Skip to main content Accessibility help
×
Home

Minor physical anomalies in patients with first-episode psychosis: their frequency and diagnostic specificity

  • T. Lloyd (a1), P. Dazzan (a2), K. Dean (a2), S. B. G. Park (a1), P. Fearon (a2), G. A. Doody (a3), J. Tarrant (a1), K. D. Morgan (a2), C. Morgan (a2), G. Hutchinson (a4), J. Leff (a2), G. Harrison (a5), R. M. Murray (a2) and P. B. Jones (a6)...

Abstract

Background

An increased prevalence of minor physical anomalies (MPAs) has been extensively documented in schizophrenia but their specificity for the disorder remains unclear. We investigated the prevalence and the predictive power of MPAs in a large sample of first-episode psychotic patients across a range of diagnoses.

Method

MPAs were examined in 242 subjects with first-episode psychosis (50% schizophrenia, 45% affective psychosis and 5% substance-induced psychosis) and 158 healthy controls. Categorical principal components analysis and analysis of variance were undertaken, and individual items with the highest loading were tested using the χ2 test.

Results

Overall facial asymmetry, assymetry of the orbital landmarks, and frankfurt horizontal significantly differentiated patients with schizophrenia and affective psychosis from controls, as did a ‘V-shaped’ palate, reduced palatal ridges, abnormality of the left ear surface and the shape of the left and right ears. Patients with affective psychosis had significantly lowered eye fissures compared with control subjects.

Conclusions

MPAs are not specific to schizophrenia, suggesting a common developmental pathway for non-affective and affective psychoses. The topographical distribution of MPAs in this study is suggestive of an insult occurring during organogenesis in the first trimester of pregnancy.

Copyright

Corresponding author

*Address for correspondence: Dr Tuhina Lloyd, M.Medsci, M.R.C.Psych, Division of Psychiatry, Duncan Macmillan House, Porchester Road, Nottingham NG3 6AA, UK. (Email: Tuhina.Lloyd@nottingham.ac.uk)

