1
|
de Witte LD, Munk Laursen T, Corcoran CM, Munk-Olsen T, Bergink V. Association between doxycycline use and long-term functioning in patients with schizophrenia. Brain Behav Immun 2024; 117:66-69. [PMID: 38169245 PMCID: PMC10932900 DOI: 10.1016/j.bbi.2023.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/24/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
IMPORTANCE AND OBJECTIVE The brain-penetrant tetracycline antibiotics, minocycline and doxycycline, have been proposed as potential candidate drugs for treatment of schizophrenia, based on preclinical studies and clinical trials. A potential long-term beneficial effect of these antibiotics for schizophrenia patients has not been investigated. This study was designed to determine if redemption of doxycycline prescription in schizophrenia is associated with decreased incidence of disability pension, a proxy for long-term functioning. DESIGN We performed a population-based cohort study with data from schizophrenia patients available through the Danish registers. Survival analysis models with time-varying covariates were constructed to assess incidence rate ratios (IRR) of disability pension after exposure to doxycycline or a non-brain penetrant tetracycline, defined as at least one filled prescription. The analysis was adjusted for age, sex, calendar year, parental psychiatric status and educational level. RESULTS We used data from 11,157 individuals with schizophrenia (4,945 female and 6,212 male; average age 22.4 years old, standard deviation (std) 4.50). 718 of these were exposed to brain-penetrant doxycycline, and 1,498 individuals redeemed a prescription of one or more of the non-brain-penetrant tetracyclines. The average years at risk per person in this cohort was 4.9, and 2,901 individuals received disability pension in the follow-up period. There was a significantly lower incidence rate of disability pension in schizophrenia patients who had redeemed doxycycline compared to patients who did not redeem a prescription of any tetracycline antibiotics (Incidence rate ratio (IRR) 0.68; 95 % CI 0.56, 0.83). There was also a significant lower rate of disability pension in schizophrenia patients who redeemed doxycycline compared to individuals who redeemed a prescription of one of the non-brain penetrant tetracycline antibiotics (IRR 0.69 95 % CI 0.55, 0.87). CONCLUSIONS In this observational study, doxycycline exposure is associated with a reduced incidence of disability pension. These data support further studies on the potential long term neuroprotective effects of doxycycline and level of functioning in schizophrenia patients.
Collapse
Affiliation(s)
- Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Thomas Munk Laursen
- The National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - Trine Munk-Olsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
2
|
Xenaki LA, Dimitrakopoulos S, Selakovic M, Stefanis N. Stress, Environment and Early Psychosis. Curr Neuropharmacol 2024; 22:437-460. [PMID: 37592817 PMCID: PMC10845077 DOI: 10.2174/1570159x21666230817153631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 08/19/2023] Open
Abstract
Existing literature provides extended evidence of the close relationship between stress dysregulation, environmental insults, and psychosis onset. Early stress can sensitize genetically vulnerable individuals to future stress, modifying their risk for developing psychotic phenomena. Neurobiological substrate of the aberrant stress response to hypothalamic-pituitary-adrenal axis dysregulation, disrupted inflammation processes, oxidative stress increase, gut dysbiosis, and altered brain signaling, provides mechanistic links between environmental risk factors and the development of psychotic symptoms. Early-life and later-life exposures may act directly, accumulatively, and repeatedly during critical neurodevelopmental time windows. Environmental hazards, such as pre- and perinatal complications, traumatic experiences, psychosocial stressors, and cannabis use might negatively intervene with brain developmental trajectories and disturb the balance of important stress systems, which act together with recent life events to push the individual over the threshold for the manifestation of psychosis. The current review presents the dynamic and complex relationship between stress, environment, and psychosis onset, attempting to provide an insight into potentially modifiable factors, enhancing resilience and possibly influencing individual psychosis liability.
Collapse
Affiliation(s)
- Lida-Alkisti Xenaki
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave., Athens, 115 28, Greece
| | - Stefanos Dimitrakopoulos
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave., Athens, 115 28, Greece
| | - Mirjana Selakovic
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave., Athens, 115 28, Greece
| | - Nikos Stefanis
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave., Athens, 115 28, Greece
| |
Collapse
|
3
|
de Witte LD, Munk Laursen T, Corcoran CM, Kahn RS, Birnbaum R, Munk-Olsen T, Bergink V. A Sex-Dependent Association Between Doxycycline Use and Development of Schizophrenia. Schizophr Bull 2023; 49:953-961. [PMID: 36869773 PMCID: PMC10318877 DOI: 10.1093/schbul/sbad008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
BACKGROUND Doxycycline and minocycline are brain-penetrant tetracycline antibiotics, which recently gained interest because of their immunomodulatory and neuroprotective properties. Observational studies have suggested that exposure to these drugs may decrease the risk to develop schizophrenia, but results are inconsistent. The aim of this study was to investigate the potential association between doxycycline use and later onset of schizophrenia. DESIGN We used data from 1 647 298 individuals born between 1980 and 2006 available through Danish population registers. 79 078 of those individuals were exposed to doxycycline, defined as redemption of at least 1 prescription. Survival analysis models stratified for sex with time-varying covariates were constructed to assess incidence rate ratios (IRRs) for schizophrenia (ICD-10 code F20.xx), with adjustment for age, calendar year, parental psychiatric status, and educational level. RESULTS In the non-stratified analysis, there was no association between doxycycline exposure and schizophrenia risk. However, men who redeemed doxycycline had a significantly lower incidence rate for schizophrenia onset compared to men that did not (IRR 0.70; 95% CI 0.57-0.86). By contrast, women had a significantly higher incidence rate for schizophrenia onset, compared to women that did not redeem doxycycline prescriptions (IRR 1.23; 95% CI 1.08, 1.40). The effects were not found for other tetracycline antibiotics (IRR 1.00; 95% CI 0.91, 1.09). CONCLUSIONS Doxycycline exposure is associated with a sex-dependent effect on schizophrenia risk. The next steps are replication of the results in independent well-characterized population cohorts, as well as preclinical studies to investigate sex-specific effects of doxycycline on biological mechanisms implicated in schizophrenia.
Collapse
Affiliation(s)
- Lot D de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - Thomas Munk Laursen
- The National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J Peters VA Medical Center, Bronx, NY, USA
| | - Rebecca Birnbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Trine Munk-Olsen
- The National Center for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
4
|
Patil A, Tyagi N, Prasad J. Age at marriage and first birth interval: A systematic review and meta-analysis. Indian J Health Sci Biomed Res 2023. [DOI: 10.4103/kleuhsj.kleuhsj_418_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
5
|
DeLuca JS, Novacek DM, Adery LH, Herrera SN, Landa Y, Corcoran CM, Walker EF. Equity in Mental Health Services for Youth at Clinical High Risk for Psychosis: Considering Marginalized Identities and Stressors. Evid Based Pract Child Adolesc Ment Health 2022; 7:176-197. [PMID: 35815004 PMCID: PMC9258423 DOI: 10.1080/23794925.2022.2042874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Prevention and early intervention programs have been initiated worldwide to serve youth at Clinical High Risk for Psychosis (CHR-P), who are adolescents and young adults experiencing subclinical psychosis and functional impairment. The primary goals of these efforts are to prevent or mitigate the onset of clinical psychosis, while also treating comorbid issues. It is important to consider issues of diversity, equity, and inclusion in CHR-P work, especially as these programs continue to proliferate around the world. Further, there is a long history in psychiatry of misdiagnosing and mistreating psychosis in individuals from racial and ethnic minority groups. Although there have been significant developments in early intervention psychosis work, there is evidence that marginalized groups are underserved by current CHR-P screening and intervention efforts. These issues are compounded by the contexts of continued social marginalization and significant mental health disparities in general child/adolescent services. Within this narrative review and call to action, we use an intersectional and minority stress lens to review and discuss current issues related to equity in CHR-P services, offer evidence-based recommendations, and propose next steps. In particular, our intersectional and minority stress lenses incorporate perspectives for a range of marginalized and underserved identities related to race, ethnicity, and culture; faith; immigration status; geography/residence; gender identity; sexual orientation; socioeconomic status/class; and ability status.
Collapse
Affiliation(s)
- Joseph S. DeLuca
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Derek M. Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, , Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Laura H. Adery
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shaynna N. Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Yulia Landa
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Elaine F. Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
6
|
Kogan S, Ospina LH, Mittal VA, Kimhy D. The impact of inflammation on neurocognition and risk for psychosis: a critical review. Eur Arch Psychiatry Clin Neurosci 2020; 270:793-802. [PMID: 31620871 PMCID: PMC7160015 DOI: 10.1007/s00406-019-01073-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/24/2019] [Indexed: 12/11/2022]
Abstract
Neurocognitive difficulties are highly prevalent among people with schizophrenia and have been linked to increased inflammation, as well as dysfunction and disability. Poor neurocognitive functioning has also been documented in individuals at clinical high risk for psychosis (CHR) and a burgeoning literature point to alterations in inflammation markers in this population. However, there is limited information regarding the putative link between inflammation and neurocognition in CHR individuals, and the potential role of inflammation in the development of cognitive difficulties and psychosis. As previous reports indicate that early treatment in schizophrenia is associated with better outcomes, there is an urgent need to identify neurobiological mechanisms underlying cognitive deterioration and psychosis in CHR individuals to provide them with care prior to significant cognitive and functional declines. To address this gap in the literature, we review and summarize the relevant literatures on inflammation and neurocognitive dysfunction in schizophrenia and CHR individuals, point to remaining gaps, and suggest directions for future research.
