Season of birth and obstetrical complications in schizophrenics

Many studies indicate that both obstetrical complications (OCs) and birth in winter or early spring are risk factors for schizophrenia, but few studies have examined how these risk factors covary in the same subjects. We assessed pre- and perinatal OCs, while blind to diagnosis, using medical data recorded at the time of subjects' births, in 29 probands with DSM-III schizophrenia or schizoaffective disorder and 39 of their unaffected adult sibs. Pre- and perinatal OCs were both significantly more common in probands than sibs. Schizophrenics not born during the winter or early spring had significantly more total and perinatal OCs than schizophrenics born in other months, but did not differ for prenatal OCs. Results indicate that OCs increase risk for schizophrenia, but also suggest the possibility that the impact of OCs on this risk may be affected by season of birth.     

Social skills and relapse history in outpatient schizophrenics

Persons with schizophrenia commonly have impaired social functioning (Wallace 1984). Those with greater impairments, particularly as measured by premorbid social attainment, have a poorer clinical prognosis (Strauss and Carpenter 1972). Interventions designed to improve social competence, such as social skills training, have yielded generalizable and durable effects and may have reduced relapse rates (Wallace and Liberman 1985; Liberman et al. 1986; Hogarty et al. 1986). Thus, a valid measure of social skills should be a useful clinical and research tool. This research explores the validity of a new instrument for measuring such skills, the Assessment of Interpersonal Problem Solving Skills (AIPSS) (Donahoe et al., this issue). The AIPSS differs from more conventional social functioning measures because it 1) utilizes observations of role-playing, rather than self-report or third-party report; 2) provides a rating of the patient's current rather than past functioning; 3) involves videotaped simulated "real life" situations that pose challenges to the patient's ability to solve socially relevant problems; 4) permits assessment of patient's social perception, processing of social information for action planning, and verbal and nonverbal social responses. In this study, we examined the relationship between these parameters of schizophrenic patients' social functioning and their recent relapse history.     

Season of birth and electrodermal unresponsiveness in male schizophrenics

The present study was designed to examine differences in the electrodermal activity of schizophrenics born in the season of excessive risk (January-April), and those born in the season of nonexcessive risk (May-December). Thirty-two male schizophrenics were presented with a series of orienting tones (1000 Hz, 80dB, 2 sec duration) while electrodermal activity was monitored. They were subdivided according to season of birth and compared in three electrodermal variables, and also in some background and clinical parameters. We found that schizophrenics born in the season of excessive risk were characterized by significantly lower electrodermal activity and more negative symptoms than those born in the season of nonexcessive risk.     

VBR in schizophrenia: relationship to family history of psychosis and season of birth

Ventricular enlargement has been consistently demonstrated in schizophrenia using both CT and MRI. Despite this, the structural changes that underlie increased ventricle-brain ratio (VBR) and its relationship to environmental factors (intrauterine viral exposure, obstetric complications, etc.) and family history of schizophrenia remain poorly defined. Increased VBR has been shown in some studies to correlate with an absence of family history of schizophrenia and with Winter-Spring birth. In an attempt to obtain a clearer picture of the contribution of environmental and genetic factors to VBR, we studied 54 patients with DSM III-R schizophrenia. VBR was determined from head CT scans via computerized planimetry. Family history of psychosis and non-psychotic mood disorder was determined with the family informant method. Season of birth was encoded in several ways, including season, trimester and dichotomously. Patients without a family history of psychosis had significantly larger VBR than patients with such a history; family history of mood disorder was not related to VBR. Season of birth was not predictive of VBR. Family history of psychosis and season of birth were not related to each other. These results are in line with prior work demonstrating an association between increased VBR and sporadic (non-familial) schizophrenia. We did not find a relationship between VBR and season of birth, which suggests that risk of perinatal viral exposure and other seasonal environmental factors may not account for the ventricular enlargement in non-familial schizophrenia observed in our sample.     

