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The British Journal of Psychiatry (2004) 184: 216-222
© 2004 The Royal College of Psychiatrists

Genotype-environment interaction in schizophrenia-spectrum disorder

Long-term follow-up study of Finnish adoptees

Pekka Tienari, MD

Department of Psychiatry, University of Oulu, Finland

Lyman C. Wynne, MD, PhD

University of Rochester, USA

Anneli Sorri, MD, Ilpo Lahti, MD, Kristian Läksy, MD, Juha Moring, MD, Mikko Naarala, MD, Pentti Nieminen, PhD and Karl-Erik Wahlberg, PhD

Department of Psychiatry, University of Oulu, Finland

Correspondence: Professor Pekka Tienari, Department of Psychiatry, University of Oulu, PL 5000,90014 Oulun yliopisto, Finland. Tel: +358(0)50 351 7927; fax: +358(0)8 333 167; e-mail ptienari{at}cc.oulu.fi

Declaration of interest None. Funding detailed in Acknowledgements.

Background Earlier adoption studies have convincingly confirmed the importance of a genetic contribution to schizophrenia. The designs, however, did not incorporate observations of the rearing-family environment.

Aims To test the hypothesis that genetic factors moderate susceptibility to environmentally mediated risks associated with rearing-family functioning.

Method A Finnish national sample of adopted-away offspring of mothers with schizophrenia-spectrum disorders was compared blindly with adoptees without this genetic risk. Adoptive rearing was assessed using family rating scales based upon extended family observations at initial assessment. Adoptees were independently re-diagnosed after a median interval of12 years, with register follow-up after 21 years.

Results In adoptees at high genetic risk of schizophrenia, but not in those at low genetic risk, adoptive-family ratings were a significant predictor of schizophrenia-spectrum disorders in adoptees at long-term follow-up.

Conclusions Adoptees at high genetic risk are significantly more sensitive to adverse v. ‘healthy’ rearing patterns in adoptive families than are adoptees at low genetic risk.

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