High Prevalence Of Schizophrenia Research Articles

The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l'aide de données administratives liées.

First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve and off-reserve to all other children living in Manitoba. The research team, which included First Nations and non-First Nations researchers, utilized population-based administrative data that linked de-identified individual-level records from the 2016 First Nations Research File to health and social information for children living in Manitoba. Adjusted rates and rate ratios of mental disorders and suicide behaviours were calculated using a generalized linear modelling approach to compare First Nations children (n = 40,574) and all other children (n = 197,109) and comparing First Nations children living on- and off-reserve. Compared with all other children, First Nations children had a higher prevalence of schizophrenia (adjusted rate ratio (aRR): 4.42, 95% confidence interval (CI), 3.36 to 5.82), attention-deficit hyperactivity disorder (ADHD; aRR: 1.21, 95% CI, 1.09 to 1.33), substance use disorders (aRR: 5.19; 95% CI, 4.25 to 6.33), hospitalizations for suicide attempts (aRR: 6.96; 95% CI, 4.36 to 11.13) and suicide deaths (aRR: 10.63; 95% CI, 7.08 to 15.95). The prevalence of ADHD and mood/anxiety disorders was significantly higher for First Nations children living off-reserve compared with on-reserve; in contrast, hospitalization rates for suicide attempts were twice as high on-reserve than off-reserve. When the comparison cohort was restricted to only other children in low-income areas, a higher prevalence of almost all disorders remained for First Nations children. Large disparities were found in mental health indicators between First Nations children and other children in Manitoba, demonstrating that considerable work is required to improve the mental well-being of First Nations children. Equitable access to culturally safe services is urgently needed and these services should be self-determined, planned, and implemented by First Nations people.

Association of Urbanicity with Schizophrenia and Related Mortality in China: Association de l'urbanicité avec la schizophrénie et la mortalité qui y est reliée en Chine.

Although higher prevalence of schizophrenia in Chinese urban areas was observed, studies focused on the association between schizophrenia and urbanicity were less in China. Using a national representative population-based data set, this study aimed to investigate the relationship between urbanicity and schizophrenia and its related mortality among adults aged 18 years old and above in China. Data were obtained from the Second China National Sample Survey on Disability in 2006 and follow-up studies from 2007 to 2010 each year. We restricted our analysis to 1,909,205 participants aged 18 years or older and the 2,071 schizophrenia patients with information of survival and all-caused mortality of the follow-up surveys from 2007 to 2010.Schizophrenia was ascertained according to the International Statistical Classification of Diseases, 10th Revision. The degree of urbanicity and the region of residence were used to be the proxies of urbanicity. Of these, the degree of urbanicity measured by the ratio of nonagricultural population to total population and the region of residence measured by six categorical variables (first-tier cities, first-tier city suburbs, second-tier cities, second-tier city suburbs, other city areas, and rural areas). Logistics regression models and restricted polynomial splines were used to examine the linear/nonlinear relationship between urbanicity and the risk of schizophrenia. Cox proportional hazards regression models were used to test the role of urbanicity on mortality risk of schizophrenia patients. 10% increase in the degree of urbanicity was associated with increased risk of schizophrenia (OR = 1.44; 95% CI, 1.32 to 1.57). The nonlinear model further confirmed the association between the degree of urbanicity and the risk of schizophrenia. This association existed sex difference, as the level of urbanicity increased, schizophrenia risk of males grew faster than the risk of females. The hazard ratio (HR) of mortality in schizophrenia patients decreased with the elevated of urbanicity level, with a HR of 0.42 (95% CI, 0.21 to 0.84). This research suggested that incremental changes in the degree of urbanicity linked to higher risk of schizophrenia, and as the degree of urbanicity elevated, the risk of schizophrenia increased more for men than for women. Additionally, we found that schizophrenia patients in higher degree of urbanicity areas had lower risk of mortality. These findings contributed to the literature on schizophrenia in developing nations under a non-Western context and indicates that strategies to improve mental health conditions are needed in the progress of urbanicity.