Collapse
Affiliation(s)
- Sophia Kogan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Luz H. Ospina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, IL
| | - David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 1230, New York, NY, 10029, USA. .,Mental Illness Research Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA.
| |
Collapse
|
7
|
Sánchez-Gutiérrez T, Rodríguez-Toscano E, Llorente C, de la Serna E, Moreno C, Sugranyes G, Romero S, Calvo A, Baeza I, Sánchez-Gistau V, Espliego A, Castro-Fornieles J, Moreno D. Neuropsychological, clinical and environmental predictors of severe mental disorders in offspring of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2020; 270:739-748. [PMID: 31312885 DOI: 10.1007/s00406-019-01044-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 07/03/2019] [Indexed: 12/30/2022]
Abstract
Offspring of individuals with schizophrenia (SZCOff) are at an increased risk for this disorder. Neuropsychological decline is a core feature of the disorder and researchers have reported increasing impairments in cognition during the prodromal phase in high-risk adolescents. Additionally, factors like the presence of prodromal symptoms or specific behavioral patterns could predict, together with neurocognitive functioning, the risk of conversion to severe mental disorders in SCZOff. This study aims to compare the neuropsychological functioning of a sample of 41 SCZOff children and adolescents and 105 community control offspring (CCOff) and to develop a prediction model to examine whether neuropsychological functioning, clinical and behavioral factors predict subsequent risk of severe mental disorders. We collected demographic, clinical and neuropsychological data. We found significant differences between groups in working memory, speed of processing, verbal memory and learning, visual memory and intelligence quotient (IQ). The socioeconomic status, verbal memory, working memory and positive prodromal symptoms predicted a significant proportion of the dependent variable variance. In conclusion, SCZOff showed neurocognitive impairments in several neuropsychological domains compared to CCOff. Neuropsychological functioning, environmental factors and positive prodromal symptoms could predict the risk of onset of severe mental disorders in SCZOff.
Collapse
Affiliation(s)
- Teresa Sánchez-Gutiérrez
- Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Madrid, Spain. .,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.
| | - Elisa Rodríguez-Toscano
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Universidad Complutense, Madrid, Spain
| | - Cloe Llorente
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Centre Consortium (CIBERSAM), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Carmen Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Centre Consortium (CIBERSAM), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Centre Consortium (CIBERSAM), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Ana Calvo
- Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Madrid, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Centre Consortium (CIBERSAM), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Vanessa Sánchez-Gistau
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Centre Consortium (CIBERSAM), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ana Espliego
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Centre Consortium (CIBERSAM), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Dolores Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| |
Collapse
|
8
|
De Matteis T, D'Andrea G, Lal J, Berardi D, Tarricone I. The impact of peri-natal stress on psychosis risk: results from the Bo-FEP incidence study. BMC Res Notes 2020; 13:153. [PMID: 32178713 PMCID: PMC7074980 DOI: 10.1186/s13104-020-04992-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/03/2020] [Indexed: 11/12/2022] Open
Abstract
Objective According to the gene-environment interaction model the pathogenesis of psychosis relies on an adverse neuro-socio-developmental pathway. Perinatal stress represents an important risk factor for the development of psychosis because of the increasingly evident interference with socio-neuro-development in the earlier phases of life. We aim to investigate the correlation of perinatal risk factors with the onset of psychosis with a case–control–incidence study. Results Patients (and their mothers) were eligible if they presented with first-episode psychosis at the Bologna West Community Mental Health Centre (Bo-West CMHC) between 2002 and 2012. The Bo-West CMHC serves a catchment area of about 200,000 people. The controls were recruited in the same catchment area and study period. 42 patients, 26 controls and their mothers were included. We collected the history of peri-natal stress and calculated crude and adjusted Odds Ratios for onset of first-episode psychosis. Adjusted logistic regression showed that psychosis onset was significantly associated with stressful situations during pregnancy, lower level of maternal physical health before or during pregnancy, use of anti-inflammatory drugs during pregnancy, and low level of maternal education. The results of our study suggest that stress during perinatal period increases the risk of developing psychosis.
Collapse
Affiliation(s)
- Tiziano De Matteis
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Sciences, Alma Mater Studiorum Bologna University, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Bologna University, Via Giovanni Masserenti, 9 - Pavillon 11, 40138, Bologna, Italy
| | - Giuseppe D'Andrea
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Sciences, Alma Mater Studiorum Bologna University, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Bologna University, Via Giovanni Masserenti, 9 - Pavillon 11, 40138, Bologna, Italy
| | - Jatin Lal
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Sciences, Alma Mater Studiorum Bologna University, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Bologna University, Via Giovanni Masserenti, 9 - Pavillon 11, 40138, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Bologna University, Via Giovanni Masserenti, 9 - Pavillon 11, 40138, Bologna, Italy
| | - Ilaria Tarricone
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Sciences, Alma Mater Studiorum Bologna University, Bologna, Italy. .,Department of Medical and Surgical Sciences (DIMEC), University of Bologna; Clinica Medica, Policlinico Sant'Orsola-Malpighi, Via Masserenti 9, 40138, Bologna, Italy.
| |
Collapse
|
9
|
Korpela H, Miettunen J, Rautio N, Isohanni M, Järvelin MR, Jääskeläinen E, Auvinen J, Keinänen-Kiukaanniemi S, Nordström T, Seppälä J. Early environmental factors and somatic comorbidity in schizophrenia and nonschizophrenic psychoses: A 50-year follow-up of the Northern Finland Birth Cohort 1966. Eur Psychiatry 2020; 63:e24. [PMID: 32146919 PMCID: PMC7315879 DOI: 10.1192/j.eurpsy.2020.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background. We studied the cumulative incidence of physical illnesses, and the effect of early environmental factors (EEFs) on somatic comorbidity in schizophrenia, in nonschizophrenic psychosis and among nonpsychotic controls from birth up to the age of 50 years. Methods. The sample included 10,933 members of the Northern Finland Birth Cohort 1966, of whom, 227 had schizophrenia and 205 had nonschizophrenic psychosis. Diagnoses concerning physical illnesses were based on nationwide registers followed up to the end of 2016 and classified into 13 illness categories. Maternal education and age, family type at birth and paternal socioeconomic status were studied as EEFs of somatic illnesses. Results. When adjusted by gender and education, individuals and especially women with nonschizophrenic psychosis had higher risk of morbidity in almost all somatic illness categories compared to controls, and in some categories, compared to individuals with schizophrenia. The statistically significant adjusted hazard ratios varied from 1.27 to 2.42 in nonschizophrenic psychosis. Regarding EEFs, single-parent family as the family type at birth was a risk factor for a higher somatic score among men with schizophrenia and women with nonschizophrenic psychosis. Maternal age over 35 years was associated with lower somatic score among women with nonschizophrenic psychosis. Conclusions. Persons with nonschizophrenic psychoses have higher incidence of somatic diseases compared to people with schizophrenia and nonpsychotic controls, and this should be noted in clinical work. EEFs have mostly weak association with somatic comorbidity in our study.
Collapse
Affiliation(s)
- Hanna Korpela
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Cancer Research and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Nina Rautio
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Center for Environment & Health, School of Public Health, Imperial College London, London, United Kindom.,Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Tanja Nordström
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jussi Seppälä
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Department of Psychiatry and Substance Use, South Karelia Social and Health Care District, Lappeenranta, Finland
| |
Collapse
|
10
|
Buhagiar K, Ghafouri M, Dey M. Oral antipsychotic prescribing and association with neighbourhood-level socioeconomic status: analysis of time trend of routine primary care data in England, 2011-2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:165-73. [PMID: 31630215 DOI: 10.1007/s00127-019-01793-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Increasing rates of antipsychotic prescribing have been reported previously, particularly for second-generation antipsychotics (SGAs), which are generally better tolerated than the older first-generation antipsychotics (FGAs). Prescribers, however, may exert bias, favouring prescriptions of novel drugs for patients of higher socioeconomic status (SES). We aimed to examine time trends in: (1) prescriptions of oral FGAs vs. SGAs and (2) associations between antipsychotic prescriptions and neighbourhood-level SES in England between 2011 and 2016. METHODS We used publicly available data for prescriptions made in primary care and linked general practices' postcodes with the Index of Multiple Deprivation (IMD) as a measure for neighbourhood-level SES. Absolute numbers of antipsychotic prescriptions were calculated. Linear regression analysis was used to examine the association of SGA vs. FGA prescription pattern with time and with SES. RESULTS A total of 27,486,000 oral antipsychotics were prescribed during the study period, mostly SGAs (n = 21,700,000; 78.9%). There was a significant increase in the ratio of SGA/FGA prescriptions over time (β = 0.376, 95% CI 0.277-0.464, P < 0.001). Individual FGAs were increasingly prescribed in areas of lower SES and the converse for SGAs except amisulpride. During the study period, a significantly larger proportion of total SGA prescriptions relative to total FGAs were made in areas of higher SES (β = 0.182, 95% CI 0.117-0.249, P < 0.001). CONCLUSION Prescriptions of antipsychotics continue to rise overall, with SGAs taking preference especially in areas of higher SES. The pattern of antipsychotic prescription favouring people in areas of lower social deprivation carries implications on inequalities even among sub-groups of people with mental disorders.
