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A dimensional approach to assessing psychiatric risk in adults born very preterm

Published online by Cambridge University Press:  19 January 2018

Jasmin Kroll ,
Sean Froudist-Walsh ,
Philip J. Brittain ,
Chieh-En J. Tseng ,
Vyacheslav Karolis ,
Robin M. Murray  and
Chiara Nosarti
Jasmin Kroll
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
Sean Froudist-Walsh
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY 10029, USA
Philip J. Brittain
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
Chieh-En J. Tseng
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
Vyacheslav Karolis
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
Robin M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
Chiara Nosarti*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, St Thomas’ Hospital, London SE1 7EH, UK
*
Author for correspondence: Chiara Nosarti, E-mail: [email protected]
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Abstract

Background

Individuals who were born very preterm have higher rates of psychiatric diagnoses compared with term-born controls; however, it remains unclear whether they also display increased sub-clinical psychiatric symptomatology. Hence, our objective was to utilize a dimensional approach to assess psychiatric symptomatology in adult life following very preterm birth.

Methods

We studied 152 adults who were born very preterm (before 33 weeks’ gestation; gestational range 24–32 weeks) and 96 term-born controls. Participants’ clinical profile was examined using the Comprehensive Assessment of At-Risk Mental States (CAARMS), a measure of sub-clinical symptomatology that yields seven subscales including general psychopathology, positive, negative, cognitive, behavioural, motor and emotional symptoms, in addition to a total psychopathology score. Intellectual abilities were examined using the Wechsler Abbreviated Scale of Intelligence.

Results

Between-group differences on the CAARMS showed elevated symptomatology in very preterm participants compared with controls in positive, negative, cognitive and behavioural symptoms. Total psychopathology scores were significantly correlated with IQ in the very preterm group only. In order to examine the characteristics of participants’ clinical profile, a principal component analysis was conducted. This revealed two components, one reflecting a non-specific psychopathology dimension, and the other indicating a variance in symptomatology along a positive-to-negative symptom axis. K-means (k = 4) were used to further separate the study sample into clusters. Very preterm adults were more likely to belong to a high non-specific psychopathology cluster compared with controls.

Conclusion and Relevance

Very preterm individuals demonstrated elevated psychopathology compared with full-term controls. Their psychiatric risk was characterized by a non-specific clinical profile and was associated with lower IQ.

Keywords

developmental riskdimensional psychiatrypretermpsychopathologyneurodevelopment
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 10 , July 2018 , pp. 1738 - 1744
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

These authors contributed equally to this work.

