[Familial occurrence and obstetric complications in siblings discordant for schizophrenia].

Obstetric complications seem to play a relevant role in the development of schizophrenia. This study aimed to assess whether not only frequency but also severity of obstetric complications was different in schizophrenic patients when compared with their healthy siblings. Furthermore, we examined whether a family history positive for schizophrenia was related to an increased frequency or severity of obstetric complications in healthy siblings. Frequency and severity of obstetric complications were evaluated in 76 subjects (30 schizophrenics and 46 siblings). The diagnosis of schizophrenia were made according to DSM III-R. Mothers were interviewed to gather data about obstetric complications and the "midwife protocol" by Parnas et al. (1982) was used to quantify presence and entity of obstetric complications. Information regarding family history were collected from mothers. We used the method of segregation analysis to test the mode of inheritance. Complicated births were more frequently found in schizophrenics independently from a family history positive for schizophrenia or schizophrenia related personality disorders and obstetric complications were more severe in schizophrenics with respect to siblings. Obstetric complications occurred more frequently among schizophrenics without genetic risk; the same result was not found in healthy sibs. Our findings show that obstetric complications would play a major role in patients especially if they show a negative family history for schizophrenia. Moreover, a family history positive for schizophrenia or schizophrenia related personality disorder seems not to augment the frequency or severity of obstetric complications in healthy sibs.

Bersani G ，Taddei I ，Venturi P ，Pancheri P ... -  《-》

[Obstetrical complications and schizophrenia. Comparative study of obstetric antecedents in schizophrenic and bipolar patients].

Information on pregnancy and birth complications was recorded for 46 patients with DSM III-R schizophrenia or bipolar disorder. The biological mothers of the patients were interviewed personally to obtain obstetric information. There were no significant differences between schizophrenic and bipolar patients in age at the assessment, distribution of sex, paternal social class, age of the mother at birth, and birth order. Biological mothers of schizophrenics had more often than mothers of bipolar patients an history of miscarriage, but this trend failed to reach statistical significance. Pregnancy complications and birth weight were not significantly different between schizophrenic and bipolar patients. Birth complications were scored according to the method described by Parnas et al. (1982). Three scores were obtained for each patient: a frequency score, a severity score, and a total score. All the scores were significantly higher in the schizophrenic than in the bipolar group (frequency score p < 0.011; severity score p < 0.015; total score p < 0.01). Surprisingly, birth complications were more severe in female than in male schizophrenics (p < 0.017). The two groups of patients could not be differentiated by specific birth complication. The schizophrenic patients with a history of birth complication and those without such an history did not differ in age at onset, age at first hospitalization, family history of schizophrenic or non-affective psychotic disorder, neuroleptic resistance, and type of schizophrenia. Because of the small number of subjects in each group a type II error cannot be excluded for these negative results.(ABSTRACT TRUNCATED AT 250 WORDS)

Verdoux H ，Bourgeois M 《ENCEPHALE-REVUE DE PSYCHIATRIE CLINIQUE BIOLOGIQUE ET THERAPEUTIQUE》

Obstetric complications in siblings of Japanese schizophrenics: data from the Maternal and Child Health Handbook.

Although the precise etiology of schizophrenia remains unknown, the development of schizophrenia has been associated with a history of obstetric complication (OC). Furthermore, some studies show structural and functional brain abnormalities in the unaffected siblings of schizophrenics. In this study the perinatal histories of 18 unaffected siblings of schizophrenics and 15 unrelated healthy controls, as detailed in their mothers' Maternal and Child Health Handbook records, were retrospectively analyzed. Records were scored for obstetric complication by the method developed by [Parnas, J., Schulsinger, F., Teasdale, T.W., Shulsinger, H., Feldman, P.M., Mednick, S.A., 1982. Perinatal complications and clinical outcome within the schizophrenia spectrum. Br. J. Psychiatry 140, 416-420]. The authors found the sibling group had greater pregnancy and birth complication (PBC) frequency, severity and total scores than the control population.

Ohara K ，Tanabu S ，Yoshida K ，Sato Y ，Shibuya H ... -  《PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY》

The potential role of high or low birthweight as risk factor for adult schizophrenia.

Obstetric complications may be an important factor in the development of schizophrenia. The aim of this study is to evaluate the role of these complications in the development of schizophrenia in adult life, with particular attention to the potential role of birth weight. We carried out a case-control study, comprising schizophrenics and patients with diseases of the schizophrenia spectrum as cases, and their healthy male brothers as controls. Obstetric complications were assessed using the "Midwife Protocol" of Parnas et al. The main result was that birth weight may be a risk factor for schizophrenia, as indicated by odds ratio analysis. The confidence intervals are very wide and, without compromising the clinical significance of the results, they give a limited indication of the real entity of the risk. The results contribute to understanding of the role played by a single complications.

Bersani G ，Manuali G ，Ramieri L ，Taddei I ，Bersani I ，Conforti F ，Cattaruzza MS ，Osborn J ，Pancheri P ... -  《JOURNAL OF PERINATAL MEDICINE》

[Early familial and environmental processes in schizophrenia. Importance of premorbid personality evaluation].

According to the neurodevelopmental hypothesis, antenatal aggressions (hypoxia and seasonal viral infections) could increase the risk of schizophrenia in adulthood as shown by an excess of obstetric complications and births in winter--spring in schizophrenic patients. As schizoid and schizotypal personality disorders are genetically linked to schizophrenia, we wanted to verify whether such disorders in the premorbid period in schizophrenic patients could be markers of a more genetic and less environmental sub-type of schizophrenia. Therefore, the aim of this study was to assess schizoid and schizotypal premorbid personality disorders (PPD) in 60 schizophrenic patients, and to assess the weight of familial and environmental factors according to the diagnosis of PPD. 41.7% of patients (25/60) had a schizoid or schizotypal PPD. Compared with patients without PPD, patients with PPD had more often schizophrenia spectrum disorders in first degree relatives (33.3% vs 14.7%, NS), less often obstetric complications (20.8% vs 50.0%, p < 0.05) and were less often born in the first half-year (44.0% vs 68.6%, p = 0.05). So, we showed a non significant positive association between schizoid--schizotypal PPD and family history of schizophrenia spectrum disorders, and a significant negative association between PPD and environmental factors: obstetric complications (OC) and birth in winter-spring. So, the absence of PPD could enable us to identify a sub-group of patients in whom environmental factors play a major role. Moreover, the relations between genetic factors and PPD seem to be complicated. Nevertheless, the notion of PPD could give information about the kind of genetic factors implicated in schizophrenia.

Chabot B ，Germain-Robin S ，Petit M ，Dollfus S ... -  《ENCEPHALE-REVUE DE PSYCHIATRIE CLINIQUE BIOLOGIQUE ET THERAPEUTIQUE》