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Neeser NB, Martani A, De Clercq E, De Geyter C, Vulliemoz N, Elger BS, Wangmo T. Building a family at advanced parental age: a systematic review on the risks and opportunities for parents and their offspring. Hum Reprod Open 2023; 2023:hoad042. [PMID: 38045093 PMCID: PMC10692762 DOI: 10.1093/hropen/hoad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
STUDY QUESTION What is the existing empirical literature on the psychosocial health and wellbeing of the parents and offspring born at an advanced parental age (APA), defined as 40 years onwards? SUMMARY ANSWER Although the studies show discrepancies in defining who is an APA parent and an imbalance in the empirical evidence for offspring, mothers, and fathers, there is a drive towards finding psychotic disorders and (neuro-)developmental disorders among the offspring; overall, the observed advantages and disadvantages are difficult to compare. WHAT IS KNOWN ALREADY In many societies, children are born to parents at advanced ages and there is rising attention in the literature towards the consequences of this trend. STUDY DESIGN SIZE DURATION The systematic search was conducted in six electronic databases (PubMed including Medline, Embase, Scopus, PsycInfo, CINAHL, and SocINDEX) and was limited to papers published between 2000 and 2021 and to English-language articles. Search terms used across all six electronic databases were: ('advanced parental age' OR 'advanced maternal age' OR 'advanced paternal age' OR 'advanced reproductive age' OR 'late parent*' OR 'late motherhood' OR 'late fatherhood') AND ('IVF' OR 'in vitro fertilization' OR 'in-vitro-fertilization' OR 'fertilization in vitro' OR 'ICSI' OR 'intracytoplasmic sperm injection' OR 'reproductive techn*' OR 'assisted reproductive technolog*' OR 'assisted reproduction' OR 'assisted conception' OR 'reproduction' OR 'conception' OR 'birth*' OR 'pregnan*') AND ('wellbeing' OR 'well-being' OR 'psycho-social' OR 'social' OR 'ethical' OR 'right to reproduce' OR 'justice' OR 'family functioning' OR 'parental competenc*' OR 'ageism' OR 'reproductive autonomy' OR 'outcome' OR 'risk*' OR 'benefit*'). PARTICIPANTS/MATERIALS SETTING METHODS The included papers were empirical studies in English published between 2000 and 2021, where the study either examined the wellbeing and psychosocial health of parents and/or their children, or focused on parental competences of APA parents or on the functioning of families with APA parents. A quality assessment of the identified studies was performed with the QATSDD tool. Additionally, 20% of studies were double-checked at the data extraction and quality assessment stage to avoid bias. The variables sought were: the geographical location, the year of publication, the methodological approach, the definitions of APA used, what study group was at the centre of the research, what research topic was studied, and what advantages and disadvantages of APA were found. MAIN RESULTS AND THE ROLE OF CHANCE A total number of 5403 articles were identified, leading to 2543 articles being included for title and abstract screening after removal of duplicates. This resulted in 98 articles included for a full-text reading by four researchers. Ultimately, 69 studies were included in the final sample. The key results concerned four aspects relevant to the research goals. (i) The studies showed discrepancies in defining who is an APA parent. (ii) There was an imbalance in the empirical evidence produced for different participant groups (mothers, fathers, and offspring), with offspring being the most studied study subjects. (iii) The research topics studied underlined the increased risks of neuro-developmental and psychotic disorders among offspring. (iv) The observed advantages and disadvantages were varied and could not be compared, especially for the offspring of APA parents. LIMITATIONS REASONS FOR CAUTION Only English-language studies, published between 2000 and 2021, found in the above-mentioned databases were considered for this review. WIDER IMPLICATIONS OF THE FINDINGS More research is necessary to understand the risks and benefits of building a family at an APA for the offspring when they reach adulthood. Furthermore, studies that explore the perspective of older fathers and older parents from non-Western societies would be highly informative. STUDY FUNDING/COMPETING INTERESTS The writing of this manuscript was permitted by financial support provided by the Swiss National Science Foundation (Weave/Lead Agency funding program, grant number 10001AL_197415/1, project title 'Family Building at Advanced Parental Age: An Interdisciplinary Approach'). The funder had no role in the drafting of this manuscript and the views expressed therein are those of the authors. The authors have no conflicts of interest. REGISTRATION NUMBER This systematic review is registered in Prospero: CRD42022304564.
