Abstract: In Uganda, a previous study reported high HIV prevalence in persons with severe mental illness (SMI) compared to the general population, suggesting that persons with SMI might constitute a high-risk group for HIV. However, the study included first-time psychiatric admissions only, a group whose HIV prevalence may not reflect the prevalence in persons with SMI in general. We determined prevalence and correlates of HIV in both first-time and previous psychiatric admissions, in a psychiatric hospital in Uganda.
Abstract: Although increased risk for schizophrenia among immigrants is well established, knowledge of the broader spectrum of psychiatric disorders associated with a foreign migration background is lacking.
Abstract: Despite a history of conflicts and widespread human rights violation in sub-Saharan Africa, little is known about the prevalence of interpersonal violence among the population in this region. Evidence from high-income countries suggests that exposure to violence has mental health consequences and violence also has associations with experiences of sexual coercion.
Abstract: Second-generation immigrants have an increased risk of schizophrenia, a finding that still lacks a satisfactory explanation. Various operational definitions of second-generation immigrants have been used, including foreign parental country of birth. However, with increasing global migration, it is not clear that parental country of birth necessarily is informative with regard to ethnicity. We compare two independently collected measures of parental foreign ethnicity, parental foreign country of birth versus genetic divergence, based on genome-wide genotypic data, to access which measure most efficiently captures the increased risk of schizophrenia among second-generation immigrants residing in Denmark.
Abstract: Little focus has been paid to the role of mental health among young people with regard to risky sexual behavior and HIV prevention in sub-Saharan Africa. The aim of this study was to investigate the relationship between poor mental health and risky sexual behavior (HIV/AIDS) among a population of university students in Uganda.
Abstract: Increased incidence rates of schizophrenia in immigrants still lack a satisfactory explanation. The aim of this study was to examine the hypothesis that risk factors for schizophrenia also increase the risk of emigration to a foreign country. If valid, Danes emigrating from Denmark carry a higher predisposition to develop schizophrenia compared to Danes living in Denmark.
Abstract: Poor mental health predicts sexual risk behaviours in high-income countries, but little is known about this association in low-income settings in sub-Saharan Africa where HIV is prevalent. This study investigated whether depression, psychological distress and alcohol use are associated with sexual risk behaviours in young Ugandan adults.
Abstract: Violence against women is an increasing global phenomenon. Little is known about violence against foreign-born women, despite a possible increased concentration of risk factors in this group.
Abstract: This study investigated whether 'unwanted pregnancy' (i.e. a negative or ambivalent attitude towards the pregnancy/reproduction) is associated with schizophrenia-spectrum and affective disorders in the offspring in adulthood, and if so, whether other pregnancy, perinatal, childhood or genetic-risk factors account for this association.
Abstract: The mechanism underlying the association between urban birth/upbringing and increased schizophrenia risk is unknown. This study explored whether an urban effect might be present in a low-income country setting, where the ;urban' environment may have radically different components, for example urban architecture, pollution levels or social cohesion.
Abstract: Accumulating evidence suggests that AIDS orphanhood status is accompanied by increased levels of psychological distress such as anxiety, depression, intense guilt, shame, and anger. However, few studies have examined the possible reduction of psychological distress in AIDS orphans through the help of interventions that promote well-being. The objective of the study was to evaluate the effects of a school-based peer-group support intervention combined with periodic somatic health assessments and treatment on the psychosocial well-being of AIDS orphans in the Mbarara District of southwestern Uganda. In a cluster randomized controlled design, 326 AIDS orphans aged 10-15 years were assigned to either peer-group support intervention combined with monthly somatic healthcare (n=159) or control group (n=167) for follow-up assessment. Baseline and 10 week follow-up psychological assessments were conducted in both groups using self-administered Beck Youth Inventories. Complete data were available for 298 orphans. After adjusting for baseline scores, follow-up scores for the intervention group in comparison with controls showed significant improvement in depression, anger, and anxiety but not for self-concept. This study demonstrated that peer-group support intervention decreased psychological distress, particularly symptoms of depression, anxiety and anger. Thus, the use of peer-group support interventions should be incorporated into existing school health programs.
Abstract: The cause of increased schizophrenia rates among immigrants in Europe is unknown. This study explores psychotic features in persons aspiring and actively planning to emigrate, prior to their potential emigration.
