An Explanatory Model to Predict Pediatric Psychosis Spectrum Based on Parent Psychiatric Profile and Children and Adolescents Comorbid Disorders as a Mediator Construct
,
Abstract
Objective: Psychosis is one of the most vital disorders in children and youths. The definite pathophysiology of schizophrenia and other psychotic disorders in the growth period has remained ambiguous. Therefore, the purpose of the current study was to investigate the predictive value of parental psychiatric disorders and the mediator role of comorbid disorders of children and youths.
Method: The sample, consisting of 29884 individuals aged between 6 to 18 years old from the Iranian population, were selected by multistage cluster sampling during September 22, 2016 to January 3, 2018. Parents were requested to complete a survey around their potential psychiatric disorders, based on their Millon’s Clinical Multiaxial Inventory-III (MCMI-III). The Semi-Structured Interview (Kiddie-SADS-Present, Lifetime Form (K-SADS-PL)) was utilized to analyze psychiatric disorders concurring to the DSM.
Results: The fit indices of the model show that the research model has a good fit and the psychiatric disorders of parents directly and indirectly through comorbid disorders are effective on the psychosis symptoms of children and adolescents (RMSEA=0.06, CFI=0.89, PGFI=0.75, PNFI=0.75).The incidence of Schizotypal Personality Disorder, Anxiety, Bipolar Spectrum Disorder, PTSD, Schizophrenia Spectrum and Delusional Disorder were statistically higher in parents of psychotic children and adolescents. However, Borderline Personality Disorder was more frequent among their mothers while Alcohol Dependency and Drug Dependency were significantly more prevalent among their fathers.
Conclusion: The outcomes of our study showed that there were statistically significant differences between the mean scores of each scale assessed by Millon’s inventory between parents of psychotic versus non-psychotic pediatric cases. In addition, psychiatric disorders were more common among children and youths with psychosis spectrum in comparison with the general population.
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6. Meyers LS, Gamst G, Guarino AJ. Applied multivariate research: Design and interpretation: Sage publications; 2016.
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9. Dalsgaard S, Mortensen PB, Frydenberg M, Maibing CM, Nordentoft M, Thomsen PH. Association between Attention-Deficit Hyperactivity Disorder in childhood and schizophrenia later in adulthood. Eur Psychiatry. 2014;29(4):259-63.
10. Bevan Jones R, Thapar A, Lewis G, Zammit S. The association between early autistic traits and psychotic experiences in adolescence. Schizophr Res. 2012;135(1-3):164-9.
11. Engqvist U, Rydelius PA. The occurrence and nature of early signs of schizophrenia and psychotic mood disorders among former child and adolescent psychiatric patients followed into adulthood. Child Adolesc Psychiatry Ment Health. 2008;2(1):30.
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13. Jacob T, Leonard KE, Randolph Haber J. Family interactions of alcoholics as related to alcoholism type and drinking condition. Alcohol Clin Exp Res. 2001;25(6):835-43.
14. Cengel Kültür SE, Unal MF, Ozusta S. [Psychopathology in children of alcoholic fathers]. Turk Psikiyatri Derg. 2006;17(1):3-11.
15. Dvir Y, Denietolis B, Frazier JA. Childhood trauma and psychosis. Child Adolesc Psychiatr Clin N Am. 2013;22(4):629-41.
16. Hainsworth C, Starling J, Brand F, Groen K, Munro K. Trauma and psychotic symptoms: data from a pediatric mental health inpatient unit. J Trauma Stress. 2011;24(4):491-4.
17. Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand. 2005;112(5):330-50.
18. Davis KL. Neuropsychopharmacology: the fifth generation of progress: an official publication of the American College of Neuropsychopharmacology: LWW; 2002.
19. Cannon M, Jones PB, Murray RM. Obstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiatry. 2002;159(7):1080-92.
20. McClellan J, McCurry C, Speltz ML, Jones K. Symptom factors in early-onset psychotic disorders. J Am Acad Child Adolesc Psychiatry. 2002;41(7):791-8.
