title: Does consanguinity increase the risk of schizophrenia? Study based on primary health care centre visits.
abstract: Background Consanguinity has been suggested as a risk factor for the development of schizophrenia in offspring in some Middle Eastern countries. Aim The purpose of this study was to review the frequency, pattern of parental consanguinity, and family history of schizophrenia among schizophrenia patients in Qatar, and to determine their impact on the associated risk factors. Design This is a cross-sectional study which was conducted between January 2009 and December 2010, in the setting of primary health care (PHC) centres of the Supreme Council of Health, State of Qatar. Subjects A total of 1491 patients aged 18-55 years were approached, of whom 1184 individuals agreed to participate in the study, giving a response rate of 79.4%. Methods The study was based on face-to-face interviews using a specially designed questionnaire that covered sociodemographic characteristics and genetic and other biological factors (e.g. obstetric complications), and a diagnostic screening questionnaire which consisted of six questions about the symptoms of schizophrenia. The diagnostic screening questionnaire was reviewed and used to calculate the final score, which determined a provisional diagnosis. The psychiatrists discussed the psychiatric diagnosis and confirmed it using DSM-IV criteria. The degree of consanguinity between the patient's parents was recorded. Consanguinity was evaluated based on the coefficient of inbreeding (F), which is the probability of homozygosity. Results More than half of the schizophrenia patients were female (57.1%) and over 45 years of age (62.5%). A family history of schizophrenia was significantly more common in parents of schizophrenia patients than in the Arab population without schizophrenia (24.6% vs. 17.1%; P = 0.038). Parental consanguinity was elevated among the patients with schizophrenia (41.3%) with a higher mean coefficient of inbreeding (0.04356 ± 0.028) than in non-schizophrenic subjects (28.7%) with a lower mean coefficient of inbreeding (0.0298 ± 0.035). Schizophrenia diagnoses were more frequent among the offspring of consanguineous parents than among the offspring of non-consanguineous parents. Conclusion The substantial risk observed in the present study reveals that consanguinity is an important risk factor for schizophrenia in Qatar. In addition, the study confirms that the higher familial risks provide strong genetic epidemiological evidence for the overall heritable effects in the aetiology of schizophrenia.
authors.affiliation: Department of Medical Statistics and Epidemiology, Hamad General Hospital, Hamad Medical Corporation, Department of Public Health, Weill Cornell Medical College, Doha, Qatar; and Dept. Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.
authors.forename: Abdulbari
authors.initials: A
authors.lastname: Bener
authors.forename: Elnour E
authors.initials: EE
authors.lastname: Dafeeah
authors.forename: Nancy
authors.initials: N
authors.lastname: Samson
keywords: birth complication; consanguinity; genetic disorders; inbreeding; obstetric complication; schizophrenia