A Call to Action: A High Prevalence of Mental Health Conditions in Septic Compared with Aseptic Revision Total Hip Arthroplasty

AbstractProsthetic joint infections (PJIs) after primary total hip arthroplasty (pTHA) are known to have a profound impact on patients' pain and function. However, there is little evidence on the association between PJIs and mental health in pTHA and revision total hip arthroplasty (rTHA) patients. The purpose of this study was to compare the prevalence of mental health conditions among patients undergoing (1) pTHA, (2) septic rTHA, and (3) aseptic rTHA. All THAs performed between 2005 and 2014 were queried using the Healthcare Cost and Utilization Project State Inpatient Databases. This yielded 468,663 patients. Patients were separated into the following cohorts based on procedure: primary, septic revision, and aseptic revision. Diagnoses of any mental health condition as well as the following specific conditions were compared among the three cohorts: schizophrenia/delusion, bipolar disorder, depression/mood disorder, personality disorder, anxiety/somatic/dissociative disorder, eating disorders, attention-deficit/hyperactivity disorder/conduct/impulse control, alcohol abuse, and drug abuse. Univariate analysis was performed to assess differences and trends in mental health conditions among the three cohorts. The prevalence of mental health conditions overall in rTHA patients increased throughout the study period. There was a significantly higher prevalence of mental health conditions overall among patients in the septic rTHA cohort (n = 1,818, 28.0%) compared with the pTHA (n = 81,616, 19.2%; p < 0.001), and aseptic rTHA (n = 7,594, 20.9%; p < 0.001) cohorts. Specifically, septic rTHA patients had a higher prevalence of schizophrenia (p < 0.001; p < 0.001), bipolar disorder (p < 0.001; p < 0.001), depression (p < 0.001; p < 0.001), personality disorders (p = 0.0015; p = 0.013), anxiety (p < 0.001; p = 0.0055), eating disorders (p < 0.001; p = 0.006), alcohol abuse (p < 0.001; p < 0.001), and drug abuse (p < 0.001; p < 0.001) compared with primary THA and aseptic rTHA, respectively. Overall, rates of mental health conditions were significantly higher among septic rTHA patients. Alcohol and drug abuse were approximately twice as prevalent among patients undergoing rTHA for infection compared with primary or aseptic rTHA patients. The level of evidence of the study is level III.

Being Born during a Flu Pandemic as Risk Factors for Development of Schizophrenia

Abstract Background Schizophrenia is a neurodevelopmental disorder of complex etiopathogenesis involving genetic and environmental factors. Mother’s exposure to infectious agents during pregnancy has been, implicated in the pathogenesis of schizophrenia. Studies in experimental models support that flu virus can cause embryonic neurodevelopment damage such as that described for embryos that later develop schizophrenia, but epidemiological studies of the association between schizophrenia and gestation in times of a documented flu pandemic) are contradictory. Methods The study is a cross-sectional study within the APNA Study (Navarre primary health care prospective cohort) that included 470942 people over 18 years old in Navarre (Spain). Date of birth, sex, and schizophrenia diagnoses made by psychiatrist on the basis of ICD-10 were extracted. People were classified according if their birth dates occurred within or around periods of flu pandemics in the second half of the 20th century: 1957, 1968 and 1977. The dates for these groups were from January of the year of the pandemic until December of the subsequent year. Logistic regression of adjusted by sex, age, and month of birth was performed. Because the cohort only includes people over 18 years of age, data for patients born during the influenza A subtype H1N1 outbreak of 2009 were not available. Results Males have a higher prevalence of schizophrenia than females (OR = 1.516, 95% CI: 1.388-1.655), Adjusting by gender, month of birth and age, subjects born during (or the year after) years of flu pandemic relative to subjects born in non-pandemic years (OR = 1.335, 95% CI = 1.199-1.486). The latter relationship held for each pandemic studied in isolation of the others, with ORs of 1.476 (95% CI: 1.244-1.750) for the 1957-59 pandemic, 1.261 (95% CI: 1.060-1.493) for the 1968-70 pandemic and 1.280 (95% CI: 1,072- 1,528) for the 1977-78 pandemic. Conclusions Been born during a flu pandemic may increase the risk of developing schizophrenia. Key messages Exposure to the influenza virus during gestation may increase the risk of schizophrenia. Flu Vaccination in pregnant women may reduce the risk of schizophrenia in their children.

