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Although schizotypal traits, such as anhedonia and aberrant perceptions,
may increase the risk for schizophrenia-spectrum disorders, little is
known about early-life characteristics that predict more pronounced
To examine whether birth size or several other early-life factors that
have been previously linked with schizophrenia predict schizotypal traits
Participants of the Northern Finland 1966 Birth Cohort Study
(n = 4976) completed a questionnaire on positive and
negative schizotypal traits at the age of 31 years.
Lower placental weight, lower birth weight and smaller head circumference
at 12 months predicted elevated positive schizotypal traits in women
after adjusting for several confounders (P<0.02).
Moreover, higher gestational age, lower childhood family socioeconomic
status, undesirability of pregnancy, winter/autumn birth, higher birth
order and maternal smoking during pregnancy predicted some augmented
schizotypal traits in women, some in men and some in both genders.
The results point to similarities in the aetiology of schitzotypal traits
and schizophrenia-spectrum disorders.
Recent interest has focused on the association between cannabis use and risk
of psychosis. In the largest unselected population-based study on this topic
to date, we examined cannabis use and prodromal symptoms of psychosis at age
15-16 years among 6330 adolescents. Those who had tried cannabis (n=352;
5.6% of the total sample) were more likely to present three or more
prodromal symptoms even after controlling for confounders including previous
behavioural symptoms (OR=2.23; 95% CI 1.70-2.94). A dose-response effect was
seen. We conclude that cannabis use is associated with prodromal symptoms of
psychosis in adolescence.
There are numerous instruments for screening for depression. A feasible screen is good at both recognising and predicting depression.
To study the ability of the Depression Scale and its items to recognise and predict a depressive episode.
A sample of patients attending primary care was examined in 1991–1992 and again 7 years later. The accuracy of the Depression Scale at baseline and at follow-up was tested against the Short Form of the Composite International Diagnostic Interview (CIDI-SF) diagnosis of depression at follow-up. The sensitivity and specificity of the Depression Scale and its items were assessed.
Both baseline and follow-up Depression Scale scores were consistent with the CIDI–SF diagnoses. It was possible to find single items efficient at both recognising and predicting depression.
The Depression Scale is a useful screening instrument for depression, with both diagnostic and predictive validity.
There is an excess of death from natural causes among people with
Schizophrenia and its treatment with neuroleptics were studied for their
prediction of mortality in a representative population sample of 7217
Finns aged ⩾30 years.
A comprehensive health examination was carried out at baseline.
Schizophrenia was determined using the Present State Examination and
previous medical records.
During a 17-year follow-up, 39 of the 99 people with schizophrenia died.
Adjusted for age and gender, the relative mortality risk between those
with schizophrenia and others was 2.84 (95% CI 2.06–3.90), and was2.25
(95%CI1.61–3.15) after further adjusting for somatic diseases, blood
pressure, cholesterol, body mass index, smoking, exercise, alcohol intake
and education. The number of neuroleptics used at the time of the
baseline survey showed a graded relation to mortality. Adjusted for age,
gender, somatic diseases and other potential risk factors for premature
death, the relative risk was 2.50 (95% CI1.46–4.30) per increment of one
There is an urgent need to ascertain whether the high mortality in
schizophrenia is attributable to the disorder itself or the antipsychotic
The impact of clinically diagnosed mental disorders on mortality in the general population has not been established.
To examine mental disorders for their prediction of cause-specific mortality.
Mental disorders were determined using the 36-item version of the General Health Questionnaire and the Present State Examination in a nationally representative sample of 8000 adult Finns.
During the 17-year follow-up period 1597 deaths occurred. The presence of a mental disorder detected at baseline was associated with an elevated mortality rate. The relative risk in men was 1.6 (95% confidence interval 1.3–1.8) and in women, 1.4 (95% Cl 1.2–1.6). In men and women with schizophrenia the relative risks of death during the follow-up period were 3.3 (95% Cl 2.3–4.9) and 2.3 (95% Cl 1.3–3.8) respectively, compared with the rest of the sample. In both men and women with schizophrenia the risk of dying of respiratory disease was increased, but the risk of dying of cardiovascular disease was increased only in men with neurotic depression.
Schizophrenia and depression are associated with an elevated risk of natural and unnatural deaths.
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