Quality of life and self-esteem in 7-year-old children with familial high risk of schizophrenia or bipolar disorder: the Danish High Risk and Resilience Study-VIA 7—a population-based cohort study

Abstract

It is well established that children with familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) have a higher risk of developing mental disorders, however, little is known of to what degree the genetic and environmental vulnerabilities affect the quality of life and self-esteem of these children. We aimed to compare the quality of life and self-esteem between children with FHR-SZ or FHR-BP and controls. We used Danish nationwide registers to retrieve a cohort of 522 7-year-old children with FHR-SZ or FHR-BP and controls. Quality of life was assessed with the ‘Health-related Quality of Life Screening Instrument’, KIDSCREEN-27, and the scale ‘Social Acceptance (Bullying)’ from the KIDSCREEN-52. Self-esteem was assessed with the self-report scale ‘I think I am’. Assessors were blind to familial risk status of the children. Children with FHR-SZ displayed lower levels of the general quality of life, as well as lower scores on the ‘Psychological Well-being’ scale and the ‘School Environment’ scale of the KIDSCREEN-27 compared with controls. Both children with FHR-SZ and FHR-BP reported more bullying victimization compared with controls. Children with FHR-SZ reported lower self-esteem on the total scale of ‘I think I am’, as well as on the ‘Skills and talents’, the ‘Psychological well-being’, and the ‘Relationships with others’ subscales compared with controls. The findings of lower quality of life and self-esteem in children with FHR-SZ together with more bullying victimization in both familial high-risk groups call for studies on low risk, early intervention strategies towards this group of vulnerable children.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. 1.

    Dean K, Stevens H, Mortensen PB et al (2010) Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Arch Gen Psychiatry 67:822–829. https://doi.org/10.1001/archgenpsychiatry.2010.86

    Article  PubMed  Google Scholar 

  2. 2.

    Rasic D, Hajek T, Alda M, Uher R (2014) Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophr Bull 40:28–38. https://doi.org/10.1093/schbul/sbt114

    Article  PubMed  Google Scholar 

  3. 3.

    Thorup AAE, Laursen TM, Munk-Olsen T et al (2017) Incidence of child and adolescent mental disorders in children aged 0–17 with familial high risk for severe mental illness—a Danish register study. Schizophr Res. https://doi.org/10.1016/j.schres.2017.11.009

    Article  PubMed  Google Scholar 

  4. 4.

    Ross RG, Compagnon N (2001) Diagnosis and treatment of psychiatric disorders in children with a schizophrenic parent. Schizophr Res 50:121–129

    CAS  Article  Google Scholar 

  5. 5.

    Sanchez-Gistau V, Romero S, Moreno D et al (2015) Psychiatric disorders in child and adolescent offspring of patients with schizophrenia and bipolar disorder: a controlled study. Schizophr Res 168:197–203. https://doi.org/10.1016/j.schres.2015.08.034

    Article  PubMed  Google Scholar 

  6. 6.

    Goetz M, Sebela A, Mohaplova M et al (2017) Psychiatric disorders and quality of life in the offspring of parents with bipolar disorder. J Child Adolesc Psychopharmacol. https://doi.org/10.1089/cap.2016.0056

    Article  PubMed  Google Scholar 

  7. 7.

    Bella T, Goldstein T, Axelson D et al (2011) Psychosocial functioning in offspring of parents with bipolar disorder. J Affect Disord 133:204–211. https://doi.org/10.1016/j.jad.2011.03.022

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Agnew-Blais J, Seidman LJ (2013) Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and qualitative review. Cogn Neuropsychiatry 18:44–82. https://doi.org/10.1080/13546805.2012.676309

    Article  PubMed  Google Scholar 

  9. 9.

    Bora E, Özerdem A (2017) A meta-analysis of neurocognition in youth with familial high risk for bipolar disorder. Eur Psychiatry 44:17–23. https://doi.org/10.1016/j.eurpsy.2017.02.483

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    de la Serna E, Sugranyes G, Sanchez-Gistau V et al (2017) Neuropsychological characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder. Schizophr Res 183:110–115. https://doi.org/10.1016/j.schres.2016.11.007

    Article  PubMed  Google Scholar 

  11. 11.