Abstract: Urban birth, a risk factor for schizophrenia, is more frequent among second-generation immigrants. The aim of the current study was to determine whether the increased risk for schizophrenia found in second-generation immigrants is explained by the degree of urbanization of birthplace and/or factors related to parentage, such as geographic origin or history of residence abroad during upbringing.
Abstract: An exploration of the evidence that a history of migration is a risk factor for schizophrenia and an evaluation of those studies that seek an explanation for this.
Abstract: The increased schizophrenia risks for residents of cities with high levels of competition and for members of disadvantaged groups (for example migrants from low- and middle-income countries, people with low IQ, hearing impairments or a history of abuse) suggest that social factors are important for aetiology. Dopaminergic dysfunctioning is a key mechanism in pathogenesis. This editorial is a selective literature review to delineate a mechanism whereby social factors can disturb dopamine function in the brain. Experiments with rodents have shown that social defeat leads to dopaminergic hyperactivity and to behavioural sensitisation, whereby the animal displays an enhanced behavioural and dopamine response to dopamine agonists. Neuroreceptor imaging studies have demonstrated the same phenomena in patients with schizophrenia who had never received antipsychotics. In humans, the chronic experience of social defeat may lead to sensitisation (and/or increased baseline activity) of the mesolimbic dopamine system and thereby increase the risk for schizophrenia.
Abstract: Increasing numbers of intercountry adoptees are reaching adulthood, the age of onset for most serious mental disorders. Little is known about the development of schizophrenia in intercountry adoptees, a group with potentially increased vulnerability. The aim of this study was to investigate the risk of developing schizophrenia in adoptees and in non-adoptees.
Abstract: More than 11 million children under 15 years in sub-Saharan Africa have lost at least one parent to AIDS. In Uganda, about 2 million children are orphans, with one or both parents dead. The objective of this study was to investigate the psychosocial consequences of AIDS orphanhood in a rural district in Uganda and to identify potential areas for future interventions. The study was conducted in a randomly selected sub-county in Bushenyi District in Uganda. The study population consisted of 123 children aged 11-15 years whose parents (one or both) were reported to have died from AIDS and 110 children of similar age and gender living in intact households in the same neighbourhood. Symptoms of psychological distress were assessed using the Beck Youth Inventories of Emotional and Social Impairment (BYI). The standardized interview also included questions concerning current and past living conditions. A multivariate analysis of factors with possible relevance for BYI outcome showed that orphan status was the only significant outcome predictor. Orphans had greater risk (vs. non-orphans) for higher levels of anxiety (odds ratios (OR)=6.4), depression (OR=6.6), and anger (OR=5.1). Furthermore, orphans had significantly higher scores than non-orphans on individual items in the Beck Youth Depression Inventory that are regarded as particularly "sensitive" to the possible presence of a depressive disorder, i.e. vegetative symptoms, feelings of hopelessness, and suicidal ideation. High levels of psychological distress found in AIDS orphans suggest that material support alone is not sufficient for these children.
Abstract: The authors synthesize findings of previous studies implicating migration as a risk factor for the development of schizophrenia and provide a quantitative index of the associated effect size.
Abstract: Previous findings of increased rates of psychotic disorders among immigrants to Sweden are primarily based on hospital samples. The aim of the current study was to compare the risks of first contact for psychotic and schizophrenic disorders among first- and second-generation immigrants to the risks in native 'Swedes'.
Abstract: The hypothesis that chronic and long-term experience of 'social defeat' may increase the risk for schizophrenia is proposed. This increased risk may result from sensitisation of the mesolimbic dopamine system and/or increased baseline activity of this system. Data supporting the social defeat hypothesis are presented.
Abstract: While the association between increased maternal age and congenital disorders has long been recognized, the offspring of older fathers are also at increased risk of congenital disorders related to DNA errors during spermatogenesis. Recent studies have drawn attention to an association between increased paternal age and increased risk of schizophrenia. The aim of the current study was to examine both paternal and maternal age as risk factors for the broader category of psychosis.
Abstract: A growing body of evidence suggests that migration is a risk factor for the development of schizophrenia, although the putative mechanism remains obscure.