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Affiliation(s)
- Nathalie B Neeser
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Andrea Martani
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Christian De Geyter
- Reproductive Medicine and Gynaecological Endocrinology (RME), University Hospital, University of Basel, Basel, Switzerland
| | - Nicolas Vulliemoz
- Centre de Procréation Médicalement Assistée (CPMA), Lausanne, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Fountoulakis KN, Panagiotidis P, Tegos T, Kimiskidis V, Nimatoudis I. Paternal age and specific neurological soft signs as reliable and valid neurobiological markers for the diagnosis of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:1087-1096. [PMID: 34842982 DOI: 10.1007/s00406-021-01357-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022]
Abstract
Advanced parental age at delivery and neurological soft signs (NSS) constitute risk factors for schizophrenia. The aim of the current study was to develop a neurobiological diagnostic index by combining them, and without the contribution of clinical symptomatology. The study sample included 133 patients suffering from schizophrenia according to DSM-IV-TR (77 males and 56 females; aged 33.55 ± 11.22 years old) and 122 normal controls (66 males and 56 females; aged 32.89 ± 9.91 years old). The assessment included the Neurological Evaluation Scale (NES), and a number of scales assessing the clinical symptoms and adverse effects. The statistical analysis included exploratory t-test, Pearson Correlation coefficient (R) and Discriminant Function Analysis (DFA). Exploratory t-tests and Pearson's R suggested that sex, parental age and NSS constitute independent components. On the basis of DFA results, the Psychotic Neurological Index was developed. At the cut-off PNI score of 8.5, sensitivity was equal to 94.74 and specificity to 93.44. The current is probably the first study to report on an easily obtainable diagnostic neurobiological marker with identifiable properties which is absolutely independent from the clinical manifestations and could serve in distinguishing between patients with schizophrenia and healthy controls with high efficacy.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Panagiotis Panagiotidis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Tegos
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Kimiskidis
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Couture V, Delisle S, Mercier A, Pennings G. The other face of advanced paternal age: a scoping review of its terminological, social, public health, psychological, ethical and regulatory aspects. Hum Reprod Update 2020; 27:305-323. [PMID: 33201989 DOI: 10.1093/humupd/dmaa046] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a global tendency for parents to conceive children later in life. The maternal dimension of the postponement transition has been thoroughly studied, but interest in the paternal side is more recent. For the moment, most literature reviews on the topic have focused on the consequences of advanced paternal age (APA) on fertility, pregnancy and the health of the child. OBJECTIVE AND RATIONALE The present review seeks to move the focus away from the biological and medical dimensions of APA and synthesise the knowledge of the other face of APA. SEARCH METHODS We used the scoping review methodology. Searches of interdisciplinary articles databases were performed with keywords pertaining to APA and its dimensions outside of biology and medicine. We included scientific articles, original research, essays, commentaries and editorials in the sample. The final sample of 177 documents was analysed with qualitative thematic analysis. OUTCOMES We identified six themes highlighting the interdisciplinary nature of APA research. The 'terminological aspects' highlight the lack of consensus on the definition of APA and the strategies developed to offer alternatives. The 'social aspects' focus on the postponement transition towards reproducing later in life and its cultural dimensions. The 'public health aspects' refer to attempts to analyse APA as a problem with wider health and economic implications. The 'psychological aspects' focus on the consequences of APA and older fatherhood on psychological characteristics of the child. The 'ethical aspects' reflect on issues of APA emerging at the intersection of parental autonomy, children's welfare and social responsibility. The 'regulatory aspects' group different suggestions to collectively approach the implications of APA. Our results show that the field of APA is still in the making and that evidence is lacking to fully address the issues of APA. The review suggests promising avenues of research such as introducing the voice of fathers of advanced age into the research agenda. WIDER IMPLICATIONS The results of this review will be useful for developing policies and preconception health interventions that consider and include prospective fathers of advanced age.
