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VIA 7, 11 & 15 – The Danish High Risk and Resilience Study

Principal investigator Anne Amalie Elgaard Thorup, MD, professor.

The Danish High Risk and Resilience Study VIA 7, 11 & 15 has followed a cohort of 7-year-old children, the majority of whom has a mother or a father with one of two diagnoses. The VIA-studies are hunting down relationships that will increase our understanding of the development of schizophrenia and bipolar disorder. The purpose is to, amongst other things, analyze the significance of genetic risk, familiar risk and environmental factors on development of psychiatric illness and especially bipolar disorder and schizophrenia. By continuing to follow the cohort in the VIA 11 study (when the children are 11 years old) and VIA 15 study (when the children are 15 years old), it will be possible to investigate the psychological and biological development and resilience in children, who have a well-defined genetic voulnerability. Hopefully this study can contribute to the identification of biomarkers, differences in risk profiles and factors, that promote mental health in children. ​

Having one (or two) parents with either bipolar disorder or schizophrenia puts a child at higher risk of developing serious mental illness. The VIA 7 study describes early risk factors and aims to uncover the mental health of children whose parents are diagnosed with one of the two diseases. The VIA 11 study is the first follow-up, where the children are examined again at the age of 11, this time also with blood tests and an MRI scan of the brain. The VIA 15 study is the second follow-up, which examines the now young people's risk behaviour, school skills, mental health and again includes blood tests and brain scans.

A greater understanding of resilience in children

The Danish High Risk and Resilience Study examines how we can predict the development of serious mental illness later in life at an early stage, but also focuses on the children who remain healthy. Some children show early signs of mental illness, but the symptoms may be transient. However, we do not know why some children seem to overcome the risk and outgrow the symptoms. It can be connected to several different factors, e.g. good cognitive abilities, good support and stimulation in the home environment, limited amount of stressful life events or good relations with the surrounding society, e.g. through leisure interests or other communities.

It is of great importance to learn more about resilience and disease development in children and young people in order to understand why some children, who have an innate genetic vulnerability and thus an increased risk, develop mental illness, while others do not. The study of children with a familial predisposition helps to understand what other factors are important in how they fare throughout life.

The possibility to examine this large and representative cohort group of children of exactly the same age, and to be able to carry out repeated clinical examinations over time, is remarkable and a great strength of the study. The researchers look in the two follow-up studies for familial vulnerability, examine the children clinically for symptoms, perform magnetic resonance (MR) scanning of the brain, and also do an electrophysiological study (EEG) to monitor the brain's electrical impulses and identify biological markers of psychological vulnerability and resilience.

The researchers' interest in exploring the neurobiological basis for the changes and developmental disorders found in the children stems from the hope that it will eventually be possible to develop treatment methods that directly address the deviations and problems that exist and strengthen the areas in the brain and the functions that are affected in children from families at risk of serious mental illness. Furthermore, the researchers hope to become better at identifying precursors to mental illness and to initiate early, preventive intervention. At the same time, the researchers are working to increase knowledge about the importance of mental illness in a parent in a family.

Engaged and motivated families

Previous MRI studies, which have focused on healthy family members, have yielded inconsistent results, and are most often performed in adolescents or young adults. There are very few studies that have examined young people with a familial risk of serious mental illness with MRI examinations, and no studies have examined children before the age of puberty, as has been the case with the VIA studies.

The motivation to participate in the study again in VIA 11 has been very high among the families who first participated in the VIA 7 study. Among other things, this may be a result of the professionalism and deep commitment with which the families have been met at both the first and second survey, where the follow-up percentage was 89 – a participation rate the researchers are very happy with, and which they hope will continue in the years ahead. The plan is to follow the group until at least the age of 21, and if funding can be obtained, even longer.​



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