Collapse
|
11
|
Vargas T, Rakhshan Rouhakhtar PJ, Schiffman J, Zou DS, Rydland KJ, Mittal VA. Neighborhood crime, socioeconomic status, and suspiciousness in adolescents and young adults at Clinical High Risk (CHR) for psychosis. Schizophr Res 2020; 215:74-80. [PMID: 31759810 PMCID: PMC7036021 DOI: 10.1016/j.schres.2019.11.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/09/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Contextual factors representing chronic stressors, such as neighborhood crime characteristics, have been repeatedly linked to compromised mental and physical health, and may contribute to the pathologizing of normative/non-clinical experiences. However, the impact of such structural factors has seldom been incorporated in Clinical High Risk (CHR) for psychosis research. Understanding how context can influence the presence or severity of symptoms such as suspiciousness/paranoia may have important relevance for promoting valid and reliable assessment, as well as for understanding ways in which environment may be related to illness development and expression. METHODS A total of 126 adolescents and young adults (nCHR = 63, ncontrol = 63) underwent clinical interviews for Clinical High-Risk syndromes. Neighborhood crime indices and socioeconomic status were calculated through geocoding and extracting of publicly available Census and Federal Bureau of Investigation (FBI) data. Analyses examined presence of associations between neighborhood crime indices, socioeconomic status, suspiciousness and total symptoms. RESULTS Greater neighborhood crime was related to increased suspiciousness in CHR individuals, even after controlling for neighborhood socioeconomic status, r = 0.27, p = .03. Neighborhood crime was not related to total symptoms, and neither was neighborhood socioeconomic status. DISCUSSION Results suggest neighborhood crime uniquely related to suspiciousness symptoms in CHR individuals, while this was not the case for healthy volunteers (HV). Future work will be critical for determining the extent to which assessors are pathologizing experiences that are normative for a particular context, or rather, if a stressful context is serving as a sufficient environmental stressor to unmask emerging psychosis.
Collapse
Affiliation(s)
- Teresa Vargas
- Northwestern University, Department of Psychology, USA.
| | | | | | - Denise S Zou
- Northwestern University, Department of Psychology, USA
| | | | - Vijay A Mittal
- Northwestern University, Department of Psychology, Department of Psychiatry, Department of Medical Social Sciences, Institute for Policy Research, Institute for Innovations in Developmental Sciences, USA
| |
Collapse
|
12
|
Abstract
IMPORTANCE Evidence linking parental socioeconomic position and offspring's schizophrenia risk has been inconsistent, and how risk is associated with parental socioeconomic mobility has not been investigated. OBJECTIVE To elucidate the association between parental income level and income mobility during childhood and subsequent schizophrenia risk. DESIGN, SETTING, AND PARTICIPANTS National cohort study of all persons born in Denmark from January 1, 1980, to December 31, 2000, who were followed up from their 15th birthday until schizophrenia diagnosis, emigration, death, or December 31, 2016, whichever came first. Data analyses were from March 2018 to June 2019. EXPOSURE Parental income, measured at birth year and at child ages 5, 10, and 15 years. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) for schizophrenia were estimated using Cox proportional hazard regression. Cumulative incidence values (absolute risks) were also calculated. RESULTS The cohort included 1 051 033 participants, of whom 51.3% were male. Of the cohort members, 7544 (4124 [54.7%] male) were diagnosed with schizophrenia during 11.6 million person-years of follow-up. There was an inverse association between parental income level and subsequent schizophrenia risk, with children from lower income families having especially elevated risk. Estimates were attenuated, but risk gradients remained after adjustment for urbanization, parental mental disorders, parental educational levels, and number of changes in child-parent separation status. A dose-response association was observed with increasing amount of time spent in low-income conditions being linked with higher schizophrenia risk. Regardless of parental income level at birth, upward income mobility was associated with lower schizophrenia risk compared with downward mobility. For example, children who were born and remained in the lowest income quintile at age 15 years had a 4.12 (95% CI, 3.71-4.58) elevated risk compared with the reference group, those who were born in and remained in the most affluent quintile, but even a rise from the lowest income quintile at birth to second lowest at age 15 years appeared to lessen the risk elevation (HR, 2.80; 95% CI, 2.46-3.17). On the contrary, for those born in the most affluent quintile, downward income mobility between birth and age 15 years was associated with increased risks of developing schizophrenia. CONCLUSIONS AND RELEVANCE This study's findings suggest that parental income level and income mobility during childhood may be linked with schizophrenia risk. Although both causation and selection mechanisms could be involved, enabling upward income mobility could influence schizophrenia incidence at the population level.
Collapse
Affiliation(s)
- Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,CIRRAU Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Roger T. Webb
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom,Manchester Academic Health Sciences Centre (MAHSC), Manchester, United Kingdom,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, United Kingdom
| | - Carsten B. Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,CIRRAU Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark,CIRRAU Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Pearl L. H. Mok
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom,Manchester Academic Health Sciences Centre (MAHSC), Manchester, United Kingdom
| |
Collapse
|
13
|
Malaspina D, Kranz T, Kleinhaus K, Daboul S, Rothman K, Gilman C, Getz M, Harlap S, Friedlander Y. Short duration of marriage at conception as an independent risk factor for schizophrenia. Schizophr Res 2019; 208:190-195. [PMID: 30857873 DOI: 10.1016/j.schres.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 01/28/2019] [Accepted: 03/02/2019] [Indexed: 01/22/2023]
Abstract
UNLABELLED Short duration of marriage (DoM) is a risk factor for preeclampsia that is also related to the risk for schizophrenia. This analysis examined the risk for schizophrenia associated with DoM and its independence from parental psychiatric disorders, parental ages and fathers' age at marriage. METHOD Relative Risks (RR) for schizophrenia were estimated using continuous and stratified Cox proportional hazards models in the 90,079 offspring from the prospective population-based Jerusalem birth cohort study (1964-1976). Schizophrenia diagnos in offspring and parental diagnoses of schizophrenia or other psychiatric conditions were identified by cross-linkage to Israel's psychiatric case registry. DoM and paternal age at marriage were abstracted from birth certificates. RESULTS In the full model, RR for schizophrenia decreased for each 5 years DoM: 0.83 (0.75-0.95), ptrend = 0.0015. Stratified analyses showed the greatest RR risk for DoM <2 years: 1.53 (1.11-1.66) with lesser risk for 2-4 years DoM: 1.38 (1.05-1.81) compared to more DOM of 10+ years. DoM effects were independent from parental psychiatric diagnoses (RRs = 2-6, p~0.00001), paternal age (1.34: p = 0.0001 /5 years- including fathers of 25-34 years). The apparent risk related to later fathers' age at marriage (1.27: p < 0.0001) was eliminated in after accounting for DoM and later paternal age. CONCLUSIONS Offspring born to couples married for less than 3 years, across all paternal ages, harbored a small increased risk for schizophrenia, which was independent of parental psychiatric disorders and paternal age. Fathers who married late had particularly short DoM, which, along with paternal age, completely explained the risks related to later paternal age at marriage. Further studies are needed to replicate these results and examine if pathogenic pathways include prenatal immune activation.
