Early Childhood Neurocognition in Relation to Middle Childhood Psychotic Experiences in Children at Familial High Risk of Schizophrenia or Bipolar Disorder and Population-Based Controls: The Danish High Risk and Resilience Study.

This article investigates the longitudinal associations between early childhood neurocognitive functioning and the risk of psychotic experiences in middle childhood among children at familial high risk of schizophrenia (FHR-SZ), familial high risk of bipolar disorder (FHR-BP), and population-based controls (PBC). Using data from the Danish High Risk and Resilience Study, neurocognitive functions at age 7—including intelligence, processing speed, attention, memory, working memory, and set-shifting—were assessed, and psychotic experiences from ages 7 to 11 were evaluated through interviews. The study found that impaired set-shifting at age 7 was specifically associated with an increased risk of psychotic experiences in children at FHR-SZ, while poorer working memory and visuospatial memory predicted psychotic experiences across all groups. Adjusting for concurrent psychopathology attenuated some associations, suggesting that neurocognitive impairments may serve as early vulnerability markers but are influenced by other factors. The findings highlight set-shifting as a potential early risk marker for psychotic experiences in children at familial risk of schizophrenia and underscore the need for further research on neurocognitive predictors of psychosis in high-risk populations.