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A.E. Bennett Research Award. Prenatal rubella, premorbid abnormalities, and adult schizophrenia
A S Brown1, P Cohen, J Harkavy-Friedman
1Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, New York 10032, USA.
Insights
Prenatal rubella exposure is linked to schizophrenia spectrum disorders (SSD). Rubella-exposed individuals who developed SSD showed greater premorbid neurodevelopmental impairments compared to controls.
Area of Science:
- Neuroscience
- Psychiatry
- Developmental Psychology
Background:
- Schizophrenia spectrum disorders (SSD) are associated with premorbid neurocognitive, neuromotor, and behavioral disturbances.
- Prenatal rubella infection has been previously linked to an increased risk of nonaffective psychosis.
- This study investigates premorbid function in rubella-exposed individuals who developed SSD.
Purpose of the Study:
- To determine if rubella-exposed subjects who develop schizophrenia spectrum disorders (SSD) exhibit greater premorbid functional impairments than rubella-exposed controls.
- To compare IQ decline, neuromotor, and behavioral dysfunction between cases and controls.
- To examine the gestational timing of rubella infection in relation to SSD risk.
Main Methods:
- A birth cohort with clinically and serologically documented prenatal rubella was assessed.
- Subjects underwent comprehensive research assessments and consensus diagnosis.
- Comparisons of IQ decline, premorbid neuromotor, and behavioral dysfunction were made between rubella-exposed SSD cases and controls.
Main Results:
- The rubella-exposed birth cohort showed a significantly increased risk of SSD (20.4%).
- Rubella-exposed SSD cases exhibited IQ decline from childhood to adolescence and increased premorbid neuromotor and behavioral abnormalities compared to controls.
- Early gestational rubella exposure appeared to be a period of heightened vulnerability for SSD.
Conclusions:
- Prenatal rubella exposure is associated with a deviant neurodevelopmental trajectory.
- These findings link early-life viral exposure to later-onset schizophrenia spectrum disorders.
- The study highlights the role of prenatal factors in the etiology of schizophrenia.
Background:
Premorbid neurocognitive, neuromotor, and behavioral function tends to be disturbed in schizophrenia. We previously demonstrated that a birth cohort clinically and serologically documented with prenatal rubella evidenced a marked increase in risk of nonaffective psychosis. In our study, we examined whether rubella-exposed subjects destined to develop schizophrenia and other schizophrenia spectrum disorders (SSD), compared with exposed control subjects, had greater impairment in several premorbid functions.
Methods:
Subjects were interviewed using a direct, comprehensive research assessment and diagnosed by consensus. We compared the degree of IQ decline, as well as premorbid neuromotor and behavioral dysfunction, between rubella-exposed subjects who developed schizophrenia spectrum psychosis (SSP) and exposed control subjects from the cohort. We also compared the gestational timing of rubella infection between the cases and control subjects.
Results:
This rubella-exposed birth cohort evidenced a markedly increased risk of SSD (20.4% or 11/53). Rubella-exposed SSP cases, compared with rubella-exposed control subjects, demonstrated a decline in IQ from childhood to adolescence, and increased premorbid neuromotor and behavioral abnormalities. Moreover, it appears that early gestational rubella exposure may represent a period of increased vulnerability for SSD.
Conclusions:
These findings link a known prenatal exposure, a deviant neurodevelopmental trajectory in childhood and adolescence, and SSP in adulthood within the same individuals.
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