Mental Health problem and Sustainable Development in India: An Overview

Mental health is an emerging problem in the world, particularly in the developing countries like India, which is a big challenge for the sustainable human development. Health is a vital requirement for sustainable human development, and there can be no health without mental health. The role of mental health is very important in accomplishing social inclusion and equity. It also plays a vital role in acquiring universal health coverage, access to justice and human rights, and sustainable economic development. The World Health Organisation (WHO) defines health is not only the absence of disease but it implicates the physical, social, spiritual and mental health (Park, 2015:12-13). Since primordial eras, India, has emphasised on the health of its citizens and has underlined the need for a physically and mentally healthy society. In the new SDGs, the UN has lastly demarcated that mental health is one of the most universal development precedence, and set the scene for an ambitious plan to tackle the world’s challenges in the coming 15 years. WHO has also projected two indicators to strengthen mental health in the SDGs, which are fully aligned with the WHO Global Mental Health Action plan, both within the health goal: (1) suicide rate; and (2) service coverage (proportion treated) of persons with severe mental illness (World Health Organization, 2015). This paper is based on secondary data. The main thrust of this paper was to explore the frequency and pattern of mental disorder and its impact on families or household. This paper also analysed the mental morbidity rate and its cause in India. The findings demonstrated that 13.7 per cent of India’s general population has various mental disorders; 10.6 per cent of them need instant mediations. Whereas, almost 10 per cent of the population has common mental disorders, 1.9 per cent of the masses suffer from severe mental disorders. The result shows that the frequency of schizophrenia is more in urban metros then rural counterparts. The occurrence of mental illness is found to be very high in urban centres, where there is a higher prevalence of schizophrenia, mood disorders and neurotic or stress-related disorders.

A systematic review of the indirect costs of schizophrenia in Europe.

BackgroundSchizophrenia is a chronic disease associated with significant and long-lasting effects on health, and it is also a social and financial burden, not only for patients but also for families, other caregivers, and the wider society. It is essential to conduct the assessment of indirect costs, to understand all the effects of the disease on society. Our aim is to gain a better understanding of the indirect costs of schizophrenia in Europe.MethodsWe conducted a comprehensive systematic literature review covering EMBASE, Medline, and PsycINFO as well as reviewing Health Technology Assessment databases from different countries. We used a qualitative research synthesis for presenting information, as most of the studies were methodologically diverse, a quantitative analysis would have been impractical.ResultsIndirect cost adjusted to inflation ranged vastly between studies included in the review from 119 Euros to 62, 034 Euros annually. The average proportion of indirect costs of total costs was 44%. Studies highlighted important cost drivers as age, gender, and disease severity, explaining the variation in costs between treatment and patient groups.ConclusionsRegardless of the methodological heterogeneity of the reviewed studies, there was an agreement about the significance of indirect costs of schizophrenia on the society. Considering the relatively high prevalence of schizophrenia in Europe, a need for more cost of illness studies especially from Central Eastern and Southern Europe is suggested.

Schizophrenia in type 2 diabetes mellitus: Prevalence and clinical characteristics

BackgroundThis study investigated the prevalence and characteristics of schizophrenia in patients with type 2 diabetes mellitus (T2DM) in Taiwan. MethodsNational Health Insurance claims data for patients with principal diagnoses of schizophrenia and T2DM were analysed. ResultsCompared with patients with schizophrenia in the general population (GP), those with schizophrenia and T2DM were more likely to have higher Charlson comorbidity index (CCI) scores and multiple comorbidities, and were older. The prevalence of schizophrenia was significantly higher in patients with T2DM than in the GP from 2000 to 2010. In addition, during this period, the prevalence of schizophrenia in patients with T2DM increased from 0.64% to 0.85%; such an increase in the GP was also observed. A high prevalence of schizophrenia was observed in patients with T2DM aged less than 60 years old; those residing in eastern Taiwan; those with incomes of ≤NT$17,280, NT$17,281–NT$22,880, NT$22,881–NT$28,800, and NT$36,301–NT$45,800; and those with CCI > 2. ConclusionsOur study found the prevalence of schizophrenia is higher in patients with T2DM than in the GP, particularly those with earlier ages less than 60 years old. Public health initiatives are necessary to prevent and treat schizophrenia in patients with T2DM, specifically for those with the aforementioned and premature death risk.