21. Castro-Fornieles J, Baeza I, de la Serna E, Gonzalez-Pinto A, Parellada M, Graell M, et al. Two-year diagnostic stability in early-onset first-episode psychosis. J Child Psychol Psychiatry. 2011;52(10):1089-98.
22. Schnack HG, Nieuwenhuis M, van Haren NE, Abramovic L, Scheewe TW, Brouwer RM, et al. Can structural MRI aid in clinical classification? A machine learning study in two independent samples of patients with schizophrenia, bipolar disorder and healthy subjects. Neuroimage. 2014;84:299-306.
23. Peña J, Ojeda N, Segarra R, Eguiluz JI, García J, Gutiérrez M. Executive functioning correctly classified diagnoses in patients with first-episode psychosis: evidence from a 2-year longitudinal study. Schizophr Res. 2011;126(1-3):77-80.
24. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019;14(1):1-15.
25. Ghanizadeh A. ADHD, bruxism and psychiatric disorders: does bruxism increase the chance of a comorbid psychiatric disorder in children with ADHD and their parents? Sleep Breath. 2008;12(4):375-80.
26. Millon T, Davis RD. The millon adolescent personality inventory and the millon adolescent clinical inventory. J Couns Dev. 1993;71(5):570-4.
27. Sharifi A, Molavi H, Namdari K. Diagnostic validity of Millon Clinical Multiaxial Inventory–III. Science and Research in Psychology. 2007;34:27-38.
28. Millon T. Millon clinical multiaxial inventory: I & II. Journal of Counseling & Development. 1992;70(3):421-6.
29. Mohammadi MR, Ahmadi N, Kamali K, Khaleghi A, Ahmadi A. Epidemiology of Psychiatric Disorders in Iranian Children and Adolescents (IRCAP) and Its Relationship with Social Capital, Life Style and Parents' Personality Disorders: Study Protocol. Iran J Psychiatry. 2017;12(1):66-72.
30. Mulaik SA, James LR, Van Alstine J, Bennett N, Lind S, Stilwell CD. Evaluation of goodness-of-fit indices for structural equation models. Psychological bulletin. 1989;105(3):430.
31. Parnas J, Cannon TD, Jacobsen B, Schulsinger H, Schulsinger F, Mednick SA. Lifetime DSM-III-R diagnostic outcomes in the offspring of schizophrenic mothers. Results from the Copenhagen High-Risk Study. Arch Gen Psychiatry. 1993;50(9):707-14.
32. Goodman SH. Emory University Project on Children of Disturbed Parents. Schizophr Bull. 1987;13(3):411-23.
33. McGrath JJ, McLaughlin KA, Saha S, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, et al. The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries. Psychol Med. 2017;47(7):1230-45.
34. Cutajar MC, Mullen PE, Ogloff JR, Thomas SD, Wells DL, Spataro J. Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Arch Gen Psychiatry. 2010;67(11):1114-9.
35. Mørkved N, Endsjø M, Winje D, Johnsen E, Dovran A, Arefjord K, et al. Childhood trauma in schizophrenia spectrum disorder as compared to other mental health disorders. Psychosis. 2017;9(1):48-56.
36. Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 2012;38(4):661-71.
37. Bonoldi I, Simeone E, Rocchetti M, Codjoe L, Rossi G, Gambi F, et al. Prevalence of self-reported childhood abuse in psychosis: a meta-analysis of retrospective studies. Psychiatry Res. 2013;210(1):8-15.
38. McGrath JJ, Saha S, Al-Hamzawi AO, Alonso J, Andrade L, Borges G, et al. Age of Onset and Lifetime Projected Risk of Psychotic Experiences: Cross-National Data From the World Mental Health Survey. Schizophr Bull. 2016;42(4):933-41.
