affected Parents. Am J Psychiatry.
Click here for a link to the published article!
2022
Sex-Specific transmission of anxiety disorders from parents to offspring
Anxiety disorders are the most common psychiatric disorders in childhood. They can negatively impact children’s ability to enjoy the educational and social experiences to the full. We know that children are more likely to develop an anxiety disorder if one or both of their parents have it. This is due to a combination of genetic and environmental influences. But does this depend on whether the father or mother has it? And whether the child is a son or a daughter?
Using the data from 398 FORBOW youth participants and their parents, we looked at whether the transmission of anxiety is influenced by the child and parent being the same sex (i.e., mother and daughter, or father and son) or the opposite sex (i.e., mother and son, or father and daughter).
We found that if the parent with anxiety is the same sex as the child, the child is more likely to have an anxiety disorder too. What is more, if the parent of the same sex does not have anxiety and shares the household with their child, it makes it less likely that the child will have anxiety.
We think it is because children may be more likely to learn anxious behaviour if it is being displayed by their same-sex parent (i.e. sons learning their fathers' behaviour and daughters learning their mothers’ behaviour). Because children share approximately the same amount of genetic material with their mothers and fathers, our findings suggest that the role of environmental factors may be especially strong in the transmission of anxiety. This means that transmission of anxiety from parents to children may be preventable. We are working on testing this theory.
Pavlova, B., Bagnell, A., Cumby, J., Howes Vallis, E., Abidi, S., Lovas, D., Propper, L., Alda, M., & Uher, R. (2022). Sex-Specific Transmission of Anxiety Disorders From Parents to Offspring. JAMA Network Open, 5(7), e2220919. https://doi.org/10.1001/jamanetworkopen.2022.20919
Click here for a link to the published article!
Using the data from 398 FORBOW youth participants and their parents, we looked at whether the transmission of anxiety is influenced by the child and parent being the same sex (i.e., mother and daughter, or father and son) or the opposite sex (i.e., mother and son, or father and daughter).
We found that if the parent with anxiety is the same sex as the child, the child is more likely to have an anxiety disorder too. What is more, if the parent of the same sex does not have anxiety and shares the household with their child, it makes it less likely that the child will have anxiety.
We think it is because children may be more likely to learn anxious behaviour if it is being displayed by their same-sex parent (i.e. sons learning their fathers' behaviour and daughters learning their mothers’ behaviour). Because children share approximately the same amount of genetic material with their mothers and fathers, our findings suggest that the role of environmental factors may be especially strong in the transmission of anxiety. This means that transmission of anxiety from parents to children may be preventable. We are working on testing this theory.
Pavlova, B., Bagnell, A., Cumby, J., Howes Vallis, E., Abidi, S., Lovas, D., Propper, L., Alda, M., & Uher, R. (2022). Sex-Specific Transmission of Anxiety Disorders From Parents to Offspring. JAMA Network Open, 5(7), e2220919. https://doi.org/10.1001/jamanetworkopen.2022.20919
Click here for a link to the published article!
2021
THE DEvelopmental brain age is associated with adversity, depression, and functional outcomes among adolescents
Most psychiatric disorders emerge in the second decade of life and may be related to abnormal brain development. But how can we map normal brain development? In this study we built a model to accurately predict brain age in typically developing adolescents. In order to do this we applied artificial intelligence techniques on 1000s of MRI scans.
The difference between a person’s predicted brain age and their chronological age results in what is referred to as a brain-age-gap. If there is a wide gap between the two, there could be an increased risk of cognitive impairment, traumatic brain injury, and Alzheimer’s disease, along with severe mental illness – including both mood and psychotic disorders. While the brain age concept is well established in adults, less is known about how the brain-age-gap relates to mental illness in adolescence.
The interesting part of the study was when we applied the model in FORBOW participants who have developed depression, experienced adversity, or had trouble with functioning. On average, these youth showed a higher brain-age-gap, or in other words an older appearing brain than their peers. Future studies can see if this difference remains as the youth grow older and if there are certain techniques that can reduce the brain-age-gap.
Drobinin, V., Van Gestel, H., Helmick, C. A., Schmidt, M. H., Bowen, C. V., & Uher, R. (2021). The developmental brain age is associated with adversity, depression, and functional outcomes among adolescents. Biological Psychiatry. Cognitive Neuroscience and Neuroimaging. https://doi.org/10.1016/j.bpsc.2021.09.004
Click here for a link to the published article!
The difference between a person’s predicted brain age and their chronological age results in what is referred to as a brain-age-gap. If there is a wide gap between the two, there could be an increased risk of cognitive impairment, traumatic brain injury, and Alzheimer’s disease, along with severe mental illness – including both mood and psychotic disorders. While the brain age concept is well established in adults, less is known about how the brain-age-gap relates to mental illness in adolescence.
The interesting part of the study was when we applied the model in FORBOW participants who have developed depression, experienced adversity, or had trouble with functioning. On average, these youth showed a higher brain-age-gap, or in other words an older appearing brain than their peers. Future studies can see if this difference remains as the youth grow older and if there are certain techniques that can reduce the brain-age-gap.
Drobinin, V., Van Gestel, H., Helmick, C. A., Schmidt, M. H., Bowen, C. V., & Uher, R. (2021). The developmental brain age is associated with adversity, depression, and functional outcomes among adolescents. Biological Psychiatry. Cognitive Neuroscience and Neuroimaging. https://doi.org/10.1016/j.bpsc.2021.09.004
Click here for a link to the published article!
attention-deficit/ Hyperactivity Disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder
Children of parents with bipolar disorder and depression often present with early problems related to the development of brain functions, such as attention, motor coordination and speech. We call these problems neurodevelopmental disorders. To find out whether some or all of these problems are related to bipolar disorder or depression, we compared the rates of neurodevelopmental disorders in children of parents with bipolar disorder, depression, and children of parents with no mood disorder (controls).
The FORBOW team assessed for neurodevelopmental symptoms in 400 children when they were on average 11 years old. We found that more children of parents with mood disorders than controls had attention-deficit/hyperactivity disorder (ADHD), but there were no differences in other types of neurodevelopmental disorders. The rates of ADHD were highest among children of parents with bipolar disorder, intermediate among children of parents with depression and lowest in control children of parents with no mood disorder. If the parent’s mood disorder was chronic, ADHD in their children was even more frequent.
Our findings suggest that ADHD is related to familial disposition for mood disorders, especially bipolar disorder. Monitoring for ADHD in children of parents with mood disorders may improve early diagnosis and treatment.