Abstract: Little is known about the possible mechanisms contributing to increased risk for psychosis found among immigrants. We used the NATO bombing campaign of Kosovo as a naturalistic experiment to explore the role of potentially stressful aspects of minority group status. We examined all patient admissions to the psychiatric clinic in Malmö during the months of the NATO campaign in Kosovo in 1999 and during control months in 1997. Admission rates showed significantly differing trends over time, with an increasing proportion of immigrant patients with psychosis admitted during the NATO campaign months and a decreasing proportion of such patients admitted during control months. A significantly greater proportion of the immigrant patients admitted for psychosis during the NATO campaign months versus control months had been exposed to extreme duress before migration. Cumulative adversity, either solely or in combination with current stress, may possibly contribute to increased risk for psychosis among immigrants.
Abstract: Maternal stress during pregnancy is a possible risk factor for schizophrenia in the offspring. Using data from the Israel Psychiatric Registry we examined the impact of wars in Israel.
Abstract: The meaning and relevance of the increased rates of neuromotoric deviation (ND) observed in patients with schizophrenia and their biological relatives remain unclear. ND could represent free-floating, independent characteristics of individuals in these families vs. signs of an increased risk for current or future mental disorder. The co-temporaneous relationship between ND and mental disorder at 6 years of age was investigated among 31 children with an increased risk for schizophrenia and similar psychoses, defined as having a mother with a history of schizophrenia or unspecified functional psychosis. As compared with high-risk cases with a low level of ND, the subgroup of 10 high-risk offspring showing notably increased rates of ND had significantly more frequent psychiatric diagnoses (typically language disorders and enuresis), poor functioning on global assessment, poor interpersonal competency and high anxiety proneness. Neuromotoric items representing "overflow" (e.g., choreatic movements, tremor) were significantly positively related to each of these mental characteristics. Among high-risk offspring, an increased rate of ND is very clearly associated with increased rates of current mental disorder, and might potentially identify a subgroup with an especially high risk for serious mental disorder in the future.
Abstract: The incidence of schizophrenia among Surinamese immigrants to the Netherlands is high. The authors tested Ødegaard's hypothesis that this phenomenon is explained by selective migration.
Abstract: Previous studies have shown high rates of psychosis among Afro-Caribbean immigrants to the UK and immigrants to the Netherlands. Rates of schizophrenia-like psychoses (SLP), i.e. schizophrenia or other non-affective psychosis, among the native-born and immigrant populations were assessed in Malmö, the city in Sweden with the highest proportion of immigrants.
Abstract: The question of whether dyskinesia of the type found in tardive dyskinesia (TD) related to schizophrenia has a neurodevelopmental background was studied in a sample of 60 younger schizophrenia patients (mean age 38 years) and 21 of their non-ill siblings. TD-like dyskinesia was studied in relation to selected risk factors in the patients, and to neurological abnormality and parkinsonism in both patients and siblings. One or more signs of TD-like dyskinesia in patients were predicted by male gender, a history of obstetric complications, shorter illness duration, and shorter neuroleptic exposure. One or more signs of TD-like dyskinesia were found in 28.5 percent of the siblings and tended to be associated with neurological abnormality. Little co-occurrence of TD-like dyskinesia was found in the sibling and the patient in the same family. Patients' TD-like dyskinesia was significantly associated with hard neurological signs (independent of involuntary movements) but not with soft signs or primitive reflexes per se. TD-like dyskinesia showed a significant positive relationship to parkinsonism in patients. TD-like dyskinesia in younger schizophrenia patients appears to have neurodevelopmental antecedents and seems to represent one aspect of the total neurological abnormality associated with schizophrenia.
Abstract: The purpose of the current study is twofold: (a) to provide an overall synthesis of recent research on substance abuse in schizophrenia and (b) to present findings in a Swedish patient sample. Studies conducted since 1990 have found a wide range of abuse prevalence rates, with male gender and younger age as primary correlates. Less certainty exists regarding substance abuse as an independent risk factor for schizophrenia and its further impact on illness course. In a sample of 87 patients attending a psychiatric clinic in Malmö, lifetime prevalence of substance abuse was 48.3%, with abuse debut primarily preceding first contact for psychotic symptoms. Significant correlates of abuse were male gender, family history of substance abuse, and increased rates of hospitalization and criminality, with poorer outcome found in previous as well as current abusers. Alcohol abuse, either solely or in combination with other substances, was the main type of substance abuse. Although the specific factors (social, behavioural, genetic) that predispose schizophrenic patients to substance abuse remain unclear, the predominantly male profile of abusers might suggest a link between substance abuse and the poorer clinical outcome frequently observed, especially in male schizophrenic patients.