Use of the Patient Satisfaction with Pharmacist Services Questionnaire (PSPSQ) 2.0 in a telephonic medication therapy management center

Chromosome 22q11.2 deletion syndrome (22q11DS) is a neurodevelopmental disorder associated with a broad phenotype of clinical, cognitive and psychiatric features. Due to the very high prevalence of schizophrenia (30–40%), the investigation of psychotic symptoms in the syndrome is promising to reveal biomarkers for the development of psychosis, also in the general population. Since schizophrenia is seen as a disorder of the dynamic interactions between brain networks, we here investigated brain dynamics, assessed by the variability of blood oxygenation level dependent (BOLD) signals, in patients with psychotic symptoms. We included 28 patients with 22q11DS presenting higher positive psychotic symptoms, 29 patients with lower positive psychotic symptoms and 69 healthy controls between 10 and 30 years old. To overcome limitations of mass-univariate approaches, we employed multivariate analysis, namely partial least squares correlation, combined with proper statistical testing, to analyze resting-state BOLD signal variability and its age-relationship in patients with positive psychotic symptoms. Our results revealed a missing positive age-relationship in the dorsal anterior cingulate cortex (dACC) in patients with higher positive psychotic symptoms, leading to globally lower variability in the dACC in those patients. Patients without positive psychotic symptoms and healthy controls had the same developmental trajectory in this region. Alterations of brain structure and function in the ACC have been previously reported in 22q11DS and linked to psychotic symptoms. The present results support the implication of this region in the development of psychotic symptoms and suggest aberrant BOLD signal variability development as a potential biomarker for psychosis.

Schizophrenias’ Quality of Life and Emotional Intelligence in Songklanagarind Hospital

Objective: To estimate the level of quality of life (QoL), emotional intelligence (EI) and the association between QoL and EI in schizophreniaMaterial and Method: A cross-sectional study was conducted at the outpatient department of Songklanagarind Hospital from; May to November, 2016. A total of 96 participants were interviewed. Demographic data and medical history were collected. QoL and EI were assessed using the WHO QOL BREF (Best available techniques REFerence document) Thai version and the Thai EI Screening Test for ages of 18-60. The results were analyzed by descriptive statistics and multiple logistic regression.Results: Our subjects were predominantly single males. Sixty-seven point seven percent of the participants were poor to moderate QoL while only two factors significantly related to their poor to moderate QoL; difficulties from psychiatric conditions and a lower level of life satisfaction. Fifty-seven point four to eighty-seven point two percent of the participants were generally within normal EI in every subscale. Moreover, there was statistical significance for positive relationships between EI with QoL in schizophrenia.Conclusion: The high prevalence of schizophrenia was a moderate QoL. A positive relationship of individual subscales of EI towards QoL was substantially found.

Psychotic symptoms influence the development of anterior cingulate BOLD variability in 22q11.2 deletion syndrome

