Obstetric adversity and age at first presentation with schizophrenia: evidence of a dose-response relationship.
OBJECTIVE
The purpose of the study was to determine if a dose-response relationship exists between obstetric adversity and age at first presentation with schizophrenia.


METHODS
The Dublin Psychiatric Case Register was used to identify subjects with schizophrenia. Data on obstetric complications, social class of origin, and family history of psychiatric illness were obtained for those subjects.


RESULTS
A total of 409 patients with ICD-9 schizophrenia were identified. Patients with a history of obstetric complications presented earlier to psychiatric services. As the number of complications increased, the mean age at first presentation decreased. This effect was independent of social class of origin and family history of psychiatric illness.


CONCLUSIONS
Obstetric adversity exerts an independent influence on the age at first presentation with schizophrenia, in a dose-response manner. This finding supports the existence of a causal relationship between obstetric adversity and age at first presentation with schizophrenia.
Kelly
Brendan D
BD
Stanley Research Unit, Department of Adult Psychiatry, Hospitaller Order of St. John of God, Cluain Mhuire Service, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland.
Feeney
Larkin
L
O'Callaghan
Eadbhard
E
Browne
Roy
R
Byrne
Majella
M
Mulryan
Niamh
N
Scully
Ann
A
Morris
Mary
M
Kinsella
Anthony
A
Takei
Noriyoshi
N
McNeil
Thomas
T
Walsh
Dermot
D
Larkin
Conall
C
D000328:Adult; D000367:Age Factors; D015984:Causality; D005190:Family; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007494:Ireland / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000235:genetics; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D012042:Registries; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012923:Social Class