Collapse
Affiliation(s)
- Dolores Malaspina
- Icahn School of Medicine at Mt Sinai, Department of Psychiatry, New York, NY 10128, USA.
| | - Thorsten Kranz
- Skirball Institute of Biomolecular Medicine, Departments of Cell Biology, Physiology & Neuroscience and Psychiatry, New York University, New York, NY, USA; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | | | - Sulaima Daboul
- Icahn School of Medicine at Mt Sinai, Department of Psychiatry, New York, NY 10128, USA
| | - Karen Rothman
- Department of Psychology, University of Miami, Coral Gables, FL 33124, USA
| | - Caitlin Gilman
- Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mara Getz
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Susan Harlap
- Unit of Epidemiology, School of Public Health, Hebrew University of Jerusalem, Israel
| | - Yechiel Friedlander
- Unit of Epidemiology, School of Public Health, Hebrew University of Jerusalem, Israel
| |
Collapse
|
14
|
Cao B, Wang DF, Yan LL, McIntyre RS, Rosenblat JD, Musial N, Liu YQ, Xie Q, Wang JY, Lu QB. Parental characteristics and the risk of schizophrenia in a Chinese population: a case-control study. Nord J Psychiatry 2019; 73:90-95. [PMID: 30900499 DOI: 10.1080/08039488.2018.1529196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Genetic studies have provided convergent results indicating that schizophrenia is a polygenic disorder with a heritability estimate of ∼60-80%. The propensity for schizophrenia is ∼10 times higher in individuals with first-degree relatives with schizophrenia when compared to the general population. AIM To identify associations between parental characteristics and the risk of schizophrenia in a Chinese population. METHODS Participants with a diagnosis of schizophrenia were recruited along with healthy controls (HCs) matched for age and gender from Weifang, China. Logistic regression models and generalized linear models were used to explore the associations between parental characteristics with the risk and age at onset of schizophrenia. In total, 414 cases and 639 HCs were recruited for the study. RESULTS We observed an inverse association between levels of paternal and maternal education and risk of schizophrenia after controlling for potential confounders (Paternal: OR = 1.525, 95% CI: 1.080-2.153, p = .017; Maternal: OR = 1.984, 95% CI: 1.346-2.924, p = .001). Younger paternal and maternal childbearing age were associated with a higher risk of diagnosis of schizophrenia. We furtherly observed that individuals with earlier age at onset of schizophrenia had fewer siblings (p = .007) and had higher rates of parental marital disharmony (p = .033). CONCLUSION Our results indicate that parental years of education and age of childbearing are associated with an increased risk of schizophrenia in a Chinese population. Age of onset of schizophrenia was positively associated with a greater number of siblings and negatively associated with parental marital disharmony.
Collapse
Affiliation(s)
- Bing Cao
- a Department of Laboratorial Science and Technology, School of Public Health , Peking University , Beijing , China
| | | | - Lai-Lai Yan
- a Department of Laboratorial Science and Technology, School of Public Health , Peking University , Beijing , China.,c Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety , Beijing , China.,d Peking University Medical and Health Analysis Center , Peking University , Beijing , China
| | - Roger S McIntyre
- e Mood Disorders Psychopharmacology Unit, Toronto Western Hospital , University Health Network , Toronto , Canada.,f The Brain and Cognition Discovery Foundation , Toronto , Canada
| | - Joshua D Rosenblat
- e Mood Disorders Psychopharmacology Unit, Toronto Western Hospital , University Health Network , Toronto , Canada
| | - Natalie Musial
- e Mood Disorders Psychopharmacology Unit, Toronto Western Hospital , University Health Network , Toronto , Canada
| | - Ya-Qiong Liu
- a Department of Laboratorial Science and Technology, School of Public Health , Peking University , Beijing , China
| | - Qing Xie
- a Department of Laboratorial Science and Technology, School of Public Health , Peking University , Beijing , China
| | - Jing-Yu Wang
- a Department of Laboratorial Science and Technology, School of Public Health , Peking University , Beijing , China.,c Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety , Beijing , China.,d Peking University Medical and Health Analysis Center , Peking University , Beijing , China
| | - Qing-Bin Lu
- a Department of Laboratorial Science and Technology, School of Public Health , Peking University , Beijing , China.,c Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety , Beijing , China
| |
Collapse
|
15
|
Chen R, Liou TH, Chang KH, Yen CF, Liao HF, Chi WC, Chou KR. Assessment of functioning and disability in patients with schizophrenia using the WHO Disability Assessment Schedule 2.0 in a large-scale database. Eur Arch Psychiatry Clin Neurosci 2018; 268:65-75. [PMID: 28801847 DOI: 10.1007/s00406-017-0834-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/06/2017] [Indexed: 12/28/2022]
Abstract
Schizophrenia is a common mental disorder characterized by deficits in multiple domains of functioning. This study is arguably the first of its kind in Taiwan to examine, in a multifaceted and objective manner, the disability of patients with schizophrenia and the factors affecting it. A cross-sectional design was adopted to gather data from 24,299 patients with schizophrenia who were listed in the Taiwan Databank of Persons with Disabilities. The level of disability in these patients was measured using the World Health Organization Disability Assessment Schedule 2.0. Statistical analyses were conducted through the χ 2 statistic and Poisson regression. The highest level of disability was in participation and the lowest was in self-care. An analysis of disability in all six domains of functioning on the basis of sex, age, type of residence, and socioeconomic status (SES) showed significant differences (P < 0.05). Significant factors (P < 0.05) affecting disability in these domains were female gender, age, educational attainment, SES, type of residence, and employment status. The overall degree of disability in schizophrenia patients was moderate. Six domains were measured in this study. The degrees of disability in mobility and self-care were mild while cognition, getting along, life activities, and participation were moderate. Moreover, female gender, an age of 45 or older, low educational attainment, middle to low SES, staying at healthcare institutions, and unemployment were crucial factors affecting disability of the participants. Preventive and rehabilitation programs should be developed to delay disability and functional degeneration in schizophrenic patients with these characteristics.
Collapse
|
16
|
Lawrence GM, Friedlander Y, Calderon-Margalit R, Enquobahrie DA, Huang JY, Tracy RP, Manor O, Siscovick DS, Hochner H. Associations of social environment, socioeconomic position and social mobility with immune response in young adults: the Jerusalem Perinatal Family Follow-Up Study. BMJ Open 2017; 7:e016949. [PMID: 29273651 PMCID: PMC5778288 DOI: 10.1136/bmjopen-2017-016949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Immune response to cytomegalovirus (CMV) impacts adult chronic disease. This study investigates associations of childhood and adulthood social environment, socioeconomic position (SEP) and social mobility with CMV response in young adults. DESIGN Historical prospective study design. SETTING Subcohort of all 17 003 births to residents of Jerusalem between 1974 and 1976. PARTICIPANTS Participants included 1319 young adults born in Jerusalem with extensive archival and follow-up data, including childhood and adulthood SEP-related factors and anti-CMV IgG titre levels and seroprevalence measured at age 32. MAIN EXPOSURE AND OUTCOME MEASURES Principal component analysis was used to transform correlated social environment and SEP-related variables at two time points (childhood and adulthood) into two major scores reflecting household (eg, number of siblings/children, religiosity) and socioeconomic (eg, occupation, education) components. Based on these components, social mobility variables were created. Linear and Poisson regression models were used to investigate associations of components and mobility with anti-CMV IgG titre level and seroprevalence, adjusted for confounders. RESULTS Lower levels of household and socioeconomic components in either childhood or adulthood were associated with higher anti-CMV IgG titre level and seropositivity at age 32. Compared with individuals with stable favourable components, anti-CMV IgG titre level and risk for seropositivity were higher in stable unfavourable household and socioeconomic components (household: β=3.23, P<0.001; relative risk (RR)=1.21, P<0.001; socioeconomic: β=2.20, P=0.001; RR=1.14, P=0.01), downward household mobility (β=4.32, P<0.001; RR=1.26, P<0.001) and upward socioeconomic mobility (β=1.37, P=0.04; RR=1.19, P<0.001). Among seropositive individuals, associations between household components and mobility with anti-CMV IgG titre level were maintained and associations between socioeconomic components and mobility with anti-CMV IgG titre level were attenuated. CONCLUSIONS Our study provides evidence that accumulating low SEP from childhood through adulthood and social mobility may compromise immune response in young adulthood.
