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Third ventricle enlargement and developmental delay in first-episode psychosis: preliminary findings

Section of Cognitive Psychopharmacology, Institute of Psychiatry, London

Correspondence: Dr Dominic Fannon, Department of Psychiatry, Institute of Psychiatry, Denmark Hill, London SE5 8AF, UK. Tel: 020 7919 2066; fax: 020 7252 3172; e-mail: d.fannon{at}iop.kcl.ac.uk

Declaration of interest Financially supported by Grosvenor House Group Estates and Psychmed Ltd.

Background Third rather than lateral ventriculomegaly may be a more specific finding in psychosis. The relevance of ventricular abnormality remains unclear.

Aims To investigate the developmental correlates of ventricular enlargement.

Method Information on childhood development and magnetic resonance images in 1.5-mm contiguous sections were collected on 21 patients experiencing a first episode of psychosis.

Results Patients (n=21) had significantly less whole brain volume and enlarged third and lateral ventricles compared to controls (n=25). Third ventricle (r=0.48, P<0.03) and lateral ventricle (r=0.65, P<0.01) volumes correlated with developmental score. Patients with developmental delay had significantly larger third and lateral ventricles than those without.

Conclusions Enlargement of both third and lateral ventricles is found in first-episode psychosis and is related to developmental delay in childhood. Insult to periventricular areas is relevant to the neurobiology of the disease. These findings support the view that schizophrenia involves disturbance of neurodevelopmental processes in some patients.

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