References

Aarnoudse-Moens, CS, Smidts, DP, Oosterlaan, J, Duivenvoorden, HJ and Weisglas-Kuperus, N (2009) Executive function in very preterm children at early school age. Journal of Abnormal Child Psychology 37, 981–993.Google Scholar
Anderson, PJ and Doyle, LW (2004) Executive functioning in school-aged children who were born very preterm or with extremely low birth weight in the 1990s. Pediatrics 114, 50–57.Google Scholar
Arpi, E and Ferrari, F (2013) Preterm birth and behaviour problems in infants and preschool-age children: a review of the recent literature. Developmental Medicine & Child Neurology 55, 788–796.Google Scholar
Ball, G, Pazderova, L, Chew, A, Tusor, N, Merchant, N, Arichi, T et al. (2015) Thalamocortical connectivity predicts cognition in children born preterm. Cerebral Cortex 25, 4310–4318.CrossRefGoogle ScholarPubMed
Benjamini, Y and Hochberg, Y (1995) Controlling the false discovery rate – a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society Series B-Methodological 57, 289–300.Google Scholar
Botting, N, Powls, A, Cooke, RW and Marlow, N (1997) Attention deficit hyperactivity disorders and other psychiatric outcomes in very low birthweight children at 12 years. Journal of Child Psychology and Psychiatry 38, 931–941.CrossRefGoogle Scholar
Burnett, A, Davey, CG, Wood, SJ, Wilson-Ching, M, Molloy, C, Cheong, JL et al. (2014) Extremely preterm birth and adolescent mental health in a geographical cohort born in the 1990s. Psychological Medicine 44, 1533–1544.Google Scholar
Cannon, TD, Rosso, IM, Hollister, JM, Bearden, CE, Sanchez, LE and Hadley, T (2000) A prospective cohort study of genetic and perinatal influences in the etiology of schizophrenia. Schizophrenia Bulletin 26, 351–366.Google Scholar
Carta, MG and Angst, J (2016) Screening for bipolar disorders: a public health issue. Journal of Affective Disorders 205, 139–143.CrossRefGoogle ScholarPubMed
Catani, M, Dell'Acqua, F, Budisavljevic, S, Howells, H, Thiebaut de Schotten, M, Froudist-Walsh, S et al. (2016) Frontal networks in adults with autism spectrum disorder. Brain 139, 616–630.Google Scholar
Delobel-Ayoub, M, Arnaud, C, White-Koning, M, Casper, C, Pierrat, V, Garel, M et al. (2009) Behavioral problems and cognitive performance at 5 years of age after very preterm birth: the EPIPAGE study. Pediatrics 123, 1485–1492.CrossRefGoogle ScholarPubMed
Demjaha, A, Valmaggia, L, Stahl, D, Byrne, M and McGuire, P (2012) Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophrenia Bulletin 38, 351–359.Google Scholar
D'Onofrio, BM, Class, QA, Rickert, ME, Larsson, H, Langstrom, N and Lichtenstein, P (2013) Preterm birth and mortality and morbidity: a population-based quasi-experimental study. JAMA Psychiatry 70, 1231–1240.Google Scholar
Dutta, R, Greene, T, Addington, J, McKenzie, K, Phillips, M and Murray, RM (2007) Biological, life course, and cross-cultural studies all point toward the value of dimensional and developmental ratings in the classification of psychosis. Schizophrenia Bulletin 33, 868–876.Google Scholar
Elgen, I, Sommerfelt, K and Markestad, T (2002) Population based, controlled study of behavioural problems and psychiatric disorders in low birthweight children at 11 years of age. Archives of Disease in Childhood 87, F128–F132.Google Scholar
Fischi-Gomez, E, Vasung, L, Meskaldji, DE, Lazeyras, F, Borradori-Tolsa, C, Hagmann, P et al. (2014) Structural brain connectivity in school-Age preterm infants provides evidence for impaired networks relevant for higher order cognitive skills and social cognition. Cerebal Cortex 25, 2793–2805.CrossRefGoogle ScholarPubMed
Friston, KJ and Frith, CD (1995) Schizophrenia: a disconnection syndrome? Clinical Neuroscience. 3, 89–97.Google Scholar
Froudist-Walsh, S, Bloomfield, M, Veronese, M, Kroll, J, Karolis, V, Jauhar, J et al. (2017) The effect of perinatal brain injury on dopaminergic function and hippocampal volume in adult life. eLife 6, e29088.Google Scholar
Froudist-Walsh, S, Karolis, V, Caldinelli, C, Brittain, PJ, Kroll, J, Rodriguez-Toscano, E et al. (2015) Very early brain damage leads to remodeling of the working memory system in adulthood: a combined fMRI/tractography study. Journal of Neuroscience 35, 15787–15799.Google Scholar
Fusar-Poli, P, Deste, G, Smieskova, R, Barlati, S, Yung, AR, Howes, O et al. (2012) Cognitive functioning in prodromal psychosis: a meta-analysis. Archives of General Psychiatry 69, 562–571.Google Scholar
Hack, M, Taylor, HG, Schluchter, M, Andreias, L, Drotar, D and Klein, N (2009) Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental & Behavioral Pediatrics 30, 122–130.Google Scholar
