Association between cognitive phenotype in unaffected siblings and prospective 3-and 6-year clinical outcome in their proband affected by psychosis
Burger, Thijs J.; Schirmbeck, Frederike; Vermeulen, Jentien M.; Quee, Piotr J.; De Koning, Mariken B.; Bruggeman, Richard; De Haan, Lieuwe; Van Amelsvoort, Therese; Bartels-Velthuis, Agna A.; Bruggeman, Richard; Cahn, Wiepke; De Haan, Lieuwe; Schirmbeck, Frederike; Simons, Claudia J.P.; Van Os, Jim
(2021) Psychological medicine, volume 51, issue 11, pp. 1916 - 1926
(Article)
Abstract
BackgroundCognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients.MethodsIn total, 629 probands with non-affective psychosis
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and their sibling not affected by psychosis were assessed at baseline, 3-and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes ('normal', 'mixed' and 'impaired') in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype.ResultsProbands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype.ConclusionsCross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.
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Keywords: Cognition, cognitive phenotype, familial risk, long-term outcome, psychosis, siblings, symptomatic outcome, Applied Psychology, Psychiatry and Mental health, Journal Article
ISSN: 0033-2917
Publisher: Cambridge University Press
Note: Funding Information: The infrastructure for the GROUP study is funded through the Geestkracht program of the Dutch Health Research Council (Zon-Mw, grant number 10-000-1001), and matching funds from participating pharmaceutical companies (Lundbeck, AstraZeneca, Eli Lilly and Janssen Cilag) and universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia Psycho-medical Center, The Hague. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGzE, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Mondriaan, Virenze riagg, Zuyderland GGZ, MET ggz, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal and Delta). Publisher Copyright: Copyright © The Author(s) 2020. Published by Cambridge University Press.
(Peer reviewed)