Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T05:27:04.845Z Has data issue: false hasContentIssue false
  • English
  • Français

The Brain Damage Hypothesis of the Seasonality of Births in Schizophrenia and Major Affective Disorders: Evidence from Computerised Tomography

Published online by Cambridge University Press:  02 January 2018

Emilio Sacchetti ,
Alessandro Calzeroni ,
Antonio Vita ,
Andrea Terzi ,
Franco Pollastro  and
Carlo Lorenzo Cazzullo
Emilio Sacchetti*
Affiliation:
Chief University Service of Psychiatry, Ospedale San Paolo, Milan
Alessandro Calzeroni
Affiliation:
University Service of Psychiatry, Ospedale San Paolo, Milan
Antonio Vita
Affiliation:
Institute of Psychiatry, Milan University School of Medicine
Andrea Terzi
Affiliation:
University Service of Psychiatry, Ospedale San Paolo, Milan
Franco Pollastro
Affiliation:
University Service of Psychiatry, Ospedale San Paolo, Milan
Carlo Lorenzo Cazzullo
Affiliation:
Institute of Psychiatry, Milan University School of Medicine
*
∗Professor E. Sacchetti, Chair of Psychosomatics, University Service of Psychiatry, Ospedale San Paolo, Via A. Di Rudini', 8-20142 Milano, Italy
Get access Rights & Permissions [Opens in a new window]

Abstract

Although the excess of schizophrenic births in the winter and early spring has been replicated and some non-conclusive work supports the same seasonal birth trend in patients with major affective disorders, the aetiopathogenetic foundations of this phenomenon remain uncertain. The primary role of perinatal seasonal factors that predispose to the development of schizophrenia via induction of brain damage has been invoked, as has a tendency for patients to conceive during the spring and early summer. In order to test these two hypotheses, cerebral ventricular size and cortical atrophy in 206 schizophrenics and 107 patients with major affective disorders were assessed by CT and analysed in relation to month of birth. Compared with schizophrenics born during the remainder of the year, those born between December and April, particularly in cases lacking a family history of schizophrenia, showed increased chances for ventricular enlargement, but not for cortical atrophy. No association between season of birth and central or cortical atrophy was found for patients with major affective disorders. This suggests that the brain-damaging effect played by perinatal seasonal factors has both a disease and an anatomical specificity.

Type
Papers
Information
The British Journal of Psychiatry , Volume 160 , Issue 3 , March 1992 , pp. 390 - 397
Copyright
Copyright © Royal College of Psychiatrists, 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Baron, M. & Gruen, R. (1988) Risk factors in schizophrenia: season of birth and family history. British Journal of Psychiatry, 152, 460–465.Google Scholar
Barry, H. & Barry, H. (1961) Season of birth: an epidemiological study. Archives of General Psychiatry, 5, 292–300.CrossRefGoogle ScholarPubMed
Benes, F., Sunderland, P., Jones, B. D., et al (1982) Normal ventricles in young schizophrenics. British Journal of Psychiatry, 141, 90–93.Google Scholar
Boronow, J., Pickar, D., Ninan, P. T., et al (1985) Atrophy limited to the third ventricle in chronic schizophrenic patients. Archives of General Psychiatry, 42, 266–271.Google Scholar
Boyd, J. H., Pulver, A. E. & Stewart, W. (1986) Season of birth: schizophrenia and bipolar disorder. Schizophrenia Bulletin, 12, 173–186.Google Scholar
Bradbury, T. N. & Miller, G. A. (1985) Season of birth in schizophrenia: a review of evidence, methodology and etiology. Psychological Bulletin, 98, 569–594.Google Scholar
