Although patients with bipolar disorder, bipolar psychosis, and schizophrenia share several early risk factors, patients with schizophrenia often have more severe cognitive problems during childhood than those with bipolar disorder, according to a new study.
Bipolar disorder and schizophrenia share several elements including age of onset, family history patterns, as well as similar symptoms leading up to the disorder. Patients who develop bipolar psychosis have even more in common with those who develop schizophrenia.
However, until now, there has been minimal research into how cognitive impairment in childhood and adolescence differs between individuals who later develop schizophrenia compared with those who go on to develop bipolar disorder or bipolar psychosis.
To further investigate these early risk factors, Larry J. Seidman, Ph.D., of the Department of Psychiatry at Harvard Medical School recently conducted a study using data from 99 patients with either bipolar psychosis or schizophrenia as well as data from 101 nonpsychotic control participants.
Seidman assessed the participants’ IQs and cognitive abilities using data from school tests when they were seven years old and also looked at family history to determine its influence on future psychosis.
He found that although bipolar disorder, bipolar psychosis, and schizophrenia all shared early risk factors, the participants with schizophrenia had more severe cognitive impairments and memory and attention deficits in childhood than the participants with bipolar disorder or bipolar psychosis.
Family history greatly increased the risk for psychosis in all of the participants — most prominently in those who developed schizophrenia. The patients with bipolar had the lowest levels of cognitive impairment and academic problems in childhood, followed closely by those who later developed bipolar psychosis.
Seidman hopes that these study findings will give educators valuable information that can be used to identify children most at risk for future psychotic problems. He also believes that these findings could help prevent children from being misdiagnosed with other conditions that often mimic symptoms arising before the actual illness, such as defiance issues or attention deficit hyperactivity (ADHD).
Children with neuropsychological problems, especially those with a family history of psychosis, should be closely monitored and targeted for early identification of schizophrenia, bipolar disorder or bipolar psychosis, said Seidman.
“Future work should assess genetic and environmental factors that explain this [family history] effect,” he said.
Source: Psychological Medicine