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Zhao D, Zhang X, Xu Z, Cheng J, Xie M, Zhang H, Wang S, Li K, Yang H, Wen L, Wang X, Su H. Impact of short-term temperature variability on emergency hospital admissions for schizophrenia stratified by season of birth. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:589-599. [PMID: 27539022 DOI: 10.1007/s00484-016-1235-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 07/31/2016] [Accepted: 08/08/2016] [Indexed: 06/06/2023]
Abstract
Diurnal temperature range (DTR) and temperature change between neighboring days (TCN) are important meteorological indicators closely associated with global climate change. However, up to date, there have been no studies addressing the impacts of both DTR and TCN on emergency hospital admissions for schizophrenia. We conducted a time-series analysis to assess the relationship between temperature variability and daily schizophrenia onset in Hefei, an inland city in southeast China. Daily meteorological data and emergency hospital admissions for schizophrenia from 2005 to 2014 in Hefei were collected. After stratifying by season of birth, Poisson generalized linear regression combined with distributed lag nonlinear model (DLNM) was used to examine the relationship between temperature variability and schizophrenia, adjusting for long-term trend and seasonality, mean temperature, and relative humidity. Our analysis revealed that extreme temperature variability may increase the risk for schizophrenia onset among patients born in spring, while no such association was found in patients born in summer and autumn. In patients born in spring, the relative risks of extremely high DTR comparing the 95th and 99th percentiles with the reference (50th, 10 °C) at 3-day lag were 1.078 (95 % confidence interval (CI) 1.025-1.135) and 1.159 (95 % CI 1.050-1.279), respectively. For TCN effects, only comparing 99th percentile with reference (50th, 0.7 °C) was significantly associated with emergency hospital admissions for schizophrenia (relative risk (RR) 1.111, 95 % CI 1.002-1.231). This study suggested that exposure to extreme temperature variability in short-term may trigger later days of schizophrenia onset for patients born in spring, which may have important implications for developing intervention strategies to prevent large temperature variability exposure.
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Affiliation(s)
- Desheng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Xulai Zhang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4509, Australia
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Mingyu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Heng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Shusi Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Kesheng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Huihui Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Liying Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Xu Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
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Norman RMG. Are the effects of duration of untreated psychosis socially mediated? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:518-22. [PMID: 25565684 PMCID: PMC4197785 DOI: 10.1177/070674371405901004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 06/01/2014] [Indexed: 11/15/2022]
Abstract
Investigation of possible mechanisms by which longer duration of untreated psychosis (DUP) could influence treatment outcomes has focused primarily on evidence for neurotoxic effects. It is also possible that longer DUP has psychosocial effects, which could mediate its impact on outcomes. The evidence of relevance to such socially toxic effects is reviewed, with particular reference to the possible role of social support. There is no definite evidence for social support as a mediator of the influence of DUP, but further investigation of this issue is warranted.
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Affiliation(s)
- Ross M G Norman
- Professor, Departments of Psychiatry, Psychology, and Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario
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Tsuang MT, Stone WS, Faraone SV. Conceptualization of the liability for schizophrenia: clinical implications. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22034209 PMCID: PMC3181581 DOI: 10.31887/dcns.1999.1.3/mtsuang] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Historically, the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for schizophrenia have emphasized several features, including symptoms of psychosis, a dissociation of symptoms from their etiology, a reliance on clinical symptoms, and a categorical approach to classifying the disorder. Although these emphases are quite useful, they have limitations. We review these here, and stress the importance of incorporating recent data on the genetic /biological and neurodevelopmental origins of schizophrenia into current conceptions of the disorder. We also review “schizotaxia, ” which is a concept thai embodies this point of view, occurs before the onset of psychosis, and is hypothesized to represent the liability for schizophrenia. If our hypothesis on this point is correct, the identification of schizotaxic individuals will eventually facilitate the development of prevention strategies by identifying a premorbid (but clinically significant) condition for schizophrenia. Moreover, the identification of biological or neuropsychological components of schizotaxia will provide more specific bases for developing novel treatment interventions. Our initial attempts to develop protocols for the assessment and treatment of schizotaxia are encouraging, and will be reviewed.
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Affiliation(s)
- M T Tsuang
- Harvard Medical School Department of Psychiatry at the Massachusetts Mental Health Center and Brockton / West Roxbury Veterans Affairs Medical Center and Harvard Institute of Psychiatric Epidemiology and Genetics, USA; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
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Hans SL, Auerbach JG, Auerbach AG, Marcus J. Development from birth to adolescence of children at-risk for schizophrenia. J Child Adolesc Psychopharmacol 2005; 15:384-94. [PMID: 16092905 DOI: 10.1089/cap.2005.15.384] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Offspring of patients with schizophrenia are at-risk for developing schizophrenia in adult life. The aim of this paper is to describe the development from infancy through adolescence of a sample of Israeli young people at-risk for schizophrenia. METHODS The Jerusalem Infant Development Study (JIDS) has followed prospectively from birth through adolescence 15 young people who have a parent with schizophrenia. Neurobehavioral data were gathered at infancy, middle childhood, and adolescence. Mental disorder was assessed at adolescence. RESULTS Data suggest that some children whose parents have schizophrenia are at increased risk for a variety of neuromotor, cognitive, and attentional problems during infancy and childhood, compared to children whose parents had no mental disorder or nonschizophrenia mental disorder. Those high-risk children with neurobehavioral signs are also more likely to have poorer social adjustment, greater social withdrawal, and more symptoms within the schizophrenia spectrum. Case studies are presented of two children with early neurobehavioral impairment who, as adolescents, developed disorders within the schizophrenia spectrum. CONCLUSION Because neurobehavioral impairment may be marking genetic vulnerability to schizophrenia spectrum disorders, clinicians treating children whose parents have schizophrenia need to thoroughly evaluate symptoms of mental disorder--but also neuromotor and neuropsychological functioning.
