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Increased Risk of Affective Disorders in Males after Second Trimester Prenatal Exposure to the Dutch Hunger Winter of 1944–45

Published online by Cambridge University Press:  02 January 2018

Alan S. Brown*
Affiliation:
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, USA
Ezra S. Susser
Affiliation:
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, USA
Shang P. Lin
Affiliation:
Statistical Sciences and Epidemiology Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
Richard Neugebauer
Affiliation:
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, USA
Jack M. Gorman
Affiliation:
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, USA
*
Dr Brown, New York State Psychiatric Institute, Unit 2, 722 West 168th St., New York, NY 10032, USA

Abstract

Background

Prenatal and perinatal factors have been linked to affective disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an increased risk of affective disorders.

Method

Monthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944–45 were identified. The cumulative incidences of affective psychoses and neurotic depression (ICD–9 criteria) were compared between exposed and unexposed cohorts during each trimester of gestation.

Results

The relative risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was significantly increased (broad: RR (95% confidence interval) = 1.62 (1.19, 2.20); restricted: 1.59 (1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); restricted: 2.40 (1.49, 3.89)), but not females (broad: 1.28 (0.84, 1.94); restricted: 1.17 (0.73, 1.86)). The risk of neurotic depression was not increased after prenatal famine exposure.

Conclusions

These results suggest a possible relationship between prenatal famine during the second trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Further studies of this relationship are warranted.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1995 

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Footnotes

Presented in part at the 146th Annual Meeting (New Research) of the American Psychiatric Association, San Francisco, CA, 24 May 1993.

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