Parental severe mental illnesses (SMIs), including schizophrenia, bipolar disorder, and major depressive disorder (MDD), can impact children's well-being, yet existing meta-analyses are limited in scope and methodology and do not comprehensively assess cognitive and academic performance in offspring across SMIs. This meta-analysis aimed to synthesize the existing evidence on the association between parental SMIs and offspring cognitive and academic performance. MEDLINE, EMBASE, PsycINFO, and CINAHL were searched from their inception to December 2025. We included studies assessing associations between parental SMIs and offspring cognitive/academic performance at any age, including attention, memory, language, executive function, processing speed, IQ, social cognition, and academic performance. Standardized mean differences (SMDs) between offspring of parents with SMIs and controls were calculated. Differences in cognitive performance between affected offspring and controls were pooled using random-effects meta-analyses, with robust variance estimation. The meta-analysis included 109 studies (1,586,339 participants). Parental schizophrenia was strongly associated with several cognitive domains, including general cognition (SMD = -1.07, 95% CI: -1.92, -0.22), language (-0.70; -1.20, -0.20), and IQ (-0.53; -0.72, -0.34). Parental bipolar disorder was associated with general cognition (SMD = -0.45, 95% CI = -0.79, -0.12), memory (-0.40; -0.60, -0.19), executive function (-0.34; -0.51, -0.16), IQ (-0.32; -0.48, -0.17), and language (-0.18, 95% CI -0.34, -0.02). Parental MDD showed weaker but statistically significant associations with executive function, general cognition, and language development. Children of parents with SMIs, particularly schizophrenia or bipolar disorder, are at increased risk of cognitive difficulties. Population-level early intervention strategies targeting these families may improve offspring's cognitive performance.
Adane et al. (2026) studied this question.