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Poster #83 FAMILY HISTORY OF MENTAL ILLNESSES IN FIRST- AND SECOND-GENERATION MIGRANTS: EVIDENCE FROM THE AESOP FIRST-ONSET STUDY
Abstracts of the 3rd Biennial Schizophrenia International Research Conference / Schizophrenia Research 136, Supplement 1 (2012) S1–S375
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first generation immigrants. MHS-delay was longer for patients who were treated already by MHS for other diagnoses. Discussion: Specific interventions are needed focusing on patients living in highly urbanized areas and first generation immigrants in order to shorten patient delay. MHS should improve early detection of psychosis in patients already in treatment for other diagnosis.
that first-generation immigrants are less likely to report a family history of mental illnesses. However, given the elevated rates of psychotic disorders observed in migrant and minority ethnic groups, it is plausible that secondgeneration migrants are more likely to have a family history of illness than the first generation, in line with previous observations (Sugarman and Craufurd 1994; Hutchinson et al. 1996).
Poster #83 FAMILY HISTORY OF MENTAL ILLNESSES IN FIRST- AND SECOND-GENERATION MIGRANTS: EVIDENCE FROM THE AESOP FIRST-ONSET STUDY
Poster #84 THE PREVALENCE OF DIABETES MELLITUS IS INCREASED IN RELATIVES OF PATIENTS WITH A PSYCHOTIC DISORDER
Francois Bourque 1 , Susana Borges 1 , Jane Boydell 2 , Paul Fearon 3 , Gerard Hutchinson 4 , Kevin Morgan 5 , Gillian Doody 6 , Peter B. Jones 7 , Robin M. Murray 2, Paola Dazzan 2 , Craig Morgan 1 1 Section of Social Psychiatry, Health Service and Population Research, Institute of Psychiatry, King’s College London, London, United Kingdom; 2 Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, United Kingdom; 3 St Patrick’s University Hospital and Trinity College, Dublin, Ireland; 4 Department of Psychiatry, University of West Indies, St. Augustine, Trinidad and Tobago; 5 Department of Psychiatry, University of Westminster, London, United Kingdom; 6 Department of Psychiatry, University of Nottingham, Nottingham, United Kingdom; 7 Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom Background: There is consistent evidence that black and minority ethnic groups have higher rates of psychosis in the UK, and that these elevated rates affect not only foreign-born migrants (first generation), but also those born in the UK to migrant parents (second generation). While the reasons for this phenomenon are still unclear, the contribution of social and environmental factors is increasingly suspected. If that were the case, it is plausible that first-generation migrants, and possibly also secondgeneration migrants, may be less likely to have a positive family history for mental illness than the reference population. Prior family studies have sought to assess the role of genetic factors in the Black Caribbean population in the UK and found that rates of schizophrenia were much higher among siblings of UK-born Black Caribbean patients than among siblings of white patients, whereas the rates of schizophrenia among the white and Black Caribbean parents were similar (Sugarman and Craufurd, 1994; Hutchinson et al. 1996). We sought to determine whether first- and second-generation migrants were less likely to present a family history of psychosis or mental illness than the white British, based on cases from the AESOP (Aetiology and Ethnicity of Schizophrenia and Other Psychoses) first-onset study. Methods: The ÆSOP study, a three-centre population based incidence and case-control study of first episode psychosis, recruited a cohort of 535 individuals with a first episode of psychosis, including 229 white British patients, 144 first-generation migrants and 156 second-generation migrants. Family history of psychotic disorder and any other mental illnesses was documented using the Family Interview for Genetic Studies. We compared the family history of both any mental illness and psychotic disorders in first-degree relatives according to migrant generation status (white British versus first-generation versus second-generation immigrants). We also conducted sub-analyses specifically for Black Caribbean and Black African migrants. Results: The FIGS schedule was completed on 151 cases, including 92 white British, 26 first-generation migrants and 33 second-generation migrants. First-generation migrants were much less likely to have a first degree relative with any mental illness (7.7%) than second-generation immigrants (27.3%) and white British cases (39.1%) (χ2 =9.64, p=0.008). When we restricted our analyses to Black African and Black Caribbean migrant groups, first-generation migrants were much less likely to have a family history of any mental illness in first degree relatives (5.9%) than second-generation migrants (34.8%) or white British (39.1%) χ2 =7.07, p=0.029). Differences between these groups were no longer significant when analyses were conducted for family history of psychosis only, which may be due to the reduced sample. Discussion: First-generation migrants appear much less likely to report a family history of mental illness in first degree relatives than either second-generation migrants or the reference populations, suggesting that the increased frequency of disorder in this group may be due primarily to environmental rather than genetic factors. A potential caveat may be
Hanneke Welie, Eske Derks, Kim Verweij, Harold de Valk, Rene Kahn, Wiepke Cahn UMC Utrecht, Utrecht, Netherlands Background: Patients with schizophrenia are more likely to develop diabetes mellitus (DM) compared to the general population. The causal mechanism (e.g., genetic overlap or disease-specific effects) remains unclear, while an increased rate of DM in relatives has not consistently been reported. This inconsistency may be explained by a focus on first-degree relatives within a limited age range. The aim of this study is to review the literature on DM in relatives of patients with a psychotic disorder and to compare DM rates in a large sample of first- and second-degree unaffected relatives with the rates in healthy controls. Methods: The Family Interview for Genetic Studies (FIGS) was administered to asses DM in 186 families of patients with non-affective psychosis and 124 healthy families. The pedigrees included siblings, parents, parents’ siblings and grandparents. Patients and relatives with a history of psychosis (affected people) and non-Caucasian people were excluded, resulting in a total of 3,856 subjects (2,156 relatives of patients; 1,700 controls). Results: Of the first- and second-degree relatives of patients with a nonaffective psychotic disorder, 5.3% had DM, compared to 2.9% of the healthy control subjects (OR=1.60, p=0.010). The largest difference was found in the ages between 50-69 years. Discussion: We have shown a significantly increased risk to develop DM in unaffected first- and second-degree relatives of patients with a nonaffective disorder, compared with healthy controls. In the ages between 50-69 years, there is even a nearly threefold increase risk of DM in patient families. The fact that the difference in DM rate varies by age may explain the inconsistent findings of previous studies. Our findings support the hypothesis of a genetic link between DM and non-affective psychotic disorders.