Reference to the full article: Propper L, Sandstrom A, Rempel S, Howes Vallis E, Abidi S, Bagnell A, Lovas D, Alda M, Pavlova B, Uher R. Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder. Psychol Med. 2021 Jun 18:1-8. doi: 10.1017/S0033291721001951. Epub ahead of print. PMID: 34140050.
Click here for a link to the published article!
The FORBOW team assessed for neurodevelopmental symptoms in 400 children when they were on average 11 years old. We found that more children of parents with mood disorders than controls had attention-deficit/hyperactivity disorder (ADHD), but there were no differences in other types of neurodevelopmental disorders. The rates of ADHD were highest among children of parents with bipolar disorder, intermediate among children of parents with depression and lowest in control children of parents with no mood disorder. If the parent’s mood disorder was chronic, ADHD in their children was even more frequent.
Our findings suggest that ADHD is related to familial disposition for mood disorders, especially bipolar disorder. Monitoring for ADHD in children of parents with mood disorders may improve early diagnosis and treatment.
Reference to the full article: Propper L, Sandstrom A, Rempel S, Howes Vallis E, Abidi S, Bagnell A, Lovas D, Alda M, Pavlova B, Uher R. Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder. Psychol Med. 2021 Jun 18:1-8. doi: 10.1017/S0033291721001951. Epub ahead of print. PMID: 34140050.
Click here for a link to the published article!
YOUTH EXPERIENCE TRACKER INSTRUMENT: A SELF-REPORT MEASURE OF DEVELOPMENTAL ANTECEDENTS TO SEVERE MENTAL ILLNESS
A range of experiences and behaviours in youth help predict mental health and illness across the life course. Mood, anxiety, emotional stability, sleep, and unusual experiences of oneself and the world are all relevant, but assessment of all of these often require multiple lengthy interviews and questionnaires. We wanted to see if a much briefer assessment may be possible. To do this, FORBOW youth participants aged 8 to 23 completed a one page ‘YETI’ questionnaires alongside full-length assessments including interviews, questionnaires and testing.
We found that the single-page YETI provided adequate information on six areas of behaviour and experiences that are relevant to life-long mental health. Availability of a brief self-report measure will make it easier to assess and monitor youth mental health in a variety of settings. Using the same measure from late childhood through adolescence and into young adulthood will help track mental health through a crucial developmental period.
Reference to the full article: Patterson V.C., Pencer A., Pavlova B., Awadia A., MacKenzie L.E., Zwicker A., Drobinin V., Howes Vallis E., Uher R. Youth experience tracker instrument: A self-report measure of developmental antecedents to severe mental illness. Early Interv Psychiatry.
Click here for a link to the published article!
We found that the single-page YETI provided adequate information on six areas of behaviour and experiences that are relevant to life-long mental health. Availability of a brief self-report measure will make it easier to assess and monitor youth mental health in a variety of settings. Using the same measure from late childhood through adolescence and into young adulthood will help track mental health through a crucial developmental period.
Reference to the full article: Patterson V.C., Pencer A., Pavlova B., Awadia A., MacKenzie L.E., Zwicker A., Drobinin V., Howes Vallis E., Uher R. Youth experience tracker instrument: A self-report measure of developmental antecedents to severe mental illness. Early Interv Psychiatry.
Click here for a link to the published article!
2020
reliability of multimodal mri brain measures in youth at risk for mental illness
Many researchers are interested in using MRI to study adolescent brain development. However, things like head motion can cause image artifacts, and may happen more often in younger people. In this study we looked at the quality of different types of brain images in young people.
We obtained repeated MRI scans, an average a few weeks apart, from 50 youth. Half of the youth in the study had a diagnosis of an anxiety disorder; and over a quarter had attention-deficit/hyperactivity disorder (ADHD). We measured the consistency of the images between the two different time points.
After removing some clearly problematic scans, we showed that most of the images were highly consistent, even in youth at risk for mental illness and those already affected by certain disorders. However, other researchers should keep in mind that certain types of brain measurements and some areas were harder to image than others.
Drobinin, V., Van Gestel, H., Helmick, C. A., Schmidt, M. H., Bowen, C. V., & Uher, R. (2020). Reliability of multimodal MRI brain measures in youth at risk for mental illness. Brain and Behavior, 10(6), e01609.
Click here for a link to the published article!
We obtained repeated MRI scans, an average a few weeks apart, from 50 youth. Half of the youth in the study had a diagnosis of an anxiety disorder; and over a quarter had attention-deficit/hyperactivity disorder (ADHD). We measured the consistency of the images between the two different time points.
After removing some clearly problematic scans, we showed that most of the images were highly consistent, even in youth at risk for mental illness and those already affected by certain disorders. However, other researchers should keep in mind that certain types of brain measurements and some areas were harder to image than others.
Drobinin, V., Van Gestel, H., Helmick, C. A., Schmidt, M. H., Bowen, C. V., & Uher, R. (2020). Reliability of multimodal MRI brain measures in youth at risk for mental illness. Brain and Behavior, 10(6), e01609.
Click here for a link to the published article!
Cognition in offspring of parents with psychotic and non-psychotic severe mental illness
Individuals with severe mental illness (schizophrenia, bipolar disorder, major depressive disorder) sometimes experience difficulties with thinking and reasoning abilities (cognition). Those who experience psychotic symptoms in severe mental illness often have greater difficulties. However, it is unclear whether cognition difficulties are present as a developmental risk factor before the onset of the illness or if they are only present after illness onset.
To investigate whether cognition difficulties are a developmental risk factor for severe mental illness, we used a wide range of tests in sons and daughters of parents with severe mental illness, including parents with and without psychotic symptoms. The tests were designed to assess a broad range of cognition, including overall thinking and reasoning, verbal tests, visual tests, problem solving, mental speed, decision-making, and attention.
We found that sons and daughters of parents with psychotic severe mental illness had greater difficulties in overall thinking and reasoning abilities, and with tests of verbal cognition, verbal memory, mental speed, and attention, when compared with sons and daughters of parents with non-psychotic severe mental illness. Children and youth of parents with non-psychotic severe mental illness also showed milder difficulties with verbal cognition, visual memory, and decision-making. Our results suggest that mild to moderate difficulties with thinking and reasoning abilities may be a developmental risk factor for any type of severe mental illness. Future research may examine the development of early interventions focused on cognition and their long-term impact for sons and daughters of parents affected with severe mental illness.
