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


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.

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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).

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Correspondence to Ditte Ellersgaard.

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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

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