Collapse
Affiliation(s)
- Gabriella M Lawrence
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Yehiel Friedlander
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | | - Daniel A Enquobahrie
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Jonathan Yinhao Huang
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Russell P Tracy
- Departments of Pathology and Biochemistry, University of Vermont, Burlington, Vermont, USA
| | - Orly Manor
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - David S Siscovick
- Institute for Urban Health, New York Academy of Medicine, New York City, New York, USA
| | - Hagit Hochner
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| |
Collapse
|
17
|
Abstract
We review the hypotheses concerning the association between the paternal age at childbearing and childhood psychiatric disorders (autism spectrum- and attention deficit/hyperactive disorder) and adult disorders (schizophrenia, bipolar-, obsessive-compulsive-, and major depressive disorder) based on epidemiological studies. Several hypotheses have been proposed to explain the paternal age effect. We discuss the four main-not mutually exclusive-hypotheses. These are the de novo mutation hypothesis, the hypothesis concerning epigenetic alterations, the selection into late fatherhood hypothesis, and the environmental resource hypothesis. Advanced paternal age in relation to autism spectrum disorders and schizophrenia provided the most robust epidemiological evidence for an association, with some studies reporting a monotonic risk increase over age, and others reporting a marked increase at a given age threshold. Although there is evidence for the de novo mutation hypothesis and the selection into late fatherhood hypothesis, the mechanism(s) underlying the association between advanced paternal age and psychiatric illness in offspring remains to be further clarified. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Hilde de Kluiver
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- EMGO+ Institute for Health and Care ResearchAmsterdamThe Netherlands
| | | | - Conor V. Dolan
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- EMGO+ Institute for Health and Care ResearchAmsterdamThe Netherlands
| | - Dorret I. Boomsma
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- EMGO+ Institute for Health and Care ResearchAmsterdamThe Netherlands
- Neuroscience Campus AmsterdamAmsterdamThe Netherlands
| |
Collapse
|
18
|
Pruessner M, Cullen AE, Aas M, Walker EF. The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neurosci Biobehav Rev 2017; 73:191-218. [DOI: 10.1016/j.neubiorev.2016.12.013] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
|
19
|
Savitsky B, Manor O, Friedlander Y, Burger A, Lawrence G, Calderon-Margalit R, Siscovick DS, Enquobahrie DA, Williams MA, Hochner H. Associations of socioeconomic position in childhood and young adulthood with cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-Up Study. J Epidemiol Community Health 2016; 71:43-51. [PMID: 27417428 DOI: 10.1136/jech-2014-204323] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 11/30/2015] [Accepted: 06/29/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Several stages in the life course have been identified as important to the development of cardiovascular disease. This study aimed to assess the associations of childhood and adulthood socioeconomic position (SEP) and social mobility with cardiometabolic risk factors (CMRs) later in life. METHODS We conducted follow-up examinations of 1132 offspring, aged 32, within a population-based cohort of all births in Jerusalem from 1974 to 1976. SEP was indicated by parents' occupation and education, and adulthood SEP was based on offspring's occupation and education recorded at age 32. Linear regression models were used to investigate the associations of SEP and social mobility with CMRs. RESULTS Childhood-occupational SEP was negatively associated with body mass index (BMI; β=-0.29, p=0.031), fat percentage (fat%; β=-0.58, p=0.005), insulin (β=-0.01, p=0.031), triglycerides (β=-0.02, p=0.024) and low-density lipoprotein cholesterol (LDL-C; β=-1.91, p=0.015), independent of adulthood SEP. Adulthood-occupational SEP was negatively associated with waist-to-hip ratio (WHR; β=-0.01, p=0.002), and positively with high-density lipoprotein cholesterol (HDL-C; β=0.87, p=0.030). Results remained similar after adjustment for smoking and inactivity. Childhood-educational SEP was associated with decreased WHR and LDL-C level (p=0.0002), and adulthood-educational SEP was inversely associated with BMI (p=0.001), waist circumference (p=0.008), WHR (p=0.001) and fat% (p=0.0002) and positively associated with HDL-C (p=0.030). Additionally, social mobility (mainly upward) was shown to have adverse cardiometabolic outcomes. CONCLUSIONS Both childhood and adulthood SEP contribute independently to CMR. The match-mismatch hypothesis may explain the elevated CMRs among participants experiencing social mobility. Identification of life-course SEP-related aspects that translate into social inequality in cardiovascular risk may facilitate efforts for improving health and for reducing disparities in cardiovascular disease.
Collapse
Affiliation(s)
- B Savitsky
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - O Manor
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Y Friedlander
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - A Burger
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - G Lawrence
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - R Calderon-Margalit
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - D S Siscovick
- Cardiovascular Health Research Unit, Department of Medicine and Epidemiology, University of Washington, Seattle, Washington, USA
| | - D A Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - M A Williams
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - H Hochner
- The Braun School of Public Health, The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| |
Collapse
|
20
|
Fuller-Thomson E, Hollister B. Schizophrenia and Suicide Attempts: Findings from a Representative Community-Based Canadian Sample. Schizophr Res Treatment 2016; 2016:3165243. [PMID: 26977319 PMCID: PMC4764754 DOI: 10.1155/2016/3165243] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 12/13/2015] [Accepted: 12/14/2015] [Indexed: 11/17/2022]
Abstract
This study examined factors associated with suicide attempts among those with schizophrenia (n = 101) versus those without (n = 21,643) in a representative sample of noninstitutionalized Canadians. The lifetime prevalence of suicide attempts among persons with schizophrenia was 39.2% versus 2.8% of nonafflicted individuals. After adjusting for sociodemographics, childhood adversities, substance abuse/dependence, depression/anxiety, and chronic pain, those with schizophrenia had 6 times the odds (OR = 6.47) of attempting suicide. Among persons with schizophrenia, suicide attempts were associated with female gender (OR = 4.59), substance abuse/dependence (OR = 6.31), depression (OR = 4.93), and childhood physical abuse (OR = 5.75). Community-dwelling persons with schizophrenia appear to be at high risk for suicide attempts.
Collapse
Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada M5S 1V4
| | - Bailey Hollister
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada M5S 1V4
| |
Collapse
|
21
|
O'Donoghue B, Fanning F, Lyne J, Renwick L, Madigan K, Kinsella A, Lane A, Turner N, O'Callaghan E, Clarke M. Social class at birth and risk of psychosis. Int J Soc Psychiatry 2015; 61:768-76. [PMID: 25897057 DOI: 10.1177/0020764015581434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with psychotic disorders are represented more in the lower social classes, yet there is conflicting evidence to whether these individuals drift into the lower social classes or whether lower social class is a risk factor for developing psychosis. The aim of this study was to examine whether the social class at birth is a risk factor for developing psychosis. METHODS We included individuals with a first episode of psychosis (FEP) whose social class at birth was determined from birth records. We employed a case-control study design and also compared the distribution of the social classes at birth of the cases to that of the general population. RESULTS A total of 380 individuals with an FEP and 760 controls were included in the case-control study. The odds ratio for developing an FEP associated with social class (low vs high) was .62 (95% confidence interval (CI): .46-.85, p < .001), indicating that individuals from a lower social class at birth have a reduced risk of psychosis. Individuals born between 1961 and 1980 with an FEP were more likely to be from a higher social class at birth compared to the general population (60.8% vs 36.7%, χ(2) = 60.85, df = 1, p < .001). However, this association was not observed for those born between 1981 and 1990. CONCLUSION A higher social class at birth is associated with a greater risk for developing a psychotic disorder; however, this effect may show temporal variation.
Collapse
Affiliation(s)
- Brian O'Donoghue
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Felicity Fanning
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - John Lyne
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Laoise Renwick
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Kevin Madigan
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Anthony Kinsella
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Abbie Lane
- University College Dublin, Dublin, Ireland
| | - Niall Turner
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Eadbhard O'Callaghan
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Mary Clarke
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| |
Collapse
|
22
|
Weiser M, Kapra O, Werbeloff N, Goldberg S, Fenchel D, Reichenberg A, Yoffe R, Ginat K, Fruchter E, Davidson M. A population-based longitudinal study of suicide risk in male schizophrenia patients: Proximity to hospital discharge and the moderating effect of premorbid IQ. Schizophr Res 2015; 169:159-164. [PMID: 26490295 DOI: 10.1016/j.schres.2015.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 09/24/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Abstract
Suicide is a major cause of death in schizophrenia. Identifying factors which increase the risk of suicide among schizophrenia patients might help focus prevention efforts. This study examined risk of suicide in male schizophrenia patients using population-based data, examining the timing of suicide in relation to the last hospital discharge, and the effect of premorbid IQ on risk of suicide. Data on 930,000 male adolescents from the Israeli military draft board were linked with data from the Israeli Psychiatric Hospitalization Case Registry and vital statistics from the Israeli Ministry of Health. The relationship between premorbid IQ and risk for suicide was examined among 2881 males hospitalized with schizophrenia and compared to a control group of 566,726 males from the same cohort, who were not hospitalized for a psychiatric disorder, using survival analysis methods. Over a mean follow-up period of 9.9 years (SD=5.8, range: 0-22 years), 77/3806 males with schizophrenia died by suicide (a suicide rate of 204.4 per 100,000 person-years). Approximately 48% of the suicides occurred within a year of discharge from the last hospital admission for schizophrenia. Risk of suicide was higher in male schizophrenia patients with high premorbid IQ (HR=4.45, 95% CI=1.37-14.43) compared to those with normal premorbid IQ. These data indicate that male schizophrenia patients with high premorbid IQ are at particularly high risk of suicide, and the time of peak risk is during the first year after the last hospitalization discharge.