Chromosome 22q11.2 deletion syndrome (22q11DS) is a neurodevelopmental disorder associated with a broad phenotype of clinical, cognitive and psychiatric features. Due to the very high prevalence of schizophrenia (30–40%), the investigation of psychotic symptoms in the syndrome is promising to reveal biomarkers for the development of psychosis, also in the general population. Since schizophrenia is seen as a disorder of the dynamic interactions between brain networks, we here investigated brain dynamics, assessed by the variability of blood oxygenation level dependent (BOLD) signals, in patients with psychotic symptoms. We included 28 patients with 22q11DS presenting higher positive psychotic symptoms, 29 patients with lower positive psychotic symptoms and 69 healthy controls between 10 and 30years old. To overcome limitations of mass-univariate approaches, we employed multivariate analysis, namely partial least squares correlation, combined with proper statistical testing, to analyze resting-state BOLD signal variability and its age-relationship in patients with positive psychotic symptoms. Our results revealed a missing positive age-relationship in the dorsal anterior cingulate cortex (dACC) in patients with higher positive psychotic symptoms, leading to globally lower variability in the dACC in those patients. Patients without positive psychotic symptoms and healthy controls had the same developmental trajectory in this region. Alterations of brain structure and function in the ACC have been previously reported in 22q11DS and linked to psychotic symptoms. The present results support the implication of this region in the development of psychotic symptoms and suggest aberrant BOLD signal variability development as a potential biomarker for psychosis.

Socioeconomic disadvantage and schizophrenia in migrants under mental health detention orders

Migrants with mental hospital orders according to section 63 of the German criminal code are overrepresented in relation to their numbers in the general population. Subgroups originating from certain world regions are diagnosed with schizophrenia at a much higher rate than others. In the present literature, there is a strong evidence for a substantial correlation between migration, social disadvantage and the prevalence of schizophrenia. This study investigates the relationship between countries of origin, the risk of becoming a forensic patient and the proportion of schizophrenia spectrum disorders. Data from a comprehensive evaluation tool of forensic inpatients in the German federal state of Baden-Württemberg (FoDoBa) were compared with population statistics and correlated with the Human Development Index (HDI) and Multidimensional Poverty Index (MPI). For residents with migration background, the risk ratio to receive a mental hospital order is 1.3 in comparison to non-migrants. There was a highly significant correlation between the HDI of the country of origin and the risk ratio for detention in a forensic psychiatric hospital. The proportion of schizophrenia diagnoses also correlated significantly with the HDI. In contrast, the MPI country rankings were not associated with schizophrenia diagnoses. Two lines of explanations are discussed: first, higher prevalence of schizophrenia in migrants originating from low-income countries, and second, a specific bias in court rulings with regard to involuntary forensic treatment orders for these migrant groups.

Mice with a naturally occurring DISC1 mutation display a broad spectrum of behaviors associated to psychiatric disorders.

Disrupted in schizophrenia-1 (DISC1) gene is associated with several neuropsychiatric disorders as it is disrupted by a balanced translocation involving chromosomes 1 and 11 in a large Scottish pedigree with high prevalence of schizophrenia, bipolar disorder and major depression. Since its identification, several mouse models with DISC1 genetic modifications have been generated using different approaches. Interestingly, a natural deletion of 25bp in the 129 mouse strain alters the DISC1 gene reading frame leading to a premature stop codon very close to the gene breakpoint in the mutant allele of the Scottish family. In the present study we confirmed that the 129DISC1Del mutation results in reduced level of full length DISC1 in hippocampus of heterozygous mice and we have characterized the behavioral consequences of heterozygous 129DISC1Del mutation in a mixed B6129 genetic background. We found alterations in spontaneous locomotor activity (hyperactivity in males and hypoactivity in females), deficits in pre-pulse inhibition (PPI) and also increased despair behavior in heterozygous 129DISC1Del mice, thus reproducing typical behaviors associated to psychiatric disorders. Since this mouse strain is widely and commercially available, we propose it as an amenable tool to study DISC1-related biochemical alterations and psychiatric behaviors.

AS07-01 - Completed suicide vs suicide atempt: similarities and differences ?