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Affiliation(s)
- Vincent Couture
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada.,Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Stéphane Delisle
- Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Alexis Mercier
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada
| | - Guido Pennings
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Gent 9000, Belgium
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Fountoulakis KN, Gonda X, Siamouli M, Panagiotidis P, Moutou K, Nimatoudis I, Kasper S. A case-control study of paternal and maternal age as risk factors in mood disorders. Int J Psychiatry Clin Pract 2019; 23:90-98. [PMID: 30880518 DOI: 10.1080/13651501.2018.1519079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Advanced parental age might constitute a risk factor for various disorders. We tested whether this concerns also mood disorder patients. Methods: The study included 314 subjects (42 bipolar-BD patients; 21 manics and 21 depressives, 68 unipolar-UD, and 204 normal controls-NC). Analysis of Covariance (ANCOVA) and the calculation of the Relative Risk (RR) and the Odds Ratio (OR) were used for the analysis. Results: Paternal age differed between NC and UD patients (29.42 ± 6.07 vs. 32.12 ± 5.54; p = .01) and manics (29.42 ± 6.07 vs. 35.00 ± 5.75; p = .001) and maternal age between NC and manics (25.46 ± 4.52 vs. 31.43 ± 4.75; p < .001) and manic and UD (31.43 ± 4.75 vs. 26.75 ± 6.03; p = .002). The RR and OR values suggested that advanced parental age constitutes a risk factor for the development of mood disorders. Conclusions: In a non-dose dependent and gender-independent, advanced parental age constitutes a risk factor for the development of BD with index episode of mania (probably manic predominant polarity); only advanced paternal age constitutes a risk factor for the development of UD and BD with index episode of depression (probably depressive predominant polarity). This is the first study suggesting differential effect of advanced parental age depending on predominant polarity of BD.
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Affiliation(s)
- Konstantinos N Fountoulakis
- a 3rd Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Xenia Gonda
- b Department of Psychiatry and Psychotherapy , Semmelweis University , Budapest , Hungary
| | - Melina Siamouli
- a 3rd Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Panagiotis Panagiotidis
- a 3rd Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Ioannis Nimatoudis
- a 3rd Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Siegfried Kasper
- d Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien , Vienna , Austria
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Fountoulakis KN, Gonda X, Siamouli M, Panagiotidis P, Moutou K, Nimatoudis I, Kasper S. Paternal and maternal age as risk factors for schizophrenia: a case-control study. Int J Psychiatry Clin Pract 2018; 22:170-176. [PMID: 29069946 DOI: 10.1080/13651501.2017.1391292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Advanced parental age might constitute a generic risk factor for mental and somatic disorders. The current study tested whether this concerns also patients with schizophrenia. METHODS A total of 231 schizophrenic, 56 other severe mental disorders patients and 204 controls were diagnosed according to DSM-IV-TR. Data were tested with ANOVA models including relative risk and odds ratios. RESULTS Patients with schizophrenia manifested higher paternal (32.55 ± 6.35 vs. 29.42 ± 6.07, p < .001) and maternal age (27.66 ± 5.57 vs. 25.46 ± 4.52, p < .001). Patients with other mental disorders had higher paternal (33.29 ± 8.35; p = .001) but not maternal age (26.69 ± 5.89; p = .296) compared to controls. There was no difference between the two patient groups concerning either paternal or maternal age (p > .05). There seems to be a higher risk for the development of schizophrenia in offspring with paternal age above 25 years and maternal age above 22 years at delivery. CONCLUSIONS The current study provides further support for the suggestion that advanced paternal age constitutes a risk factor (in a non-dose dependent and gender-independent way) for the development of schizophrenia but also for other mental disorders. In contrast, advanced maternal age characterises schizophrenia specifically. The higher risk is evident after 25 years of paternal and 22 years of maternal age, respectively.
