Minor physical anomalies and quantitative measures of the head and face in patients with psychosis.
BACKGROUND
The aim of this study was to examine minor physical anomalies and quantitative measures of the head and face in patients with psychosis vs healthy controls.


METHODS
Based on a comprehensive prevalence study of psychosis, we recruited 310 individuals with psychosis and 303 controls. From this sample, we matched 180 case-control pairs for age and sex. Individual minor physical anomalies and quantitative measures related to head size and facial height and depth were compared within the matched pairs. Based on all subjects, we examined the specificity of the findings by comparing craniofacial summary scores in patients with nonaffective or affective psychosis and controls.


RESULTS
The odds of having a psychotic disorder were increased in those with wider skull bases (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.02-1.17), smaller lower-facial heights (glabella to subnasal) (OR, 0.57; 95% CI, 0.44-0.75), protruding ears (OR, 1.72; 95% CI, 1.05-2.82), and shorter (OR, 2.29; 95% CI, 1.37-3.82) and wider (OR, 2.28; 95% CI, 1.43-3.65) palates. Compared with controls, those with psychotic disorder had skulls that were more brachycephalic. These differences were found to distinguish patients with nonaffective and affective psychoses from controls.


CONCLUSIONS
Several of the features that differentiate patients from controls relate to the development of the neuro-basicranial complex and the adjacent temporal and frontal lobes. Future research should examine both the temporal lobe and the middle cranial fossa to reconcile our anthropomorphic findings and the literature showing smaller temporal lobes in patients with schizophrenia. Closer attention to the skull base may provide clues to the nature and timing of altered brain development in patients with psychosis.
McGrath
John
J
Queensland Centre for Schizophrenia Research, Wolston Park Hospital, Wacol Q4076, Australia. jjm@brain.wph.uq.edu.au
El-Saadi
Ossama
O
Grim
Vivian
V
Cardy
Sue
S
Chapple
Ben
B
Chant
David
D
Lieberman
Daniel
D
Mowry
Bryan
B
D000015:Abnormalities, Multiple / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D001921:Brain / Q000254:growth & development / Q000503:physiopathology; D015897:Comorbidity; D016001:Confidence Intervals; D019465:Craniofacial Abnormalities / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005145:Face / Q000002:abnormalities*; D005260:Female; D006257:Head / Q000002:abnormalities*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*