Family history of schizophrenia ups risk for nonpsychotic disorders

Individuals with a family history of schizophrenia are at a significantly increased risk for a wide range of nonpsychotic DSM-IV axis I psychiatric disorders, US research shows.

Jordan DeVylder and Ellen Lukens, from Columbia University School of Social Work in New York, found that the risk for 11 nonpsychotic axis I disorders was significantly elevated among individuals with a first-degree relative diagnosed with schizophrenia.

"Our findings reinforce the need for careful attention to assessing, monitoring, and developing strategies for prevention and early intervention among first-degree relatives of persons diagnosed with schizophrenia," comment the researchers.

The findings come from a study of 5115 individuals, aged 18 years or older, without a lifetime history of psychotic disorders who participated in the National Survey of American Life. The study mostly comprised African-Americans (58%), followed by Black Americans of Caribbean descent (24%), and non-Hispanic Whites (18%) from neighborhoods of similar socioeconomic status.

Of the participants, 223 (4.4%) reported having a close relative with schizophrenia.

After accounting for age, gender, ethnicity, and other variables, logistic regression analysis showed that participants with a family history of schizophrenia had a significantly greater risk for 11 out of 20 nonpsychotic axis I disorders than those without such a family history.

These conditions, in order of declining risk, included: bipolar I disorder (adjusted odds ratio [aOR]=4.27), bulimia (aOR=3.81), generalized anxiety disorder (aOR=3.49), separation anxiety disorder (aOR=3.10), drug abuse (aOR=2.83), conduct disorder (aOR=2.53), dysthymia (aOR=2.51), post-traumatic stress disorder (aOR=2.30), alcohol abuse (aOR=2.27), major depressive disorder (aOR=2.18), and social phobia (aOR=2.00).

Furthermore, the researchers say the list included conditions not expected, from examination of the literature, to be associated with schizophrenia, such as bulimia and disorders of childhood onset, as well as those that were expected to be associated, such as affective, anxiety, and substance use disorders.

"The main finding of the present study is that having a first-degree relative with schizophrenia significantly increases one's chance of having a lifetime diagnosis of a wide range of nonpsychotic axis I psychiatric conditions," conclude DeVylder and Lukens in the Journal of Psychiatric Research.

They add: "This paper contributes to a growing body of literature indicating that risk factors for schizophrenia may in actuality be risk factors for more broadly defined psychopathology."

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