Childhood parental loss and schizophrenia: evidence against pathogenic but for some pathoplastic effects

Furukawa, Toshi A; Mizukawa, Rokuro; Hirai, Toshiyuki; Fujihara, Shigeki; Kitamura, Toshinori; Takahashi, Keiichi

doi:10.1016/s0165-1781(98)00113-9

Cited by 29 publications

(24 citation statements)

References 33 publications

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“…Even though both were highly significant, the effect of loss due to parental death was more striking than that of separation, and the effect of separation did not vary by cause of separation. One previous study 30 did not find an association between early separation and loss and psychosis; however, this may be attributable to the low statistical power of that study and the use of a low threshold for separation (1 month). When number of family arrangements was analyzed, our cases were more likely to report 2 or more arrangements, indicating that this variable may also be considered an early marker indexing exposure to risk factors for psychosis.…”

Section: Discussionmentioning

confidence: 60%

Social Disadvantage: Cause or Consequence of Impending Psychosis?

Stilo

Morgan

Flach

et al. 2010

Schizophrenia Research

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Background: An association between social disadvantage and established psychosis is well documented in the literature, but there remains a lack of data on the social circumstances of patients before they became ill. We investigated whether social disadvantage at, and prior to, first contact with psychiatric services, is associated with psychosis. Method: We collected information on social disadvantage in childhood and adulthood from 278 cases presenting with their first episode of psychosis to the South London and Maudsley National Health Service Foundation Trust and from 226 controls recruited from the local population. Three markers of childhood social disadvantage and 3 markers of disadvantage in adulthood were analyzed. Results: Long term separation from, and death of, a parent before the age of 17 years were both strongly associated with a 2-to 3-fold-increased odds of psychosis. Cases were also significantly more likely to report 2 or more markers of adult social disadvantage than healthy controls (OR = 9.03) at the time of the first presentation with psychosis, independent of a number of confounders. When we repeated these analyses for long-standing adult social disadvantage, we found that the strength of the association decreased but still remained significant for 1 year (OR = 5.67) and 5 years (OR = 2.57) prior to the first contact. Conclusions: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood.

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Section: Discussionmentioning

confidence: 60%

Social Disadvantage: Cause or Consequence of Impending Psychosis?

Stilo

Morgan

Flach

et al. 2010

Schizophrenia Research

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“…As an additional sensitivity analysis, we excluded the effect extracted from Furuhawa et al,13 the only eligible study for which a significant negative association between childhood trauma (death of one or both parents) and psychosis was estimated. The exclusion of this study did not alter the pattern of findings for the analyses focusing in the overall association between adversity and psychosis.…”

Section: Resultsmentioning

confidence: 99%

Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies

Varese

Smeets

Drukker

et al. 2012

Schizophrenia Bulletin

1,865

1,303

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Evidence suggests that adverse experiences in childhood are associated with psychosis. To examine the association between childhood adversity and trauma (sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death, and bullying) and psychosis outcome, MEDLINE, EMBASE, PsychINFO, and Web of Science were searched from January 1980 through November 2011. We included prospective cohort studies, large-scale cross-sectional studies investigating the association between childhood adversity and psychotic symptoms or illness, case-control studies comparing the prevalence of adverse events between psychotic patients and controls using dichotomous or continuous measures, and case-control studies comparing the prevalence of psychotic symptoms between exposed and nonexposed subjects using dichotomous or continuous measures of adversity and psychosis. The analysis included 18 case-control studies (n = 2048 psychotic patients and 1856 nonpsychiatric controls), 10 prospective and quasi-prospective studies (n = 41 803) and 8 population-based cross-sectional studies (n = 35 546). There were significant associations between adversity and psychosis across all research designs, with an overall effect of OR = 2.78 (95% CI = 2.34–3.31). The integration of the case-control studies indicated that patients with psychosis were 2.72 times more likely to have been exposed to childhood adversity than controls (95% CI = 1.90–3.88). The association between childhood adversity and psychosis was also significant in population-based cross-sectional studies (OR = 2.99 [95% CI = 2.12–4.20]) as well as in prospective and quasi-prospective studies (OR = 2.75 [95% CI = 2.17–3.47]). The estimated population attributable risk was 33% (16%–47%). These findings indicate that childhood adversity is strongly associated with increased risk for psychosis.

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“…Early case-control studies on parental loss and schizophrenia produced mixed results. 24,26,36,37 The methodological diversity and limitation may explain the varied findings and make it difficult to draw firm conclusion.…”

Section: Discussionmentioning

confidence: 99%

“…15 Childhood parental loss has been studied in relation to some psychiatric diseases, 16–21 especially major depression. 16–18 The studies on schizophrenia have yielded equivocal findings 22–26 and a number of methodological limitations make it difficult to draw firm conclusions. Furthermore, it has not been clarified the extent to which the severity of the stressful life event would play a role (for example, the closeness of the relationship and multiple losses), or if age at exposure modifies the risk of schizophrenia.…”

Section: Introductionmentioning

confidence: 99%