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Risk of Schizophrenia and Age Difference with Older Siblings

Evidence for a Maternal Viral Infection Hypothesis?

Published online by Cambridge University Press:  02 January 2018

Pak C. Sham*
Affiliation:
Departments of Psychiatry and Biostatistics & Computing, Institute of Psychiatry, London, and Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
Charles J. Maclean
Affiliation:
Departments of Psychiatry and Human Genetics, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
Kenneth S. Kendler
Affiliation:
Departments of Psychiatry and Human Genetics, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
*
Department of Psychological Medicine, Institute of Psychiatry, DeCrespigny Park, Denmark Hill, London SE5 8AF

Abstract

Recent reports that some influenza epidemics may be followed by a transient increase in the births of schizophrenic patients have led to the hypothesis that maternal viral infections contribute to the aetiology of schizophrenia. It is well known that respiratory viral infections are frequently brought into the home by young children. We tested the predictions that the risk of schizophrenia is decreased in first-born children, and increased in individuals who had siblings of a young age while in utero, using data from a Swedish family study. Our results are consistent with these predictions. In particular, having siblings three to four years older was associated with a significantly increased risk of schizophrenia, even after allowing for birth order, sibship size, and other potential confounders. If replicated, these results provide indirect support for the maternal viral infection hypothesis, although there are alternative explanations.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