39. Kelleher I, Cannon M. Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychol Med. 2011;41(1):1-6.
2. Gottesman II. Schizophrenia genesis: The origins of madness: WH Freeman/Times Books/Henry Holt & Co; 1991.
3. Starling J, Feijo I. Schizophrenia and other psychotic disorders of early onset. IACAPAP Textbook of Child and Adolescent Mental Health. 2012.
4. Kendler KS, Gruenberg AM, Kinney DK. Independent diagnoses of adoptees and relatives as defined by DSM-III in the provincial and national samples of the Danish Adoption Study of Schizophrenia. Arch Gen Psychiatry. 1994;51(6):456-68.
5. Kendler KS, McGuire M, Gruenberg AM, O'Hare A, Spellman M, Walsh D. The Roscommon Family Study. I. Methods, diagnosis of probands, and risk of schizophrenia in relatives. Arch Gen Psychiatry. 1993;50(7):527-40.
6. Meyers LS, Gamst G, Guarino AJ. Applied multivariate research: Design and interpretation: Sage publications; 2016.
7. Mortensen PB, Pedersen MG, Pedersen CB. Psychiatric family history and schizophrenia risk in Denmark: which mental disorders are relevant? Psychol Med. 2010;40(2):201-10.
8. Şahin Ş, Elboğa G. Family history in chronic psychotic disorders. Med. Sci. Discov. 2019;6(2):8-11.
9. Dalsgaard S, Mortensen PB, Frydenberg M, Maibing CM, Nordentoft M, Thomsen PH. Association between Attention-Deficit Hyperactivity Disorder in childhood and schizophrenia later in adulthood. Eur Psychiatry. 2014;29(4):259-63.
10. Bevan Jones R, Thapar A, Lewis G, Zammit S. The association between early autistic traits and psychotic experiences in adolescence. Schizophr Res. 2012;135(1-3):164-9.
11. Engqvist U, Rydelius PA. The occurrence and nature of early signs of schizophrenia and psychotic mood disorders among former child and adolescent psychiatric patients followed into adulthood. Child Adolesc Psychiatry Ment Health. 2008;2(1):30.
12. Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R. Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry. 2003;60(7):709-17.
13. Jacob T, Leonard KE, Randolph Haber J. Family interactions of alcoholics as related to alcoholism type and drinking condition. Alcohol Clin Exp Res. 2001;25(6):835-43.
14. Cengel Kültür SE, Unal MF, Ozusta S. [Psychopathology in children of alcoholic fathers]. Turk Psikiyatri Derg. 2006;17(1):3-11.
15. Dvir Y, Denietolis B, Frazier JA. Childhood trauma and psychosis. Child Adolesc Psychiatr Clin N Am. 2013;22(4):629-41.
16. Hainsworth C, Starling J, Brand F, Groen K, Munro K. Trauma and psychotic symptoms: data from a pediatric mental health inpatient unit. J Trauma Stress. 2011;24(4):491-4.
17. Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand. 2005;112(5):330-50.
18. Davis KL. Neuropsychopharmacology: the fifth generation of progress: an official publication of the American College of Neuropsychopharmacology: LWW; 2002.
19. Cannon M, Jones PB, Murray RM. Obstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiatry. 2002;159(7):1080-92.
20. McClellan J, McCurry C, Speltz ML, Jones K. Symptom factors in early-onset psychotic disorders. J Am Acad Child Adolesc Psychiatry. 2002;41(7):791-8.
21. Castro-Fornieles J, Baeza I, de la Serna E, Gonzalez-Pinto A, Parellada M, Graell M, et al. Two-year diagnostic stability in early-onset first-episode psychosis. J Child Psychol Psychiatry. 2011;52(10):1089-98.
22. Schnack HG, Nieuwenhuis M, van Haren NE, Abramovic L, Scheewe TW, Brouwer RM, et al. Can structural MRI aid in clinical classification? A machine learning study in two independent samples of patients with schizophrenia, bipolar disorder and healthy subjects. Neuroimage. 2014;84:299-306.
