Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T08:06:05.677Z Has data issue: false hasContentIssue false

Age at onset and outcome in schizophrenia are related to the degree of familial loading

Published online by Cambridge University Press:  03 January 2018

Jaana M. Suvisaari*
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
Jari Haukka
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
Antti Tanskanen
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
Jouko K. Lönnqvist
Affiliation:
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
*
Dr Jaana Suvisaari, Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. Fax: 358-9-47448478; e-mail: [email protected]

Abstract

Background

Recent research suggests that high familial loading is associated with early onset of schizophrenia. Results concerning outcome have been controversial.

Method

We assessed the relationship between familial loading, age at onset and outcome in all Finnish patients with schizophrenia born between 1950 and 1969. Patients and their first-degree relatives were identified using nationwide registers. Familial loading scores were calculated for schizophrenia and for combined psychotic disorders, and patients were accordingly classified into three groups: high (n = 761), intermediate (n = 14 247), and low familial loading (n = 725). Linear mixed models and the Cox proportional hazard model were used in the analyses.

Results

Onset was earliest, hospitalisation longest and risk of retirement in receipt of a disability pension highest in the group with high familial loading, with opposite extremes found in the group with low familial loading.

Conclusions

High familial loading for schizophrenia is associated with early onset and poor outcome of schizophrenia.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albus, M., Scherer, J., Hueber, S., et al (1994) The impact of familial loading on sex differences in age at onset of schizophrenia. Acta Psychiatrica Scandinavica, 89, 132134.CrossRefGoogle ScholarPubMed
Aida, M., Ahrem, B., Lit, W., et al (1996) Age of onset in familial and sporadic schizophrenia. Acta Psychiatrica Scandinavica, 93, 447450.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington. DC: APA.Google Scholar
Castle, D. J., Abel, K., Takei, N., et al (1995) Gender differences in schizophrenia: hormonal effect or subtypes? Schizophrenia Bulletin, 1, 112.Google Scholar
DeLisi, L. E. (1992) The significance of age at onset for schizophrenia. Schizophrenia Bulletin, 18, 209215.Google Scholar
DeLisi, L. E., Goldin, L. R., Maxwell, E., et al (1987) Clinical features of illness in siblings with schizophrenia or schizoaffective disorder. Archives of General Psychiatry, 44, 891896.Google Scholar
Eaton, W. W., Mortensen, P. B., Herrman, H., et al (1992) Long-term course of hospitalization for schizophrenia: Part 1. Risk for rehospitalization. Schizophrenia Bulletin, 18, 217228.Google Scholar
Gorwood, P., Leboyer, M., Jay, M., et al (1995) Sex and age at onset in schizophrenia: impact of family history. American Journal of Psychiatry 152, 208212.Google Scholar
Hambrecht, M. (1995) A second case of schizophrenia in the family: is it observed differently? European Archives of Psychiatry and Clinical Neuroscience, 245, 267269.CrossRefGoogle ScholarPubMed
Hovatta, I., Terwillinger, J. D., Lichtermann, D., et al (1997) Schizophrenia in the genetic isolate of Finland. American Journal of Medical Genetics (Neuropsychiatric Genetics), 74, 353360.Google Scholar
Kendler, K. S., Tsuang, M. T. & Hays, P. (1987) Age at onset in schizophrenia. A familial perspective. Archives of General Psychiatry, 44, 881890.Google Scholar
Kendler, K. S. & Maclean, C. J. (1990) Estimating familial effects on age at onset and liability to schizophrenia. Genetic Epidemiology, 7, 409417.Google Scholar
Maier, W., Lichtermann, D., Minges, J., et al (1993) The impact of sex and age at onset on the familial aggregation of schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 242, 279285.CrossRefGoogle ScholarPubMed
Maurer, K. & Häfner, H. (1995) Methodological aspects of onset assessment in schizophrenia. Schizophrenia Research, 315, 265276.Google Scholar
Murphy, B. M., Burke, J. G., Bray, J. C., et al (1994) An analysis of the clinical features of familial schizophrenia. Acta Psychiatrica Scandinavica, 89, 421–27.Google Scholar
Pakaslahti, A. (1987) On the diagnosis of schizophrenic psychoses in clinical practice. Psychiatrica Fennica, 18, 6372.Google Scholar
Roy, M. A. & Crowe, R. R. (1994) Validity of the familial and sporadic subtypes of schizophrenia. American Journal of Psychiatry, 151, 805814.Google Scholar
Salokangas, R. K. R. (1983) Prognostic implications of the sex of schizophrenic patients. British Journal of Psychiatry, 142, 145151.Google Scholar
Salokangas, R. K. R. (1993) First-contact rate for schizophrenia in community psychiatric care. Consideration of the oestrogen hypothesis. European Archives of Psychiatry and Clinical Neuroscience, 242, 337346.Google Scholar
Sham, P. C., Maclean, C. J. & Kendler, K. S. (1994) A typological model of schizophrenia based on age at onset, sex and familial morbidity. Acta Psychiatrica Scandinavica, 89, 135141.Google Scholar
Shimizu, A. & Kurachi, M. (1989) Do women without a family history of schizophrenia have a later onset of schizophrenia? Japanese Journal of Psychiatry and Neurology, 43, 133136.Google Scholar
StatSci, MathsSoft Inc. (1995) S-Plus Guide to Statistical and Mathematical Analysis. Version 3.3. Seattle. WA: StatSci.Google Scholar
Verdoux, H., Van Os, J., Sham, P., et al (1996) Does familiality predispose to both emergence and persistence of psychosis? A follow-up study. British Journal of Psychiatry, 168, 620626.Google Scholar
World Health Organization (1967) Manual of the International Statistical Classification of Diseases. Injuries and Causes of Death (8th edn) (ICD–8). Geneva: WHO.Google Scholar
World Health Organization (1977) Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death (9th edn) (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.