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Affiliation(s)
- Konstantinos N Fountoulakis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Xenia Gonda
- b Department of Psychiatry and Psychotherapy , Semmelweis University , Budapest , Hungary.,c MTA-SE Neuropsychopharmacology and Neurochemistry Research Group , Hungarian Academy of Sciences, Semmelweis University , Budapest , Hungary
| | - Melina Siamouli
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Panagiotis Panagiotidis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Ioannis Nimatoudis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Siegfried Kasper
- e Universitätsklinik für Psychiatrie und Psychotherapie , Medizinische Universität , Vienna , Austria
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Butjosa A, Gómez-Benito J, Huerta-Ramos E, Del Cacho N, Barajas A, Baños I, Usall J, Dolz M, Sánchez B, Carlson J, Maria Haro J, Ochoa S. Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis. Psychiatry Res 2016; 245:108-115. [PMID: 27541345 DOI: 10.1016/j.psychres.2016.08.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023]
Abstract
This study presents a quantitative analysis of the incidence of stressful life events (SLEs) and the variables gender, age at onset, family history and psychotic symptoms in patients with first-episode psychosis (FEP). A descriptive, cross-sectional methodology was used to interview 68 patients with FEP between 13 and 47 years of age. The Psychiatric Epidemiology Research Interview Life Events Scale collected one-year period prior to onset of FEP - used to analyse the subcategories academic, work, love and marriage, children, residence, legal affairs, finances and social activities-, Positive and Negative Syndrome Scale, and Clinical Global Impression-Schizophrenia scale were used to assess the relevance of certain SLEs during adolescence. Age at onset showed a significant negative correlation with the categories academic and social activities. By contrast, it showed a positive correlation with work and children. A significant relationship was found between paternal family history and social activities and between maternal family history and academic and love and marriage. Finally, an inverse relationship was observed between negative symptoms and the categories children and finance. Depressive symptoms were significantly correlated with the category academic. Our results show the importance of SLEs during adolescence and suggest that there is a clear need to develop preventive actions that promote effective strategies for dealing with the accumulation of psychosocial stress.
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Affiliation(s)
- Anna Butjosa
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Sant Joan de Déu Research Foundation, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain; Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Barcelona, Spain.
| | - Juana Gómez-Benito
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Barcelona, Spain; Institute for Brain, Cognition, and Behaviour (IR3C), University of Barcelona, Spain
| | - Elena Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Sant Joan de Déu Research Foundation, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain
| | - Núria Del Cacho
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Sant Joan de Déu Research Foundation, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain
| | - Ana Barajas
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Sant Joan de Déu Research Foundation, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain; Hospital Sant Joan de Déu, Acute Unit, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain; Centro de Higiene Mental de Les Corts Research Unit, Barcelona, Spain
| | - Iris Baños
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Sant Joan de Déu Research Foundation, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Montserrat Dolz
- Hospital Sant Joan de Déu, Acute Unit, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu, Acute Unit, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain
| | - Janina Carlson
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Sant Joan de Déu Research Foundation, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain; Hospital Sant Joan de Déu, Acute Unit, CIBERSAM, Esplugues de Llobregat, Barcelona, Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | | | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
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Lehrer DS, Pato MT, Nahhas RW, Miller BR, Malaspina D, Buckley PF, Sobell JL, Walsh-Messinger J, Genomic Psychiatry Cohort Consortium, Pato CN. Paternal age effect: Replication in schizophrenia with intriguing dissociation between bipolar with and without psychosis. Am J Med Genet B Neuropsychiatr Genet 2016; 171:495-505. [PMID: 26183902 DOI: 10.1002/ajmg.b.32334] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/02/2015] [Indexed: 01/27/2023]
Abstract
Advanced paternal age (APA) is a risk factor for schizophrenia (Sz) and bipolar disorder (BP). Putative mechanisms include heritable genetic factors, de novo mutations, and epigenetic mechanisms. Few studies have explored phenotypic features associated with APA. The Genomic Psychiatry Cohort established a clinically characterized repository of genomic samples from subjects with a Sz-BP diagnosis or unaffected controls, 12,975 with parental age information. We estimated relative risk ratios for Sz, schizoaffective depressed and bipolar types (SA-D, SA-B), and BP with and without history of psychotic features (PF) relative to the control group, comparing each paternal age group to the reference group 20-24 years. All tests were two-sided with adjustment for multiple comparisons. Subjects with fathers age 45+ had significantly higher risk for all diagnoses except for BP w/o PF. APA also bore no significant relation to family psychiatric history. In conclusion, we replicated APA as a risk factor for Sz. To our knowledge, this is the first published report of APA in a BP sample stratified by psychosis history, extending this association only in BP w/PF. This suggests that phenotypic expression of the APA effect in Sz-BP spectrum is psychosis, per se, rather than other aspects of these complex disorders. The lack of a significant relationship between paternal age and familial disease patterns suggests that underlying mechanisms of the paternal age effect may involve a complex interaction of heritable and non-heritable factors. The authors discuss implications and testable hypotheses, starting with a focus on genetic mechanisms and endophenotypic expressions of dopaminergic function. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas S Lehrer
