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[Early familial and environmental processes in schizophrenia. Importance of premorbid personality evaluation]
B Chabot1, S Germain-Robin, M Petit
1Groupe de recherche UPRES JE 2014, Centre Hospitalier Universitaire, Caen.
Insights
Schizoid and schizotypal premorbid personality disorders (PPD) in schizophrenia patients were linked to fewer environmental risk factors like obstetric complications. Absence of PPD may indicate a greater role for environmental factors in schizophrenia development.
Area of Science:
- Psychiatry
- Genetics
- Neurodevelopmental Disorders
Context:
- The neurodevelopmental hypothesis suggests prenatal factors influence schizophrenia risk.
- Schizoid and schizotypal personality disorders share genetic links with schizophrenia.
- Investigating premorbid personality disorders (PPD) may differentiate schizophrenia subtypes.
Purpose:
- To assess schizoid and schizotypal PPD in 60 schizophrenia patients.
- To evaluate the influence of familial and environmental factors based on PPD diagnosis.
- To determine if PPD indicates a more genetic schizophrenia subtype.
Summary:
- 41.7% of patients exhibited schizoid or schizotypal PPD.
- Patients with PPD showed fewer obstetric complications and less winter-spring births.
- A significant negative association was found between PPD and environmental factors (obstetric complications, birth season).
Impact:
- Absence of PPD may identify schizophrenia patients with a stronger environmental influence.
- The relationship between genetic factors and PPD is complex.
- Premorbid personality disorders offer insights into the genetic underpinnings of schizophrenia.
Abstract:
According to the neurodevelopmental hypothesis, antenatal aggressions (hypoxia and seasonal viral infections) could increase the risk of schizophrenia in adulthood as shown by an excess of obstetric complications and births in winter--spring in schizophrenic patients. As schizoid and schizotypal personality disorders are genetically linked to schizophrenia, we wanted to verify whether such disorders in the premorbid period in schizophrenic patients could be markers of a more genetic and less environmental sub-type of schizophrenia. Therefore, the aim of this study was to assess schizoid and schizotypal premorbid personality disorders (PPD) in 60 schizophrenic patients, and to assess the weight of familial and environmental factors according to the diagnosis of PPD. 41.7% of patients (25/60) had a schizoid or schizotypal PPD. Compared with patients without PPD, patients with PPD had more often schizophrenia spectrum disorders in first degree relatives (33.3% vs 14.7%, NS), less often obstetric complications (20.8% vs 50.0%, p < 0.05) and were less often born in the first half-year (44.0% vs 68.6%, p = 0.05). So, we showed a non significant positive association between schizoid--schizotypal PPD and family history of schizophrenia spectrum disorders, and a significant negative association between PPD and environmental factors: obstetric complications (OC) and birth in winter-spring. So, the absence of PPD could enable us to identify a sub-group of patients in whom environmental factors play a major role. Moreover, the relations between genetic factors and PPD seem to be complicated. Nevertheless, the notion of PPD could give information about the kind of genetic factors implicated in schizophrenia.