Studies based on the Danish Adoption Register: Schizophrenia, BMI, smoking, and mortality in perspective
Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, DK-1357 Copenhagen K, Denmark.Scandinavian Journal of Public Health (Impact Factor: 1.83). 07/2011; 39(7 Suppl):191-5. DOI: 10.1177/1403494810396560
INTRODUCTION: 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. RESEARCH TOPICS: 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. CONCLUSION: 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.
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ABSTRACT: Studies have shown that obstetrical complications during one's birth play significant roles in the development of schizophrenia in one's lifetime, especially in males. Hence, schizophrenia needs careful management practice from one's birth. This paper argues that schizophrenia needs to be treated as a collaborative process and as a result, the 'awareness' and 'knowledge-sharing' capability of various roles involved in the management process need to be addressed explicitly. This paper proposes high-level specification of a novel methodology for identifying and evaluating the level of awareness required by these roles for 'at risk' schizophrenics throughout their lives. The authors have both applied and validated a collaborative management approach and an associated analytical tool called the Awareness Information Net AIN model to assist in maintaining awareness capabilities among various roles involved in the management of schizophrenics. The ultimate goal of the current study is to develop conceptual foundation for an automated workflow management system for a collaborative management process for schizophrenia.
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ABSTRACT: Background: Schizophrenia is among the major causes of disability worldwide and the mortality from cardiovascular disease (CVD) is significantly elevated. There is a growing concern that this health challenge is not fully understood and efficiently addressed. Methods: Non-systematic review using searches in PubMed on relevant topics as well as selection of references based on the authors’ experience from clinical work and research in the field. Results: In most countries, the standardized mortality rate in schizophrenia is about 2.5, leading to a reduction in life expectancy between 15 and 20 years. A major contributor of the increased mortality is due to CVD, with CVD mortality ranging from 40 to 50% in most studies. Important causal factors are related to lifestyle, including poor diet, lack of physical activity, smoking, and substance abuse. Recent findings suggest that there are overlapping pathophysiology and genetics between schizophrenia and CVD-risk factors, further increasing the liability to CVD in schizophrenia. Many pharmacological agents used for treating psychotic disorders have side effects augmenting CVD risk. Although several CVD-risk factors can be effectively prevented and treated, the provision of somatic health services to people with schizophrenia seems inadequate. Further, there is a sparseness of studies investigating the effects of lifestyle interventions in schizophrenia, and there is little knowledge about effective programs targeting physical health in this population. Discussion: The risk for CVD and CVD-related deaths in people with schizophrenia is increased, but the underlying mechanisms are not fully known. Coordinated interventions in different health care settings could probably reduce the risk. There is an urgent need to develop and implement effective programs to increase life expectancy in schizophrenia, and we argue that mental health workers should be more involved in this important task.