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Affiliation(s)
- Sydney L Hans
- School of Social Service Administration, University of Chicago, IL 60637, USA.
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Abstract
There is a growing emphasis on attempts to identify the early signs and symptoms of schizophrenia, largely because early detection and treatment of psychosis (i.e., secondary prevention) are associated with relatively favorable clinical outcomes. This raises the issue of whether prevention of psychosis itself is possible. The achievement of this goal will require the identification of a premorbid state that could serve as the foundation for treatment strategies aimed ultimately at the prevention of schizophrenia. Fortunately, evidence for such a state is emerging, in part because schizophrenia may result from a neurodevelopmental disorder that is associated with a variety of clinical, neurobiological, and neuropsychologic features occurring well before the onset of psychosis. These features may serve as both indicators of risk for subsequent deterioration and the foundation of treatment efforts. We reformulated Meehl's term schizotaxia to describe this liability and discuss here how its study could form the basis for future strategies of prevention. We also include a description of our initial attempts to devise treatment protocols for schizotaxia. It is concluded that schizotaxia is a feasible concept on which to base prevention efforts, and that treatment of adult schizotaxia may be among the next steps in the process.
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Affiliation(s)
- M T Tsuang
- Harvard Medical School Department of Psychiatry at Brockton/West Roxbury VA Medical Center and Massachusetts Mental Health Center, Boston, Massachusetts, USA
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Kinney DK, Jacobsen B, Jansson L, Faber B, Tramer SJ, Suozzo M. Winter birth and biological family history in adopted schizophrenics. Schizophr Res 2000; 44:95-103. [PMID: 10913740 DOI: 10.1016/s0920-9964(99)00162-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To investigate relationships between birth season and biological family history in schizophrenia, this study used a sample of schizophrenics that had the advantages of (a) particularly thorough diagnostic assessments of schizophrenics' relatives, including information from direct interviews as well as chart reviews, and (b) schizophrenic probands who were adopted at early age, mitigating the usual confounding of genetic and postnatal environmental influences of the family. Adopted schizophrenics with no biological family history of schizophrenia-spectrum disorders were significantly more likely to be born in winter months than were either (a) their own biological relatives, including their sibs and half-sibs, (b) schizophrenics with a positive family history for schizophrenia-spectrum disorders, or (c) people in the general population. Family-history-positive schizophrenics and their schizophrenic relatives were, in turn, significantly less likely than their own non-schizophrenic biological relatives to be born in the winter; schizophrenics in these families tended to be born in the milder-weather seasons, particularly the spring and fall. Results suggest that environmental factors associated with winter birth may be etiologically important in schizophrenia, particularly for cases in which familial liability factors are weak. By contrast, a familial, probably genetic, liability factor may be especially important in schizophrenics born in mild weather.
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Affiliation(s)
- D K Kinney
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Torrey EF, Miller J, Rawlings R, Yolken RH. Seasonality of births in schizophrenia and bipolar disorder: a review of the literature. Schizophr Res 1997; 28:1-38. [PMID: 9428062 DOI: 10.1016/s0920-9964(97)00092-3] [Citation(s) in RCA: 400] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
More than 250 studies, covering 29 Northern and five Southern Hemisphere countries, have been published on the birth seasonality of individuals who develop schizophrenia and/or bipolar disorder. Despite methodological problems, the studies are remarkably consistent in showing a 5-8% winter-spring excess of births for both schizophrenia and mania/bipolar disorder. This seasonal birth excess is also found in schizoaffective disorder (December-March), major depression (March-May), and autism (March) but not in other psychiatric conditions with the possible exceptions of eating disorders and antisocial personality disorder. The seasonal birth pattern also may shift over time. Attempts to correlate the seasonal birth excess with specific features of schizophrenia suggest that winter-spring births are probably related to urban births and to a negative family history. Possible correlations include lesser severity of illness and neurophysiological measures. There appears to be no correlation with gender, social class, race, measurable pregnancy and birth complications, clinical subtypes, or neurological, neuropsychological, or neuroimaging measures. Virtually no correlation studies have been done for bipolar disorder. Regarding the cause of the birth seasonality, statistical artifact and parental procreational habits are unlikely explanations. Seasonal effects of genes, subtle pregnancy and birth complications, light and internal chemistry, toxins, nutrition, temperature/weather, and infectious agents or a combination of these are all viable possibilities.
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Affiliation(s)
- E F Torrey
- Stanley Foundation Research Programs, NIMH Neuroscience Center, St. Elizabeths Hospital, Washington, DC 20032, USA
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