Abstract
To measure the importance of early neurodevelopmental disturbance for schizophrenia, early trauma and dysmorphogenesis (i.e. obstetric complications (OCs), minor physical anomalies (MPAs), head circumference (HC) and dermatoglyphic characteristics) were studied in relationship to adult neurodysfunction (i.e. neurological abnormality (NA), neurocognitive dysfunction (NCGD), tardive dyskinesia (TD) and parkinsonism) in 60 schizophrenia patients, 21 of their non-ill siblings and 75 normal comparison subjects.
Patients showed reduced neonatal HC (nHC), increased rates of OCs, MPAs, NA and NCGD, and frequent signs of TD and parkinsonism. Siblings showed increased rates of MPAs, NA, and NCGD and frequent signs of TD, implicating a general familial vulnerability for schizophrenia-related neurodysfunction. Patients differed from siblings by having reduced nHC and increased OCs, and higher rates of MPAs and adult neurodysfunction, signalling two different levels of early trauma/dysmorphogenesis and neurodysfunction: one characterising at-risk families in general, and another higher, disease-related level characterising the patient group. Early trauma/dysmorphogenesis was generally unrelated to adult neurodysfunction. HC in patients was reduced at birth but disproportionately large in males in adulthood. NA was related to level of global functioning in adulthood. Early trauma/dysmorphogenesis thus seems to initiate an early pathophysiological process, but additional factors influence adult neurodysfunction in schizophrenia. The findings in total would be consistent with a 'multi-hit' neurodevelopmental model of schizophrenia. The effective factors would vary from individual to individual and include both genetic and early/later environmental components.
Patients showed reduced neonatal HC (nHC), increased rates of OCs, MPAs, NA and NCGD, and frequent signs of TD and parkinsonism. Siblings showed increased rates of MPAs, NA, and NCGD and frequent signs of TD, implicating a general familial vulnerability for schizophrenia-related neurodysfunction. Patients differed from siblings by having reduced nHC and increased OCs, and higher rates of MPAs and adult neurodysfunction, signalling two different levels of early trauma/dysmorphogenesis and neurodysfunction: one characterising at-risk families in general, and another higher, disease-related level characterising the patient group. Early trauma/dysmorphogenesis was generally unrelated to adult neurodysfunction. HC in patients was reduced at birth but disproportionately large in males in adulthood. NA was related to level of global functioning in adulthood. Early trauma/dysmorphogenesis thus seems to initiate an early pathophysiological process, but additional factors influence adult neurodysfunction in schizophrenia. The findings in total would be consistent with a 'multi-hit' neurodevelopmental model of schizophrenia. The effective factors would vary from individual to individual and include both genetic and early/later environmental components.
| Original language | English |
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| Qualification | Doctor |
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| Supervisors/Advisors |
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| Award date | 2003 Dec 1 |
| Publisher | |
| ISBN (Print) | 91-631-4318-6 |
| Publication status | Published - 2003 |
Bibliographical note
Defence detailsDate: 2003-12-01
Time: 09:15
Place: Segerfalkssalen, BMC, Lund
External reviewer(s)
Name: Murray, Robin
Title: Prof.
Affiliation: Institute of Psychiatry, London
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Article: B Ismail, E Cantor-Graae, TF McNeil. Neurological abnormalities in schizophrenic patients and their siblings. American Journal of Psychiatry 1998;155:84-89.BT Ismail, E Cantor-Graae, S Cardenal, TF McNeil. Neurological abnormalities in schizophrenia: clinical, etiological and demographic correlates. Schizophrenia Research 1998;30:229-238.B Ismail, E Cantor-Graae, TF McNeil. Minor physical anomalies in schizophrenic patients and their siblings. American Journal of Psychiatry 1998;155:1695-1702.B Ismail, E Cantor-Graae, TF McNeil. Minor physical anomalies in schizophrenia: cognitive, neurological and other clinical correlates. Journal of Psychiatric Research 2000;34:45-56.B Ismail, E Cantor-Graae, TF McNeil. Neurodevelopmental origins of tardivelike dyskinesia in schizophrenia patients and their siblings. Schizophrenia Bulletin 2001;27:629-642.E Cantor-Graae, B Ismail, TF McNeil. Are neurological abnormalities in schizophrenic patients and their siblings the result of perinatal trauma? Acta Psychiatrica Scandinavica 2000;101:142-147.E Cantor-Graae, B Ismail, TF McNeil. Neonatal head circumference and related indices of disturbed fetal development in schizophrenic patients. Schizophrenia Research 1998;32:191-199.
Subject classification (UKÄ)
- Occupational Health and Environmental Health
Free keywords
- Psychiatry
- clinical psychology
- klinisk psykologi
- neurodevelopmental model
- psychosomatics
- Psykiatri
- tardive dyskinesia
- neurological abnormality
- neurocognitive dysfunction
- dermatoglyphics
- head circumference
- minor physical anomalies
- Schizophrenia
- obstetric complications
- psykosomatik