Neglect and hereditary risk: Their relative contribution to schizophrenia with negative symptomatology.

Abstract

There is evidence that genetic and environmental stressors contribute to the genesis of schizophrenia. However, the relevant impact of each factor remains unclear. We tested for an interactive effect between childhood neglect and family history of serious mental illness. Data were further analyzed for a possible connection to type of schizophrenic symptoms. Data for the study are taken from the medical records of 641 patients with schizophrenia from a large state hospital in the northeastern United States. Clinical assessments were divided into positive and negative symptomatology through application of the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS) and the Positive and Negative Syndrome Scale (PANSS). Detailed information about childhood neglect and family history of serious mental illness was obtained through Social Service Assessment interviews at intake and during hospital stay. Among clients with no family history of mental illness, childhood neglect does not meaningfully affect the risk of negative versus positive schizophrenia. For clients with such history, on the other hand, neglect significantly raises the risk of schizophrenia with negative symptomatology. Our central finding is that risk for negative symptoms of schizophrenia are elevated by childhood neglect combined with a history of serious mental illness within the family. This is the only report to combine schizophrenic symptoms, familial risk and childhood neglect to date. Implications for primary prevention and treatment are discussed.