Abstract: The aim of the study was to determine whether a history of obstetric complications and congenital minor physical anomalies are related to differences in the characteristics of brain structures observed within monozygotic twin pairs discordant for schizophrenia.
Abstract: Minor physical anomalies (MPAs) are minor congenital malformations which are found with significantly increased frequency among both patients with schizophrenia and their siblings, suggesting the effect of early developmental disturbance in their families. The aim of this study was to explore the relationship between these signs of early dysmorphogenesis and cognitive and neurological dysfunction in the patients and their siblings as well as the clinical characteristics of the patients. Sixty patients with schizophrenia, 21 nonpsychotic siblings and 75 normal comparison subjects were studied. Increased rates of cognitive and neurological dysfunction and high MPA scores were found in both the patients and their siblings. High rates of MPAs were not significantly related to cognitive or neurological dysfunction in the patients or siblings, or to premorbid history or other characteristics of the clinical disease process in the patients. These results suggest that MPAs are possibly markers of general early neuromaldevelopment rather than markers of a specific cognitive/neurological or clinical subtype of schizophrenia.
Abstract: Recent years have witnessed increasingly intense research activity concerning early life somatic trauma and dysmorphogenesis which are associated with the later development of schizophrenia. The two somatic factors that have received the most extensive scientific attention as antecedents of schizophrenia are obstetric complications (OCs) and the congenital malformations termed 'minor physical anomalies' (MPAs). Head circumference (HC) at birth has also been studied as a measure of prenatal cerebral development. A great number of studies indicate clearly that schizophrenia patients have a significantly increased history of OCs, representing many different OCs from pregnancy, labor-delivery and the neonatal period. The probable common denominator of these OCs is oxygen deprivation. Especially labor-delivery OCs relate strongly to brain structure abnormality in ill twins from monozygotic pairs discordant for schizophrenia. Schizophrenia patients very consistently have evidenced an increased frequency of MPAs in the global head, eyes, mouth, ears, hands, feet and limbs. Specific MPAs occur with considerable frequency even among normal comparison subjects, but combination models for specific MPAs efficiently discriminate most patients from comparison subjects. Schizophrenia patients also have significantly reduced HC at birth, independently of gestational age, suggesting a disturbance in prenatal cerebral development, and most frequently observed in female patients. Evidence has thus accumulated, increasingly, for the role of various forms of early trauma and dysmorphogenesis in subsequent schizophrenia, and efforts continue to determine the manner in which these early trauma influence both the early developing brain and the brain of the adult patient with manifest schizophrenia.
Abstract: To evaluate the possibility of using neuromotor deviation (NMD) as an individual-orientated, early life marker for increased risk for schizophrenia.
Abstract: To evaluate the possibility of using congenital minor physical anomalies (MPA) and obstetric complications (OC) as individual-orientated, early life markers signalling increased risk for schizophrenia.
Abstract: Previous findings of increased neurological abnormalities in schizophrenic patients and their non-psychotic siblings raise the question of possible causes. The purpose of the present study was to examine the role of perinatal trauma in the aetiology of neurological abnormality.
Abstract: Many authors have suggested that theoretically the labor-delivery complications (LDCs) that frequently appear in the histories of individuals with schizophrenia represent the secondary consequence of preexistent abnormality in the fetus. The question of whether LDCs are systematically associated with prenatal complications and fetal abnormality was studied in 70 singleton schizophrenia patients, in 23 monozygotic twin pairs discordant and 10 pairs concordant for schizophrenia, and in 33 individuals with inferred genetic risk for schizophrenia. Schizophrenia cases with signs of prenatal abnormality (reduced head size, increased minor physical anomalies, greater within-twin-pair birthweight differences) did not have more LDCs than other schizophrenia cases. LDCs were not more frequent in genetic-risk cases with congenital malformations than in genetic-risk cases without malformations. Instead, individuals with schizophrenia who had a history of abnormal length of labor had significantly fewer pregnancy complications and minor physical anomalies than did other individuals with schizophrenia. No support was found for suggestions that LDCs among individuals who have not yet developed schizophrenia are the result of identifiable preexistent fetal abnormality.