References

Hide All
Akabaliev, V. H. & Sivkov, S. T. (2003). Sexual dimorphism in minor physical anomalies in schizophrenic patients and normal controls. Comprehensive Psychiatry 44, 341348.
Alexander, R. C., Mukherjee, S., Richter, J. & Kaufmann, C. A. (1994). Minor physical anomalies in schizophrenia. Journal of Nervous and Mental Disorders 182, 639644.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). American Psychiatric Association: Washington, DC.
Bebbington, P. E. & Nayani, T. (1995). The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research 5, 1120.
Dean, K., Dazzan, P., Lloyd, T., Morgan, C., Morgan, K., Doody, G. A., Hutchinson, G., Orr, K., Jones, P. B., Murray, R. M. & Fearon, P. (2006). Minor physical anomalies across ethnic groups in a first-episode psychosis sample. Schizophrenia Research 89, 8690.
Dean, K., Fearon, P., Morgan, K., Hutchinson, G., Orr, K., Chitnis, J., Suckling, J., Mallet, R., Leff, J., Jones, P. B., Murray, R. M. & Dazzan, P. (2006). Grey matter correlates of minor physical anomalies in the AESOP first-episode psychosis study. British Journal of Psychiatry 189, 221228.
Green, M. F., Salz, P. & Christenson, C. D. (1994). Minor physical anomalies in schizophrenia patients, bipolar patients and their siblings. Schizophrenia Bulletin 20, 433440.
Green, M. F., Satz, P., Gaier, D., Ganzell, S. & Kharabi, F. (1989). Minor physical anomalies in schizophrenia. Schizophrenia Bulletin 15, 9199.
Gualtieri, C. T., Adams, A., Shen, C. D. & Loiselle, D. (1982). Minor physical anomalies in alcoholic and schizophrenic adults and hyperactive and autistic children. American Journal of Psychiatry 139, 640643.
Guy, J. D., Majorski, L. V., Wallace, C. J. & Guy, M. P. (1983). The incidence of minor physical anomalies in adult male schizophrenics. Schizophrenia Bulletin 9, 571582.
Jablensky, A., Sartorius, N., Ernberg, G., Anker, M., Korten, A., Cooper, J. E., Day, R. & Bertelsen, A. (1992). Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organisation ten-country study. Psychological Medicine Monograph supplement 20, 197.
Jelovac, P. B., Milicic, J., Rudan, P., Turek, S., Ugrenovic, Z. & Milas, M. (1998). Dermatoglyphic analysis in bipolar affective disorder and schizophrenia: ‘Continuum of Psychosis’ hypothesis corroborated? abstract. American Journal of Medical Genetics 81, 535536.
Kirkbride, J. B., Fearon, P., Morgan, C., Dazzan, P., Morgan, K., Tarrant, J., Lloyd, T., Holloway, J., Hutchinson, G., Leff, J., Mallett, R. M., Harrison, G. L., Murray, R. M. & Jones, P. B. (2006). Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AESOP study. Archives of General Psychiatry 63, 250258.
Lane, A., Kinsella, A., Murphy, P., Byrne, M., Keenan, J., Colgan, K., Cassidy, B., Sheppard, R., Horgan, J. L., Waddington, C., Larkin, C. & O'Callaghan, E. (1997). The anthropometric assessment of dysmorphic features in schizophrenia as an index of its developmental origins. Psychological Medicine 27, 11551164.
Lloyd, T., Doody, G., Brewin, J., Park, B. & Jones, P. (2003). Minor physical anomalies in schizophrenia: is age a confounding factor? Schizophrenia Research 61, 6773.
Lloyd, T., Kennedy, N., Fearon, P., Kirkbride, J., Mallett, R. M., Leff, J., Holloway, J., Harrison, G. L., Dazzan, P., Morgan, K., Murray, R. M. & Jones, P. B. (2005). Incidence of bipolar affective disorder in three UK cities: results from the AESOP study. British Journal of Psychiatry 186, 126131.
Lohr, J. B. & Flynn, K. (1993). Minor physical anomalies in schizophrenia and mood disorders. Schizophrenia Bulletin 19, 551556.
Lohr, J. B., Alder, M., Flynn, K., Harris, M. J. & McAdams, L. (1997). Minor physical anomalies in older patients with late-onset schizophrenia, early-onset schizophrenia, depression and Alzheimer's disease. American Journal of Geriatric Psychiatry 5, 318323.
McGrath, J., El-Saadi, O., Grim, V., Cardy, S., Chapple, B., Chant, D., Lieberman, D. & Mowry, B. (2002). Minor physical anomalies and quantitative measures of the head and face in patients with psychosis. Archives of General Psychiatry 59, 458464.
McGrath, J. J., Van Os, J., Hoyos, C., Jones, P. B., Harvey, I. & Murray, R. M. (1995). Minor physical anomalies in psychoses: associations with clinical and putative aetiological variables. Schizophrenia Research 18, 920.
Michailidis, G. & de Leeuw, J. (1998). The Gifi system of descriptive multivariate analysis. Statistical Science 13, 307336.
Murray, R. M., O'Callahan, E., Castle, D. J. & Lewis, S. W. (1992). A neurodevelopmental approach to the classification of schizophrenia. Schizophrenia Bulletin 18, 319332.
Nelson, H. E. & Willison, J. R. (1991). National Adult Reading Test (part II). Test Manual. NFER-Nelson: Windsor.
O'Callaghan, E., Larkin, C., Kinsella, A. & Waddington, J. L. (1991). Familial, obstetric and other clinical correlates of minor physical anomalies and schizophrenia. American Journal of Psychiatry 148, 479483.
Tarrant, C. J. & Jones, P. B. (1999). Precursors to schizophrenia: do biological markers have specificity? Canadian Journal of Psychiatry 44, 335349.
Torrey, E. F. (1999). Epidemiological comparison of schizophrenia and bipolar disorder. Schizophrenia Research 39, 101106.
Torrey, E. F., Miller, J., Rawlings, R. & Yolken, R. H. (1997). Seasonality of births in schizophrenia and bipolar disorder: a review of the literature. Schizophrenia Research 28, 138.
Torrey, E. F., Rawlings, R. R., Ennis, J. M., Merrill, D. D. & Flores, D. S. (1996). Birth seasonality in bipolar disorder, schizophrenia, schizoaffective disorder and stillbirths. Schizophrenia Research 21, 141149.
Trixler, M., Tenyi, T., Csabi, G. & Szabo, R. (2001). Minor physical anomalies in schizophrenia and bipolar affective disorder. Schizophrenia Research 53, 95201.
Waldrop, M. F., Pederson, F. A. & Bell, R. Q. (1968). Minor physical anomalies and behaviour in preschool children. Child Development 39, 391400.
Waddington, J. L., Lane, A., Larkin, C. & O'Callaghan, E. (1999). The neurodevelopmental basis of schizophrenia: clinical clues from cerebro-craniofacial dysmorphogenesis, and the roots of a lifetime trajectory of disease. Biological Psychiatry 46, 3139.
Waddington, J. L., Youssef, H. A. & Kinsella, A. (1998). Antipsychotic polypharmacy and absence of adjunctive anticholinergics over the course of a 10-year prospective study. British Journal of Psychiatry 173, 325329.
Weinberger, D. R. (1987). Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry 44, 600669.
WHO (1994). Schedules for Clinical Assessment in Neuropsychiatry (SCAN) – Version 2.0. Geneva: World Health Organisation.

Minor physical anomalies in patients with first-episode psychosis: their frequency and diagnostic specificity

  • T. Lloyd (a1), P. Dazzan (a2), K. Dean (a2), S. B. G. Park (a1), P. Fearon (a2), G. A. Doody (a3), J. Tarrant (a1), K. D. Morgan (a2), C. Morgan (a2), G. Hutchinson (a4), J. Leff (a2), G. Harrison (a5), R. M. Murray (a2) and P. B. Jones (a6)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed