Time Trends in Schizophrenia: Changes in Obstetric Risk Factors With Industrialization

Abstract

The frequency of schizophrenia may have increased during the early stages of industrialization and may now be declining. Early in the process of development, the illness appeared to be more common among the upper classes and later, more common in the lower classes. As with certain other diseases, the occurrence of schizophrenia may be influenced by the transition from poverty to affluence. Explanations for such a pattern of occurrence include the combined effect of (1) variation in the rate of birth complications owing to cephalopelvic disproportion secondary to changes in nutrition, and (2) increased infant survival following improvements in obstetric and neonatal care. These effects help elucidate the pattern of occurrence of schizophrenia in immigrant groups.

Are obstetrical complications really involved in the etiology and course of schizophrenia and mood disorders?

“…puerperal infections) (Thornton et al, 2010) Future studies should be conducted prospectively in order to collect precise data about mental health of offspring with a history of obstetrical complications and to reduce the risk of developing a psychiatric disorder. As outlined years ago, it could be possible to reduce the risk of schizophrenia in some genetically at-risk individuals by careful prenatal and perinatal monitoring (Warner, 1995).…”

Hippocampal Volume Development in Healthy Siblings of Childhood-Onset Schizophrenia Patients

“…For example, Suvisaari et al (82) found that a decline in bacterial illnesses and initiation of immunization programs may have led to a decline in the incidence of schizophrenia in Finland since the 1950s. In addition, prenatal and perinatal monitoring may also decrease the risk of schizophrenia in some genetically at-risk individuals (83). As hippocampal pathology likely begins and progresses in early brain development, measures to attenuate or reverse volume loss should be initiated early.…”

Schizophrenia and Migration: A Meta-Analysis and Review

“…There is some preliminary evidence that greater paternal age contributes to the etiology of schizophrenia (63), and this factor could be further explored in migrants. More speculatively, it has been proposed that cephalopelvic disproportion arising from improved nutritional standards could lead to an elevated incidence of schizophrenia among second-generation migrants (64). Two studies have investigated history of obstetric complications in African Caribbean versus white British-born patients (65,66).…”