Buck, C. & Simpson, H. (1978) Season of birth among the sibs of schizophrenics. British Journal of Psychiatry, 132, 358–380.CrossRefGoogle Scholar
Cazzullo, C. L., Sacchetti, E., Vita, A., et al (1986) Cerebral ventricular size in schizophrenic spectrum disorders: relationship to clinical, neuropsychological and immunogenetic variables. In Biological Psychiatry 1985 (eds Shagass, C. et al), pp. 1060–1062. Amsterdam: Elsevier Science.Google Scholar
Cazzullo, C. L., Vita, A. & Sacchetti, E. (1989) Cerebral ventricular enlargement in schizophrenia: prevalence and correlates. In Schizophrenia: Scientific Progress (eds Schulz, S. C. & Tamminga, C. A.), pp. 195–206. Oxford: Oxford University Press.Google Scholar
Crow, T. J. (1980) Molecular pathology of schizophrenia: more than one disease process. British Medical Journal, 280, 66–68.Google Scholar
Dales, P. (1979) Month of birth and mental disorders. In Biometereological Survey (eds Tromp, S. W. & Bouma, J. J.), London: Heyden and Son.Google Scholar
Dales, P. (1988) Schizophrenia, season of birth, and maternal age. British Journal of Psychiatry, 153, 727–733.Google Scholar
Dales, P. (1990) Does age incidence explain all season-of-birth effects in the literature? Schizophrenia Bulletin, 16, 11–12.Google Scholar
Dawson, D. F. (1978) An explanation for the seasonality of births in schizophrenia. American Journal of Psychiatry, 135, 1434–1435.Google ScholarPubMed
DeLisi, L. E., Goldin, L. R., Hamovit, J. R., et al (1986) A family study of the association of increased ventricular size with schizophrenia. Archives of General Psychiatry, 43, 148–153.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–73.CrossRefGoogle ScholarPubMed
Goetz, K. L. & van Kammen, D. P. (1986) Computerized axial tomography scans and subtypes of schizophrenia. Journal of Nervous and Mental Disease, 174, 31–41.CrossRefGoogle ScholarPubMed
Hare, E. H. (1976) The season of birth of siblings of psychiatric patients. British Journal of Psychiatry, 129, 49–54.Google Scholar
Hare, E. H. (1986) Aspects of the epidemiology of schizophrenia. British Journal of Psychiatry, 149, 554–561.CrossRefGoogle ScholarPubMed
Hare, E. H. & Price, J. S. (1968) Mental disorder and season of birth: comparison of psychoses with neurosis. British Journal of Psychiatry, 115, 533–540.CrossRefGoogle Scholar
Illowsky, B. P., Juliano, D. M., Bigelow, L. B., et al (1988) Stability of CT scan findings in schizophrenia: results of an eight years follow-up study. Journal of Neurology, Neurosurgery and Psychiatry, 51, 209–213.Google Scholar
Jacoby, R. J. & Levy, R. (1980) Computed tomography in the elderly. 3. Affective disorder. British Journal of Psychiatry, 136, 270–275.Google Scholar
James, W. H. (1978) Seasonality in schizophrenia. Lancet, i, 664.Google Scholar
Jeste, D. V., Lohr, J. B. & Goodwin, F. K. (1988) Neuroanatomies studies of major affective disorders. A review and suggestions for further research. British Journal of Psychiatry, 153, 444–459.CrossRefGoogle ScholarPubMed
Kinney, D. K. & Jacobsen, B. (1978) Environmental factors in schizophrenia: new adoption study evidence and its implications for genetic and environmental research. In The Nature of Schizophrenia: New Approaches to Research and Treatment (eds Wynne, L. C., Cromwell, R. L. & Matthysse, S.). New York: John Wiley & Sons.Google Scholar
Kling, A. S., Kurtz, N., Tachiki, K., et al (1982) CT scan in subgroups of chronic schizophrenics. Journal of Psychiatric Research, 17, 375–394.CrossRefGoogle ScholarPubMed
Larson, C. A. & Nyman, G. E. (1976) Birth month of schizophrenics and their sibs. IRCS Medical Science, 4, 56.Google Scholar
Lewis, M. S. (1989) Age incidence and schizophrenia: the season of birth controversy. Schizophrenia Bulletin, 15, 59–73.Google Scholar