Reference to the full article: MacKenzie, L.E., Howes Vallis, E., Rempel, S., Zwicker, A., Drobinin, V., Pavlova, B., Uher, R. Cognition in offspring of parents with psychotic and non-psychotic severe mental illness. J Psychiatr Res. 130: 306-312.
Click here for a link to the published article!
To investigate whether cognition difficulties are a developmental risk factor for severe mental illness, we used a wide range of tests in sons and daughters of parents with severe mental illness, including parents with and without psychotic symptoms. The tests were designed to assess a broad range of cognition, including overall thinking and reasoning, verbal tests, visual tests, problem solving, mental speed, decision-making, and attention.
We found that sons and daughters of parents with psychotic severe mental illness had greater difficulties in overall thinking and reasoning abilities, and with tests of verbal cognition, verbal memory, mental speed, and attention, when compared with sons and daughters of parents with non-psychotic severe mental illness. Children and youth of parents with non-psychotic severe mental illness also showed milder difficulties with verbal cognition, visual memory, and decision-making. Our results suggest that mild to moderate difficulties with thinking and reasoning abilities may be a developmental risk factor for any type of severe mental illness. Future research may examine the development of early interventions focused on cognition and their long-term impact for sons and daughters of parents affected with severe mental illness.
Reference to the full article: MacKenzie, L.E., Howes Vallis, E., Rempel, S., Zwicker, A., Drobinin, V., Pavlova, B., Uher, R. Cognition in offspring of parents with psychotic and non-psychotic severe mental illness. J Psychiatr Res. 130: 306-312.
Click here for a link to the published article!
Cognitive-behavioural interventions for prevention and treatment of anxiety in young children: a systematic review and meta-analysis
Anxiety disorders are common and impairing throughout the life course. Already in preschool children, anxiety disorders impact emotional development and school readiness. Anxiety in early childhood is associated with risk of mood disorders, substance use, and suicide during adulthood. Therefore, early interventions need to be considered. We aimed to determine if cognitive-behavioural interventions are effective for anxiety in young children.
To do this, we reviewed the literature and identified 43 studies with young children participating in a cognitive-behavioural intervention for anxiety. We found that anxiety in young children decreased after cognitive-behavioural interventions. Anxiety decreased more in children who received intervention than in children who did not. The improvement was maintained over follow-up. We found that cognitive-behavioural interventions are effective for the prevention and treatment of anxiety in young children.
Reference to the full article: Howes Vallis, E., Zwicker A., Uher R., Pavlova, B. Cognitive-behavioural interventions for prevention and treatment of anxiety in young children: A systematic review and meta-analysis. Clinical Psychology Review .
Click here for a link to the published article!
To do this, we reviewed the literature and identified 43 studies with young children participating in a cognitive-behavioural intervention for anxiety. We found that anxiety in young children decreased after cognitive-behavioural interventions. Anxiety decreased more in children who received intervention than in children who did not. The improvement was maintained over follow-up. We found that cognitive-behavioural interventions are effective for the prevention and treatment of anxiety in young children.
Reference to the full article: Howes Vallis, E., Zwicker A., Uher R., Pavlova, B. Cognitive-behavioural interventions for prevention and treatment of anxiety in young children: A systematic review and meta-analysis. Clinical Psychology Review .
Click here for a link to the published article!
Visual memory and psychotic symptoms in youth
Psychotic symptoms are common during childhood and adolescence. Psychotic symptoms refer to hearing, seeing, and believing things that do not exist. Some young people who experience psychotic symptoms will develop mental illness in the future while many will not. Lower visual memory performance has been suggested as a risk factor for future mental illness. We aimed to explore the relationship between psychotic symptoms and visual memory performance among youth.
We wanted to know if young people who experience psychotic symptoms have lower visual memory performance. To examine this, 205 FORBOW participants completed interviews about psychotic symptoms as well as a test of visual memory performance.
We found that lower visual memory performance is associated with psychotic symptoms among youth. This suggests that visual memory performance may be an indicator of risk of mental illness among youth who are already experiencing psychotic symptoms.
Reference to the full article: Howes Vallis E., MacKenzie, L.E., Zwicker, A., Drobinin, V., Rempel, S., Abidi S., Lovas D., Bagnell A., Propper, L., Omisade, A., Pavlova, B, & Uher, R. Visual memory and psychotic symptoms in youth. Cognitive Neuropsychaitry.
Click here for a link to the published article!
We wanted to know if young people who experience psychotic symptoms have lower visual memory performance. To examine this, 205 FORBOW participants completed interviews about psychotic symptoms as well as a test of visual memory performance.
We found that lower visual memory performance is associated with psychotic symptoms among youth. This suggests that visual memory performance may be an indicator of risk of mental illness among youth who are already experiencing psychotic symptoms.
Reference to the full article: Howes Vallis E., MacKenzie, L.E., Zwicker, A., Drobinin, V., Rempel, S., Abidi S., Lovas D., Bagnell A., Propper, L., Omisade, A., Pavlova, B, & Uher, R. Visual memory and psychotic symptoms in youth. Cognitive Neuropsychaitry.
Click here for a link to the published article!
vISUAL MEMORY IN OFFSPRING OF PARENTS WITH MENTAL ILLNESS
Some individuals with schizophrenia, bipolar disorder, and schizophrenia perform lower on measures of cognition. Young people who are at increased risk of mental illness in the future may show lower cognitive performance. For the current research, we were interested in visual memory among young people.
We wanted to know if family history of mental illness is associated with lower visual memory performance in young people. To examine this, we completed a test of visual memory with 214 FORBOW participants. We measured family history of mental illness during interviews with parents.
We found that young people with more severe family history of mental illness demonstrated lower visual memory performance. Lower visual memory performance may be associated with increased risk of mental illness. Future studies may aim to explore multiple measurements of visual memory performance over many years.
Reference to the full article: Howes Vallis, E. MacKenzie, L.E., Rempel, S., Stephens, M., Howard, C., Drobinin, V., Propper, L., Omisade, A., Pavlova, B, & Uher, R. Visual memory in offspring of parents with mental illness. Psychiatry Research.
Click here for a link to the published article!
We wanted to know if family history of mental illness is associated with lower visual memory performance in young people. To examine this, we completed a test of visual memory with 214 FORBOW participants. We measured family history of mental illness during interviews with parents.
We found that young people with more severe family history of mental illness demonstrated lower visual memory performance. Lower visual memory performance may be associated with increased risk of mental illness. Future studies may aim to explore multiple measurements of visual memory performance over many years.