Hack, M, Youngstrom, EA, Cartar, L, Schluchter, M, Taylor, HG, Flannery, D et al. (2004) Behavioral outcomes and evidence of psychopathology among very low birth weight infants at age 20 years. Pediatrics 114, 932–940.Google Scholar
Healy, E, Reichenberg, A, Nam, KW, Allin, MP, Walshe, M, Rifkin, L et al. (2013) Preterm birth and adolescent social functioning-alterations in emotion-processing brain areas. The Journal of Pediatrics 163, 1596–1604.Google Scholar
Her Majesty's Stationary Office H (1991) Office of Population Censuses and Surveys, Standard Occupational Classification. London: HMSO.Google Scholar
Howes, OD and Kapur, S (2009) The dopamine hypothesis of schizophrenia: version III – the final common pathway. Schizophrenia Bulletin 35, 549–562.Google Scholar
Howes, OD and Murray, RM (2014) Schizophrenia: an integrated sociodevelopmental-cognitive model. Lancet 383, 1677–1687.CrossRefGoogle ScholarPubMed
Hudziak, JJ, Achenbach, TM, Althoff, RR and Pine, DS (2007) A dimensional approach to developmental psychopathology. International Journal of Methods Psychiatric Research 16(Suppl 1), S16–S23.Google Scholar
Indredavik, MS, Vik, T, Evensen, KA, Skranes, J, Taraldsen, G and Brubakk, AM (2010) Perinatal risk and psychiatric outcome in adolescents born preterm with very low birth weight or term small for gestational age. The Journal of Developmental and Behavioral Pediatrics 31, 286–294.Google Scholar
Johnson, S, Hollis, C, Kochhar, P, Hennessy, E, Wolke, D and Marlow, N (2010) Psychiatric disorders in extremely preterm children: longitudinal finding at age 11 years in the EPICure study. Journal of the American Academy of Child and Adolescent Psychiatry 49, 453–63 e1.Google Scholar
Johnson, S and Marlow, N (2011) Preterm birth and childhood psychiatric disorders. Pediatric Research 69, 11R–18R.Google Scholar
Johnson, S and Marlow, N (2014) Growing up after extremely preterm birth: lifespan mental health outcomes. Seminars in Fetal & Neonatal Medicine 19, 97–104.Google Scholar
Johnson, S and Wolke, D (2013) Behavioural outcomes and psychopathology during adolescence. Early Human Development 89, 199–207.Google Scholar
Karolis, VR, Froudist-Walsh, S, Brittain, PJ, Kroll, J, Ball, G, Edwards, AD et al. (2016) Reinforcement of the brain's rich-club architecture following early neurodevelopmental disruption caused by very preterm birth. Cerebal Cortex 26, 1322–1335.Google Scholar
Kendler, KS, Gallagher, TJ, Abelson, JM and Kessler, RC (1996) Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Archives in General Psychiatry 53, 1022–1031.Google Scholar
Lærum, AM, Reitan, SK, Evensen, KA, Lydersen, S, Brubakk, AM, Skranes, J et al. (2017) Psychiatric disorders and general functioning in low birth weight adults: a longitudinal study. Pediatrics 139, e20162135.Google Scholar
Landis, JR and Koch, GG (1977) The measurement of observer agreement for categorical data. Biometrics 33, 159–174.Google Scholar
Lund, LK, Vik, T, Lydersen, S, Lohaugen, GC, Skranes, J, Brubakk, AM et al. (2012) Mental health, quality of life and social relations in young adults born with low birth weight. Health & Quality of Life Outcomes 10, 146.Google Scholar
Lund, LK, Vik, T, Skranes, J, Brubakk, AM and Indredavik, MS (2011) Psychiatric morbidity in two low birth weight groups assessed by diagnostic interview in young adulthood. Acta Paediatrica 100, 598–604.Google Scholar
McLaughlin, KA, Koenen, KC, Friedman, MJ, Ruscio, AM, Karam, EG, Shahly, V et al. (2015) Subthreshold posttraumatic stress disorder in the world health organization world mental health surveys. Biological Psychiatry 77, 375–384.Google Scholar
Montagna, A and Nosarti, C (2016) Socio-emotional development following very preterm birth: pathways to psychopathology. Frontiers in Psychology 7, 80.Google Scholar
Nam, KW, Castellanos, N, Simmons, A, Froudist-Walsh, S, Allin, MP, Walshe, M et al. (2015) Alterations in cortical thickness development in preterm-born individuals: implications for high-order cognitive functions. NeuroImage 115, 64–75.CrossRefGoogle ScholarPubMed
Nierop, M, Os, J, Gunther, N, Zelst, C, Graaf, R, Have, MT et al. (2014) Does social defeat mediate the association between childhood trauma and psychosis? Evidence from the NEMESIS-2 study. Acta Psychiatrica Scandinavica 129(6), 467–476.Google Scholar
Nosarti, C, Reichenberg, A, Murray, RM, Cnattingius, S, Lambe, MP, Yin, L et al. (2012) Preterm birth and psychiatric disorders in young adult life. Archives of General Psychiatry 69, E1–E8.CrossRefGoogle ScholarPubMed
Nosarti, C, Walshe, M, Rushe, TM, Rifkin, L, Wyatt, J, Murray, RM et al. (2011) Neonatal ultrasound results following very preterm birth predict adolescent behavioral and cognitive outcome. Developmental Neuropsychology 36, 118–135.Google Scholar
