Parental communication linked to children’s psychosis risk
medwireNews: Communication deviance (CD) in parents is associated with increased psychosis risk in their children, a meta-analysis confirms.
The analysis included 19 case-control studies and one prospective study, involving a total of 1753 parents. After excluding one study with an unusually large effect size, the researchers found a pooled effect size from the remaining studies that was significant and of large magnitude, at 0.97.
There was significant heterogeneity among the studies, so the team, led by Paulo de Sousa (University of Liverpool, UK) ran analyses looking at the effect of variables including study type, type of control group, education, age, verbosity, diagnostic criteria, year of publication, methods of obtaining speech samples, and inter-rater reliability.
"The most striking consequence was that all of these analyses continued to reveal large and significant effect sizes suggesting that variation between studies should not undermine our overall confidence in the association between CD in parents and psychosis in offspring," the team writes in Schizophrenia Bulletin.
These analyses also revealed that the effect of CD in mothers was significantly stronger than that of CD in fathers.
De Sousa et al describe CD as "vague, fragmented, and contradictory" communication, which "compromises the development and sharing of meaning between the parent and the offspring, leading to the consequent breakdown in communication."
They cite studies showing that CD in parents precedes psychosis in children, suggesting that CD is not merely a parent's reaction to psychosis in their children. But they note the potential for shared genetic effects, in which case "CD among parents of psychotic offspring should be interpreted against a broader context of cognitive deficits that are believed to be an expression of genetic liability for schizophrenia among unaffected first-degree relatives."
Nevertheless, the researchers say that interventions aimed at family interactions could have important clinical effects, as parental CD has been linked not only to psychosis development in children, but also to relapse.
"Hence, a fruitful avenue for enhancing these interventions might be to target the quality of the family communication from a CD standpoint," they suggest.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Eleanor McDermid, Senior medwireNews Reporter