The Antecedents of Schizophrenia: A Review of Birth Cohort Studies

Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia.
Schizophrenia Bulletin (Impact Factor: 8.45). 05/2009; 35(3):603-23. DOI: 10.1093/schbul/sbn084
Source: PubMed Central


Birth cohort (BC) studies demonstrate that individuals who develop schizophrenia differ from the general population on a range of developmental indices. The aims of this article were to summarize key findings from BC studies in order to identify areas of convergence and to outline areas requiring further research.
We define BC studies as studies based on general population BCs where data are collected prospectively from birth or childhood and which identify schizophrenia or related disorders as an outcome. To identify such studies, we searched various electronic databases using the search parameters (schizo* OR psych*) AND (birth cohort). We also checked the references of relevant articles and previous reviews.
We identified 11 BCs from 7 countries that have examined schizophrenia as an outcome in adulthood. There is relatively consistent evidence that, as a group, children who later develop schizophrenia have behavioral disturbances and psychopathology, intellectual and language deficits, and early motor delays. Evidence with respect to alterations in language, educational performance, and physical growth has also been identified in some studies. BC studies have also contributed evidence about a wide range of putative risk factors for schizophrenia.
BC studies have provided important, convergent insights into how the developmental trajectory of individuals who develop schizophrenia differs from their peers. The combination of new paradigms and larger cohorts, with the tools of modern epidemiology and biomedical science, is advancing our understanding of the developmental pathways to schizophrenia.

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    • "However, the population studies mentioned above have been carried out with samples of non-clinical participants that have never been admitted. Moreover, both retrospective and prospective birth cohort studies have found that social isolation in childhood is associated with a later diagnosis of schizo Q4 phrenia (Jones et al., 1994; Cannon et al., 2008; Welham et al., 2009). In a cohort study of 50,054 Swedish conscripts, individuals who later developed psychotic experiences at a 15-year follow up were significantly more likely to have fewer than two friends and to prefer smaller groups (Malmberg et al., 1998) suggesting that social isolation may predate the onset of symptoms and the diagnosis. "
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    ABSTRACT: Recent work has focused on the role of the environment in psychosis with emerging evidence that specific psychotic experiences are associated with specific types of adversity. One risk factor that has been often associated with psychosis is social isolation, with studies identifying isolation as an important feature of prodromal psychosis and others reporting that social networks of psychotic patients are smaller and less dense than those of healthy individuals. In the present study, we tested a prediction that social isolation would be specifically associated with formal thought disorder. 80 patients diagnosed with psychosis-spectrum disorder and 30 healthy participants were assessed for formal thought disorder with speech samples acquired during an interview that promoted personal disclosure and an interview targeting everyday topics. Social isolation was significantly associated with formal thought disorder in the neutral interview and in the salient interview, even when controlling for comorbid hallucinations, delusions and suspiciousness. Hallucinations, delusions and suspiciousness were not associated with social isolation when formal thought disorder was controlled for. Formal thought disorder is robustly and specifically associated with social isolation. Social cognitive mechanisms and processes are discussed which may explain this relationship as well as implications for clinical practice and future research.
    Psychiatry Research 09/2015; DOI:10.1016/j.psychres.2015.09.010 · 2.47 Impact Factor
    • "risk factors (Murray et al., 1985). On the other hand, an intriguing finding in psychosis research is that, despite schizophrenia and other psychoses running in families, most affected individuals do not have family history of the illness (Welham et al., 2009). There is now increasing evidence suggesting that cognitive dysfunction is a reliable and stable feature of psychosis (Barch and Ceaser, 2012) and that it predicts psychosocial functioning and functional capacity better than clinical manifestations in schizophrenia patients (Bowie et al., 2008). "
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    ABSTRACT: Schizophrenia and other psychoses are complex disorders with high rates of cognitive impairment and a considerable degree of genetic and environmental influence on its etiology. Whether cognitive impairment is related to dimensional scores of familial liability is still matter of debate. We conducted a cross-sectional study including 169 patients with psychotic disorders and 26 healthy controls. Attention, memory and executive functions were assessed, and familial loading scores for schizophrenia and mood disorders were calculated. The relationships between familial liability and neuropsychological performance were examined with Spearman׳s correlation coefficients. In addition, patients were classified into three groups by family loading tertiles, and comparisons were performed between the patients in the top and bottom tertiles. Low familial loading scores for schizophrenia showed a significant association with poor executive functioning and delayed visual memory. And these results were also achieved when the subset of psychotic patients in the two extreme tertiles of family loadings of schizophrenia and mood disorders were compared. Low familial liability to schizophrenia seems to be a contributing factor for the severity of cognitive impairment in patients with a broad putative schizophrenia spectrum diagnosis. Copyright © 2015. Published by Elsevier Ireland Ltd.
    04/2015; 227(2-3). DOI:10.1016/j.psychres.2015.03.024
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    • "For example, Chapman et al. (1994) initially demonstrated that adolescents who rated high on scales of magical ideation and perceptual aberration had high rates of psychotic outcomes 10 years later. These results have been further replicated in several distinct cohorts (Poulton et al., 2000; Cannon et al., 2002; Hanssen et al., 2005; Welham et al., 2009). Despite the routine observation that a subset of children who experience multiple risk factors are much more likely to experience adverse psychological outcomes than those with single risk factors (Rutter, 1979; Rutter, 1981), to date there are a paucity of data on the cumulative effects of psychosis-related risk factors. "
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    ABSTRACT: Although epidemiological studies provide strong support for demographic and environmental risk factors in psychotic disorders, few data examine how these risk factors relate to the putative aberrant neurodevelopment associated with illness. The present study examined how the accumulation of risk factors including low IQ, low parental socioeconomic status, history of adolescent cannabis use and childhood trauma, and high levels of subclinical psychotic-like experiences contributed to aberrant neurodevelopmental outcomes in 112 otherwise healthy adults recruited from the community. Participants were studied with diffusion tensor imaging, and voxel-wise statistical analysis of fractional anisotropy (FA) using tract-based spatial statistics was used to examine the relation between cumulative risk (CR) for psychosis and white matter (WM) integrity across the whole brain. Analyses revealed that higher CR was significantly associated with lower FA in a cluster in the left superior longitudinal fasciculus. These results suggest that risk factors previously associated with psychotic disorders are associated with WM integrity even in otherwise healthy adults and may provide insight into how previously identified risk factors contribute to the structural brain abnormalities associated with psychotic illness. Prospective longitudinal studies examining the effect of risk factors on the developmental trajectory of brain WM are warranted.
    Psychiatry Research: Neuroimaging 12/2014; 224(3). DOI:10.1016/j.pscychresns.2014.09.001 · 2.42 Impact Factor
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