nutritional deficiency and schizophrenia

Prenatal Exposure to Famine Increases Schizophrenia Risk


NEW YORK (Reuters Health) Aug 02 - Intrauterine exposure to famine is associated with an increased incidence of schizophrenia in adulthood, according to evidence generated during a famine between 1959 and 1961 in China.

A link between severe maternal nutritional deficiency and schizophrenia was first reported in 1992, based on studies of the 1944-1945 "Dutch Hunger Winter," senior author Dr. Lin He and colleagues note in the August 3rd issue of the Journal of the American Medical Association. However, the number of cases was small and the findings were of modest statistical significance.

Dr. He, from the Shanghai Institute of Biological Sciences, and associates evaluated data from the Wuhu region of Anhui province, which was affected by the 1959-1961 Chinese famine. The approximate population during this time was 1.5 million. Cases were identified from psychiatric referrals to a local hospital between 1971 and 2001.

The mortality-adjusted relative risk of schizophrenia was 2.30 for those born in 1960 and 1.93 for those born in 1961 (p < 0.001 for both years). The data indicate that exposure through early gestation was the critical period for increased odds of schizophrenia.

"Using a much larger sample size with clear evidence of exposure, our findings are internally consistent and almost exactly replicate the Dutch findings," the authors note. Moreover, "since the two populations are ethnically and culturally distinct, the processes involved may apply in all populations undergoing famine."

It remains to be established whether the risk of schizophrenia arises from a global nutritional deficiency or a specific micronutrient deficiency, Dr. Richard Neugebauer, from New York State Psychiatric Institute in New York, maintains in an accompanying editorial.

Either way, he adds, the hypothesis that schizophrenia is a result of a genetic neurodevelopmental disease "raises the possibility, a prospect once considered entirely utopian, of primary prevention strategies for this most devastating of psychiatric disorders."

JAMA 2005;294:557-562,621-623.

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