Season of birth among siblings of schizophrenics

Many studies have shown schizophrenics to be born with unusual frequency in the period January-April, and one interpretation of this seasonality of birth is that the parents of schizophrenics have an unusually strong general tendency to conceive offspring who will be born in January-April. This parental conception habits interpretation may be tested by studying whether the siblings of schizophrenics are also born with increased frequency in January- April. The present study investigated the season of birth of 288 full siblings and 44 half-siblings in 91 families of male schizophrenics. Approximately 5 % of the siblings were known to be schizophrenic; with the schizophrenic siblings excluded from the analyses, the full siblings showed a birth pattern much closer (nonsignificant) to that of the schizophrenics than to that of the general population. Half siblings showed January-April birth rates at or below the population level. Although the mechanisms responsible for the current results still remain unclear, the study suggests that seasonality of births of schizophrenics may be related to the parents' conception habits as well as to an etiological or triggering effect on the development of schizophenia in the offspring.     

Season of birth of schizophrenics in Tokyo,Japan

The monthly distribution of births of 7,960 schizophrenic patients in Tokyo born during the period 1841–1950 was studied in comparison with that of a control population in Tokyo. A spring excess of schizophrenic births were found after 1901 as in previous studies in Western countries. Before 1900, however, there was no significant spring excess. The maximum excess of schizophrenic births occurred in May before 1900 and in April after 1901. The possibility of a shift in the seasonality of schizophrenic births was discussed.     

Low birth weight and a family history of schizophrenia predict poor premorbid functioning in psychosis.

Risk factors thought to predispose to schizophrenia, and premorbid functioning, were assessed blind to diagnosis by interviewing the mothers of 73 patients with DSM-III schizophrenia or affective psychosis. Higher risk of schizophrenia in relatives, lower mean birth weight, a more frequent history of obstetric complications, and poorer educational achievement distinguished the patients with schizophrenia from those with affective psychosis. Low birth weight and obstetric complications each predicted childhood schizoid and schizotypal traits. Poor social adjustment between ages 5 and 11 was predicted by low birthweight and by a family history of schizophrenia.     

Antisocial personality in the biological relatives of schizophrenics

Psychiatric morbidity in the relatives of schizophrenics has been the focus of many papers, with antisocial personality, or sociopathy, the focus of several studies.^1–3 A diagnosis of antisocial personality in the relatives of schizophrenics has been noted by many researchers, with probably the highest rates reported by Kallman with 17%⁴ and Heston with 19%.⁵ However, other researchers have found no difference in antisocial personality or sociopathy between schizophrenic and control samples.^6,7Those who find an excess of antisocial personality in the relatives of schizophrenics offer a variety of explanations for the higher rates. One explanation is that antisocial personality is actually part of the schizophrenia spectrum.^4,5,8 Another explanation, given the evidence that antisocial personality is a distinct genetic disorder,^9,10 is that the high figures noted may be due to assortative mating, that is the tendency of schizophrenics to mate with sociopaths.^3,11 On the other hand, it has been suggested that sampling bias¹² such as the use of adoption samples and out of wedlock conception, both of which are weighted toward lower class and associated with antisocial personality, could be an explanation of the results obtained. Finally, methodological techniques, such as very broad diagnostic categories for schizophrenic relatives, have also been used to explain the rates obtained.¹³To explore the issues mentioned above, this article examines the prevalence of antisocial personality in the biological relatives of adopted schizophrenics as contrasted to biological relatives of a control group. Of particular importance is the fact that several sources of information are used to make a diagnosis, and research diagnostic criteria based on validated diagnostic criteria¹⁴ are used to make the diagnosis of antisocial personality.     