Reference to the full article: Howes Vallis, E. MacKenzie, L.E., Rempel, S., Stephens, M., Howard, C., Drobinin, V., Propper, L., Omisade, A., Pavlova, B, & Uher, R. Visual memory in offspring of parents with mental illness. Psychiatry Research.
Click here for a link to the published article!
ACTIVE BEHAVIORS AND SCREEN TIME IN OFFSPRING OF PARENTS WITH MAJOR DEPRESSIVE DISORDER, BIPOLAR DISORDER AND SCHIZOPHRENIA
We asked 357 youth aged 6 to 21 and their parents about how the young person spends their time. We asked about screen activities like using social media, watching TV and playing video games, as well as physically and mentally active behaviours like exercise, reading, being outside, and spending time with friends.
We found that children who have a parent with a mood or psychotic disorder (major depressive disorder, bipolar disorder, or schizophrenia) spend more time using screens and less time outside, reading, exercising and socializing compared to children of parents who do not have major depressive disorder, bipolar disorder or schizophrenia. In addition, lower current levels of depression in mothers were associated with less screen time and more active time in their children.
Because screen time is associated with worse mental health and active behaviours are associated with better mental health, these findings give us another hint at how we may be able to help children of parents with mental illness grow up healthy. It is possible that encouraging these youth to take part in activities including sports, reading, seeing friends, and playing outside may increase their resilience to mental illness. Our findings also highlight that the mental health of parents is very important for children. Parents are frequently very busy and tend to prioritize their children’s needs before their own. However, it is possible that by treating parental symptoms of depression we may be able to help increase active behaviours in their kids.
Reference to the full article: Pizzo P, Drobinin V, Sandstrom A, Zwicker A, Howes Vallis E, Fine A, Rempel S, Stephens M, Howard C, Villars K, MacKenzie LE, Propper L, Abidi S, Lovas D, Bagnell A, Cumby J, Alda M, Uher R, Pavlova B. Active behaviors and screen time in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychiatry Research.
Click here for a link to the published article!
We found that children who have a parent with a mood or psychotic disorder (major depressive disorder, bipolar disorder, or schizophrenia) spend more time using screens and less time outside, reading, exercising and socializing compared to children of parents who do not have major depressive disorder, bipolar disorder or schizophrenia. In addition, lower current levels of depression in mothers were associated with less screen time and more active time in their children.
Because screen time is associated with worse mental health and active behaviours are associated with better mental health, these findings give us another hint at how we may be able to help children of parents with mental illness grow up healthy. It is possible that encouraging these youth to take part in activities including sports, reading, seeing friends, and playing outside may increase their resilience to mental illness. Our findings also highlight that the mental health of parents is very important for children. Parents are frequently very busy and tend to prioritize their children’s needs before their own. However, it is possible that by treating parental symptoms of depression we may be able to help increase active behaviours in their kids.
Reference to the full article: Pizzo P, Drobinin V, Sandstrom A, Zwicker A, Howes Vallis E, Fine A, Rempel S, Stephens M, Howard C, Villars K, MacKenzie LE, Propper L, Abidi S, Lovas D, Bagnell A, Cumby J, Alda M, Uher R, Pavlova B. Active behaviors and screen time in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychiatry Research.
Click here for a link to the published article!
NEURODEVELOPMENTAL AND GENETIC DETERMINANTS OF EXPOSURE TO ADVERSITY AMONG YOUTH AT RISK FOR MENTAL ILLNESS
Many people experience some form of adversity growing up, including poverty, abuse, or bullying. Adversity is also a known risk factor for mental illness. Previous studies have found that people who score lower on intelligence tests and people who have more ADHD or oppositional defiant disorder symptoms are at higher risk of experiencing certain forms of adversity. We wanted to know if risk of experiencing adversity was associated with genetic predisposition to intelligence and ADHD.
To do this, we asked FORBOW participants about their experiences with adversity, including socioeconomic disadvantage, abuse, neglect, and bullying. We measured intelligence using IQ scores. We also calculated genetic scores that quantified each individual’s genetic predisposition to intelligence and ADHD. We collected information from 297 children and youth.
We found that people with higher genetic predisposition to ADHD were more likely to experience adversity. When we looked at this association separately among individuals with and without a diagnosis of ADHD, people with higher genetic predisposition to ADHD were more likely to experience adversity in both groups. We did not find a relationship between genetic predisposition to intelligence and adversity.
This study shows an association between genetic and environmental risk factors for mental illness. However, it is important to remember that genes are not destiny. Everyone has some genetic risk for mental illness and there are many other risk and protective factors for mental illness that we did not examine in this study.
Reference to the full article: Zwicker A, MacKenzie LE, Drobinin V, Bagher AM, Howes Vallis E, Propper L, Bagnell A, Abidi S, Pavlova B, Alda M, Denovan-Wright EM, Uher R. Neurodevelopmental and genetic determinants of exposure to adversity among youth at risk for mental illness. Journal of Child Psychology and Psychiatry.
Click here for a link to the published article!
To do this, we asked FORBOW participants about their experiences with adversity, including socioeconomic disadvantage, abuse, neglect, and bullying. We measured intelligence using IQ scores. We also calculated genetic scores that quantified each individual’s genetic predisposition to intelligence and ADHD. We collected information from 297 children and youth.
We found that people with higher genetic predisposition to ADHD were more likely to experience adversity. When we looked at this association separately among individuals with and without a diagnosis of ADHD, people with higher genetic predisposition to ADHD were more likely to experience adversity in both groups. We did not find a relationship between genetic predisposition to intelligence and adversity.
This study shows an association between genetic and environmental risk factors for mental illness. However, it is important to remember that genes are not destiny. Everyone has some genetic risk for mental illness and there are many other risk and protective factors for mental illness that we did not examine in this study.
Reference to the full article: Zwicker A, MacKenzie LE, Drobinin V, Bagher AM, Howes Vallis E, Propper L, Bagnell A, Abidi S, Pavlova B, Alda M, Denovan-Wright EM, Uher R. Neurodevelopmental and genetic determinants of exposure to adversity among youth at risk for mental illness. Journal of Child Psychology and Psychiatry.
Click here for a link to the published article!
PSYCHOTIC SYMPTOMS ARE ASSOCIATED WITH LOWER CORTICAL FOLDING IN YOUTH AT RISK FOR MENTAL ILLNESS
Psychosis refers to a loss of contact with reality and is characterized by hallucinations and delusions. A person experiencing psychosis might see or hear things that are not really there, or believe things that are not true; for example, hearing voices, or feeling constantly monitored or spied on.