Poster #85 THE CCC2000 BIRTH COHORT STUDY: THEORY OF MIND IN CHILDREN AT RISK OF PSYCHOSIS Lars Clemmensen 1 , Anja Munkholm 1 , Charlotte Eberhardt 1 , Jim van Os 2,3 , Anne Mette Skovgaard 1,4 , Pia Jeppesen 1,4 1 Child and Adolescent Psychiatric Centre Glostrup, Copenhagen, Denmark; 2 Institute of Psychiatry, King’s College, London, United Kingdom; 3 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands; 4 Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark Background: The presence of psychotic symptoms in the absence of diagnostic-able psychotic illness in childhood may express psychosis liability. As much as 6-14% of all children aged 11-14 years have experienced hallucinations, delusions or other psychotic-like symptoms or experiences (PLE). Psychological models of psychosis explain delusions as the result of the individual trying to make sense of unusual experience. Deficits in Theory of Mind (ToM), which refers to the ability to understand the emotions and intentions of others, may limit the normal human capacity to attribute mental states, and to consider unusual experiences in the light of common sense and thus, to make likely explanations of the reason for such experiences. ToM deficits have been found to be associated to both psychotic and negative symptoms of schizophrenia in clinical as well as in non-clinical samples. Methods: The study is conducted as part of the 11-year follow-up of the CCC2000, a prospective longitudinal investigation of 6090 children born in
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first generation immigrants. MHS-delay was longer for patients who were treated already by MHS for other diagnoses. Discussion: Specific interventions are needed focusing on patients living in highly urbanized areas and first generation immigrants in order to shorten patient delay. MHS should improve early detection of psychosis in patients already in treatment for other diagnosis.
that first-generation immigrants are less likely to report a family history of mental illnesses. However, given the elevated rates of psychotic disorders observed in migrant and minority ethnic groups, it is plausible that secondgeneration migrants are more likely to have a family history of illness than the first generation, in line with previous observations (Sugarman and Craufurd 1994; Hutchinson et al. 1996).
Poster #83 FAMILY HISTORY OF MENTAL ILLNESSES IN FIRST- AND SECOND-GENERATION MIGRANTS: EVIDENCE FROM THE AESOP FIRST-ONSET STUDY
Poster #84 THE PREVALENCE OF DIABETES MELLITUS IS INCREASED IN RELATIVES OF PATIENTS WITH A PSYCHOTIC DISORDER
Francois Bourque 1 , Susana Borges 1 , Jane Boydell 2 , Paul Fearon 3 , Gerard Hutchinson 4 , Kevin Morgan 5 , Gillian Doody 6 , Peter B. Jones 7 , Robin M. Murray 2, Paola Dazzan 2 , Craig Morgan 1 1 Section of Social Psychiatry, Health Service and Population Research, Institute of Psychiatry, King’s College London, London, United Kingdom; 2 Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, United Kingdom; 3 St Patrick’s University Hospital and Trinity College, Dublin, Ireland; 4 Department of Psychiatry, University of West Indies, St. Augustine, Trinidad and Tobago; 5 Department of Psychiatry, University of Westminster, London, United Kingdom; 6 Department of Psychiatry, University of Nottingham, Nottingham, United Kingdom; 7 Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom Background: There is consistent evidence that black and minority ethnic groups have higher rates of psychosis in the UK, and that these elevated rates affect not only foreign-born migrants (first generation), but also those born in the UK to migrant parents (second generation). While the reasons for this phenomenon are still unclear, the contribution of social and environmental factors is increasingly suspected. If that were the case, it is plausible that first-generation migrants, and possibly also secondgeneration migrants, may be less likely to have a positive family history for mental illness than the reference population. Prior family studies have sought to assess the role of genetic factors in the Black Caribbean population in the UK and found that rates of schizophrenia were much higher among siblings of UK-born Black Caribbean patients than among siblings of white patients, whereas the rates of schizophrenia among the white and Black Caribbean parents were similar (Sugarman and Craufurd, 1994; Hutchinson et al. 1996). We sought to determine whether first- and second-generation migrants were less likely to present a family history of psychosis or mental illness than the white British, based on cases from the AESOP (Aetiology and Ethnicity of Schizophrenia and Other Psychoses) first-onset study. Methods: The ÆSOP study, a three-centre population based incidence and case-control study of first episode psychosis, recruited a cohort of 535 individuals with a first episode of psychosis, including 229 white British patients, 144 first-generation migrants and 156 second-generation migrants. Family history of psychotic disorder