Abstract: A study was conducted in Sweden in 1989-1992 to evaluate differences in quality of life (QL) in consecutive male and female patients after acute myocardial infarction (AMI), coronary artery by-pass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA). Somatic and psychological dimensions of QL were assessed by self-administered questionnaire in patients one month (n = 376) and one year (n = 349) after the cardiac event. Normal controls (n = 88) were used for comparison. Differences between gender groups, as well as between study patients and controls in somatic and psychological dimensions of QL were studied. Patients were shown to experience poorer QL when compared with demographically similar controls, especially at the one-month assessment. Female patients had poorer QL after one month (in general health, feeling of arrythmia, anxiety, depression, self-esteem, experience of sex life) and after one year (general health, anxiety, depression) compared with male patients. In all dimensions of QL a proportion of patients (19-45%) experienced a decrease in QL from the one-month to the one-year assessment occasion. Healthcare workers concerned with secondary prevention must be aware that QL differs between male and female patients in several dimensions after a cardiac event. These findings should be taken into account in the clinical management of patients, particularly for female patients who may need special attention.
Abstract: The aim of this study was to investigate the prevalence and type of neurological abnormalities in schizophrenic patients and their nonpsychotic siblings.
Abstract: An increased rate of neurological abnormality (NA) is typically observed in samples of schizophrenic patients, but the origin and relevance of the NA remain unclear. To investigate this further, relationships were studied between the patient's degree of NA and a range of clinical, putative etiological and demographic characteristics among 60 patients with schizophrenia who had previously been shown to have an elevated rate of NA. No significant relationships were found between NA and demographic, etiological or most clinical history characteristics, including past and current neuroleptic exposure. However, an increased rate of NA was significantly related to current poor global functioning. In total, the findings suggest that NA may represent one manifestation of an early and rather stable disease process, with an additional fluctuating clinically related component.
Abstract: Neonatal head circumference and dermatoglyphic patterns were examined in 60 schizophrenic patients with previous findings of elevated rates of minor physical anomalies. Neonatal head circumference was reduced in patients vs neonatal matched-controls. Patients did not differ from healthy adult controls on total finger ridge count, a-b palmar ridge count, or pattern type asymmetry. No significant relationships were found in patients between neonatal head circumference, dermatoglyphics and minor physical anomalies, with one exception: reduced a-b palmar ridge count was associated with abnormalities of the mouth. No relationship was found between patients' neonatal head circumference and their adult head circumference. Adult male schizophrenic patients had larger head circumference relative to body length than their male controls.
Abstract: The aim of the current study was to evaluate the utility of maternal recall for obtaining history of obstetric complications (OCs) in psychiatric research.
Abstract: The relationships between obstetric complications (OCs) and both family history of psychosis and season of birth were investigated among 70 demographically matched pairs of schizophrenic patients and control cases by using OC scores produced by three different OC scales. OCs were studied through blindly assessed hospital records. The particular OC scale had a great influence on the nature of the relationships observed between OCs and both family history and season of birth. Across the three scales, the findings varied from no relationship at all to completely opposite relationships between OCs and both of the other variables. More attention needs to be paid to OC methodological differences as a source of variation in study outcome, and attempts should be made to standardize methods for OC assessment across studies.
Abstract: Several studies during recent years have reported an increased occurrence of schizophrenia in selected immigrant groups. However, difficulties in establishing the population denominator for immigrant rates of mental disorder, selective referral for treatment, and other problems may have influenced such results. The current study aims at testing empirically the influence of some of these methodological problems.
Abstract: Evidence that history of obstetric complications (OCs) may contribute to the development of schizophrenia has generated renewed focus on characteristics of mothers of preschizophrenics. We studied the relationship between increased history of obstetric complications (OCs) and maternal age, parity, and social class in 70 Research Diagnosis Criteria schizophrenic patients vs 70 demographically matched controls. The sample has previously been studied concerning OC rates in schizophrenic patients, their relationship to other presumptive etiological factors, as well as head circumference at birth. Parity was the only maternal characteristic significantly associated with increased OCs in mothers of preschizophrenics. As compared with nulliparous control mothers, nulliparous mothers of preschizophrenics had significantly increased rates of total OCs and labour/delivery complications, while primi- and multiparous mothers of preschizophrenics (vs parity-matched control mothers) did not have increased rates of OCs. Abnormal labour length was significantly increased in the nulliparous mothers of preschizophrenics. Previous findings of significantly reduced head circumference at birth in preschizophrenic neonates vs controls were reconfirmed selectively in the nulliparous group.