    Ranning A, Munk Laursen T, Thorup A et al (2016) Children of parents with serious mental illness: with whom do they grow up? A prospective, population-based study. J Am Acad Child Adolesc Psychiatry 55:953–961. https://doi.org/10.1016/j.jaac.2016.07.776

    Article  PubMed  Google Scholar 

  12. 12.

    Ranning A, Munk Laursen T, Thorup A et al (2015) Serious mental illness and disrupted caregiving for children: a nationwide, register-based cohort study. J Clin Psychiatry 76:e1006–1014. https://doi.org/10.4088/JCP.13m08931

    Article  PubMed  Google Scholar 

  13. 13.

    Thorup AAE, Jepsen JR, Ellersgaard DV et al (2015) The Danish High Risk and Resilience Study-VIA 7—a cohort study of 520 7-year-old children born of parents diagnosed with either schizophrenia, bipolar disorder or neither of these two mental disorders. BMC Psychiatry 15:233. https://doi.org/10.1186/s12888-015-0616-5

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Ellersgaard D, Jessica Plessen K, Richardt Jepsen J et al (2018) Psychopathology in 7-year-old children with familial high risk of developing schizophrenia spectrum psychosis or bipolar disorder—the Danish High Risk and Resilience Study-VIA 7, a population-based cohort study. World Psychiatry 17:210–219. https://doi.org/10.1002/wps.20527

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Burton BK, Thorup AAE, Jepsen JR et al (2017) Impairments of motor function among children with a familial risk of schizophrenia or bipolar disorder at 7 years old in Denmark: an observational cohort study. Lancet Psychiatry 4:400–408. https://doi.org/10.1016/S2215-0366(17)30103-7

    Article  PubMed  Google Scholar 

  16. 16.

    Hemager N, Plessen KJ, Thorup A et al (2018) Assessment of neurocognitive functions in 7-year-old children at familial high risk for schizophrenia or bipolar disorder: the Danish High Risk and Resilience Study VIA 7. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2018.1415

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Alkan O, Kushnir J, Bar M, Kushnir T (2016) Quality of life of adult daughters of women with schizophrenia: associations with psychological resource losses and gains. Compr Psychiatry 68:11–17. https://doi.org/10.1016/j.comppsych.2016.03.002

    Article  PubMed  Google Scholar 

  18. 18.

    Pavlickova H, Turnbull OH, Myin-Germeys I, Bentall RP (2015) The inter-relationship between mood, self-esteem and response styles in adolescent offspring of bipolar parents: an experience sampling study. Psychiatry Res 225:563–570. https://doi.org/10.1016/j.psychres.2014.11.046

    Article  PubMed  Google Scholar 

  19. 19.

    Gomes BC, Kleinman A, Carvalho AF et al (2016) Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder. J Affect Disord 202:53–57. https://doi.org/10.1016/j.jad.2016.05.041

    Article  PubMed  Google Scholar 

  20. 20.

    Manjula M, Raguram A (2009) Self-concept in adult children of schizophrenic parents: an exploratory study. Int J Soc Psychiatry 55:471–479. https://doi.org/10.1177/0020764008094732

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Goodday SM, Bentall R, Jones S et al (2018) Coping strategies and self-esteem in the high-risk offspring of bipolar parents. Aust N Z J Psychiatry. https://doi.org/10.1177/0004867418761577

    Article  PubMed  Google Scholar 

  22. 22.

    Pellegrini D, Kosisky S, Nackman D et al (1986) Personal and social resources in children of patients with bipolar affective disorder and children of normal control subjects. Am J Psychiatry 143:856–861. https://doi.org/10.1176/ajp.143.7.856

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Jones SH, Tai S, Evershed K et al (2006) Early detection of bipolar disorder: a pilot familial high-risk study of parents with bipolar disorder and their adolescent children. Bipolar Disord 8:362–372. https://doi.org/10.1111/j.1399-5618.2006.00329.x

    Article  PubMed  Google Scholar 

  24. 24.