- Department of Psychiatry, Wright State University, Dayton, Ohio.,Summit Behavioral Healthcare, Ohio Department of Mental Health & Addiction Services, Cincinnati, Ohio
| | - Michele T Pato
- College of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York.,Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California
| | - Ramzi W Nahhas
- Department of Psychiatry, Wright State University, Dayton, Ohio.,Department of Community Health, Wright State University, Dayton, Ohio
| | - Brian R Miller
- Department of Psychiatry, Georgia Medical College at Georgia Regents University, Augusta, Georgia
| | | | - Peter F Buckley
- Department of Psychiatry, Georgia Medical College at Georgia Regents University, Augusta, Georgia.,Office of the Dean, Georgia Medical College at Georgia Regents University, Augusta, Georgia
| | - Janet L Sobell
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California
| | - Julie Walsh-Messinger
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Carlos N Pato
- College of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York.,Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California
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Ek M, Wicks S, Svensson AC, Idring S, Dalman C. Advancing paternal age and schizophrenia: the impact of delayed fatherhood. Schizophr Bull 2015; 41:708-14. [PMID: 25378438 PMCID: PMC4393690 DOI: 10.1093/schbul/sbu154] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE It is well known that advancing paternal age is associated with an increased risk of schizophrenia in offspring, but the mechanism behind this association remains unknown. This study investigates if delayed fatherhood rather than advancing paternal age per se might explain the increased risk of schizophrenia in offspring associated with advancing paternal age. METHODS This is a register-based study of the Swedish population looking at people born 1955-1985 who have 1 or 2 siblings (n = 2 589 502). The main analysis investigated whether the association between advancing paternal age and schizophrenia was explained by delayed fatherhood. Possible confounding factors were taken into account. Cox regression was used throughout. RESULTS In the main analysis the association between advancing paternal age and increased risk of schizophrenia in offspring disappeared after controlling for delayed fatherhood (hazard ratio [HR] = 0.93, 95% CI = 0.72-1.21 comparing 45+ years old fathers to those 25-29), whereas delayed fatherhood showed an association with increased risk of schizophrenia in offspring comparing 35-39 and 40-44 years old fathers to 25-29 year olds (HR = 1.37, 95% CI = 1.18-1.58; HR = 1.81, 95% CI = 1.44-2.28, respectively). The results remained when controlling for possible confounders. CONCLUSIONS This study suggests that the association between paternal age and schizophrenia is not due to paternal age per se, but rather to an unknown factor associated with both delayed fatherhood and schizophrenia.
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Affiliation(s)
- Mats Ek
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Swerdlow NR, Gur RE, Braff DL. Consortium on the Genetics of Schizophrenia (COGS) assessment of endophenotypes for schizophrenia: an introduction to this Special Issue of Schizophrenia Research. Schizophr Res 2015; 163:9-16. [PMID: 25454799 PMCID: PMC4382419 DOI: 10.1016/j.schres.2014.09.047] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 09/26/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND The COGS is a multi-site NIMH-sponsored investigation of the genetic basis of 12 primary and multiple secondary quantitative endophenotypes in schizophrenia. METHODS Since 2003, COGS has completed studies using a family-based ascertainment strategy (COGS-1), and a case-control ascertainment strategy (COGS-2) (cumulative "n">4000). RESULTS COGS-1 family study confirmed robust deficits in, and heritability of, these endophenotypes in schizophrenia, and provided evidence for a coherent genetic architecture underlying the risk for neurocognitive and neurophysiological deficits in this disorder. COGS-2 case-control findings, many reported herein, establish a foundation for fine genomic mapping and other analyses of these endophenotypes and risk genes for SZ. Several reports in this Special Issue compare findings of endophenotype deficits generated by fundamentally different COGS-1 vs. COGS-2 ascertainment strategies. Despite the expectation that family-based and case-control designs would establish demographically and potentially biologically distinct patient cohorts, findings generally revealed comparable patterns of endophenotype deficits across studies. The COGS-2 case-control design facilitated the accrual of a larger "n", permitting detailed analyses of factors moderating endophenotype performance. Some COGS-2 endophenotypes not assessed in COGS-1 are also reported, as is a new factor analytic strategy for identifying shared vs. unique factors among the COGS endophenotypes which can be used to develop composite variables with distinct genetic signatures. DISCUSSION The path to date of COGS-1 endophenotype and genetic findings, followed by replication and extension in COGS-2, establishes benchmarks for endophenotype deficits in SZ and their moderation by specific factors, and clear expectations for informative findings from upcoming COGS-2 genetic analyses.