Abstract: Patients with schizophrenia have previously been found to have decreased head circumference (HC) at birth and increased rates of obstetric complications (OCs). To determine whether this is restricted to schizophrenia or also characterizes other rather similar psychoses, 30 patients with schizo-affective disorder or unspecified functional psychosis defined by Research Diagnostic Criteria were compared with 30 demographically matched control cases from the same delivery series on HC and OCs, blindly studied through hospital birth records. As compared with controls, the 30 nonschizophrenic patients had significantly decreased HC but not lower birthweight, shoulder circumference or shorter body length. HC was significantly decreased among female but not male patients. Rates of OCs were not significantly increased in the 30 nonschizophrenic patients versus controls. Neither HC nor OC rates were systematically associated with family history of psychosis or season of birth among patients. The findings indicate that these nonschizophrenic psychoses are similar to schizophrenia in having reduced HC at birth but dissimilar from schizophrenia in not having increased rates of OCs. The findings suggest that the gender focus in schizophrenia's etiology should be broadened to include other rather similar diagnostic categories.
Abstract: Neuropsychological test performance and clinical symptoms were assessed in 14 schizophrenic patients at admission to and discharge from an acute inpatient psychiatric service. Despite significant clinical improvement at discharge, no major change in cognitive performance was observed. Furthermore, patients at discharge were significantly impaired compared with normal control subjects case-matched for gender, age, handedness and level of education. The results suggest that some degree of cognitive impairment may be relatively independent from schizophrenic symptoms and that such impairment may represent part of a residual enduring "trait" vulnerability.
Abstract: Histories of obstetric complications (OCs) during pregnancy, labor-delivery and the neonatal period were investigated by detailed maternal report for 23 monozygotic (MZ) twin pairs discordant for schizophrenia, 10 MZ twin pairs concordant for schizophrenia and 7 normal MZ control pairs. Statistically significant differences in OC rates were found across these 3 groups. OCs being most frequent in discordant pairs and least frequent in normal control pairs. Labor complications were significantly more frequent in discordant than concordant pairs. OC rates were equivalent in sick and well discordant twins. The results provide evidence for the role of OCs in the development of schizophrenia, complications at the time of birth being especially associated with the development of schizophrenia in discordant twins.
Abstract: The aim of the current study was to explore the relevancy of early pregnancy complications for the development of minor physical anomalies in monozygotic twins discordant and concordant for schizophrenia.
Abstract: Neurological abnormalities found in schizophrenic subjects and their healthy relatives have raised questions concerning etiology. The aim of the present study was to investigate the genetic and environmental antecedents of neurological impairment in monozygotic twins discordant for schizophrenia, with particular focus on the well discordant twins. The etiological factors of interest were history of obstetric complications, family history of psychosis, history of substance abuse, and history of postnatal cerebral trauma.
Abstract: The history of obstetric complications was studied in 70 Research Diagnostic Criteria schizophrenic patients and 70 demographically matched controls from the same delivery series, using information prospectively recorded at birth. Schizophrenic patients were exposed to greater numbers of obstetric complications than their matched controls. Rates of obstetric complications were enhanced in patients born during the winter months (January-April) and in patients with no family history of psychosis in first- and second-degree biological relatives. Winter birth was associated with absence of family history of psychosis. Analyses by gender indicated that the relationship between obstetric complications and these other risk factors may be more relevant for male patients. The results suggest that the seasonal effect in schizophrenia may be due partially to seasonal variation in obstetric complications and that obstetric complications and winter birth may represent a distinctively separate etiological mechanism from that of inferred genetic risk for schizophrenia.