Psychotic experiences are common, but for some people they become persistent and may develop into a range of disorders, most notably schizophrenia. Researchers believe schizophrenia is a result of abnormal brain development from infancy until symptoms appear in early adulthood. One of the most important parts of brain development is the way the brain folds to allow more brain cells in the limited space of the skull. Studies that have used non-invasive brain scanning techniques in adults experiencing schizophrenia have found problems with brain folding.
We wanted to find out whether we can see these brain changes early on in children and teens who are experiencing transient psychotic symptoms. To do this we collected magnetic resonance images (MRI) from 110 youth and analyzed the extent of folding with software.
We found that youth with psychotic symptoms showed an overall trend towards lower brain folding across all brain regions, with more noticeable effects in specific regions in the frontal and occipital lobes. Time will tell if these changes can be normalized during further development.
Reference to the full article: Drobinin, V., Gestel, H. V., Zwicker, A., MacKenzie, L., Cumby, J., Patterson, V. C., Howes Vallis, E., Campbell, N., Hajek, T., Helmick, C. A., Schmidt, M., Alda, M., Bowen, C.V., Uher, R. Psychotic symptoms are associated with lower cortical folding in youth at risk for mental illness. Journal of Psychiatry & Neuroscience.
Click here for a link to the published article!
Psychotic experiences are common, but for some people they become persistent and may develop into a range of disorders, most notably schizophrenia. Researchers believe schizophrenia is a result of abnormal brain development from infancy until symptoms appear in early adulthood. One of the most important parts of brain development is the way the brain folds to allow more brain cells in the limited space of the skull. Studies that have used non-invasive brain scanning techniques in adults experiencing schizophrenia have found problems with brain folding.
We wanted to find out whether we can see these brain changes early on in children and teens who are experiencing transient psychotic symptoms. To do this we collected magnetic resonance images (MRI) from 110 youth and analyzed the extent of folding with software.
We found that youth with psychotic symptoms showed an overall trend towards lower brain folding across all brain regions, with more noticeable effects in specific regions in the frontal and occipital lobes. Time will tell if these changes can be normalized during further development.
Reference to the full article: Drobinin, V., Gestel, H. V., Zwicker, A., MacKenzie, L., Cumby, J., Patterson, V. C., Howes Vallis, E., Campbell, N., Hajek, T., Helmick, C. A., Schmidt, M., Alda, M., Bowen, C.V., Uher, R. Psychotic symptoms are associated with lower cortical folding in youth at risk for mental illness. Journal of Psychiatry & Neuroscience.
Click here for a link to the published article!
affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia
People with depression, bipolar disorder, and schizophrenia may experience sudden and unexpected changes in their mood. Previous research has found that sons and daughters of parents with bipolar disorder are also more likely to experience these unpredictable mood changes. We wanted to know if these mood changes are also common among sons and daughters of people with depression or schizophrenia.
We examined this question by asking FORBOW participants and their parents to fill out questionnaires to measure the participants’ mood changeability. We collected information from 137 youth who have a parent with depression, 68 youth who have a parent with bipolar disorder, 24 youth who have a parent with schizophrenia and 91 youth who do not have a parent with a mood or psychotic disorder. We compared the scores from youth with a parent with each one of those 3 diagnoses to the scores obtained from youth whose parents do not have one of these disorders. We now report results from the first 320 FORBOW participants.
We found that youth who have parents with depression and bipolar disorder were more likely to experience sudden, unexpected changes in their mood, compared to youth who do not have a parent with a mood or psychotic disorder. Our results suggest that rapid and unpredictable mood changes during childhood and adolescence are a marker of familial risk for mood disorders, like depression and bipolar disorder.
Reference to the full research article: Zwicker A, Drobinin V, MacKenzie LE, Howes Vallis E, Patterson VC, Cumby J, Propper L, Abidi S, Bagnell A, Pavlova B, Alda M, Uher R. Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. European Child & Adolescent Psychiatry.
Click here for a link to the published article abstract!
We examined this question by asking FORBOW participants and their parents to fill out questionnaires to measure the participants’ mood changeability. We collected information from 137 youth who have a parent with depression, 68 youth who have a parent with bipolar disorder, 24 youth who have a parent with schizophrenia and 91 youth who do not have a parent with a mood or psychotic disorder. We compared the scores from youth with a parent with each one of those 3 diagnoses to the scores obtained from youth whose parents do not have one of these disorders. We now report results from the first 320 FORBOW participants.
We found that youth who have parents with depression and bipolar disorder were more likely to experience sudden, unexpected changes in their mood, compared to youth who do not have a parent with a mood or psychotic disorder. Our results suggest that rapid and unpredictable mood changes during childhood and adolescence are a marker of familial risk for mood disorders, like depression and bipolar disorder.
Reference to the full research article: Zwicker A, Drobinin V, MacKenzie LE, Howes Vallis E, Patterson VC, Cumby J, Propper L, Abidi S, Bagnell A, Pavlova B, Alda M, Uher R. Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. European Child & Adolescent Psychiatry.
Click here for a link to the published article abstract!
Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia
Some youth who have a parent with depression, bipolar disorder or schizophrenia experience difficulties, such as inattention and anxiety. In some (but not all), these difficulties may predict the development of later mental illness. Information about these problems is usually collected by asking young people and/or their parents. But, can early behavioural and emotional difficulties also be accurately assessed by an observer?
Assessors in FORBOW observed and rated behavioural and emotional difficulties of almost 400 participating children and youth. We found that on average children and adolescents who have parents with depression, bipolar disorder and schizophrenia displayed more inattention, anxiety, oppositional behaviour, and thinking and language problems.
Not every child with behavioral and emotional difficulties will go on to develop mental illness. However, in some cases these early problems may help indicate youth who may be at risk for mental illness. Monitoring children and adolescents using an observational measure of behavioral and emotional difficulties may help identify who may benefit from early interventions. Helping young people with behavioural and emotional difficulties may help stop mental illness before it develops.
Reference to the full research article: Sandstrom A, MacKenzie L, Pizzo A, Fine A, Rempel S, Howard C, Stephens M, Patterson VC, Drobinin V, Van Gestel H, Howes Vallis E, Zwicker A, Propper L, Abidi S, Bagnell A, Lovas D, Cumby J, Alda M, Uher R, Pavlova B. Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychological Medicine.
Click here for a link to the published article abstract!
