Abstract
The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.
Highlights
Despite many technical and medical advances over the past ten years, at the end of the Decade of the Brain schizophrenia is still a personal and family disaster
We review the main evidence for the neurodevelopmental theory of schizophrenia
The rationale underlying the association of minor physical anomalies (MPA)/dermatoglyphic marks (DM) and disturbed neurogenesis is based on the fact that each of these organs originates from the same primordial tissue
Summary
Despite many technical and medical advances over the past ten years, at the end of the Decade of the Brain schizophrenia is still a personal and family disaster. Most prospective studies that have looked for neurodevelopmental abnormalities in schizophrenia before diagnosis report negative results, some did detect subtle behavior and intellectual abnormalities as possible predictors of risk for the development of schizophrenia [4] These findings, are inconsistent, raising doubts about the neurodevelopmental theory [3,4]. According to some authors [3], most schizophrenic patients display a clinical picture that fits the neurodegenerative model better than the neurodevelopmental model It consists of a decline in function of previously healthy persons, progresses over months or years with exacerbations and remissions and higher or lower expression of psychotic and/or negative symptoms, with only a small group of patients returning to the premorbid state [3]. Complete remission of schizophrenia is not often seen in patients diagnosed according to rigorous diagnostic criteria
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