title: Prognosis of schizophrenia spectrum disorder may not be predetermined during early development--the Northern Finland Birth Cohort 1966.
abstract: BACKGROUND
  Little is known about whether factors during the first years of life predict later outcomes in schizophrenia spectrum disorder (SSD). As part of the Northern Finland Birth Cohort 1966, we examined if prospectively collected early parenthood-related and developmental factors predict employment and hospitalization in individuals with and without SSD.
  
  
  METHODS
  Overall, 161 individuals with SSD and 10,116 without SSD were included in the study. Outcomes were analysed at age of 44-45years, defining "employment" as being employed for at least 25% of working days and "hospitalization" as having psychiatric hospitalization at least once during the last two years of follow-up. Maternal age, wantedness of pregnancy, grand multiparity, parental psychoses, birth weight, birth height, age of standing up and standing and walking without support were analysed as predictors.
  
  
  RESULTS
  Of the individuals with SSD, only 11.2% were employed, although 77.6% remained not hospitalized. In individuals with SSD, only young maternal age was associated with lower probability (OR 0.25, CI 0.08-0.77) of being non-hospitalized after controlling for sex and onset age of illness. Among persons without SSD, almost all parenthood-related and developmental factors were related to employment, while grand multiparity and parental psychosis were related to hospitalization after controlling for sex.
  
  
  CONCLUSIONS
  Only one of the early parenthood-related and developmental factors analysed in this study predicted outcome in individuals with SSD, while among those without SSD almost all factors were related to employment. Thus, prognosis of SSD does not seem to be predetermined much by early development.
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, P.O. Box 20, 90029 OYS Oulu, Finland. Electronic address: nina.rautio@oulu.fi.
authors.forename: Nina
authors.initials: N
authors.lastname: Rautio
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. Electronic address: juha.kakela@student.oulu.fi.
authors.forename: Juha
authors.initials: J
authors.lastname: Käkelä
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. Electronic address: tanja.nordstrom@oulu.fi.
authors.forename: Tanja
authors.initials: T
authors.lastname: Nordström
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O. Box 20, 90029 OYS Oulu, Finland. Electronic address: jouko.miettunen@oulu.fi.
authors.forename: Jouko
authors.initials: J
authors.lastname: Miettunen
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, P.O. Box 20, 90029 OYS Oulu, Finland. Electronic address: sirkka.keinanen-kiukaanniemi@oulu.fi.
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. Electronic address: leena.ala-mursula@oulu.fi.
authors.forename: Leena
authors.initials: L
authors.lastname: Ala-Mursula
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. Electronic address: jaro.karppinen@oulu.fi.
authors.forename: Jaro
authors.initials: J
authors.lastname: Karppinen
authors.affiliation: Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O. Box 20, 90029 OYS Oulu, Finland. Electronic address: matti.penttila@oulu.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Penttilä
authors.affiliation: Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. Electronic address: erika.jaaskelainen@oulu.fi.
authors.forename: Erika
authors.initials: E
authors.lastname: Jääskeläinen
mesh_terms: D017668:Age of Onset; D015331:Cohort Studies; D004651:Employment; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D011379:Prognosis; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D018709:Statistics, Nonparametric
keywords: Early predictors; Employment; Hospitalization; Schizophrenia