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Obstetric complications in schizophrenia and mania: A comparative study
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II. Risk Factors II.A. Obstetric Complications IIA. 1 RISK OF SCHIZOPHRENIA IN MALE SUBJECTS WITH A HISTORY OF OBSTETRIC COMPLICATIONS A N D THEIR SIBLINGS: A CONTROLLED STUDY G. Bersani, I. Taddei, P. Venturi, M.S. Cattaruzza* a n d P. Pancheri
3rd Psychiatric Clinic, *Institute of Public Health and Preventive Medicine, University "La Sapienza', Rome, Italy The aim of this study was to evaluate wether the risk for developing schizophrenia is increased in individuals with Obstetric Complications (OCs) at birth. The sample comprised 47 consecutively admitted male patients with the diagnosis of chronic schizophrenia, according to DSM III-R criteria, and their 51 brothers. An obstetric history was obtained by interview to the mothers and the 'midwife protocol' by Parnas et al. (1982) was used to quantify presence and entity of OCs. The hereditary 'component' was held constant by using healthy siblings as controls. We chose brothers only, so to exclude the possible confounding effect of the gender factor. Odds ratios for the effects of maternal age, birth order, birthweight and OCs were calculated using logistic regression. The only factors found to have a significant effect on the risk of schizophrenia were the measures of OCs at birth. We used three categories of total score (ts) of OC severity (ts = 0, ts = 1 and ts > 2) which yielded odds ratios of 1, 2.78 and 3.02. Our results suggest that OCs can play a important rrle in increasing the risk for the development of adult schizophrenia, where the hereditary component is constant; this seems to confirm the importance of non-genetic factors, such as OCs, in the subsequent development of the illness,
IIA. 2 O B S T E T R I C C O M P L I C A T I O N S IN SCHIZOPHRENIA A N D MANIA: A COMPARATIVE S T U D Y M. Byrne, M. Morris, R. Browne, N. M u l r y a n , A. Scully, E. M c D o n a l d , Y. Duffin, A. Kinsella, D. Walsh, T.F. McNeil, C. L a r k i n a n d E. O ' C a l l a g h a n
Cluain Mhuire Family Centre, NewtownparkAve, Blackrock, Co. Dublin, Ireland Background The issue of whether obstetric complications
are of clinical or aetiological relevance to patients with psychotic disorders remains controversial. Method. Using the Dublin Psychiatric Case Register, the birth records of 635 patients with an ICD-9 diagnosis of schizophrenia or mania were evaluated using the Lewis, Owen and Murray scale and the scale of Parnas and colleagues. Results. The mothers of those who later went on to develop schizophrenia did not differ from the mothers of those who later developed mania in terms of maternal age, parity, social class or period of pregnancy. However, males who later developed schizophrenia, experienced significantly more OC's than those with mania in terms of number:- Lewis, Owen and Murray scale (p=0.007), Parnas scale (p<0.001), and severity:- Parnas scale (p=0.018). No significant difference in terms of OC's were found between females with schizophrenia and females with mania. Conclusion. These data indicate that the birth histories of males with schizophrenia differ from, both females with schizophrenia and from those with mania. Acknowledgements: Supported by the Health Research Board, Ireland.
IIA. 3 MATERNAL DEMOGRAPHIC CORRELATES OF INCREASED HISTORY OF OBSTETRIC COMPLICATIONS IN SCHIZOPHRENIA E. C a n t o r - G r a a e , T.F. McNeil, K. Sj6str6m, L. N o r d s t r 6 m a n d T. R o s e n l u n d
Department of Psychiatry, Lund University, UniversityHospital Malmr, Sweden S-205 02 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 maternal age, parity, and social class, and increased history of OCs in 70 RDC schizophrenic patients and 70 demographically matched controis. Parity rather than age or social class was the most significant determinant of increased OCs in mothers of preschizophrenics. Within parity-matched pairs nulliparous mothers of preschizophrenics had significantly increased rates of total OCs, labour/delivery and neonatal complications vs. control mothers, while primi- and multiparous mothers of preschizophrenics did not have increased rates of OCs. Abnormal labour length and neonatal asphyxia were significantly increased in the nulliparae mothers of preschizophrenics. Previous findings of significantly reduced head circumference at birth in preschizophrenic neonates vs. controls were reconfirmed selectively in the nulliparae group. The results are in accordance with the notion that perinatal oxygen deprivation may play an etiological role in the development of schizophrenia.
