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A population-based longitudinal study of childhood neurodevelopmental disorders, IQ and subsequent risk of psychotic experiences in adolescence

Published online by Cambridge University Press:  25 April 2014

G. M. Khandaker ,
J. Stochl ,
S. Zammit ,
G. Lewis  and
P. B. Jones
G. M. Khandaker*
Affiliation:
Department of Psychiatry, University of Cambridge, UK Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK
J. Stochl
Affiliation:
Department of Psychiatry, University of Cambridge, UK Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
S. Zammit
Affiliation:
Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
G. Lewis
Affiliation:
Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK Mental Health Sciences Unit, University College London, UK
P. B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, UK Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
*
*Address for correspondence: Dr G. M. Khandaker, Department of Psychiatry, Box 189, Cambridge Biomedical Campus, Cambridge CB2 2QQ, UK. (Email: gmk24@medscl.cam.ac.uk)
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Abstract

Background.

Schizophrenia has a neurodevelopmental component to its origin, and may share overlapping pathogenic mechanisms with childhood neurodevelopmental disorders (NDs). Nevertheless, longitudinal studies of psychotic outcomes among individuals with NDs are limited. We report a population-based prospective study of six common childhood NDs, subsequent neurocognitive performance and the risk of psychotic experiences (PEs) in early adolescence.

Method.

PEs were assessed by semi-structured interviews at age 13 years. IQ and working memory were measured between ages 9 and 11 years. The presence of six NDs (autism spectrum, dyslexia, dyspraxia, dysgraphia, dysorthographia, dyscalculia) was determined from parent-completed questionnaires at age 9 years. Linear regression calculated the mean difference in cognitive scores between children with and without NDs. Associations between NDs and PEs were expressed as odds ratios (ORs) with 95% confidence intervals (CIs); effects of cognitive deficits were examined. Potential confounders included age, gender, father's social class, ethnicity and maternal education.

Results.

Out of 8220 children, 487 (5.9%) were reported to have NDs at age 9 years. Children with, compared with those without, NDs performed worse on all cognitive measures; the adjusted mean difference in total IQ was 6.84 (95% CI 5.00–8.69). The association between total IQ and NDs was linear (p < 0.0001). The risk of PEs was higher in those with, compared with those without, NDs; the adjusted OR for definite PEs was 1.76 (95% CI 1.11–2.79). IQ (but not working memory) deficit partly explained this association.

Conclusions.

Higher risk of PEs in early adolescence among individuals with childhood ND is consistent with the neurodevelopmental hypothesis of schizophrenia.

Keywords

autism spectrum disorderdyslexiaIQneurocognitive performanceneurodevelopmental disorderpsychotic experiences
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 15 , November 2014 , pp. 3229 - 3238
Copyright
Copyright © Cambridge University Press 2014 

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