and any other mental illnesses was documented using the Family Interview for Genetic Studies. We compared the family history of both any mental illness and psychotic disorders in first-degree relatives according to migrant generation status (white British versus first-generation versus second-generation immigrants). We also conducted sub-analyses specifically for Black Caribbean and Black African migrants. Results: The FIGS schedule was completed on 151 cases, including 92 white British, 26 first-generation migrants and 33 second-generation migrants. First-generation migrants were much less likely to have a first degree relative with any mental illness (7.7%) than second-generation immigrants (27.3%) and white British cases (39.1%) (χ2 =9.64, p=0.008). When we restricted our analyses to Black African and Black Caribbean migrant groups, first-generation migrants were much less likely to have a family history of any mental illness in first degree relatives (5.9%) than second-generation migrants (34.8%) or white British (39.1%) χ2 =7.07, p=0.029). Differences between these groups were no longer significant when analyses were conducted for family history of psychosis only, which may be due to the reduced sample. Discussion: First-generation migrants appear much less likely to report a family history of mental illness in first degree relatives than either second-generation migrants or the reference populations, suggesting that the increased frequency of disorder in this group may be due primarily to environmental rather than genetic factors. A potential caveat may be
Hanneke Welie, Eske Derks, Kim Verweij, Harold de Valk, Rene Kahn, Wiepke Cahn UMC Utrecht, Utrecht, Netherlands Background: Patients with schizophrenia are more likely to develop diabetes mellitus (DM) compared to the general population. The causal mechanism (e.g., genetic overlap or disease-specific effects) remains unclear, while an increased rate of DM in relatives has not consistently been reported. This inconsistency may be explained by a focus on first-degree relatives within a limited age range. The aim of this study is to review the literature on DM in relatives of patients with a psychotic disorder and to compare DM rates in a large sample of first- and second-degree unaffected relatives with the rates in healthy controls. Methods: The Family Interview for Genetic Studies (FIGS) was administered to asses DM in 186 families of patients with non-affective psychosis and 124 healthy families. The pedigrees included siblings, parents, parents’ siblings and grandparents. Patients and relatives with a history of psychosis (affected people) and non-Caucasian people were excluded, resulting in a total of 3,856 subjects (2,156 relatives of patients; 1,700 controls). Results: Of the first- and second-degree relatives of patients with a nonaffective psychotic disorder, 5.3% had DM, compared to 2.9% of the healthy control subjects (OR=1.60, p=0.010). The largest difference was found in the ages between 50-69 years. Discussion: We have shown a significantly increased risk to develop DM in unaffected first- and second-degree relatives of patients with a nonaffective disorder, compared with healthy controls. In the ages between 50-69 years, there is even a nearly threefold increase risk of DM in patient families. The fact that the difference in DM rate varies by age may explain the inconsistent findings of previous studies. Our findings support the hypothesis of a genetic link between DM and non-affective psychotic disorders.
Poster #85 THE CCC2000 BIRTH COHORT STUDY: THEORY OF MIND IN CHILDREN AT RISK OF PSYCHOSIS Lars Clemmensen 1 , Anja Munkholm 1 , Charlotte Eberhardt 1 , Jim van Os 2,3 , Anne Mette Skovgaard 1,4 , Pia Jeppesen 1,4 1 Child and Adolescent Psychiatric Centre Glostrup, Copenhagen, Denmark; 2 Institute of Psychiatry, King’s College, London, United Kingdom; 3 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands; 4 Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark Background: The presence of psychotic symptoms in the absence of diagnostic-able psychotic illness in childhood may express psychosis liability. As much as 6-14% of all children aged 11-14 years have experienced hallucinations, delusions or other psychotic-like symptoms or experiences (PLE). Psychological models of psychosis explain delusions as the result of the individual trying to make sense of unusual experience. Deficits in Theory of Mind (ToM), which refers to the ability to understand the emotions and intentions of others, may limit the normal human capacity to attribute mental states, and to consider unusual experiences in the light of common sense and thus, to make likely explanations of the reason for such experiences. ToM deficits have been found to be associated to both psychotic and negative symptoms of schizophrenia in clinical as well as in non-clinical samples. Methods: The study is conducted as part of the 11-year follow-up of the CCC2000, a prospective longitudinal investigation of 6090 children born in