Collapse
Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; IDF Medical Corps, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.
| | - Ori Kapra
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Nomi Werbeloff
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Shira Goldberg
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Daphna Fenchel
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Abraham Reichenberg
- Dept. of Psychiatry and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rinat Yoffe
- Department of Mental Health, Ministry of Health, Israel
| | | | | | - Michael Davidson
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| |
Collapse
|
23
|
Laurens KR, Luo L, Matheson SL, Carr VJ, Raudino A, Harris F, Green MJ. Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry 2015; 15:205. [PMID: 26302744 PMCID: PMC4548447 DOI: 10.1186/s12888-015-0562-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/14/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Identifying the unique and shared premorbid indicators of risk for the schizophrenia spectrum disorders (SSD) and affective psychoses (AP) may refine aetiological hypotheses and inform the delivery of universal versus targeted preventive interventions. This systematic review synthesises the available evidence concerning developmental risk factors and antecedents of SSD and AP to identify those with the most robust support, and to highlight remaining evidence gaps. METHODS A systematic search of prospective birth, population, high-risk, and case-control cohorts was conducted in Medline and supplemented by hand searching, incorporating published studies in English with full text available. Inclusion/exclusion decisions and data extraction were completed in duplicate. Exposures included three categories of risk factors and four categories of antecedents, with case and comparison groups defined by adult psychiatric diagnosis. Effect sizes and prevalence rates were extracted, where available, and the strength of evidence synthesised and evaluated qualitatively across the study designs. RESULTS Of 1775 studies identified by the search, 127 provided data to the review. Individuals who develop SSD experience a diversity of subtle premorbid developmental deficits and risk exposures, spanning the prenatal period through early adolescence. Those of greatest magnitude (or observed most consistently) included obstetric complications, maternal illness during pregnancy (especially infections), other maternal physical factors, negative family emotional environment, psychopathology and psychotic symptoms, and cognitive and motor dysfunctions. Relatively less evidence has accumulated to implicate this diversity of exposures in AP, and many yet remain unexamined, with the most consistent or strongest evidence to date being for obstetric complications, psychopathology, cognitive indicators and motor dysfunction. Among the few investigations affording direct comparison between SSD and AP, larger effect sizes and a greater number of significant associations are commonly reported for SSD relative to AP. CONCLUSIONS Shared risk factors for SSD and AP may include obstetric complications, childhood psychopathology, cognitive markers and motor dysfunction, but the capacity to distinguish common versus distinct risk factors/antecedents for SSD and AP is limited by the scant availability of prospective data for AP, and inconsistency in replication. Further studies considering both diagnoses concurrently are needed. Nonetheless, the prevalence of the risk factors/antecedents observed in cases and controls helps demarcate potential targets for preventative interventions for these disorders.
Collapse
Affiliation(s)
- Kristin R. Laurens
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Luming Luo
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Sandra L. Matheson
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia
| | - Vaughan J. Carr
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Psychiatry, Monash University, Melbourne, Australia
| | - Alessandra Raudino
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Felicity Harris
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Melissa J. Green
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia ,Neuroscience Research Australia, Sydney, Australia
| |
Collapse
|
24
|
Abstract
BACKGROUND Environmental factors such as urban birth and ethnic minority position have been related to risk for psychotic disorders. There is some evidence that not only individual, but also neighborhood characteristics influence this risk. The aim of this study was to investigate social disorganization of neighborhoods and incidence of psychotic disorders. METHOD The research was a 7-year first-contact incidence study of psychotic disorders in The Hague. Neighborhood characteristics included continuous, dichotomous and cumulative measures of socio-economic level, residential mobility, ethnic diversity, proportion of single person households, voter turnout, population density and crime level. Using multilevel Poisson regression analysis, incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of psychotic disorders were calculated for the indicators of neighborhood social disorganization. RESULTS A total of 618 incident cases were identified. Neighborhood socio-economic level and residential mobility had the strongest association with incidence of psychotic disorders [individual-level adjusted Wald χ2 1 = 13.03 (p = 0.0003) and 5.51 (p = 0.02), respectively]. All but one (proportion of single person households) of the dichotomous neighborhood indicators were significantly associated with a higher IRR. The cumulative degree of neighborhood social disorganization was strongly and linearly associated with the incidence of psychotic disorders (trend test, Wald χ2 5 = 25.76, p = 0.0001). The IRR in neighborhoods with the highest degree of social disorganization was 1.95 (95% CI 1.38-2.75) compared with the lowest disorganization category. CONCLUSIONS The findings suggest that the risk for developing a psychotic disorder is higher for people living in socially disorganized environments. Longitudinal studies are needed to investigate causality.
Collapse
Affiliation(s)
- W Veling
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - E Susser
- Department of Epidemiology,Mailman School of Public Health, Columbia University,New York,NY,USA
| | - J-P Selten
- Department of Psychiatry and Neuropsychology,Maastricht University,Maastricht,The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| |
Collapse
|
25
|
Abstract
BACKGROUND In the 1950s, researchers showed an association between low socio-economic status (SES) and psychosis. Two competing theories social causation and social drift were proposed to explain the findings. In the intervening years, contrasting evidence emerged as some studies showed no association between SES and schizophrenia. At present, the nature of the relationship is still unclear; currently, there are no reviews in the literature examining the association between social class at birth and psychosis. AIM To search the literature to clarify the relationship between social class at birth, measured by paternal occupation at birth, and the risk of adult-onset psychosis. METHODS A systematic search of the literature using a combination of keywords in Group 1 together with the keywords in Group 2 was performed in October 2012 in the following online databases: (a) MEDLINE (1946-2012), (b) PubMed, (c) Embase (1980-2012), (d) PsycINFO (1806-2012) and (e) Web of Science (1899-2012). Reference lists were also hand searched. The search provided 3,240 studies; following screening of the titles and abstracts by inclusion and exclusion criteria and quality assessment of the full text, 14 studies were identified to be appropriate for the review. The keywords used for the search were as follows: Group 1 - social class, social status, socioeconomic, socio-economic, SES; Group 2 - psychosis, psychoses, schizophrenia. RESULTS Seven studies showed an association between low SES and psychosis. Four studies showed no association, and three studies showed an association with high SES. CONCLUSION There is not enough evidence to support the association between social class and psychosis. While some findings showed an association between low social class and psychosis, there were a number of conflicting studies showing no association or a link with higher social class. Interestingly, the results followed a temporal pattern, as all the studies conducted after 2001 supported an association between low SES at birth and psychosis. Four of the six studies employed a prospective design with large sample populations, indicating the need for further investigation.
Collapse
Affiliation(s)
- Wingfai Kwok
- School of Medicine, King's College London, London, UK
| |
Collapse
|
26
|
Cullen AE, Zunszain PA, Dickson H, Roberts RE, Fisher HL, Pariante CM, Laurens KR. Cortisol awakening response and diurnal cortisol among children at elevated risk for schizophrenia: relationship to psychosocial stress and cognition. Psychoneuroendocrinology 2014; 46:1-13. [PMID: 24882153 PMCID: PMC4065330 DOI: 10.1016/j.psyneuen.2014.03.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 01/28/2023]
Abstract
Abnormal hypothalamic-pituitary-adrenal (HPA) axis function, as indexed by elevated diurnal cortisol levels and/or a blunted cortisol awakening response (CAR), has been observed among patients with first episode psychosis and associated with neurocognitive deficits in this population. However, the extent to which these features precede illness onset is unclear. The current study aimed to determine whether children who are at putatively elevated risk for psychosis because they present multiple antecedents of schizophrenia (ASz), and high-risk children with a family history of illness (FHx), are characterized by abnormal cortisol levels when compared with their typically developing (TD) peers. A further aim was to investigate the extent to which cortisol levels are associated with psychosocial stress and neurocognitive function. Thirty-three ASz children, 22 FHx children, and 40 TD children were identified at age 9-12 years using a novel community-based screening procedure or as relatives of individuals with schizophrenia. All participants were antipsychotic-naive and not currently seeking treatment for their symptoms. At age 11-14 years, participants provided salivary cortisol samples and completed psychosocial stress measures and tests of memory and executive function. Results indicated that FHx children, but not ASz children, were characterized by a blunted CAR relative to their TD peers (effect size=-0.73, p=0.01) that was not explained by psychosocial stress exposure or by distress relating to these experiences. Neither FHx nor ASz children were characterized by elevated diurnal cortisol. Among both FHx and ASz children, more pronounced HPA axis function abnormalities (i.e., higher diurnal cortisol levels and greater blunting of the CAR) were associated with poorer performance on tests of verbal memory and executive function. These findings support the notion that at least some HPA axis abnormalities described in psychosis precede illness onset, rather than being a subsequent epiphenomenon. We speculate that the blunted CAR may constitute an early (potentially genetically mediated) marker of psychosis vulnerability, whilst elevated diurnal cortisol levels may emerge only proximally to disease onset.