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Affiliation(s)
- Neal R. Swerdlow
- Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0804, USA, Corresponding author. Tel.: +1 619 543 6270; fax: +1 619 543 2493. (N.R. Swerdlow)
| | - Raquel E. Gur
- Departments of Psychiatry, Neurology & Radiology, Perelman School of Medicine, University of Pennsylvania, 10th Floor Gates Building, Philadelphia, PA 19104, USA
| | - David L. Braff
- Department of Psychiatry, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0804, USA
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Schmeidler J, Lazzeroni LC, Swerdlow NR, Ferreira RP, Braff DL, Calkins ME, Cadenhead KS, Freedman R, Green MF, Greenwood TA, Gur RE, Gur RC, Light GA, Olincy A, Nuechterlein KH, Radant AD, Seidman LJ, Siever LJ, Stone WS, Sprock J, Sugar CA, Tsuang DW, Tsuang MT, Turetsky BI, Silverman JM. Paternal age of schizophrenia probands and endophenotypic differences from unaffected siblings. Psychiatry Res 2014; 219:67-71. [PMID: 24913833 PMCID: PMC4110721 DOI: 10.1016/j.psychres.2014.05.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 02/07/2014] [Accepted: 05/18/2014] [Indexed: 01/06/2023]
Abstract
We evaluated the discrepancy of endophenotypic performance between probands with schizophrenia and unaffected siblings by paternal age at proband birth, a possible marker for de novo mutations. Pairs of schizophrenia probands and unaffected siblings (N=220 pairs) were evaluated on 11 neuropsychological or neurophysiological endophenotypes previously identified as heritable. For each endophenotype, the sibling-minus-proband differences were transformed to standardized scores. Then for each pair, the average discrepancy was calculated from its standardized scores. We tested the hypothesis that the discrepancy is associated with paternal age, controlling for the number of endophenotypes shared between proband and his or her sibling, and proband age, which were both associated with paternal age. The non-significant association between the discrepancy and paternal age was in the opposite direction from the hypothesis. Of the 11 endophenotypes only sensori-motor dexterity was significant, but in the opposite direction. Eight other endophenotypes were also in the opposite direction, but not significant. The results did not support the hypothesized association of increased differences between sibling/proband pairs with greater paternal age. A possible explanation is that the identification of heritable endophenotypes was based on samples for which schizophrenia was attributable to inherited rather than de novo/non-inherited causes.
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Affiliation(s)
- James Schmeidler
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, One Gustave L. Levy Place, Box 1230, New York, NY, USA
| | - Laura C Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Rui P Ferreira
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, One Gustave L. Levy Place, Box 1230, New York, NY, USA
| | - David L Braff
- Department of Psychiatry, University of California, San Diego, CA, USA; VISN-22 Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Robert Freedman
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver, CO, USA
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at University of California, Los Angeles, CA, USA; VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | | | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA; VISN-22 Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver, CO, USA
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Allen D Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Larry J Seidman
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School Department of Psychiatry, Boston, MA, USA
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, One Gustave L. Levy Place, Box 1230, New York, NY, USA; VISN-3 Mental Illness Research, Education, and Clinical Center, James J. Peters VA Medical Center, New York, NY, USA
| | - William S Stone
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Harvard Medical School Department of Psychiatry, Boston, MA, USA
| | - Joyce Sprock
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at University of California, Los Angeles, CA, USA; VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Debby W Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA; VISN-20 Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Bruce I Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy M Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, One Gustave L. Levy Place, Box 1230, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA.
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