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Investigating whether adverse prenatal and perinatal events are associated with non-clinical psychotic symptoms at age 12 years in the ALSPAC birth cohort

Published online by Cambridge University Press:  12 February 2009

S. Zammit ,
D. Odd ,
J. Horwood ,
A. Thompson ,
K. Thomas ,
P. Menezes ,
D. Gunnell ,
C. Hollis ,
D. Wolke  and
G. Lewis
...Show all authors
S. Zammit*
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
D. Odd
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
J. Horwood
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
A. Thompson
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
K. Thomas
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
P. Menezes
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
D. Gunnell
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
C. Hollis
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
D. Wolke
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
G. Lewis
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
G. Harrison
Affiliation:
Academic Unit of Psychiatry, University of Bristol, UK
*
*Address for correspondence: Dr S. Zammit, Department of Psychological Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, Wales, UK. (Email: [email protected])
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Abstract

Background

Non-clinical psychosis-like symptoms (PLIKS) occur in about 15% of the population. It is not clear whether adverse events during early development alter the risk of developing PLIKS. We aimed to examine whether maternal infection, diabetes or pre-eclampsia during pregnancy, gestational age, perinatal cardiopulmonary resuscitation or 5-min Apgar score were associated with development of psychotic symptoms during early adolescence.

Method

A longitudinal study of 6356 12-year-old adolescents who completed a semi-structured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Prenatal and perinatal data were obtained from obstetric records and maternal questionnaires completed during pregnancy.

Results

The presence of definite psychotic symptoms was associated with maternal infection during pregnancy [adjusted odds ratio (OR) 1.44, 95% confidence interval (CI) 1.11–1.86, p=0.006], maternal diabetes (adjusted OR 3.43, 95% CI 1.14–10.36, p=0.029), need for resuscitation (adjusted OR 1.50, 95% CI 0.97–2.31, p=0.065) and 5-min Apgar score (adjusted OR per unit decrease 1.30, 95% CI 1.12–1.50, p<0.001). None of these associations were mediated by childhood IQ score. Most associations persisted, but were less strong, when including suspected symptoms as part of the outcome. There was no association between PLIKS and gestational age or pre-eclampsia.

Conclusions

Adverse events during early development may lead to an increased risk of developing PLIKS. Although the status of PLIKS in relation to clinical disorders such as schizophrenia is not clear, the similarity between these results and findings reported for schizophrenia indicates that future studies of PLIKS may help us to understand how psychotic experiences and clinical disorders develop throughout the life-course.

Keywords

Cohort studyobstetric complicationspregnancypsychotic symptoms
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 9 , September 2009 , pp. 1457 - 1467
Copyright
Copyright © 2009 Cambridge University Press

