Obstetric Adversity and Age at First Presentation With Schizophrenia: Evidence of a Dose-Response Relationship

doi:10.1176/appi.ajp.161.5.920



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	Schizophrenia Spectrum Disorders
	Epidemiology

Am J Psychiatry 161:920-922, May 2004
© 2004 American Psychiatric Association

Brief Report

Obstetric Adversity and Age at First Presentation With Schizophrenia: Evidence of a Dose-Response Relationship

Brendan D. Kelly, M.R.C.Psych., Larkin Feeney, M.R.C.P.I., Eadbhard O’Callaghan, F.R.C.Psych., Roy Browne, M.R.C.Psych., Majella Byrne, Ph.D., Niamh Mulryan, M.R.C.Psych., Ann Scully, M.R.C.Psych., Mary Morris, B.Sc., Anthony Kinsella, M.Sc., Noriyoshi Takei, Ph.D., Thomas McNeil, Ph.D., Dermot Walsh, F.R.C.P.I., and Conall Larkin, F.R.C.Psych.

OBJECTIVE: The purpose of the study was to determine if a dose-responserelationship exists between obstetric adversity and age at firstpresentation with schizophrenia. METHOD: The Dublin PsychiatricCase Register was used to identify subjects with schizophrenia.Data on obstetric complications, social class of origin, andfamily history of psychiatric illness were obtained for thosesubjects. RESULTS: A total of 409 patients with ICD-9 schizophreniawere identified. Patients with a history of obstetric complicationspresented earlier to psychiatric services. As the number ofcomplications increased, the mean age at first presentationdecreased. This effect was independent of social class of originand family history of psychiatric illness. CONCLUSIONS: Obstetricadversity exerts an independent influence on the age at firstpresentation with schizophrenia, in a dose-response manner.This finding supports the existence of a causal relationshipbetween obstetric adversity and age at first presentation withschizophrenia.

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