title: Intellectual disability and other neuropsychiatric outcomes in high-risk children of mothers with schizophrenia, bipolar disorder and unipolar major depression.
abstract: BACKGROUND
  Recent evidence points to partially shared genetics of neuropsychiatric disorders.
  
  
  OBJECTIVE
  We examined risk of intellectual disability and other neuropsychiatric outcomes in 3174 children of mothers with schizophrenia, bipolar disorder or unipolar major depression compared with 3129 children of unaffected mothers.
  
  
  METHODS
  We used record linkage across Western Australian population-based registers. The contribution of obstetric factors to risk of intellectual disability was assessed.
  
  
  RESULTS
  Children were at significantly increased risk of intellectual disability with odds ratios (ORs) of 3.2 (95% CI 1.8-5.7), 3.1 (95% CI 1.9-4.9) and 2.9 (95% CI 1.8-4.7) in the maternal schizophrenia, bipolar disorder and unipolar depression groups respectively. Multivariate analysis suggests familial and obstetric factors may contribute independently to the risk. Although summated labour/delivery complications (OR = 1.4, 95% CI 1.0-2.0) just failed to reach significance, neonatal encephalopathy (OR = 7.7, 95% CI 3.0-20.2) and fetal distress (OR = 1.8, 95% CI 1.1-2.7) were independent significant predictors. Rates of rare syndromes in children of mothers with mental disorder were well above population rates. Risk of pervasive developmental disorders, including autism, was significantly elevated for children of mothers with bipolar disorder. Risk of epilepsy was doubled for children of mothers with unipolar depression.
  
  
  CONCLUSIONS
  Our findings provide epidemiological support for clustering of neuropsychiatric disorders. Further larger epidemiological studies are warranted.
authors.affiliation: School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Level 3 Medical Research Foundation Building, Rear 50 Murray Street, Perth, 6000, Western Australia, Australia. Vera.Morgan@uwa.edu.au
authors.forename: Vera A
authors.initials: VA
authors.lastname: Morgan
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Croft
authors.forename: Giulietta M
authors.initials: GM
authors.lastname: Valuri
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Zubrick
authors.forename: Carol
authors.initials: C
authors.lastname: Bower
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McNeil
authors.forename: Assen V
authors.initials: AV
authors.lastname: Jablensky
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology*; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D035583:Rare Diseases / Q000453:epidemiology; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D012640:Seizures / Q000453:epidemiology; D014904:Western Australia / Q000453:epidemiology