Papini, C, White, TP, Montagna, A, Brittain, PJ, Froudist-Walsh, S, Kroll, J et al. (2016) Altered resting-state functional connectivity in emotion-processing brain regions in adults who were born very preterm. Psychological Medicine, 1–15.Google ScholarPubMed
Pinto-Martin, JA, Levy, SE, Feldman, JF, Lorenz, JM, Paneth, N and Whitaker, AH (2011) Prevalence of autism spectrum disorder in adolescents born weighing <2000 grams. Pediatrics 128, 883–891.Google Scholar
Prata, DP, Mechelli, A, Fu, CH, Picchioni, M, Kane, F, Kalidindi, S et al. (2009) Opposite effects of catechol-O-methyltransferase Val158Met on cortical function in healthy subjects and patients with schizophrenia. Biological Psychiatry 65, 473–480.Google Scholar
Pyhälä, R, Wolford, E, Kautiainen, H, Andersson, S, Bartmann, P, Baumann, N et al. (2017) Self-Reported mental health problems among adults born preterm: a meta-analysis. Pediatrics 139, e20162690.Google Scholar
Reininghaus, U, Kempton, MJ, Valmaggia, L, Craig, TK, Garety, P, Onyejiaka, A et al. (2016) Stress sensitivity, aberrant salience, and threat anticipation in early psychosis: an experience sampling study. Schizophrenia Bulletin 42, 712–722.Google Scholar
Somhovd, MJ, Hansen, BM, Brok, J, Esbjorn, BH and Greisen, G (2012) Anxiety in adolescents born preterm or with very low birthweight: a meta-analysis of case-control studies. Developmental Medicine & Child Neurology 54, 988–994.CrossRefGoogle ScholarPubMed
Stewart, AL, Costello, AM, Hamilton, PA, Baudin, J, Townsend, J, Bradford, BC et al. (1989) Relationship between neurodevelopmental status of very preterm infants at one and four years. Developmental Medicine & Child Neurology 31, 756–765.Google Scholar
Takahashi, T, Wood, SJ, Yung, AR, Soulsby, B, McGorry, PD, Suzuki, M et al. (2009) Progressive gray matter reduction of the superior temporal gyrus during transition to psychosis. Archive of General Psychiatry 66, 366–376.Google Scholar
Treyvaud, K, Doyle, LW, Lee, KJ, Roberts, G, Lim, J, Inder, TE et al. (2012) Social-emotional difficulties in very preterm and term 2 year olds predict specific social-emotional problems at the age of 5 years. Journal of Pediatric Psychology 37, 779–785.Google Scholar
Treyvaud, K, Ure, A, Doyle, LW, Lee, KJ, Rogers, CE, Kidokoro, H et al. (2013) Psychiatric outcomes at age seven for very preterm children: rates and predictors. Journal of Child Psychology and Psychiatry 54, 772–779.CrossRefGoogle ScholarPubMed
Valmaggia, LR, Day, FL, Kroll, J, Laing, J, Byrne, M, Fusar-Poli, P et al. (2015) Bullying victimisation and paranoid ideation in people at ultra high risk for psychosis. Schizophrenia Research 168, 68–73.Google Scholar
Van Lieshout, RJ, Boyle, MH, Saigal, S, Morrison, K and Schmidt, LA (2015) Mental health of extremely low birth weight survivors in their 30s. Pediatrics 135, 452–459.Google Scholar
van Os, J and Kapur, S (2009) Schizophrenia. Lancet 374, 635–645.Google Scholar
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P and Krabbendam, L (2009) A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179–195.Google Scholar
Walshe, M, Rifkin, L, Rooney, M, Healy, E, Nosarti, C, Wyatt, J et al. (2008) Psychiatric disorder in young adults born very preterm: role of family history. European Psychiatry 23, 527–531.Google Scholar
Wechsler, D (1999) Wechsler Abbreviated Scale of Intelligence. New York: The Psychological Corporation.Google Scholar
Wiles, NJ, Peters, TJ, Leon, DA and Lewis, G (2005) Birth weight and psychological distress at age 45–51 years: results from the Aberdeen children of the 1950s cohort study. British Journal of Psychiatry 187, 21–28.Google Scholar
Wolke, D, Baumann, N, Strauss, V, Johnson, S and Marlow, N (2015) Bullying of preterm children and emotional problems at school age: cross-culturally invariant effects. The Journal of Pediatrics 166, 1417–1422.Google Scholar
Wolke, D, Waylen, A, Samara, M, Steer, C, Goodman, R, Ford, T et al. (2009) Selective drop-out in longitudinal studies and non-biased prediction of behaviour disorders. The British Journal of Psychiatry 195, 249–256.Google Scholar
Woodward, LJ, Lu, Z, Morris, AR and Healey, DM (2017) Preschool self regulation predicts later mental health and educational achievement in very preterm and typically developing children. Clinical Neuropsychology 31, 404–422.Google Scholar
Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'Olio, M et al. (2005) Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Australian & New Zealand Journal of Psychiatry 39, 964–971.Google Scholar