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References

ACOG (2006). ACOG Committee Opinion: the Apgar score. Obstetrics and Gynecology 107, 1209–1212.CrossRefGoogle Scholar
Bowen, E, Heron, J, Waylen, A, Wolke, D (2005). Domestic violence risk during and after pregnancy: findings from a British longitudinal study. British Journal of Obstetrics and Gynaecology 112, 1083–1089.CrossRefGoogle ScholarPubMed
Brown, AS, Begg, MD, Gravenstein, S, Schaefer, CA, Wyatt, RJ, Bresnahan, M, Babulas, VP, Susser, ES (2004). Serologic evidence of prenatal influenza in the etiology of schizophrenia. Archives of General Psychiatry 61, 774–780.Google Scholar
Byrne, M, Agerbo, E, Bennedsen, B, Eaton, WW, Mortensen, PB (2007). Obstetric conditions and risk of first admission with schizophrenia: a Danish national register based study. Schizophrenia Research 97, 51–59.Google Scholar
Callaway, LK, McIntyre, HD, O'Callaghan, M, Williams, GM, Najman, JM, Lawlor, DA (2007). The association of hypertensive disorders of pregnancy with weight gain over the subsequent 21 years: findings from a prospective cohort study. American Journal of Epidemiology 166, 421–428.Google Scholar
Cannon, M, Jones, PB, Murray, RM (2002). Obstetric complications and schizophrenia: historical and meta-analytic review. American Journal of Psychiatry 159, 1080–1092.Google Scholar
Cannon, M, Kendell, R, Susser, E, Jones, P (2003). Prenatal and perinatal risk factors for schizophrenia. In The Epidemiology of Schizophrenia (ed. Murray, R., Jones, P. B., Susser, E., van Os, J. and Cannon, M.), pp. 74–99. Cambridge University Press: Cambridge.Google Scholar
Cox, JL, Holden, JM, Sagovsky, R (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry 150, 782–786.Google Scholar
Eaton, WW, Romanoski, A, Anthony, JC, Nestadt, G (1991). Screening for psychosis in the general population with a self-report interview. Journal of Nervous and Mental Disorders 179, 689–693.CrossRefGoogle ScholarPubMed
Fatemi, SH, Reutiman, TJ, Folsom, TD, Huang, H, Oishi, K, Mori, S, Smee, DF, Pearce, DA, Winter, C, Sohr, R, Juckel, G (2008). Maternal infection leads to abnormal gene regulation and brain atrophy in mouse offspring: implications for genesis of neurodevelopmental disorders. Schizophrenia Research 99, 56–70.CrossRefGoogle ScholarPubMed
Fawke, J (2007). Neurological outcomes following preterm birth. Seminars in Fetal and Neonatal Medicine 12, 374–382.CrossRefGoogle ScholarPubMed
Golding, J, Pembrey, M, Jones, R (2001). ALSPAC – the Avon Longitudinal Study of Parents and Children. I. Study methodology. Paediatric and Perinatal Epidemiology 15, 74–87.Google Scholar
Hanssen, M, Bak, M, Bijl, R, Vollebergh, W, van Os, J (2005). The incidence and outcome of subclinical psychotic experiences in the general population. British Journal of Clinical Psychology 44, 181–191.Google Scholar
Horwood, J, Salvi, G, Thomas, K, Duffy, L, Gunnell, D, Hollis, C, Lewis, G, Menezes, P, Thompson, A, Wolke, D, Zammit, S, Harrison, G (2008). IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort. British Journal of Psychiatry 193, 185–191.Google Scholar
Inder, T, Neil, J, Yoder, B, Rees, S (2004). Non-human primate models of neonatal brain injury. Seminars in Perinatology 28, 396–404.CrossRefGoogle ScholarPubMed
Johns, LC, Cannon, M, Singleton, N, Murray, RM, Farrell, M, Brugha, T, Bebbington, P, Jenkins, R, Meltzer, H (2004). Prevalence and correlates of self-reported psychotic symptoms in the British population. British Journal of Psychiatry 185, 298–305.CrossRefGoogle ScholarPubMed
Kendler, KS, Gallagher, TJ, Abelson, JM, Kessler, RC (1996). Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Archives of General Psychiatry 53, 1022–1031.Google Scholar
Ornoy, A (2005). Growth and neurodevelopmental outcome of children born to mothers with pregestational and gestational diabetes. Pediatric Endocrinology Reviews 3, 104–113.Google ScholarPubMed
Pasamanick, B, Rogers, ME, Lilienfeld, AM (1956). Pregnancy experience and the development of behavior disorders in children. American Journal of Psychiatry 112, 613–618.Google Scholar
Perala, J, Suvisaari, J, Saarni, SI, Kuoppasalmi, K, Isometsa, E, Pirkola, S, Partonen, T, Tuulio-Henriksson, A, Hintikka, J, Kieseppa, T, Harkanen, T, Koskinen, S, Lonnqvist, J (2007). Lifetime prevalence of psychotic and bipolar I disorders in a general population. Archives of General Psychiatry 64, 19–28.Google Scholar
Plewis, I, Calderwoof, L, Hawkes, D, Nathan, G (2004). National Child Development Study and 1970 British Cohort Study Technical Report: changes in the NCDS and BCS70 populations and samples over time. Centre for Longitudinal Studies, Institute of Education: London.Google Scholar
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 1053–1058.CrossRefGoogle ScholarPubMed
Raghunathan, TE, Lepkowski, JM, Van Hoewyk, J, Solenberger, P (2001). A multivariate technique for multiply imputing missing values using a sequence of regression models. Survey Methodology 27, 85–95.Google Scholar
Rossler, W, Riecher-Rossler, A, Angst, J, Murray, R, Gamma, A, Eich, D, van Os, J, Gross, VA (2007). Psychotic experiences in the general population: a twenty-year prospective community study. Schizophrenia Research 92, 1–14.CrossRefGoogle ScholarPubMed
Royston, P (2004). Multiple imputation of missing values. Stata Journal 3, 227–241.Google Scholar
Shaffer, D, Fisher, P, Lucas, CP, Dulcan, MK, Schwab-Stone, ME (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry 39, 28–38.Google Scholar
Sorensen, HJ, Mortensen, EL, Reinisch, JM, Mednick, SA (2004). Association between prenatal exposure to analgesics and risk of schizophrenia. British Journal of Psychiatry 185, 366–371.Google Scholar
Spauwen, J, Krabbendam, L, Lieb, R, Wittchen, HU, van Os, J (2004). Early maternal stress and health behaviours and offspring expression of psychosis in adolescence. Acta Psychiatrica Scandinavica 110, 356–364.Google Scholar
St Clair, D, Xu, M, Wang, P, Yu, Y, Fang, Y, Zhang, F, Zheng, X, Gu, N, Feng, G, Sham, P, He, L (2005). Rates of adult schizophrenia following prenatal exposure to the Chinese famine of 1959–1961. Journal of the American Medical Association 294, 557–562.Google Scholar
Susser, E, Neugebauer, R, Hoek, HW, Brown, AS, Lin, S, Labovitz, D, Gorman, JM (1996). Schizophrenia after prenatal famine. Further evidence. Archives of General Psychiatry 53, 25–31.Google Scholar
Thomas, K, Harrison, G, Zammit, S, Lewis, G, Horwood, J, Heron, J, Hollis, C, Wolke, D, Thompson, A, Gunnell, D (in press). The association of measures of fetal and childhood growth with non-clinical psychotic symptoms in 12 year olds: the ALSPAC cohort. British Journal of Psychiatry.Google Scholar
van Os, J, Hanssen, M, Bijl, RV, Vollebergh, W (2001). Prevalence of psychotic disorder and community level of psychotic symptoms: an urban–rural comparison. Archives of General Psychiatry 58, 663–668.Google Scholar
Wechsler, D (1991). Manual for the Wechsler Intelligence Scale for Children – Third Edition (WISC-III). Psychological Corporation: San Antonio, TX.Google Scholar
WHO (1994). Schedules for Clinical Assessment in Neuropsychiatry. American Psychiatric Research: Washington, DC.Google Scholar
Wiles, NJ, Zammit, S, Bebbington, P, Singleton, N, Meltzer, H, Lewis, G (2006). Self-reported psychotic symptoms in the general population: results from the longitudinal study of the British National Psychiatric Morbidity Survey. British Journal of Psychiatry 188, 519–526.CrossRefGoogle ScholarPubMed