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

Published online by Cambridge University Press:  30 July 2007

T. Lloyd ,
P. Dazzan ,
K. Dean ,
S. B. G. Park ,
P. Fearon ,
G. A. Doody ,
J. Tarrant ,
K. D. Morgan ,
C. Morgan  and
G. Hutchinson
...Show all authors
T. Lloyd*
Affiliation:
Nottinghamshire Healthcare NHS Trust, Nottingham, UK
P. Dazzan
Affiliation:
Institute of Psychiatry, London, UK
K. Dean
Affiliation:
Institute of Psychiatry, London, UK
S. B. G. Park
Affiliation:
Nottinghamshire Healthcare NHS Trust, Nottingham, UK
P. Fearon
Affiliation:
Institute of Psychiatry, London, UK
G. A. Doody
Affiliation:
Division of Psychiatry, University of Nottingham, Nottingham, UK
J. Tarrant
Affiliation:
Nottinghamshire Healthcare NHS Trust, Nottingham, UK
K. D. Morgan
Affiliation:
Institute of Psychiatry, London, UK
C. Morgan
Affiliation:
Institute of Psychiatry, London, UK
G. Hutchinson
Affiliation:
University of West Indies, Trinidad, Trinidad and Tobago
J. Leff
Affiliation:
Institute of Psychiatry, London, UK
G. Harrison
Affiliation:
Department of Psychiatric Epidemiology, Bristol University, Bristol, UK
R. M. Murray
Affiliation:
Institute of Psychiatry, London, UK
P. B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, UK
*
*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)
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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.

Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 1 , January 2008 , pp. 71 - 77
Copyright
Copyright © Cambridge University Press 2007

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