Collapse
Affiliation(s)
- Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Patricia A Zunszain
- Section of Stress, Psychiatry and Immunology, Department of Psychological Medicine, Institute of Psychiatry, King's College London, 125 Coldharbour Lane, London SE5 9NU, United Kingdom
| | - Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Ruth E Roberts
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Helen L Fisher
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Carmine M Pariante
- Section of Stress, Psychiatry and Immunology, Department of Psychological Medicine, Institute of Psychiatry, King's College London, 125 Coldharbour Lane, London SE5 9NU, United Kingdom
| | - Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences (Box P023), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, United Kingdom; Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia; Schizophrenia Research Institute, Sydney, Australia.
| |
Collapse
|
27
|
Carballo JJ, García-Nieto R, Alvarez-García R, Caro-Cañizares I, López-Castromán J, Muñoz-Lorenzo L, de Leon-Martinez V, Baca-García E. Sibship size, birth order, family structure and childhood mental disorders. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1327-33. [PMID: 23407902 DOI: 10.1007/s00127-013-0661-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of this study was to determine the role that birth order, sibship size and family structure have as risk factors in the development of common childhood mental disorders. METHOD A case-control study design was conducted (N = 16,823). The group under study consisted of all those subjects who had consulted with a psychiatrist/psychologist and had received a clinical diagnosis at public mental health centres within the Region of Madrid (Spain), between 1980 and 2008. A multiple logistic regression was used to explore the independent association with each diagnosis: emotional disorders (ED) with onset specific to childhood, attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), mental retardation (MR), and pervasive developmental disorder (PDD). RESULTS Birth order and family structure significantly predicted the risk of being diagnosed with ED or ADHD. In addition, sibship size and sex predicted the risk of being diagnosed with a childhood mental disorder. CONCLUSIONS We concluded that being the middle child and living with both biological parents appear to be protective factors against the development of ED or ADHD. Living in large families appears to increase the risk of receiving a CD, MR, or PDD diagnosis. Further research is warranted.
Collapse
|
28
|
Liu T, Song X, Chen G, Buka SL, Zhang L, Pang L, Zheng X. Illiteracy and schizophrenia in China: a population-based survey. Soc Psychiatry Psychiatr Epidemiol 2013; 48:455-64. [PMID: 22810854 DOI: 10.1007/s00127-012-0552-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 07/03/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Illiterate people may frequently experience social discrimination and exclusion in our modern society. It has been suggested that social adversity increases risk of schizophrenia. The current study examines the relation between illiteracy and schizophrenia. METHODS We utilized data on 1,909,205 representative Chinese people of age 18 years or older collected by the Second China National Sample Survey on Disability in 2006 (participation rate 99.8%). Experienced clinical psychiatrists diagnosed schizophrenia among those who were psychiatrically disabled with the ICD-10 symptom checklist. RESULTS Strikingly high prevalence of schizophrenia was observed among the young illiterates aged 18-29 years (prevalence 1.64%, 95% confidence interval (CI) 1.35, 1.93) and 30-39 years (prevalence 1.51%, 95% CI 1.34, 1.68), much higher than the prevalence estimates for general Chinese population of similar age reported by any of the previous studies in mainland China. Among people aged less than 40 years, we found that the illiterates were 2.08 times more likely to develop schizophrenia than the literates with no school or primary school education (odds ratio (OR) = 2.08, 95% CI 1.84, 2.36). The association remained statistically significant after adjustment for age, gender, marital status, household income, and location of residence. Consistently, a strong association between illiteracy and schizophrenia (OR = 2.8, 95% CI 1.28, 6.11) was found in conditional logistic regression analysis among matched sibling sets aged less than 40 years that further adjusted for genetic confounding. CONCLUSION The risk of schizophrenia may have increased among the socially disadvantaged illiterate people.
Collapse
|
29
|
Wu Y, Liu X, Luo H, Deng W, Zhao G, Wang Q, Zhang L, Ma X, Liu X, Murray RA, Collier DA, Li T. Advanced paternal age increases the risk of schizophrenia and obsessive-compulsive disorder in a Chinese Han population. Psychiatry Res 2012; 198:353-9. [PMID: 22424906 PMCID: PMC3778893 DOI: 10.1016/j.psychres.2012.01.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 01/16/2012] [Accepted: 01/19/2012] [Indexed: 02/05/2023]
Abstract
Using the Structured Clinical Interview for DSM-IV, patient and non-patient version (SCID-P/NP), this study investigated 351 patients with schizophrenia, 122 with obsessive-compulsive disorder (OCD), and 238 unrelated healthy volunteers in a Chinese Han population. The relative risks posed by advanced paternal age for schizophrenia and OCD in offspring were computed under logistic regression analyses and adjusted for the participant's sex, age and co-parent age at birth. Compared to the offspring with paternal age of 25-29 years old, the relative risks rose from 2.660 to 10.183 in the paternal age range of 30-34 and ≥35. The relative risks for OCD increased from 2.225 to 5.413 in 30-34 and ≥35. For offspring with paternal age of <25, the odds ratios of developing schizophrenia and OCD were 0.628 and 0.289 respectively, whereas an association between increased maternal age and risk for schizophrenia/OCD was not seen. Interaction analysis showed an interaction effect between paternal age and maternal age at birth. Such a tendency of risk affected by parental age for schizophrenia and OCD existed after splitting out the data of early onset patients. Sex-specific analyses found that the relative risks for schizophrenia with paternal age of 30-34 and ≥35 in male offspring were 2.407 and 10.893, and in female offspring were 3.080 and 9.659. The relative risks for OCD with paternal age of 30-34 and ≥35 in male offspring were 3.493 and 7.373, and in female offspring 2.005 and 4.404. The mean paternal age of schizophrenia/OCD patients born before the early 1980s was much greater than that of patients who were born after then. The findings illustrated that advanced paternal age is associated with increased risk for both schizophrenia and OCD in a Chinese Han population, prominently when paternal age is over 35. Biological and non-biological mechanisms may both be involved in the effects of advanced paternal age on schizophrenia and OCD.
Collapse
Affiliation(s)
- Yuejing Wu
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiang Liu
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hongrong Luo
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Deng
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Gaofeng Zhao
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lan Zhang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaohong Ma
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiehe Liu
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Robin A. Murray
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - David A. Collier
- The MRC SGDP Centre, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Tao Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Corresponding author at: 28 Dian Xin Nan Road, West China Hospital, Chengdu, Sichuan, 610041, PR China.
| |
Collapse
|
30
|
Eriksson A, Romelsjö A, Stenbacka M, Tengström A. Early risk factors for criminal offending in schizophrenia: a 35-year longitudinal cohort study. Soc Psychiatry Psychiatr Epidemiol 2011; 46:925-32. [PMID: 20607212 DOI: 10.1007/s00127-010-0262-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Accepted: 06/23/2010] [Indexed: 01/19/2023]
Abstract
BACKGROUND Recent evidence suggests that factors predicting offending among individuals with no mental disorder may also predict offending among individuals with schizophrenia. AIMS The aims of the study were (1) to explore the prevalence of risk factors for criminal offending reported at age 18 among males later diagnosed with schizophrenia, (2) to explore the associations between risk factors reported at age 18 and lifetime criminal offending, (3) to predict lifetime serious violent offending based on risk factors reported at age 18, and (4) to compare the findings with those in males with no later diagnosis of schizophrenia. METHODS The study was a prospective, longitudinal study of a birth cohort followed up through registers after 35 years. The cohort consisted of 49,398 males conscripted into the Swedish Army in 1969-1970, of whom 377 were later diagnosed with schizophrenia. RESULTS Among the subjects later diagnosed with schizophrenia, strong associations were found between four of the items reported at age 18 and lifetime criminal offending: (1) low marks for conduct in school, (2) contact with the police or child care authorities, (3) crowded living conditions, and (4) arrest for public drinking. Three of these four risk factors were found to double the risk of offending among males with no later diagnosis of schizophrenia. CONCLUSIONS Criminality in individuals with schizophrenia may at least partly be understood as a phenomenon similar to criminality in individuals in the general population.
Collapse
Affiliation(s)
- Asa Eriksson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | | | | | | |
Collapse
|
31
|
Abstract
The incidence of schizophrenia, as well as the symptoms, course, and outcomes for people so diagnosed seem to vary across some cultural contexts. The mechanisms by which cultural variations may protect one from or increase one's risk of developing schizophrenia remain unclear. Recent findings from transdisciplinary cross-cultural research, indicate ways that we may better understand how socioenvironmental and cultural variables interact with physiologic pathways relating psychosocial stress and psychotic symptoms, epigenetic changes, and people's use of culturally available tools to mitigate stress, in ways that may inform relevant, effective interventions for people diagnosed with psychotic disorders worldwide.
