A.E. Bennett Research Award. Prenatal rubella, premorbid abnormalities, and adult schizophrenia.
BACKGROUND
Premorbid neurocognitive, neuromotor, and behavioral function tends to be disturbed in schizophrenia. We previously demonstrated that a birth cohort clinically and serologically documented with prenatal rubella evidenced a marked increase in risk of nonaffective psychosis. In our study, we examined whether rubella-exposed subjects destined to develop schizophrenia and other schizophrenia spectrum disorders (SSD), compared with exposed control subjects, had greater impairment in several premorbid functions.


METHODS
Subjects were interviewed using a direct, comprehensive research assessment and diagnosed by consensus. We compared the degree of IQ decline, as well as premorbid neuromotor and behavioral dysfunction, between rubella-exposed subjects who developed schizophrenia spectrum psychosis (SSP) and exposed control subjects from the cohort. We also compared the gestational timing of rubella infection between the cases and control subjects.


RESULTS
This rubella-exposed birth cohort evidenced a markedly increased risk of SSD (20.4% or 11/53). Rubella-exposed SSP cases, compared with rubella-exposed control subjects, demonstrated a decline in IQ from childhood to adolescence, and increased premorbid neuromotor and behavioral abnormalities. Moreover, it appears that early gestational rubella exposure may represent a period of increased vulnerability for SSD.


CONCLUSIONS
These findings link a known prenatal exposure, a deviant neurodevelopmental trajectory in childhood and adolescence, and SSP in adulthood within the same individuals.
Brown
A S
AS
Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, New York 10032, USA.
Cohen
P
P
Harkavy-Friedman
J
J
Babulas
V
V
Malaspina
D
D
Gorman
J M
JM
Susser
E S
ES
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000002:abnormalities; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology / Q000821:virology*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011596:Psychomotor Disorders / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications* / Q000453:epidemiology / Q000821:virology*