Assessors in FORBOW observed and rated behavioural and emotional difficulties of almost 400 participating children and youth. We found that on average children and adolescents who have parents with depression, bipolar disorder and schizophrenia displayed more inattention, anxiety, oppositional behaviour, and thinking and language problems.
Not every child with behavioral and emotional difficulties will go on to develop mental illness. However, in some cases these early problems may help indicate youth who may be at risk for mental illness. Monitoring children and adolescents using an observational measure of behavioral and emotional difficulties may help identify who may benefit from early interventions. Helping young people with behavioural and emotional difficulties may help stop mental illness before it develops.
Reference to the full research article: Sandstrom A, MacKenzie L, Pizzo A, Fine A, Rempel S, Howard C, Stephens M, Patterson VC, Drobinin V, Van Gestel H, Howes Vallis E, Zwicker A, Propper L, Abidi S, Bagnell A, Lovas D, Cumby J, Alda M, Uher R, Pavlova B. Observed psychopathology in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Psychological Medicine.
Click here for a link to the published article abstract!
2019
Basic symptoms in offspring of parents with mood and psychotic disorders
Basic symptoms are unusual experiences, including disturbances in thinking, vision, hearing, and other essential mental processes. When these experiences occur, they are perceived as being bothersome or annoying. Certain combinations of basic symptoms have traditionally been viewed as early predictors of psychotic disorders, like schizophrenia. While some people who experience basic symptoms will develop a psychotic disorder, the vast majority will not. Prior to our study, basic symptoms had not been examined among the sons and daughters of people with a range of mood and psychotic disorders, like depression, bipolar disorder and schizophrenia. We wanted to know if basic symptoms are associated with a family history of serious mental illness, regardless of the specific diagnosis.
We examined this question by asking FORBOW participants about their experiences with basic symptoms. We also spoke with the FORBOW parents to assess their mental health. We collected information from 147 youth who have a parent with a serious mood or psychotic disorder, 92 youth who have a parent with a non-serious mood disorder, and 93 youth who do not have a parent with a mood or psychotic disorder. We compared basic symptoms from youth who do not have a parent with a mood or psychotic disorder to basic symptoms among youth who have a parent with a non-serious mood disorder or a serious mood or psychotic disorder. We now report results from 332 FORBOW participants.
We found that youth who have a parent with a serious mood or psychotic disorder experienced more basic symptoms than youth who do not have a parent with these disorders. Our results suggest that basic symptoms are a marker of family history of serious mental illness, and that they are not specifically predictive of psychotic illness.
Reference to the full article: Zwicker A, MacKenzie LE, Drobinin V, Howes Vallis E, Patterson VC, Stephens M, Cumby J, Propper L, Abidi S, Bagnell A, Schultze-Lutter F, Pavlova B, Alda M, Uher R. Basic symptoms in offspring of parents with mood and psychotic disorders. BJPsych Open.
Click here for a link to the published article!
We examined this question by asking FORBOW participants about their experiences with basic symptoms. We also spoke with the FORBOW parents to assess their mental health. We collected information from 147 youth who have a parent with a serious mood or psychotic disorder, 92 youth who have a parent with a non-serious mood disorder, and 93 youth who do not have a parent with a mood or psychotic disorder. We compared basic symptoms from youth who do not have a parent with a mood or psychotic disorder to basic symptoms among youth who have a parent with a non-serious mood disorder or a serious mood or psychotic disorder. We now report results from 332 FORBOW participants.
We found that youth who have a parent with a serious mood or psychotic disorder experienced more basic symptoms than youth who do not have a parent with these disorders. Our results suggest that basic symptoms are a marker of family history of serious mental illness, and that they are not specifically predictive of psychotic illness.
Reference to the full article: Zwicker A, MacKenzie LE, Drobinin V, Howes Vallis E, Patterson VC, Stephens M, Cumby J, Propper L, Abidi S, Bagnell A, Schultze-Lutter F, Pavlova B, Alda M, Uher R. Basic symptoms in offspring of parents with mood and psychotic disorders. BJPsych Open.
Click here for a link to the published article!
Sleep in offspring of parents with mood disorders
People with depression and bipolar disorder often experience sleep problems, including irregular sleep patterns, insomnia (trouble sleeping or too little sleep), or hypersomnia (excessive sleepiness or too much sleep). Most existing research has focused on examining sleep problems in individuals who already have a diagnosis of a mood disorder. However, are sleep problems also present earlier on, before a diagnosis is made? Are there sleep problems in children at risk of developing a mood disorder?
At FORBOW, researcher Delainey Wescott examined these questions by measuring different aspects of sleep in youth who have a parent with a mood disorder compared to youth whose parents do not have any mood disorder. For two weeks, FORBOW participants wore an actigraph (a wrist-watch-like device) that measured their sleep for two weeks, including how long it took to fall asleep, how long participants slept, and how often they woke during the night. We now report results from the first 73 youth, including 23 youth who had a parent with major depressive disorder, 22 had a parent with bipolar disorder, and 28 had a parent with no mood disorder.
We found that youth of parents with depression slept, on average, half an hour longer than youth whose parents do not have a mood disorders. When comparing sleep on weeknights versus weekends, youth who have parents living with bipolar disorder slept much longer on weekend nights than on weekday nights. While almost everyone has a tendency to sleep in on the weekend, those who have bipolar disorder in their family have an even greater difference. These results suggest that altered weeknight versus weekend sleep patterns might be early indicators of vulnerability for mood disorders. At FORBOW, we will continue to work with youth and their families to find out how working on sleep habits may help to build resilience and protect mental wellbeing, including setting regular sleep schedules on weeknights and weekends.
Reference to the full research article: Wescott DL, Morash-Conway J, Zwicker A, Cumby J, Uher R, Rusak B. Sleep in offspring of parents with mood disorders. Frontiers in Psychiatry.
Click here for a link to the published article abstract!
At FORBOW, researcher Delainey Wescott examined these questions by measuring different aspects of sleep in youth who have a parent with a mood disorder compared to youth whose parents do not have any mood disorder. For two weeks, FORBOW participants wore an actigraph (a wrist-watch-like device) that measured their sleep for two weeks, including how long it took to fall asleep, how long participants slept, and how often they woke during the night. We now report results from the first 73 youth, including 23 youth who had a parent with major depressive disorder, 22 had a parent with bipolar disorder, and 28 had a parent with no mood disorder.