Lewis, M. S. (1990) Res ipsa loquitor: the author replies. Schizophrenia Bulletin, 16, 17–28.Google Scholar
Machon, R. A., Mednick, S. A. & Schulsinger, F. (1983) The interaction of seasonality, place of birth, genetic risk and subsequent schizophrenia in a high risk sample. British Journal of Psychiatry, 143, 383–388.Google Scholar
McNeil, T., Kaij, L. & Dzierzykcay-Rogalska, M. (1976) Season of birth among siblings of schizophrenics. Acta Psychiatrica Scandinavica, 54, 267–274.Google Scholar
Murray, R. M., Lewis, S. W. & Reveley, A. M. (1985) Towards an aetiological classification of schizophrenia. Lancet, i, 1023.Google Scholar
Murray, R. M., Owen, M. J., Goodman, R., et al (1990) A neurodevelopmental perspective on some epiphenomenon of schizophrenia. In Plasticity and Morphology of the Central Nervous System: A Challenge for Psychiatry of the Nineties (eds Cazzullo, C. L., Sacchetti, E., Conte, G., et al), pp. 185–202. Lancaster: Kluwer Academic.Google Scholar
Nasrallah, H. A., McCalley-Whitters, M. & Jacoby, C. G. (1982) Cerebral ventricular enlargement in young manic males: a controlled CT study. Journal of Affective Disorders, 4, 15–19.Google Scholar
Nasrallah, H. A., Kuperman, S., Jacoby, C. G., et al (1983) Clinical correlates of sulcal widening in chronic schizophrenia. Psychiatry Research, 10, 237–242.Google Scholar
Nasrallah, H. A., Olson, S. C., McCalley-Whitters, M., et al (1986) Cerebral ventricular enlargement in schizophrenia: a preliminary follow-up study. Archives of General Psychiatry, 43, 157–159.Google Scholar
Nasrallah, H. A., Coffman, J. A. & Olson, S. C. (1989) Structural brain-imaging findings in affective disorders: an overview. Journal of Neuropsychiatry, 1, 21–26.Google Scholar
Nasrallah, H. A., Coffman, J. A. & Olson, S. C. (1990) CT and MRI findings in affective disorders: clinical and research implications. In Plasticity and Morphology of the Central Nervous System: A Challenge for Psychiatry of the Nineties (eds Cazzullo, C. L., Sacchetti, E., Conte, G., et al), pp. 53–62. Lancaster: Kluwer Academic.Google Scholar
Oxenstierna, G., Bergstrand, G., Bjerkenstedt, L., et al (1984) Evidence of disturbed CSF circulation and brain atrophy in cases of schizophrenic psychosis. British Journal of Psychiatry, 144, 654–661.Google Scholar
Owen, M. J., Lewis, S. W. & Murray, R. M. (1988) Obstetric complications and schizophrenia: a computed tomographic study. Psychological Medicine, 18, 331–339.CrossRefGoogle ScholarPubMed
Owen, M. J., Jones, P., Lewis, S. W., et al (1989) The relationship between seasonality of birth and biological variables in schizophrenia. Schizophrenia Research, 2, 17.CrossRefGoogle Scholar
Pearlson, G. D. & Veroff, A. E. (1981) Computerized tomographic scan changes in manic depressive illness. Lancet, ii, 370.Google Scholar
Pearlson, G. D., Garbacz, D. J., Tompkins, R. H., et al (1984) Clinical correlates of lateral ventricular enlargement in bipolar affective disorder. American Journal of Psychiatry, 141, 253–256.Google ScholarPubMed
Pearlson, G. D., Garbacz, D. J., Morberg, P. J., et al (1985) Symptomatic familial, perinatal and social correlates of computerized axial tomography (CAT) changes in schizophrenics and bipolars. Journal of Nervous and Mental Disease, 173, 42–50.CrossRefGoogle ScholarPubMed
Pfefferbaum, A., Zipursky, R. B. & Lim, K. O. (1986) Computerized quantification of cerebral atrophy in schizophrenia. Annual Meeting of the American College of Neuropsychopharmacology, Abstracts of Panels and Posters, p. 152. Washington, DC: American College of Neuropsychopharmacology.Google Scholar