Collapse
|
32
|
Goldberg S, Fruchter E, Davidson M, Reichenberg A, Yoffe R, Weiser M. The relationship between risk of hospitalization for schizophrenia, SES, and cognitive functioning. Schizophr Bull 2011; 37:664-70. [PMID: 21602306 PMCID: PMC3122291 DOI: 10.1093/schbul/sbr047] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although most studies find low socioeconomic status (SES) to be associated with prevalence of schizophrenia, incidence studies do not generally support this, and some even report an inverse association. The objective of the current historical prospective study was to examine the relationship between SES, cognitive functioning, and risk of hospitalization for schizophrenia in a population-based sample of Israeli adolescents. Subjects were 811 487 adolescents, assessed by the Israeli military draft board for socio-demographic factors and cognitive functioning. Data on later hospitalization for schizophrenia were obtained from a population-based hospitalization registry. Findings indicated that when simply examining SES and schizophrenia, lower SES was associated with greater risk of hospitalization for schizophrenia (Hazard Ratio [HR] = 1.193, 95% CI = 1.091-1.303). When dividing the cohort into low, average, and high cognitive functioning, SES did not influence the risk for schizophrenia among individuals with high and average cognitive functioning, whereas among individuals with low cognitive functioning, high SES was found to slightly increase the risk for schizophrenia (HR = 1.21, 95% CI = 1.03-1.42). One possible explanation for this finding might be that among individuals from low socioeconomic backgrounds, low IQ may reflect decreased opportunities related to SES, whereas among individuals from high SES backgrounds, low IQ might reflect risk for later psychopathology.
Collapse
Affiliation(s)
- Shira Goldberg
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Eyal Fruchter
- Department of Mental Health, Israeli Defense Force Medical Corp, Ramat Gan, Israel
| | - Michael Davidson
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Israel,Department of Psychiatry, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Rinat Yoffe
- Department of Mental Health, Ministry of Health, Jerusalem, Israel
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Israel,Department of Mental Health, Israeli Defense Force Medical Corp, Ramat Gan, Israel,Department of Psychiatry, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel,To whom correspondence should be addressed; tel: 972-52-666-6575, fax: 972-3-6358599, e-mail:
| |
Collapse
|
33
|
Abstract
In the present article the putative role of environmental factors in schizophrenia is reviewed and synthesized. Accumulating evidence from recent studies suggests that environmental exposures may play a more significant role in the etiopathogenesis of this disorder than previously thought. This expanding knowledge base is largely a consequence of refinements in the methodology of epidemiologic studies, including birth cohort investigations, and in preclinical research that has been inspired by the evolving literature on animal models of environmental exposures. This paper is divided into four sections. In the first, the descriptive epidemiology of schizophrenia is reviewed. This includes general studies on incidence, prevalence, and differences in these measures by urban-rural, neighborhood, migrant, and season of birth status, as well as time trends. In the second section, we discuss the contribution of environmental risk factors acting during fetal and perinatal life; these include infections [e.g. rubella, influenza, Toxoplasma gondii (T. gondii), herpes simplex virus type 2 (HSV-2)], nutritional deficiencies (e.g., famine, folic acid, iron, vitamin D), paternal age, fetal/neonatal hypoxic and other obstetric insults and complications, maternal stress and other exposures [e.g. lead, rhesus (Rh) incompatibility, maternal stress]. Other putative neurodevelopmental determinants, including cannabis, socioeconomic status, trauma, and infections during childhood and adolescence are also covered. In the third section, these findings are synthesized and their implications for prevention and uncovering biological mechanisms, including oxidative stress, apoptosis, and inflammation, are discussed. Animal models, including maternal immune activation, have yielded evidence suggesting that these exposures cause brain and behavioral phenotypes that are analogous to findings observed in patients with schizophrenia. In the final section, future studies including new, larger, and more rigorous epidemiologic investigations, and research on translational and clinical neuroscience, gene-environment interactions, epigenetics, developmental trajectories and windows of vulnerability, are elaborated upon. These studies are aimed at confirming observed risk factors, identifying new environmental exposures, elucidating developmental mechanisms, and shedding further light on genes and exposures that may not be identified in the absence of these integrated approaches. The study of environmental factors in schizophrenia may have important implications for the identification of causes and prevention of this disorder, and offers the potential to complement, and refine, existing efforts on explanatory neurodevelopmental models.
Collapse
Affiliation(s)
- Alan S Brown
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, New York, NY 10032, USA.
| |
Collapse
|
34
|
Kristensen P, Gravseth HM, Bjerkedal T. Influence of early life factors on social inequalities in psychiatric outcomes among young adult Norwegian men. Eur J Public Health 2010; 20:517-23. [PMID: 20584741 PMCID: PMC2943509 DOI: 10.1093/eurpub/ckq083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Social inequalities in health can to a substantial degree be explained by social causation. However, indirect selection by early life factors has been suggested. The main aim of this study was to estimate how much adult social gradients in selected psychiatric outcomes depended on parental and individual characteristics in early life. METHODS The population comprised all males born in Norway 1967-71 (n = 170 678). We compiled data on several social and biological variables from birth onwards from different national registers. Health outcomes were collected from the Cause of Death Register (suicide) and the Labour and Welfare Administration (psychiatric disability, psychiatric sickness absence). Indicator of socio-economic position was education level at the age of 28 years. Men were followed up between 4 and 9 years from the age of 29 years. RESULTS Crude rates per 100 000 person-years were 21.8 (suicide), 145.7 (disability) and 1164.7 (sickness absence). Social inequalities were strong and consistent for all outcomes. Parental and individual characteristics accounted for a substantial part of the social inequalities in neurosis or personality disorder disability (44.1%) and a moderate role for inequalities in psychiatric sickness absence (25.6%), schizophrenia disability (20.7%) and suicide (17.4%). General ability at the age of 18 years had strongest influence on the social health gradients. Suicide and schizophrenia disability were associated with a combination of high parental and low own education level. CONCLUSION This study indicates that indirect selection explains a substantial part of social inequalities in certain psychiatric outcomes and that early life prevention is important to reduce health gradients.
Collapse
|
35
|
Affiliation(s)
- D March
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
| | | | | |
Collapse
|
36
|
Harlap S, Perrin MC, Deutsch L, Kleinhaus K, Fennig S, Nahon D, Teitelbaum A, Friedlander Y, Malaspina D. Schizophrenia and birthplace of paternal and maternal grandfather in the Jerusalem perinatal cohort prospective study. Schizophr Res 2009; 111:23-31. [PMID: 19361958 DOI: 10.1016/j.schres.2009.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 03/11/2009] [Accepted: 03/16/2009] [Indexed: 11/23/2022]
Abstract
Some forms of epigenetic abnormalities transmitted to offspring are manifested in differences in disease incidence that depend on parent-of-origin. To explore whether such phenomena might operate in schizophrenia spectrum disorders, we estimated the relative incidence of these conditions in relation to parent-of-origin by considering the two grandfathers' countries of birth. In a prospective cohort of 88,829 offspring, born in Jerusalem in 1964-76 we identified 637 cases through Israel's psychiatric registry. Relative risks (RR) were estimated for paternal and maternal grandfathers' countries of birth using proportional hazards methods, controlling for parents' ages, low social class and duration of marriage. After adjusting for multiple observations, we found no significant differences between descendants of maternal or paternal grandfathers born in Iraq, Iran, Turkey, Syria, Yemen, Morocco, Algeria, Tunisia, Libya/Egypt, Poland, USSR, Czechoslovakia, Germany or the USA. Those with paternal grandfathers from Romania (RR=1.9, 95% CI=1.3-2.8) or Hungary (1.6, 1.0-2.6) showed an increased incidence; however, those with maternal grandfathers from these countries experienced reduced incidence (RR=0.5, 0.3-0.8 and 0.4, 0.2-0.8). In post-hoc analyses we found that results were similar whether the comparison groups were restricted to descendants of other Europeans or included those from Western Asia and North Africa; and effects of paternal grandfathers from Romania/Hungary were more pronounced in females, while effects of maternal grandfathers from these countries were similar in males and females. These post-hoc "hypothesis-generating" findings lead one to question whether some families with ancestors in Romania or Hungary might carry a variant or mutation at a parentally imprinted locus that is altering susceptibility to schizophrenia. Such a locus, if it exists, might involve the X chromosome.
Collapse
|
37
|
Siegmann AE. A classification of sociomedical health indicators: perspectives for health administrators and health planners. Int J Health Serv 1976; 6:521-38. [PMID: 955757 PMCID: PMC3004532 DOI: 10.2190/my7u-4bgm-9qfy-n0tn] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The conceptualization and operationalization of measures of health status are considered. Health indicators are conceived as a subset of social indicators, and therefore, as any social indicator, they are viewed as derivative from social issues. The interrelationships of different frames of reference for defining and measuring health that have accompained three distinct health problem patterns in the United States are viewed from a developmental perspective. Mortality and morbidity rates, the traditional health indicators, by themselves no longer serve to assess health status in developed nations. Their deficiencies as indicators serve as background for a classification schema for sociomedical health status indicators that relates health definition frames of reference, measures of health status, and health problems. The role of a group of health indicators-sociomedical heath indicators-in the current formulation of health status measures is assessed.
Collapse
|