We found that youth of parents with depression slept, on average, half an hour longer than youth whose parents do not have a mood disorders. When comparing sleep on weeknights versus weekends, youth who have parents living with bipolar disorder slept much longer on weekend nights than on weekday nights. While almost everyone has a tendency to sleep in on the weekend, those who have bipolar disorder in their family have an even greater difference. These results suggest that altered weeknight versus weekend sleep patterns might be early indicators of vulnerability for mood disorders. At FORBOW, we will continue to work with youth and their families to find out how working on sleep habits may help to build resilience and protect mental wellbeing, including setting regular sleep schedules on weeknights and weekends.
Reference to the full research article: Wescott DL, Morash-Conway J, Zwicker A, Cumby J, Uher R, Rusak B. Sleep in offspring of parents with mood disorders. Frontiers in Psychiatry.
Click here for a link to the published article abstract!
Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring
Click here for an infographic of the publication summary!
A new FORBOW study examines how unusual experiences are passed on from mothers and fathers to their daughters and sons.
When parents are living with mental illness, their children are more likely to have unusual experiences that resemble the symptoms of mental illness. They may occasionally hear something that other people cannot hear or they may at times feel like the world is not real. But does it matter whether the parent living with mental illness is their mother or father? Many people feel like a son may be more likely to 'inherit' habits from his father and a daughter may be more likely to take after her mother. But is there any reason to believe this? At FORBOW, over 300 boys and girls completed interviews, tests and questionnaires about their health and experiences, once per year for three years. Their mothers and fathers also participated. When testing the links between fathers' and mothers' mental illness and unusual experiences of their daughters and sons, Dr Alice Aylott and FORBOW researchers were surprised by the results. They found that when a mother was living with mental illness, her sons were more likely to have unusual experiences than her daughters. When a father was living with mental illness, his daughters were much more likely to have unusual experiences than his sons. So rather than the old adage 'like father like son' it is 'like father like daughter' after all, at least when it comes to unusual experiences or psychotic symptoms.
What may seem surprising actually makes sense to geneticists - inheritance from the opposite sex parent suggests the role of the X chromosome, which carries a large chunk of genetic information. Fathers pass their X chromosome to their daughters but not to their sons. Sons get their only copy of the X chromosome from their mothers. So this pattern we see in FORBOW may hold a key to the genetic roots of unusual experiences and mental illness.
There are some take home messages for all of us. First, we should not neglect to monitor the daughters of fathers living with mental illness and the sons of mothers living with mental illness. Some of them may benefit from an early intervention. Unusual experiences are not mental illness, but they may be early indicators of vulnerability and we want to stop the process before mental illness develops. Second, fathers matter! Fewer fathers than mothers receive health services or participate in programs like FORBOW. If you are a father living with mental illness in Nova Scotia, get in touch!
Reference to the full research article: Aylott A, Zwicker A, MacKenzie LE, Cumby J, Propper L, Abidi S, Bagnell A, Fisher HL, Pavlova B, Alda M, Uher R. Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring. Journal of the Developmental Origin of Health and Disease, Cambridge University Press.
Click here for a link to the published article abstract!
A new FORBOW study examines how unusual experiences are passed on from mothers and fathers to their daughters and sons.
When parents are living with mental illness, their children are more likely to have unusual experiences that resemble the symptoms of mental illness. They may occasionally hear something that other people cannot hear or they may at times feel like the world is not real. But does it matter whether the parent living with mental illness is their mother or father? Many people feel like a son may be more likely to 'inherit' habits from his father and a daughter may be more likely to take after her mother. But is there any reason to believe this? At FORBOW, over 300 boys and girls completed interviews, tests and questionnaires about their health and experiences, once per year for three years. Their mothers and fathers also participated. When testing the links between fathers' and mothers' mental illness and unusual experiences of their daughters and sons, Dr Alice Aylott and FORBOW researchers were surprised by the results. They found that when a mother was living with mental illness, her sons were more likely to have unusual experiences than her daughters. When a father was living with mental illness, his daughters were much more likely to have unusual experiences than his sons. So rather than the old adage 'like father like son' it is 'like father like daughter' after all, at least when it comes to unusual experiences or psychotic symptoms.
What may seem surprising actually makes sense to geneticists - inheritance from the opposite sex parent suggests the role of the X chromosome, which carries a large chunk of genetic information. Fathers pass their X chromosome to their daughters but not to their sons. Sons get their only copy of the X chromosome from their mothers. So this pattern we see in FORBOW may hold a key to the genetic roots of unusual experiences and mental illness.
There are some take home messages for all of us. First, we should not neglect to monitor the daughters of fathers living with mental illness and the sons of mothers living with mental illness. Some of them may benefit from an early intervention. Unusual experiences are not mental illness, but they may be early indicators of vulnerability and we want to stop the process before mental illness develops. Second, fathers matter! Fewer fathers than mothers receive health services or participate in programs like FORBOW. If you are a father living with mental illness in Nova Scotia, get in touch!
Reference to the full research article: Aylott A, Zwicker A, MacKenzie LE, Cumby J, Propper L, Abidi S, Bagnell A, Fisher HL, Pavlova B, Alda M, Uher R. Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring. Journal of the Developmental Origin of Health and Disease, Cambridge University Press.
Click here for a link to the published article abstract!
2017
Hot and cold executive functions in youth with psychotic symptoms
It is common for children and adolescents to have unusual psychotic experiences, such as seeing, hearing or believing things that do not really exist. Some youth who have these experiences will go on to develop severe mental illness when they are older. However, others will not. How do we predict which children and adolescents are at a higher risk? One factor is having family members with mental illness, such as schizophrenia, depression or bipolar disorder. Another factor that is often seen with severe mental illness is impairment in one’s thinking, especially in executive functions. Executive functions refers to things like starting and planning activities, decision-making and the ability to solve problems.
Research has shown that having unusual experiences and severe mental illness are connected with executive function impairments. However, what has not been looked at is the difference between ‘hot’ and ‘cold’ executive functions. ‘Hot’ executive functions involve emotion, motivation and rewards, whereas ‘cold’ executive functions are logical but not emotional. Since psychotic symptoms are emotional and often distressing to people, it has been suggested that ‘hot’ executive functions are more closely related to psychotic symptoms than ‘cold’ functions.
In FORBOW’s study we looked at whether impairment in ‘hot’ or ‘cold’ executive functions was connected with unusual, psychotic experiences in youth who had a parent with severe mental illness. Overall, we found that 69 out of 156 (44.23%) youth experienced psychotic symptoms. Additionally, poor scores on a task of ‘hot’ executive functioning were associated with psychotic symptoms, whereas poor scores on a ‘cold’ executive functioning task were not. This suggests that when a child or adolescent has impaired ‘hot’ executive functioning, they may be at a greater risk of developing severe mental illness later in life. Recognizing these impairments, and using interventions before a mental illness is developed, should be considered.