Pulver, A. E., Moorman, C. C., Brown, C. H., et al (1990) Age-incidence artifacts do not account for the season-of-birth effect in schizophrenia. Schizophrenia Bulletin, 16, 13–15.CrossRefGoogle Scholar
Reveley, A. M., Reveley, M. A. & Murray, R. M. (1984) Cerebral ventricular enlargement in non genetic schizophrenia: a controlled twin study. British Journal of Psychiatry, 144, 89–93.Google Scholar
Reveley, M. A. (1985) CT scan in schizophrenia. British Journal of Psychiatry, 146, 367–371.CrossRefGoogle ScholarPubMed
Rieder, R. O., Donnelly, E. F., Herdt, J. R., et al (1979) Sulcal prominence in young schizophrenic patients: CT scan findings associated with impairment on neuropsychological tests. Psychiatry Research, 1, 1–8.CrossRefGoogle ScholarPubMed
Rieder, R. O., Mann, L. S., Weinberger, D. R., et al (1983) Computed tomographic scans in patients with schizophrenia, schizoaffective and bipolar affective disorder. Archives of General Psychiatry, 40, 735–739.Google Scholar
Sacchetti, E., Vita, A., Ciussani, S., et al (1984) Season of birth and cerebral ventricular enlargement in schizophrenia. Schizophrenia-An Integrative View (Milan, 15–18 June 1984, Book of Abstracts), p. 96. CINP Congress.Google Scholar
Sacchetti, E., Vita, A., Calzeroni, A., et al (1987a) Neuromorphological correlates of schizophrenic disorders: focus on cerebral ventricular enlargement. In Etiopathogenetic Hypotheses of Schizophrenia: The Impact of Epidemiological, Biochemical and Neuromorphological Studies (eds Cazzullo, C. L., Invernizzi, G., Sacchetti, E., et al), pp. 67–91. Lancaster: MTP Press.Google Scholar
Sacchetti, E., Vita, A., Calzeroni, A., et al (1987b) Cerebral ventricular enlargement: a marker for subtyping major affective disorders? In Diagnosis and Treatment of Depression “Quo Vadis?” (eds Bizière, K., Garattini, S. & Simon, P.), pp. 155–169. Paris: MEDSI/McGraw-Hill.Google Scholar
Sacchetti, E., Vita, A., Battaglia, M., et al (1987c) Season of birth and cerebral ventricular enlargement in schizophrenia. In Etiopathogenetic Hypotheses of Schizophrenia: The Impact of Epidemiological, Biochemical and Neuromorphological Studies (eds Cazzullo, C. L., Invernizzi, G., Sacchetti, E., et al), pp. 93–98. Lancaster: MTP Press.CrossRefGoogle Scholar
Sacchetti, E., Calzeroni, A., Conte, G., et al (1988) Is ventricular enlargement a variable of interest for family studies in schizophrenia? In A Genetic Perspective for Schizophrenic and Related Disorders (eds Smeraldi, E. & Bellodi, L.), pp. 217–228. Milan: Edi Ermes.Google Scholar
Sacchetti, E., Calzeroni, A., Pollastro, , et al (1989a) Schizophrenic spectrum disorders: neuromorphological evidence. In Schizophrenia: A Psychobiological View (eds Casacchia, M. & Rossi, A.), pp. 57–66. Lancaster: Kluwer Academic.Google Scholar
Sacchetti, E., Vita, A., Giobbio, G. M., et al (1989b) Season of birth and familial predisposition to schizophrenia: further data. British Journal of Psychiatry, 155, 266–267.Google Scholar
Sacchetti, E., Vita, A., Calzeroni, A., et al (1990) Neuromorphological correlates of mood disorders: focus on cerebral ventricular enlargement. In Plasticity and Morphology of the Central Nervous System: A Challenge for Psychiatry of the Nineties (eds Cazzullo, C. L., Sacchetti, E., Conte, G., et al), pp. 63–71. Lancaster: Kluwer Academic.CrossRefGoogle Scholar
Schulsinger, F., Parnas, J., Petersen, E. T., et al (1984) Cerebral ventricular size in the offspring of schizophrenic mothers: a preliminary study. Archives of General Psychiatry, 41, 602–606.Google Scholar
Schulz, S. C., Koller, M. M., Kishore, P. R., et al (1983) Ventricular enlargement in teenage patients with schizophrenia spectrum disorder. American Journal of Psychiatry, 140, 1592–1595.Google Scholar