II. Risk Factors II.A. Obstetric Complications IIA. 1 RISK OF SCHIZOPHRENIA IN MALE SUBJECTS WITH A HISTORY OF OBSTETRIC COMPLICATIONS A N D THEIR SIBLINGS: A CONTROLLED STUDY G. Bersani, I. Taddei, P. Venturi, M.S. Cattaruzza* a n d P. Pancheri
3rd Psychiatric Clinic, *Institute of Public Health and Preventive Medicine, University "La Sapienza', Rome, Italy The aim of this study was to evaluate wether the risk for developing schizophrenia is increased in individuals with Obstetric Complications (OCs) at birth. The sample comprised 47 consecutively admitted male patients with the diagnosis of chronic schizophrenia, according to DSM III-R criteria, and their 51 brothers. An obstetric history was obtained by interview to the mothers and the 'midwife protocol' by Parnas et al. (1982) was used to quantify presence and entity of OCs. The hereditary 'component' was held constant by using healthy siblings as controls. We chose brothers only, so to exclude the possible confounding effect of the gender factor. Odds ratios for the effects of maternal age, birth order, birthweight and OCs were calculated using logistic regression. The only factors found to have a significant effect on the risk of schizophrenia were the measures of OCs at birth. We used three categories of total score (ts) of OC severity (ts = 0, ts = 1 and ts > 2) which yielded odds ratios of 1, 2.78 and 3.02. Our results suggest that OCs can play a important rrle in increasing the risk for the development of adult schizophrenia, where the hereditary component is constant; this seems to confirm the importance of non-genetic factors, such as OCs, in the subsequent development of the illness,
IIA. 2 O B S T E T R I C C O M P L I C A T I O N S IN SCHIZOPHRENIA A N D MANIA: A COMPARATIVE S T U D Y M. Byrne, M. Morris, R. Browne, N. M u l r y a n , A. Scully, E. M c D o n a l d , Y. Duffin, A. Kinsella, D. Walsh, T.F. McNeil, C. L a r k i n a n d E. O ' C a l l a g h a n
Cluain Mhuire Family Centre, NewtownparkAve, Blackrock, Co. Dublin, Ireland Background The issue of whether obstetric complications
are of clinical or aetiological relevance to patients with psychotic disorders remains controversial. Method. Using the Dublin Psychiatric Case Register, the birth records of 635 patients with an ICD-9 diagnosis of schizophrenia or mania were evaluated using the Lewis, Owen and Murray scale and the scale of Parnas and colleagues. Results. The mothers of those who later went on to develop schizophrenia did not differ from the mothers of those who later developed mania in terms of maternal age, parity, social class or period of pregnancy. However, males who later developed schizophrenia, experienced significantly more OC's than those with mania in terms of number:- Lewis, Owen and Murray scale (p=0.007), Parnas scale (p<0.001), and severity:- Parnas scale (p=0.018). No significant difference in terms of OC's were found between females with schizophrenia and females with mania. Conclusion. These data indicate that the birth histories of males with schizophrenia differ from, both females with schizophrenia and from those with mania. Acknowledgements: Supported by the Health Research Board, Ireland.
IIA. 3 MATERNAL DEMOGRAPHIC CORRELATES OF INCREASED HISTORY OF OBSTETRIC COMPLICATIONS IN SCHIZOPHRENIA E. C a n t o r - G r a a e , T.F. McNeil, K. Sj6str6m, L. N o r d s t r 6 m a n d T. R o s e n l u n d
Department of Psychiatry, Lund University, UniversityHospital Malmr, Sweden S-205 02 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 maternal age, parity, and social class, and increased history of OCs in 70 RDC schizophrenic patients and 70 demographically matched controis. Parity rather than age or social class was the most significant determinant of increased OCs in mothers of preschizophrenics. Within parity-matched pairs nulliparous mothers of preschizophrenics had significantly increased rates of total OCs, labour/delivery and neonatal complications vs. control mothers, while primi- and multiparous mothers of preschizophrenics did not have increased rates of OCs. Abnormal labour length and neonatal asphyxia were significantly increased in the nulliparae mothers of preschizophrenics. Previous findings of significantly reduced head circumference at birth in preschizophrenic neonates vs. controls were reconfirmed selectively in the nulliparae group. The results are in accordance with the notion that perinatal oxygen deprivation may play an etiological role in the development of schizophrenia.