Reference to the full research article: MacKenzie LE, Patterson VC, Zwicker A, Drobinin V, Fisher HL, Abidi S, Greve AN, Bagnell A, Propper L, Alda M, Pavlova B. Hot and cold executive functions in youth with psychotic symptoms. Psychological medicine.
Click here for a link to the published abstract!
Research has shown that having unusual experiences and severe mental illness are connected with executive function impairments. However, what has not been looked at is the difference between ‘hot’ and ‘cold’ executive functions. ‘Hot’ executive functions involve emotion, motivation and rewards, whereas ‘cold’ executive functions are logical but not emotional. Since psychotic symptoms are emotional and often distressing to people, it has been suggested that ‘hot’ executive functions are more closely related to psychotic symptoms than ‘cold’ functions.
In FORBOW’s study we looked at whether impairment in ‘hot’ or ‘cold’ executive functions was connected with unusual, psychotic experiences in youth who had a parent with severe mental illness. Overall, we found that 69 out of 156 (44.23%) youth experienced psychotic symptoms. Additionally, poor scores on a task of ‘hot’ executive functioning were associated with psychotic symptoms, whereas poor scores on a ‘cold’ executive functioning task were not. This suggests that when a child or adolescent has impaired ‘hot’ executive functioning, they may be at a greater risk of developing severe mental illness later in life. Recognizing these impairments, and using interventions before a mental illness is developed, should be considered.
Reference to the full research article: MacKenzie LE, Patterson VC, Zwicker A, Drobinin V, Fisher HL, Abidi S, Greve AN, Bagnell A, Propper L, Alda M, Pavlova B. Hot and cold executive functions in youth with psychotic symptoms. Psychological medicine.
Click here for a link to the published abstract!
Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder
Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnosis, created because of concerns about the overdiagnosis of bipolar disorder in children. Signs and symptoms of DMDD include a high frequency of severe temper outbursts, sad, irritable or angry mood, and mood swings that would not be expected in a child of a certain age and maturity. When a child has family members with psychiatric disorders, they might be at a higher risk of developing psychiatric disorders themselves. Specifically, children whose parents have bipolar disorder might be at a higher risk of being diagnosed with DMDD.
In FORBOW’s recent study, we were interested in finding out whether children of parents with depression or bipolar disorder were at a greater risk of being diagnosed with DMDD than children of parents with no mental illness. This is important because by recognizing which children are at risk of developing mental illness, appropriate supports and interventions can be given to support their well-being. The results were that DMDD is uncommon (3.3%) even in children who had a parent with depression or bipolar disorder. Also, the diagnosis was only present in a small number of children of parents with depression but not in children of parents with bipolar disorder.
This study suggests that DMDD in children is not connected with a family history of bipolar disorder. Parents of children with DMDD can be reassured that DMDD is not associated with a greater risk of developing bipolar disorder in their child later on in life.
Reference to the full research article: Propper L, Cumby J, Patterson VC, Drobinin V, Glover JM, MacKenzie LE, Morash-Conway J, Abidi S, Bagnell A, Lovas D, Hajek T. Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder. The British Journal of Psychiatry.
Click here for a link to the published article abstract!
In FORBOW’s recent study, we were interested in finding out whether children of parents with depression or bipolar disorder were at a greater risk of being diagnosed with DMDD than children of parents with no mental illness. This is important because by recognizing which children are at risk of developing mental illness, appropriate supports and interventions can be given to support their well-being. The results were that DMDD is uncommon (3.3%) even in children who had a parent with depression or bipolar disorder. Also, the diagnosis was only present in a small number of children of parents with depression but not in children of parents with bipolar disorder.
This study suggests that DMDD in children is not connected with a family history of bipolar disorder. Parents of children with DMDD can be reassured that DMDD is not associated with a greater risk of developing bipolar disorder in their child later on in life.
Reference to the full research article: Propper L, Cumby J, Patterson VC, Drobinin V, Glover JM, MacKenzie LE, Morash-Conway J, Abidi S, Bagnell A, Lovas D, Hajek T. Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder. The British Journal of Psychiatry.
Click here for a link to the published article abstract!
2016
Stimulant medication and psychotic symptoms in offspring of parents with mental illness
Children who are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) are commonly prescribed stimulants (for example, medications like Ritalin, Concerta or Vyvanse) to manage their symptoms. Stimulants can help improve attention and decrease hyperactivity and impulsivity. However, there is a small possibility that some children may experience psychotic symptoms, such as seeing things that don’t exist or believing things that aren’t real. Since this outcome is rare, it is important to discover whether some children might be at a greater risk, so they have the knowledge to make treatment decisions that are right for them. It is also important because psychotic experiences as a result of medication may increase a risk of developing psychosis or other mental illnesses later on in life. One risk factor for psychotic symptoms could be having family members, such as a mother or father, with a mental illness.
At FORBOW, we wanted to find out whether children with a mother or father with mental illness, who are also taking stimulants, are more likely to have psychotic experiences than children not taking stimulants. The results showed that 62.5% of children who had taken stimulants experienced psychotic symptoms, whereas only 27.4% of children who had never taken stimulants experienced psychotic symptoms. This supports the idea that children who have a parent with mental illness might be at a higher risk of having psychotic symptoms when they take stimulants.
Reference to the full research article: MacKenzie LE, Abidi S, Fisher HL, Propper L, Bagnell A, Morash-Conway J, Glover JM, Cumby J, Hajek T, Schultze-Lutter F, Pajer K. Stimulant medication and psychotic symptoms in offspring of parents with mental illness. Pediatrics.
Click here for a link to the published article abstract!
At FORBOW, we wanted to find out whether children with a mother or father with mental illness, who are also taking stimulants, are more likely to have psychotic experiences than children not taking stimulants. The results showed that 62.5% of children who had taken stimulants experienced psychotic symptoms, whereas only 27.4% of children who had never taken stimulants experienced psychotic symptoms. This supports the idea that children who have a parent with mental illness might be at a higher risk of having psychotic symptoms when they take stimulants.
Reference to the full research article: MacKenzie LE, Abidi S, Fisher HL, Propper L, Bagnell A, Morash-Conway J, Glover JM, Cumby J, Hajek T, Schultze-Lutter F, Pajer K. Stimulant medication and psychotic symptoms in offspring of parents with mental illness. Pediatrics.
Click here for a link to the published article abstract!