23. Peña J, Ojeda N, Segarra R, Eguiluz JI, García J, Gutiérrez M. Executive functioning correctly classified diagnoses in patients with first-episode psychosis: evidence from a 2-year longitudinal study. Schizophr Res. 2011;126(1-3):77-80.
24. Mohammadi MR, Ahmadi N, Khaleghi A, Mostafavi SA, Kamali K, Rahgozar M, et al. Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents. Iran J Psychiatry. 2019;14(1):1-15.
25. Ghanizadeh A. ADHD, bruxism and psychiatric disorders: does bruxism increase the chance of a comorbid psychiatric disorder in children with ADHD and their parents? Sleep Breath. 2008;12(4):375-80.
26. Millon T, Davis RD. The millon adolescent personality inventory and the millon adolescent clinical inventory. J Couns Dev. 1993;71(5):570-4.
27. Sharifi A, Molavi H, Namdari K. Diagnostic validity of Millon Clinical Multiaxial Inventory–III. Science and Research in Psychology. 2007;34:27-38.
28. Millon T. Millon clinical multiaxial inventory: I & II. Journal of Counseling & Development. 1992;70(3):421-6.
29. Mohammadi MR, Ahmadi N, Kamali K, Khaleghi A, Ahmadi A. Epidemiology of Psychiatric Disorders in Iranian Children and Adolescents (IRCAP) and Its Relationship with Social Capital, Life Style and Parents' Personality Disorders: Study Protocol. Iran J Psychiatry. 2017;12(1):66-72.
30. Mulaik SA, James LR, Van Alstine J, Bennett N, Lind S, Stilwell CD. Evaluation of goodness-of-fit indices for structural equation models. Psychological bulletin. 1989;105(3):430.
31. Parnas J, Cannon TD, Jacobsen B, Schulsinger H, Schulsinger F, Mednick SA. Lifetime DSM-III-R diagnostic outcomes in the offspring of schizophrenic mothers. Results from the Copenhagen High-Risk Study. Arch Gen Psychiatry. 1993;50(9):707-14.
32. Goodman SH. Emory University Project on Children of Disturbed Parents. Schizophr Bull. 1987;13(3):411-23.
33. McGrath JJ, McLaughlin KA, Saha S, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, et al. The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries. Psychol Med. 2017;47(7):1230-45.
34. Cutajar MC, Mullen PE, Ogloff JR, Thomas SD, Wells DL, Spataro J. Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Arch Gen Psychiatry. 2010;67(11):1114-9.
35. Mørkved N, Endsjø M, Winje D, Johnsen E, Dovran A, Arefjord K, et al. Childhood trauma in schizophrenia spectrum disorder as compared to other mental health disorders. Psychosis. 2017;9(1):48-56.
36. Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 2012;38(4):661-71.
37. Bonoldi I, Simeone E, Rocchetti M, Codjoe L, Rossi G, Gambi F, et al. Prevalence of self-reported childhood abuse in psychosis: a meta-analysis of retrospective studies. Psychiatry Res. 2013;210(1):8-15.
38. McGrath JJ, Saha S, Al-Hamzawi AO, Alonso J, Andrade L, Borges G, et al. Age of Onset and Lifetime Projected Risk of Psychotic Experiences: Cross-National Data From the World Mental Health Survey. Schizophr Bull. 2016;42(4):933-41.
39. Kelleher I, Cannon M. Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychol Med. 2011;41(1):1-6.
| Files | ||
| Issue | Vol 19 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v19i2.15109 | |
| Keywords | ||
| Adolescence Environmental Effects Genetic Effects Psychiatric Disorders Psychos’ Spectrum | ||
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How to Cite
1.
Mohammadi MR, Ahmadi A, Karimi R, Hooshyari Z. An Explanatory Model to Predict Pediatric Psychosis Spectrum Based on Parent Psychiatric Profile and Children and Adolescents Comorbid Disorders as a Mediator Construct. Iran J Psychiatry. 2024;19(2):226-234.
