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The British Journal of Psychiatry (2002) 181: 298-305
© 2002 The Royal College of Psychiatrists

Associations between premorbid intellectual performance, early-life exposures and early-onset schizophrenia

Cohort study{dagger}

DAVID GUNNELL, PhD

Department of Social Medicine, University of Bristol

GLYNN HARRISON, FRCPsych

Division of Psychiatry, University of Bristol

FINN RASMUSSEN, PhD

Department of Epidemiology, Karolinska Institute, Stockholm, Sweden

DIMITRIS FOUSKAKIS, PhD

Division of Psychiatry, University of Bristol

PER TYNELIUS, MSc

Department of Epidemiology, Karolinska Institute, Stockholm, Sweden

Correspondence: David Gunnell, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. Tel: 0117 928 7253; fax: 0117 928 7204; e-mail: D.J.Gunnell{at}bristol.ac.uk

Declaration of interest None.

{dagger} See editorial, pp. 276–277, this issue.

Background Impaired intellectual performance is associated with an increased risk of schizophrenia.

Aims To investigate whether this association is due to the influence of prenatal and early childhood exposures on both intellectual development and the risk of schizophrenia.

Method Cohort of 197 613 Swedish male conscripts with linked birth, census and hospital admission data together with five measures of verbal and non-verbal intellectual performance recorded at conscription.

Results 109 643 subjects had complete data; over a mean 5-year follow-up, 60 developed schizophrenia and 92 developed other non-affective psychoses. Poor scores for each of the five tests were associated with 3- to 14-fold increased risk of psychosis, particularly schizophrenia. Controlling for birth-related exposures, including birth weight, and parental education did not attenuate these associations.

Conclusions Poor intellectual performance at 18 years of age is associated with early-onset psychotic disorder. Associations do not appear to be confounded by prenatal adversity or childhood circumstances, as indexed by parental education.


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