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Obstetric complications and clinical presentation in first episode of psychosis

Norma Verdolini1, Gisela Mezquida2, Isabel Valli3

  • 1Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.

Acta Neuropsychiatrica
|March 2, 2023
PubMed

Insights

Obstetric complications (OCs) are linked to more severe psychotic disorder symptoms, particularly difficulties during delivery. Understanding the timing of OCs is crucial for explaining varied clinical presentations in psychosis.

Area of Science:

  • Psychiatry
  • Neuroscience
  • Genetics

Background:

  • Psychotic disorders have complex origins involving genetic and environmental influences.
  • Obstetric complications (OCs) are recognized environmental risk factors, but their specific impact on psychosis heterogeneity is unclear.

Purpose of the Study:

  • To investigate the relationship between OCs and the clinical phenotypes of individuals experiencing a first episode of psychosis (FEP).
  • To determine if the timing and type of OCs correlate with specific psychopathological features in FEP.

Main Methods:

  • Assessed 277 FEP patients for OCs using the Lewis-Murray scale, categorizing complications by pregnancy, fetal growth, and delivery.
  • Included broader categories: any pregnancy complications and all OCs combined.
  • Evaluated clinical symptoms using the Positive and Negative Syndrome Scale for Schizophrenia.

Main Results:

  • Total OCs and delivery complications were significantly associated with more severe psychopathology in FEP patients.
  • This association remained significant after controlling for age, sex, trauma, antipsychotic dosage, and cannabis use.

Conclusions:

  • Obstetric complications are relevant to the clinical presentation of psychosis.
  • The timing of OCs is essential for understanding the diverse clinical manifestations observed in psychotic disorders.
Abstract

Keywords:
First-episode psychosisdeliveryepiphenomenaobstetric complicationspsychopathology

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