In Spain, suicide has become the leading cause of violent death, ahead of traffic accidents. Prevention programs are based on risk factors of suicidal behavior, which are mainly drawn from studies of suicide attempts and to a lesser extent, from studies of completed suicide. Our main objectives were to determine if difference exists between suicide completion and suicide attempt populations with regards to sociodemographic and clinical factors, life events, impulsivity and suicide intent. We recruited completed suicides in the province of Seville and the recruitment of suicide attempters in two university hospitals in Madrid. In the first group, data were collected through close relatives, while the latter group were interviewed within 24 hours after the suicide attempt. There were a higher proportion of males among the completed suicide compared to suicide attempter group. Suicide completers were also older, showed a lower impulsive trait and state, and had more suicide intent than attempters. Clinically, suicide completers had a higher prevalence of schizophrenia but a lower proportion of anxiety disorders than attempters. In Axis II, completers had a lower prevalence of Cluster A and Cluster C personality disorders. However, suicide completers were more likely to have a diagnosis of Narcissistic personality disorder compared to attempters. Family history of completed suicide was more frequent among suicide completers than among attempters. There are significant differences with regards to demographic, clinical, and psychological characteristics, and life events between suicide completers and suicide attempters. They seem to be two distinct populations.

Studies based on the Danish Adoption Register: Schizophrenia, BMI, smoking, and mortality in perspective

The genetic and familial environmental influences making up familial correlations in traits and familial aggregation of diseases may be disentangled by adoption studies. Thus, resemblance between the adoptee and the biological relatives indicates a contribution of the segregating gene they have in common, and resemblance between the adoptee and the rearing adoptive family members indicates influences of the shared family environment. The Danish Adoption Register includes information on all 14,425 non-familial adoptions of Danish children legally granted in Denmark from 1924 to 1947. To illustrate the adoption study approach in research, we present results achieved in schizophrenia, body fatness, smoking, and mortality. Significantly higher prevalence of schizophrenia and related conditions were found in biological relatives to adoptees with schizophrenia than among biological relatives to adoptees without schizophrenia. Clear trends in body mass index of biological relatives and the weight of adoptees were found in several settings. A genetic influence on smoking habits were found within a generation. A moderate genetic influence on the mortality rate has been found. The Danish Adoption Register has contributed to the knowledge about environmental and genetic influence in various fields. Genetic influence on the risk of schizophrenia, body fatness, smoking habits, and on the mortality rate has been found.

What research is needed in social psychiatry?

There is no such a thing as psychiatry without a social component. If the XIXth Century has been mostly dedicated to clinical descriptions and classification, if the XXth Century has been mostly therapeutic (psychotherapies, psychopharmacology and biological psychiatry), it is highly probable that the XXIst Century will be mostly oriented towards psycho-social psychiatry and mental health. Research will be an essential part of this evolution. There is also an urgent need of education of young promising psychiatrists, learning the complexity of interactions between the psycho-social aspect and the biological one in psychiatry, but also the necessity using of a rigorous methodology. There are plenty of topics which need to be investigated in social psychiatry. Some of the most important are: - Migration and mental health, especially on the seemingly higher prevalence of schizophrenia among some groups of migrants; - Religion, spirituality and mental health; as a matter of fact, they will play an increasing role in the future in the expression of psychopathology, and in psycho-social phenomena such as violence, substance abuse... - Women's mental health, especially peri-natal mental health and psychiatry; - Ethics and its relative relativity from one culture to another in psychiatric daily practice.

Spatial analysis to identify hotspots of prevalence of schizophrenia

The geographical distribution of mental health disorders is useful information for epidemiological research and health services planning. To determine the existence of geographical hotspots with a high prevalence of schizophrenia in a mental health area in Spain. The study included 774 patients with schizophrenia who were users of the community mental health care service in the area of South Granada. Spatial analysis (Kernel estimation) and Bayesian relative risks were used to locate potential hotspots. Availability and accessibility were both rated in each zone and spatial algebra was applied to identify hotspots in a particular zone. The age-corrected prevalence rate of schizophrenia was 2.86 per 1,000 population in the South Granada area. Bayesian analysis showed a relative risk varying from 0.43 to 2.33. The area analysed had a non-uniform spatial distribution of schizophrenia, with one main hotspot (zone S2). This zone had poor accessibility to and availability of mental health services. A municipality-based variation exists in the prevalence of schizophrenia and related disorders in the study area. Spatial analysis techniques are useful tools to analyse the heterogeneous distribution of a variable and to explain genetic/environmental factors in hotspots related with a lack of easy availability of and accessibility to adequate health care services.

