THE HIGHER prevalence of schizophrenia in children born to schizophrenic patients compared with the general population has generated interest in learning how being born to one or both parents with the disease alters the pre-morbid functions of the brain and behaviour in these children.

Children of parents who are both schizophrenic have a 33 per cent likelihood of inheriting the disease.

A study undertaken by researchers at SCARF (Schizophrenia Research Foundation), Chennai, compared neuropsychological functioning in children at risk with normal children born to normal parents.

Vulnerable group

Several studies have explored neurocognitive and behavioural functioning in the vulnerable group. These studies suggest that neurocognitive deficits (poor memory, attentiveness) and behavioural problems may be possible vulnerability markers.

A group of children, of patients under treatment for schizophrenia at SCARF, in the age group of 10 to 20 years, were assessed for neurocognitive functioning, intelligence and behavioural problems. Information on behavioural problems in the two groups was elicited in order to ascertain if the group at risk had a higher occurrence of such problems.

They were compared with children born to parents with no history of psychiatric problems. The assessments included various neurocognitive measures. Information on behavioural problems was obtained from the parents.

Target group

A total of 100 children, whose one or both parents were schizophrenic, were recruited. The control group comprised 100 normal children who had no history of schizophrenia or other psychiatric problems and whose parents were normal. Both the groups were matched for age and gender.

There were 52 boys and 46 girls among the risk group and 48 boys and 54 girls in the control group.

Most of the tests on neurocognitive functioning showed that children at risk performed poorly when compared with the controls. The differences were statistically significant. The findings of the study indicate the relevance of neurocognitive dysfunctions in children at risk to developing schizophrenia. The battery of neurocognitive tests used has shown that the children of schizophrenic parents scored poorer in memory, problem solving skills and perceptual motor skills.

This has been amply supported in a number of studies of populations at genetic risk for schizophrenia.

Impairment in these essential cognitive functions is seen not only as a core factor in the etiology of the disorder but as a significant predictor of who will actually develop schizophrenia.

Social behaviour

The findings also throw light on the deficits in social behaviour in the study group. Behavioural problems most frequently recorded included adamancy, aggressiveness, lack of social adjustment, clumsiness, restlessness and faulty eating habits (demanding food items inappropriate to their financial conditions).

The study helps in the identification of problems in high-risk children early. Early identification of cognitive dysfunction and behavioural problems in children belonging to high risk category will help them in dealing with these problems and help improve their current functioning, says Dr. Padmavathi Ramachandran, Consultant Psychiatrist, SCARF.

At SCARF, this study prompted the initiative to start a Child Guidance Clinic at the foundation's headquarters in Chennai, which offers help to children at risk of developing schizophrenia.

Management would include, educating parents in behaviour management, early identification of schizophrenia symptoms and prompt treatment.

The children and parents are helped by: techniques to improve attention, concentration, memory; behaviour modification strategies; parenting techniques; use of art and play as therapy; general counselling; assertiveness training; anger management; time management; stress management; dealing with problems around examination time; improving self esteem.

As part of the services, SCARF is also providing similar strategies to children born to normal parents. This programme is run by Dr S. Anuradha, Clinical Psychologist and Dr. Mubeen Taj, Consultant Psychiatrist.

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