Influence of maternal and paternal history in symptoms, cognition and metacognition in people with first-episode psychosis

Abstract Background Previous studies have found that the best predictor of individual risk when developing one or several mental and neurocognitive disorders is family history of mental disorder, more specifically, first degree relatives. The estimated risk of developing schizophrenia is of approximately 10% in individuals that present a paternal or maternal risk of psychosis, increasing to a 50% if both parents are affected; in comparison to a 1% risk in general population (Hall, 1994; Hannon et al., 2016). Having a first-degree family member with psychosis is the best individual risk predictor in developing mental or neurocognitive disorders (Bhatia et al., 2016; Thorup et al., 2018). However, literature exploring the role of family history of psychosis on symptoms, cognition, social cognition and metacognition in first-episode of psychosis (FEP) is scarce, and there is a dearth of studies examining the influence of the maternal and paternal history of psychosis independently. Methods The main aim of the present study is to assess the clinical, cognitive, social cognitive and metacognitive variables in people with FEP with family risk, considering the maternal and paternal history of mental disorder separately. As secondary aims, we will assess the clinical, cognitive, social cognition and metacognition variables considering the presence of a maternal and paternal history of psychosis. Methods A transversal, descriptive, observational design was chosen for this study. The sample was composed of people with a recent onset of psychosis, recruited from 10 public centers in Spain. We recruited 186 individuals with FEP between 18 and 45 years of age. We collected information about the diagnosis of mother and father with mental disorders. Symptoms were assed with the PANSS. A battery of questionnaires on metacognition and social cognition variables was included. Neurocognitive functioning was measured. The statistical analysis was done using SPSS. Results Individuals with a maternal history of a mental disorder showed higher scores in delusional experiences (p=0.004) and scored lower in general functioning as measured by the GAF (p=0.029). The individuals with the presence of a maternal history of psychosis scored significantly higher in the positive subscale of the PANSS (p=0.030). Individuals with a paternal history of psychotic disorder scored worse in high expectations and the need for adapting to the others and they had a greater presence of externalizing bias than those without a paternal history (p=0.026). Discussion Results yield that there is a higher prevalence of a maternal history of psychosis than the paternal history of psychosis, and furthermore, these individuals exhibit a specific clinical, cognitive, social and metacognitive profile. This study raises awareness on the different profiles of persons with first-episode psychosis and the influence of the family history on clinical, cognitive, social and metacognitive variables, which should be taken into account when offering individualized early treatment.