Abstract
BackgroundDelayed motor development in infancy and family history of psychosis are both associated with increased risk of schizophrenia, but their interaction is largely unstudied. AimTo investigate the association of the age of achieving motor milestones and parental psychosis and their interaction in respect to risk of schizophrenia. MethodsWe used data from the general population-based prospective Northern Finland Birth Cohort 1966 (n=10,283). Developmental information of the cohort members was gathered during regular visits to Finnish child welfare clinics. Several registers were used to determine the diagnosis of schizophrenia among the cohort members and psychosis among the parents. Altogether 152 (1.5%) individuals had schizophrenia by the age of 46 years, with 23 (15.1%) of them having a parent with psychosis. Cox regression analysis was used in analyses. ResultsParental psychosis was associated (P<0.05) with later achievement of holding the head up, grabbing an object, and walking without support. In the parental psychosis group, the risk for schizophrenia was increased if holding the head up (hazard ratio [HR]: 2.46; degrees of freedom [df]=1; 95% confidence interval [95% CI]: 1.07–5.66) and touching the thumb with the index finger (HR: 1.84; df=1; 95% CI: 1.11–3.06) was later. In the group without parental psychosis, a delay in the following milestones increased the risk of schizophrenia: standing without support and walking without support. Parental psychosis had an interaction with delayed touching thumb with index finger (HR: 1.87; df=1; 95% CI: 1.08–3.25) when risk of schizophrenia was investigated. ConclusionsParental psychosis was associated with achieving motor milestones later in infancy, particularly the milestones that appear early in a child's life. Parental psychosis and touching the thumb with the index finger had a significant interaction on risk of schizophrenia. Genetic risk for psychosis may interact with delayed development to raise future risk of schizophrenia, or delayed development may be a marker of other risk processes that interact with genetic liability to cause later schizophrenia.
Highlights
Schizophrenia is an etiologically heterogeneous syndrome caused by genetic and environmental factors
Parental psychosis was associated with increased risk of schizophrenia
When the group with parental psychosis was separately investigated, later achievement of the following motor milestones was associated with increased risk of schizophrenia: holding the head up (HR: 2.46; df = 1; 95% confidence intervals (95% CI): 1.07–5.66) and touching the thumb with the index finger (HR: 1.84; df = 1; 95% CI: 1.11–3.06)
Summary
Schizophrenia is an etiologically heterogeneous syndrome caused by genetic and environmental factors. The findings of the general population studies support evidence from genetic highrisk research that delayed achievement of motor milestones [16,46,37,43,4], social deficiency [41] and later speech development [16] are robust risk factors for schizophrenia (see Supplementary data, Table S1). Delayed motor development in infancy and family history of psychosis are both associated with increased risk of schizophrenia, but their interaction is largely unstudied. Parental psychosis had an interaction with delayed touching thumb with index finger (HR: 1.87; df = 1; 95% CI: 1.08–3.25) when risk of schizophrenia was investigated. Genetic risk for psychosis may interact with delayed development to raise future risk of schizophrenia, or delayed development may be a marker of other risk processes that interact with genetic liability to cause later schizophrenia
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