Minor physical anomalies in schizophrenia: A meta-analysis

Abstract

Numerous studies report an increased frequency of minor physical anomalies (MPAs) in schizophrenic individuals compared with controls. However, these studies vary considerably regarding the magnitude of the case-control disparity and the topographical distribution of the anomalies. A meta-analysis was carried out on the existing MPA literature in an effort to better understand the relationship between MPAs and schizophrenia. Following a literature search, 13 studies were identified that met our inclusion criteria. Mean total MPA scores were available for 11 of these studies, whereas only seven studies provided regional MPA scores. For both the total MPA and regional MPA analyses, pooled effect sizes (Hedges' g and pooled odds ratios, respectively) were calculated along with tests of heterogeneity. For the total MPA analyses, a meta-regression approach was used to explore the relationship between possible moderator variables (e.g., number of MPA scale items) and effect size heterogeneity. The magnitude of the pooled effect size for the total MPA scores was high (1.131; p < 0.001), indicating significantly more overall MPAs in schizophrenic individuals. Significant effect size heterogeneity was present (p < 0.001); however, this heterogeneity could not be explained by any of the included moderator variables. The regional MPA analysis revealed significantly increased MPAs in all six anatomical regions (p < 0.05), although the pooled odds ratios for these regions did not differ significantly from one another. These results suggest a lack of regional specificity for MPAs in schizophrenia.

Biomarker Profile of Minor Physical Anomalies in Schizophrenia Patients

“…It is clear that total MPA score represent a powerful discriminator between schizophrenia patients and normal controls, but further studies are needed to identify more specifi c markers for schizophrenia. 9 MPAs in the cefalo-facial area can occur along with in utero structural changes of the brain that show relation to schizophrenia development. 11,6 According to Trixler et al certain anomalies of the mouth and head have more signifi cant relationship with neurodevelopmental anomalies than the cumulative prevalence of MPAs.…”

“…12 Similarly, Weinberg et al suggest that information of the body areas showing a greater susceptibility to dysmorphic changes in the context of schizophrenia may be a key to the timing of anomalies and their relationship with neurodevelopment. 9 There is a clear developmental logic in the occurrence of these anomalies. In the early prenatal period brain and skull development are so intimately connected that changes in brain morphology could fi nd real expression in cefalo-facial morphogenesis.…”

“…Once formed, minor physical abnormalities persist into adulthood and can be measured reliably upon © 2011 Medical University Plovdiv visual examination of a particular body region. A higher frequency of MPA was established in autism, hyperactivity, epilepsy, mental retardation, impaired motor coordination 7 , attention defi cit disorder, fetal alcohol syndrome, cerebral palsy and schizophrenia 8,9 .…”

Minor physical anomalies in autism: a meta-analysis

“…However, they are of great value to the clinician because they can be utilized as indicators of underlying disease susceptibility or disturbed development (for example, they are found to be more common in individuals with an obvious major embryonic defect). [28][29][30][31] The presence of such MPAs in autism has been suggested to be related to the shared genetic risk of developing autism. 32,33 Although in the psychiatric literature 'MPAs' is generally accepted, many different terms are used to describe them, including dysmorphic features, minor congenital anomalies or minor malformations.…”

“…In a recent meta-analysis, a higher prevalence of MPAs was also established in schizophrenia. 31 Do MPAs seen in autism have a different etiology than those in schizophrenia, or do disorders associated with MPAs share a common etiological basis with schizophrenia and autism? Findings indicating overlapping markers could provide important clues regarding the underlying genetic bases of these disorders.…”