Season of birth of schizophrenics in a recent Japanese sample

Abstract  An excess of schizophrenic births in winter or early spring is a well replicated finding in studies on Western populations. However, there are few studies on Asian populations, and their results are not consistent. We examined the seasonality of schizophrenic births in Japanese subjects ( n = 1024) born between 1955 and 1960. Our results showed a significant inverse relationship between temperature and number of schizophrenic births, which is in line with the findings in Western populations. In our data, observed reduction of schizophrenic births in summer was more marked than excess births in winter. We suggest the possibility that birth in summer may have some advantage in brain growth early in life, which results in reducing the risk of developing schizophrenia.     

Season of birth of schizophrenics in Mississippi, USA.

Prior reviews indicate that schizophrenics tend to be born in the winter, relative to non-psychiatric controls. This conclusion has been criticized, however, as the association between birth seasonality and schizophrenia may be the result of a statistical artifact, the age-incidence effect. To examine this possibility, we studied the birth seasonality of 2892 schizophrenics, controlling for the age-incidence effect. Both before and after instituting these controls, we found excesses for the months of December and March. We conclude that the age-incidence hypothesis does not provide any general explanation of the season-of-birth effect in schizophrenia.     

Genetic and clinical correlates of season of birth of schizophrenics

Abstract The genetic and clinical characteristics of 55 patients with schizophrenia and 138 control patients (with major psychiatric disorders), were studied in relation to the season of birth. The morbid risk (MR) of schizophrenia was significantly higher among relatives of the schizophrenic probands born in Spring than among those of the psychiatric controls born in the same season. The MR of schizophrenia was also significantly higher among relatives of schizophrenic probands born in Winter or Spring (6.9%) than in those of schizophrenic probands born in Summer or Autumn (0%). Among the schizophrenic cases, Winter births were marginally related to the paranoid subtype, whereas other clinical variables showed no clear relationship with the season of birth.     

Rehabilitation of schizophrenics by the extended family

Patterns of care by extended and nuclear families for their patients were studied in relation to 540 Arab schizophrenic outpatients in Qatar. The extended family differs from the nuclear family not only in its larger size but also in the greater emotional commitment of its members to each other's well being. The extended family is more tolerant of patients' minor behavioural abnormalities and temporary protective withdrawals. It is more helpful in the supervision of patients' medication and their social adjustment and leisure-time occupation. Being more traditionally oriented, the extended family helps patients to understand their illness experiences in terms of cultural belief systems once they lose the components that cannot be contained in these systems. Extended family members are less likely than nuclear family members to tax the patients' emotional resources and limited repertoire of social skills.     

Relationship of neurological abnormalities in schizophrenics to family psychopathology

Competing etiological models make opposite predictions as to the relationship between focal neurological abnormalities in schizophrenics and the prevalence of psychosis in their families. In previous studies of neurological abnormalities in schizophrenia, the authors found an increased prevalence of focal neurological signs in both patients and their nonschizophrenic relatives. The current study examines the relationship between neurological abnormalities in 24 schizophrenic patients and psychopathology in their families. A family history of psychotic psychopathology was found to be associated with an increased prevalence of focal neurological abnormalities in the schizophrenics. The results are relevant to current models of the potential role of neurological factors in the etiology of schizophrenia and illustrate how family studies of the joint distribution of psychiatric and neurological data can potentially help to distinguish between different etiological models.     

Drug and family therapy in the aftercare of acute schizophrenics.

After a brief inpatient hospitalization, 104 acute, young schizophrenics, stratified by premorbid adjustment, were randomly assigned to one of four aftercare conditions for a six-week controlled trial. Conditions involved one of two dose levels of fluphenazine enanthate (1 ml or 0.25 ml) and presence or absence of crisis-oriented family therapy. Relapses during the six-week period and at six-month follow-up were least in patients who received both high-dose and family therapy (0%) and greatest (48%) in the low-dose-no therapy group. Brief Psychiatric Rating Scale symptom ratings disclosed a significant family therapy effect at six weeks that was sustained at six months only for therapy patients originally receiving the high drug dose. Numerous interactions were found between premorbid adjustment status and response to the two treatment conditions.