Psychiatrist Ensures Field Has International Focus

Psychiatrist Ensures Field Has International Focus

Season of birth interacts with measures of inbreeding in multiplex schizophrenia pedigrees: evidence from genetic isolates in Daghestan

Abstract While the season-of-birth effect is one of the most consistent epidemiological features of schizophrenia, there is a lack of consistency with respect to the interaction between season of birth and family history of schizophrenia. Apart from family history, measures related to consanguinity can be used as proxy markers of genomic heterogeneity. Thus, these measures may provide an alternate, indirect index of genetic susceptibility. We had the opportunity to explore the interaction between season of birth and measure of consanguinity in well-described genetic isolates in Daghestan, some of which are known for their relatively high prevalence of schizophrenia. Our previous population-genetic study showed Daghestan has an extremely high genetic diversity between the ethnic populations and a low genetic diversity within them. The isolates selected for this study include some with more than 200 and some with less than 100 generations of demographical history since their founding. Based on pedigrees of multiply-affected families, we found that among individuals with schizophrenia, the measure of consanguinity was significantly higher in the parents of those born in winter/spring compared to those born in summer/autumn. Furthermore, compared to summer/autumn born, winter/spring born individuals with schizophrenia had an earlier age-of-onset, and more prominent auditory hallucinations. Our results suggest that the offspring of consanguineous marriages, and thus those with reduced allelic heterogeneity, may be more susceptible to the environmental factor(s) underpinning the season-of-the effect in schizophrenia.

Social class and type of schizophrenia

Objective Current and past research strongly indicates a high prevalence of schizophrenia in the lower class in the USA and other stratified societies. To date, no study has tested for a connection between type of schizophrenia and socioeconomic status (SES). We tested for an interrelationship between schizophrenic subtype, SES and race. Methods Positive and negative symptom scales were used to evaluate 436 schizophrenic patients at a state hospital in the USA. All patients were also diagnosed by DSM standards. Social class of origin was assessed by the Occupational Classification Distributions of the U.S. Bureau of the Census. Multivariate analysis was conducted with the likelihood ratio chi-square. Results We uncovered a distinct propensity for deficit schizophrenia to be elevated among the poor. The finding presents as a pure SES effect since the likelihood of deficit schizophrenia does not vary by race when social class is held constant. Conclusion The finding is potentially an important new insight into the epidemiology of schizophrenia. It offers a better understanding for poor outcome among lower class patients in stratified societies such as the United States. It is also consistent with longitudinal research by European investigators.

Brain Anatomy in Adults With Velocardiofacial Syndrome With and WithoutSchizophrenia

Velocardiofacial syndrome is associated with interstitial deletions of chromosome 22q11, mild to borderline learning disability, characteristic dysmorphology, and a high prevalence of schizophrenia. The biological basis for this increased risk for schizophrenia is unknown, but people with velocardiofacial syndrome may have genetically determined differences in brain anatomy that predispose to the development of schizophrenia. To determine whether there are differences in brain structure between subjects with velocardiofacial syndrome with and without schizophrenia. A cross-sectional quantitative structural magnetic resonance imaging study in 39 adult subjects. Referrals were made through medical genetics clinics and psychiatric services throughout the United Kingdom. Thirteen subjects with velocardiofacial syndrome and schizophrenia, 12 with velocardiofacial syndrome without history of a psychosis, and 14 healthy controls volunteered to participate after screening for eligibility. Total and regional brain volumes were analyzed by means of manual tracing, and gray- and white-matter densities were obtained by computerized voxel-based methods. People with velocardiofacial syndrome and schizophrenia, compared with both controls and nonschizophrenic patients with velocardiofacial syndrome, had a significant (P<.05) reduction in volume of whole-brain (white + gray) matter and whole-brain white matter, and an increase in total and sulcal cerebrospinal fluid volume. Both velocardiofacial syndrome groups had a reduced cerebellar volume compared with controls. Within velocardiofacial syndrome, schizophrenia is associated with generalized differences in brain anatomy, but white matter may be particularly implicated. Studies with larger samples are needed to replicate our findings.