title: Improving risk assessment and familial aggregation of age at onset in schizophrenia using minor physical anomalies and craniofacial measures.
abstract: Age at onset is the most important feature of schizophrenia that could indicate its origin. Minor physical anomalies (MPAs) characterize potential marker indices of disturbances in early neurodevelopment. However, the association between MPAs and age at onset of schizophrenia is still unclear. We aimed to compare risk assessment and familial aggregation in patients with early-onset schizophrenia (EOS) and adult-onset schizophrenia (AOS) with MPAs and craniofacial measures.We estimated the risk assessment of MPAs among patients with EOS (n = 68), patients with AOS (n = 183), nonpsychotic relatives (n = 147), and healthy controls (n = 241) using 3 data-mining algorithms. In addition, we assessed the magnitude of familial aggregation of MPAs with respect to the age at onset of schizophrenia.The performance of EOS was superior to that of AOS, with discrimination accuracies of 89% and 76%, respectively. Combined MPA scores as the risk assessment were significantly higher in all schizophrenia subgroups and the nonpsychotic relatives of EOS patients than in the healthy controls. The recurrence risk ratio for familial aggregation of the MPA scores of EOS families (odds ratio 9.27) was substantially higher than that of AOS families (odds ratio 2.47).The results highlight that EOS improves risk assessment and has a severe magnitude of familial aggregation of MPAs. These findings indicate that EOS might result from a stronger genetic susceptibility to neurodevelopmental deficits.
authors.affiliation: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University Department of Psychiatry, Chimei Medical Center Department of Health, Jianan Mental Hospital Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science Department of Psychiatry, Kaohsiung Veterans General Hospital Tainan Branch Department of Acupressure Technology, Chung Hwa University of Medical Technology Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University Biostatistics Consulting Center, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: I-Ning
authors.initials: IN
authors.lastname: Tsai
authors.forename: Jin-Jia
authors.initials: JJ
authors.lastname: Lin
authors.forename: Ming-Kun
authors.initials: MK
authors.lastname: Lu
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Tan
authors.forename: Fong-Lin
authors.initials: FL
authors.lastname: Jang
authors.forename: Shu-Ting
authors.initials: ST
authors.lastname: Gan
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002508:Cephalometry; D000013:Congenital Abnormalities / Q000235:genetics*; D005260:Female; D005819:Genetic Markers / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005820:Genetic Testing; D006801:Humans; D008297:Male; D065886:Neurodevelopmental Disorders / Q000175:diagnosis / Q000235:genetics; D018570:Risk Assessment; D012559:Schizophrenia / Q000175:diagnosis / Q000235:genetics*; D013624:Taiwan; D055815:Young Adult
chemical_list: D005819:Genetic Markers