Shelton, R. C. & Weinberger, D. R. (1986) X-ray computerized tomography studies in schizophrenia: a review and synthesis. In Handbook of Schizophrenia, Vol. I: The Neurology of Schizophrenia (eds Nasrallah, H. A. & Weinberger, D. R.), pp. 232–275. Amsterdam: Elsevier Science.Google Scholar
Shimura, M. & Miura, T. (1980) Season of birth in mental disorders in Tokyo, Japan, by year of birth, year of admission and age at admission. Acta Psychiatrica Scandinavica, 61, 21–28.Google Scholar
Shur, E. (1982) Season of birth in high and low genetic risk schizophrenics. British Journal of Psychiatry, 140, 410–415.Google Scholar
Templer, D. I. & Veleber, D. M. (1982) Seasonality of schizophrenic births: harmful effects or genetic morphism? British Journal of Psychiatry, 140, 320–334.Google Scholar
Torrey, E. F. (1987) Hypotheses on the seasonality of schizophrenic births. In Etiopathogenetic Hypotheses of Schizophrenia: The Impact of Epidemiological, Biochemical and Neuromorphological Studies (eds Cazzullo, C. L., Invernizzi, G., Sacchetti, E., et al), pp. 41–48. Lancaster: MTP Press.Google Scholar
Torrey, E. F. & Kaufmann, C. A. (1986) Schizophrenia and neuroviruses. In Handbook of Schizophrenia, Vol. I: The Neurology of Schizophrenia (eds Nasrallah, H. A. & Weinberger, D. R.), pp. 361–376. Amsterdam: Elsevier Science.Google Scholar
Tramer, M. (1929) Uber die biologische bedeutung des geburtsmonates, insbesondere fur die psychoseerkrankung. Schweizer Archiv fur Neurologie und Psychiatric 24, 17–24.Google Scholar
Turner, S. W., Toone, B. K. & Breet-Jones, J. R. (1986) Computed tomographic scan changes in early schizophrenia: a preliminary finding. Psychological Medicine, 14, 219–226.Google Scholar
Vita, A., Sacchetti, E., Calzeroni, A., et al (1986) Computed tomography in psychiatric disorders. In Advances in Neuroimaging (eds Reisner, T., Binder, H. & Deisenhammer, E.), pp. 243–247. Wien: Verlag der Wiener Medizinische Akademie.Google Scholar
Vita, A., Sacchetti, E. & Cazzullo, C. L. (1988a) A CT scan follow up study of cerebral ventricular size in schizophrenia and major affective disorders. Schizophrenia Research, 1, 165–166.Google Scholar
Vita, A., Sacchetti, E., Valvassori, G., et al (1988b) Brain morphology in schizophrenia: a 2 to 5 years CT scan follow-up study. Acta Psychiatrica Scandinavica, 78, 618–621.Google Scholar
Vita, A., Sacchetti, E., Calzeroni, A., et al (1988c) Cortical atrophy in schizophrenia: prevalence and associated features. Schizophrenia Research, 1, 329–337.CrossRefGoogle ScholarPubMed
Vita, A., Valvassori, G., Boato, P., et al (1989) Clinical and prognostic correlates of lateral ventricular enlargement in schizophrenic disorder. In Schizophrenia: A Psychobiological View (eds Casacchia, M. & Rossi, A.), pp. 79–90. Lancaster: Kluwer Academic.Google Scholar
Watson, C. G. (1990) Schizophrenic birth seasonality and the age-incidence artifact. Schizophrenia Bulletin, 16, 5–10.Google Scholar
Weinberger, D. R., Torrey, E. F., Neophytides, A. N., et al (1979) Structural abnormalities in the cerebral cortex of chronic schizophrenia. Archives of General Psychiatry, 36, 935–939.Google Scholar
Weinberger, D. R., DeLisi, L. E., Perman, G., et al (1982) Computed tomography in schizophreniform disorder and other acute psychiatric disorders. Archives of General Psychiatry, 39, 778–783.Google Scholar
Weinberger, D. R., Wagner, R. L. & Wyatt, R. J. (1983) Neuropathological studies of schizophrenia: a selective review. Schizophrenia Bulletin, 9, 193–212.Google Scholar
Zipursky, R. B. & Schulz, S. C. (1987) Seasonality of birth and CT findings in schizophrenia. Biological Psychiatry, 22, 1288–1292.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.