    Nagler S, Glueck Z (1985) The clinical interview. Schizophr Bull 11:38–47

    CAS  Article  Google Scholar 

  25. 25.

    The KIDSCREEN Group Europe (2006) The KIDSCREEN Questionnaires—quality of life questionnaires for children and adolescents. Handbook. Pabst Science Publishers, Lengerich

    Google Scholar 

  26. 26.

    Ravens-Sieberer U, Gosch A, Rajmil L et al (2005) KIDSCREEN-52 quality-of-life measure for children and adolescents. Expert Rev Pharmacoecon Outcomes Res 5:353–364. https://doi.org/10.1586/14737167.5.3.353

    Article  PubMed  Google Scholar 

  27. 27.

    Ouvinen-Birgerstam P (2006) Sådan er Jeg-Dansk vejledning. Hogrefe Psykologisk Forlag, Denmark

  28. 28.

    Kaufman J, Birmaher B, Brent D et al (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988. https://doi.org/10.1097/00004583-199707000-00021

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Caldwell B, Bradley R (2003) Home inventory administration manual. Print Design. Inc, Little Rock

    Google Scholar 

  30. 30.

    Pavlickova H, Turnbull OH, Bentall RP (2014) Discrepancies between explicit and implicit self-esteem and their relationship to symptoms of depression and mania. Psychol Psychother 87:311–323. https://doi.org/10.1111/papt.12015

    Article  PubMed  Google Scholar 

  31. 31.

    Trzesniewski KH, Donnellan MB, Moffitt TE et al (2006) Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood. Dev Psychol 42:381–390. https://doi.org/10.1037/0012-1649.42.2.381

    Article  PubMed  Google Scholar 

  32. 32.

    Lewandowski RE, Verdeli H, Wickramaratne P et al (2014) Predictors of positive outcomes in offspring of depressed parents and non-depressed parents across 20 years. J Child Fam Stud 23:800–811. https://doi.org/10.1007/s10826-013-9732-3

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Klomek AB, Sourander A, Elonheimo H (2015) Bullying by peers in childhood and effects on psychopathology, suicidality, and criminality in adulthood. Lancet Psychiatry 2:930–941. https://doi.org/10.1016/S2215-0366(15)00223-0

    Article  PubMed  Google Scholar 

  34. 34.

    Thomas HJ, Connor JP, Lawrence DM et al (2017) Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth. Aust N Z J Psychiatry 51:909–920. https://doi.org/10.1177/0004867417707819

    Article  PubMed  Google Scholar 

  35. 35.

    Strauss GP, Raugh IM, Mittal VA et al (2018) Bullying victimization and perpetration in a community sample of youth with psychotic like experiences. Schizophr Res 195:534–536. https://doi.org/10.1016/j.schres.2017.08.056

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the families participating in the study. Mette Skjærbæk, Heidi Jensen, Marianne Melau, Cecilie Gregersen, Henriette Stadsgaard, Kate Zahle, and Maria Henriksen contributed to data collection. Carsten Bøcker Pedersen and Marianne Giørtz Pedersen retrieved the register extract. Jessica Ohland and Manon Chaine contributed to data management. MD Jamal Uddin gave statistical advice. This work was supported by the Mental Health services of the Capital Region of Denmark, the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) (Grant nos. R102-A9118 and R155-2014-1724), Aarhus University, and the Beatrice Surovell Haskell Fund for Child Mental Health Research of Copenhagen (Grant no. J.NR 11531).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Ditte Ellersgaard.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interests.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 58 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Ellersgaard, D., Gregersen, M., Ranning, A. et al. Quality of life and self-esteem in 7-year-old children with familial high risk of schizophrenia or bipolar disorder: the Danish High Risk and Resilience Study-VIA 7—a population-based cohort study. Eur Child Adolesc Psychiatry 29, 849–860 (2020). https://doi.org/10.1007/s00787-019-01397-3

Download citation

Keywords

  • Schizophrenia
  • Bipolar disorder
  • Familial high risk
  • Quality of life
  • Self-esteem