Self-reported mental health difficulties and subsequent risk for schizophrenia in females: a 5-year follow-up cohort study.
BACKGROUND
Patients with schizophrenia often report a history of premorbid mild to severe psychological distress. We investigated the association between self-reported mental health difficulties and later psychiatric hospitalization for schizophrenia.


METHODS
13,357 females aged 17, mandatory assessed by the Israeli Draft Board were followed up over 5 years for psychiatric hospitalization by means of the Israeli National Psychiatric Hospitalization Case Registry. Seventeen females, judged healthy at Draft Board assessment, were hospitalized for schizophrenia or schizoaffective disorder over the follow-up period.


RESULTS
There was a significant monotonic association between increasing self-reported mental health difficulties (psychological distress and increasing need for psychological counseling) and prevalence of schizophrenia [odds ratios over four levels: 1.56; 95% CI:1.04 to 2.34; chi2 (1) = 4.62, p = 0.03], after controlling for low IQ, immigration, SES, and presence of psychiatric disorders at age 17. Increasing severity of self-reported mental health difficulties was related to earlier age of first hospitalization [r = -0.48, p = 0.05].


CONCLUSIONS
Increased undifferentiated self-reported mental health difficulties are associated with increased risk of later hospitalization for schizophrenia prior to age 23 in females. This may reflect the prodromal phase of the illness.
Reichenberg
Abraham
A
Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L Levy Place, Box 1230, New York, NY 10029, USA. avi.reichenberg@mssm.edu
Goldenberg
Judy
J
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric; D006801:Humans; D007557:Israel; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000453:epidemiology*; D012650:Self Disclosure; D013223:Statistics as Topic