Abstract: The new McNeil-Sjöström Scale for obstetric complications (OCs), as well as scales of Lewis et al. (Schizophrenia: Scientific progress. Oxford University Press, 1989) and Parnas et al. (British Journal of Psychiatry, 140, 416-420, 1982), were applied to the OC histories of 70 singleton schizophrenics and 70 demographically-matched controls from the same hospital delivery series, using blindly assessed hospital pregnancy and birth record information. With the McNeil-Sjöström scale, schizophrenics were found to have significantly increased rates of OCs for the total reproduction, as well as for labor-delivery and the neonatal period but not for pregnancy. Significant increases in OCs in these schizophrenics were also found in scores produced by the Lewis et al. scale but not by the Parnas et al. scale. Further application of these three scales to OC data obtained through parental report for 23 monozygotic (MZ) twin pairs discordant and 10 pairs concordant for schizophrenia, as well as seven normal control MZ pairs, showed a significant difference in OC rates across the different twin pair groups, when assessed by the McNeil-Sjöström and Parnas et al. scales, but not by the Lewis et al. scale. The particular scoring system used in a study is thus of considerable importance not only for findings concerning OC histories of schizophrenics vs. controls, but also for the relationship between OCs and other presumed etiological factors in schizophrenia. Among the three scales, the McNeil-Sjöström scale provided the most sensitive assessment of OC history for schizophrenics.
Abstract: As part of a longitudinal investigation begun in the neonatal period, selected neuromotor behaviors and different facets of general mental development were investigated blind at 6 years of age in 64 index offspring of women with a history of schizophrenic, schizoaffective, affective and unspecified functional psychosis and in 95 control offspring of women with no history of psychosis. Compared with the controls, the offspring of psychotics (total index group) showed a significantly increased frequency of both multiple and specific neuromotor deviations. The offspring of women with schizophrenia and with unspecified functional psychosis showed increased rates of multiple neuromotor deviations, not found in the offspring of women with schizoaffective and affective psychoses. The neuromotor deviations were confirmed on Griffiths Developmental Test subscales reflecting gross and fine motor performance, and the deficits did not extend to subscales measuring cognitive ability and personal-social competence. No relationship was found between the individual subject's neonatal and 6-year deviation scores. The results suggest the existence of a selective neuromotor developmental deviation in the offspring of schizophrenics and women with unspecified functional psychosis. Different possible etiological factors are discussed.
Abstract: Previous investigation has shown preschizophrenics to have disproportionately small head circumferences (HC) (in relation to body length) at birth, providing further evidence of disturbed prenatal cerebral development among preschizophrenics. This reduced HC at birth appeared to have resulted from some factor(s) other than genetic risk for schizophrenia, as reduced HC was significantly related to an absence of family history of psychosis. A re-test of the finding that genetic risk for schizophrenia is not associated with reduced HC at birth was performed in the current high-risk study, which compared HC: body length ratios at birth in 31 offspring born to women with a history of schizophrenia vs. 38 demographically comparable control offspring. The genetically high-risk offspring were highly similar to control offspring of HC: body length ratios, supporting the previous findings that disturbed prenatal cerebral development, as measured by disproportionately small HC, is not a function of genetic risk for schizophrenia.
Abstract: Head circumference, body weight, body length, and shoulder circumference at birth were studied in 70 RDC schizophrenic patients and 70 demographically matched controls from the same delivery series, using information recorded in the medical records at the time of birth. With preterm babies removed from both samples, only head circumference among preschizophrenic infants was significantly smaller than that of controls. Preschizophrenic infants also had a disproportionately smaller head circumference in relation to body length than did controls. Among the former, a small head circumference was systematically related to an absence of family history of psychosis, but was not related to season of birth or recorded pregnancy complications. The findings were strongest for females. The results suggest there is an unidentified non-genetic factor in schizophrenia that disturbs prenatal cerebral development.
Abstract: Among children with normal psychiatric risk, those born with (even minor) congenital malformations (CMs) evidenced significantly poorer attention persistence in early childhood, as well as greater anxiety-proneness, poorer interpersonal relational competency, and more mental disturbance at six years of age. No significant relationship between CMs and mental characteristics was found in children at heightened psychiatric risk.
Abstract: Regional cerebral blood flow (rCBF) measurements and psychiatric ratings were performed on seven schizophrenic patients (mean age = 41.4 years) who had been examined 18 years previously in a study that used similar psychiatric ratings and a comparable rCBF technique. Neither the clinical symptomatology nor the rCBF level and distribution had changed appreciably between 1972 and 1990. The findings indicate that cerebral functional activity in chronic schizophrenia remains constant in spite of continuous neuroleptic medication.