Badger, G. F., Dingle, J. H., Feller, A. E., et al (1953) A study of illness in a group of Cleveland families: III. The introduction of respiratory infections into families. American Journal of Hygiene, 58, 4146.Google Scholar
Barr, C. E., Mednick, S. A. & Munk-Jorgensen, P. (1990) Exposure to influenza epidemics during gestation and adult schizophrenia: a 40-year study. Archives of General Psychiatry, 47, 869874.CrossRefGoogle ScholarPubMed
Bowler, A. E. & Torrey, E. F. (1990) Influenza and schizophrenia. Archives of General Psychiatry, 47, 876877.CrossRefGoogle Scholar
Brimblescombe, F. S. W., Cruickshank, R., Masters, P. L., et al (1958) Family studies of respiratory infections. British Medical Journal, i, 119128.Google Scholar
Cox, D. R. (1972) Regression models and life tables (with discussion). Journal of the Royal Statistical Society B, 34, 187220.Google Scholar
Crow, T. J., Done, D. J. & Johnstone, E. C. (1991) Schizophrenia and influenza. Lancet, 338, 116118.CrossRefGoogle Scholar
Der, G., Gupta, S. & Murray, R. M. (1990) Is schizophrenia disappearing? Lancet, 335, 513516.Google Scholar
Erlenmeyer-Kimling, L., Van Den Bosch, E. & Denham, B. (1969) The problem of birth order and schizophrenia. British Journal of Psychiatry, 115, 659678.CrossRefGoogle ScholarPubMed
Fahy, T. A., Jones, P. B., Sham, P. C., et al (1992) Schizophrenia in Afro-Caribbeans in the UK following prenatal exposure to the 1957 A2 influenza epidemic. Schizophrenia Research, 6, 9899.CrossRefGoogle Scholar
Hare, E. H. & Price, J. S. (1970) Birth rank in schizophrenia: with a consideration of the bias due to changes in birth rate. British Journal of Psychiatry, 116, 409420.Google Scholar
Hare, E. H. & Price, J. S. (1988) Temporal factors and trends, including birth seasonality and the viral hypothesis. In Handbook of Schizophrenia, Vol. 3 (ed. Nasrallah, H. A.), pp. 345377. Amsterdam: Elsevier.Google Scholar
Harrel, F. E. (1986) The PHGLM procedure. In SUGI Supplementary Library User's Guide, Version 5. Cary, NC, pp. 437466. SAS Institute Inc.Google Scholar
Kalbfleisch, J. D. & Prentice, R. L. (1980) The Statistical Analysis of Failure Time Data. New York: John Wiley & Sons.Google Scholar
Kendell, R. E. & Kemp, I. W. (1989) Maternal influenza in the etiology of schizophrenia. Archives of General Psychiatry, 46, 878882.Google Scholar
Kendler, K. S. (1988) The genetics of schizophrenia: an overview. In Handbook of Schizophrenia Vol. 3 (eds Tsuang, M. T. & Simpson, J. C.). Amsterdam: Elsevier.Google Scholar
Kunugi, H., Nanko, S. & Takei, N. (1992) Influenza and schizophrenia in Japan. British Journal of Psychiatry, 161, 274275.CrossRefGoogle ScholarPubMed
Lewis, G. H., David, A. S., Andreasson, S., et al (1992) Schizophrenia and city life. Lancet, 340, 137140.Google Scholar
Lindelius, R. (1970) A study of schizophrenia: a clinical, prognostic, and family investigation. Acta Psychiatrica Scandinavica, Supplement 216, 1125.Google Scholar
McGue, M., Gottesman, I. I. & Rao, D. C. (1983) The transmission of schizophrenia under a multifactorial threshold model. American Journal of Human Genetics, 35, 11611178.Google Scholar
Mednick, S. A., Machon, R. A., Huttenen, M. O., et al (1988) Adult schizophrenia following prenatal exposure to an influenza epidemic. Archives of General Psychiatry, 45, 189192.CrossRefGoogle Scholar
Mednick, S. A., Machon, R. A., Huttenen, M. O., et al (1990) Influenza and schizophrenia. Archives of General Psychiatry, 47, 875877.Google Scholar
Murray, R. M., Jones, P. B., O'Callaghan, E., et al (1992) Genes, viruses and neurodevelopmental schizophrenia. Journal of Psychiatric Research, 26, 225235.CrossRefGoogle ScholarPubMed
O'Callaghan, E., Gibson, T., Colohon, H., et al (1991a) Season of birth in schizophrenia: evidence for confinement of an excess of winter births to patients without a family history of mental disorder. British Journal of Psychiatry, 158, 764769.Google Scholar
O'Callaghan, E., Sham, P. C., Takei, N., et al (1991b) Schizophrenia after prenatal exposure to 1957 A2 influenza epidemic. Lancet, 337, 12481250.Google Scholar
O'Callaghan, E., Sham, P. C., Takei, N., et al (1991c) Schizophrenia and influenza epidemic. Lancet, 338, 118119.Google Scholar
O'Callaghan, E., Colgan, K., Cotter, D., et al (1992) Evidence for confinement of winter birth excess in schizophrenia to those born in cities. Schizophrenia Research, 6, 102.Google Scholar
Price, J. S. & Hare, E. H. (1969) Birth order studies: some sources of bias. British Journal of Psychiatry, 115, 633648.Google Scholar
Rao, D. C., Morton, N. E., Gottesman, I. I., et al (1981) Path analysis of qualitative data on pairs of relatives: application to schizophrenia. Human Heredity, 31, 325333.Google Scholar
Rothman, K. J. (1986) Modern Epidemiology. Boston: Little, Brown and Company.Google Scholar
SAS Institute (1985) SAS User's Guide: Statistics, Version 5 edn. Cary, NC: SAS Institute Inc.Google Scholar
Sham, P. C., O'Callaghan, E., Takei, N., et al (1992) Schizophrenia and prenatal exposure to influenza epidemics occurring between 1939 and 1960. British Journal of Psychiatry, 160, 461466.CrossRefGoogle Scholar
Takei, N., O'Callaghan, E., Sham, P., et al (1992) Winter birth excess in schizophrenia: its relationship to place of birth. Schizophrenia Research, 6, 102.Google Scholar
Torrey, E. F., Rawlings, R. & Waldman, I. N. (1988) Schizophrenic births and viral diseases in two states. Schizophrenia Research, 1, 7377.CrossRefGoogle ScholarPubMed
Watson, C. G., Kucala, T., Tilleskjor, C., et al (1984) Schizophrenic birth seasonality in relation to the incidence of infectious diseases and temperature extremes. Archives of General Psychiatry, 41, 8590.CrossRefGoogle Scholar
Wilcox, J. A. & Nasrallah, H. A. (1987) Childhood head trauma and psychosis. Psychiatric Research, 21, 303307.Google Scholar
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