Prospective study of pandysmaturation and adult mental disorder in high-risk and normal-risk offspring

• Published in: Journal of psychiatric research Vol. 45; no. 4; pp. 561 - 567
• Main Authors: McNeil, Thomas F, Fish, Barbara, Schubert, Erland W
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.04.2011; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Affective disorder; Biological and medical sciences; Child; Child of Impaired Parents - psychology; Clinical Medicine; Cognition - physiology; Developmental Disabilities - epidemiology; Developmental Disabilities - etiology; Female; Fish; Genetic susceptibility; High risk; Humans; Klinisk medicin; Logistic Models; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - etiology; Mental Disorders - genetics; Neurodevelopment; Obstetric Labor Complications - physiopathology; Odds Ratio; Pandysmaturation; Pregnancy; Prospective Studies; Psychiatric Status Rating Scales; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psykiatri; Risk Factors; Risk group; Schizophrenia; Social Behavior; Young Adult; Young adulthood; Affective disorder; Schizophrenia; Neurodevelopment; Pandysmaturation; Risk group; Human; Mood disorder; High risk; Psychosis; Progeny; Follow up study; Mental disorder; Adult
• ISSN: 0022-3956; 1879-1379; 1879-1379
• DOI: 10.1016/j.jpsychires.2010.09.010

Abstract More than 50 years ago, Fish postulated that a special form of early abnormal neurodevelopment, “pandysmaturation”, defined a priori as constituting retarded cranial development in the first year of life, combined with delay in early motor milestone attainment, was related to genetic risk for schizophrenia, and was associated with schizophrenia-spectrum disorders in young adulthood. Fish confirmed this in a very small sample. We retested Fish’s postulation in a larger prospective study. Pandysmaturation was blindly investigated through medical records and prospective researcher and maternal observations, studying 75 “high-risk” offspring of women with a history of schizophrenia or affective psychosis and 91 “normal-risk” offspring. Subjects were studied prospectively from mother’s pregnancy to 22 years of age, at which time the offspring were independently assessed for schizophrenia-spectrum and affective disorders. Pandysmaturation ( n  = 13, with 10 “definite” and 3 “probable” degrees) was significantly related to genetic risk for schizophrenia (Odds Ratio 4.9, p  = 0.02) but not to genetic risk for affective disorders (OR 1.2, p  = 0.81). Pandysmaturation was significantly associated with schizophrenia-spectrum (OR 6.2, p  = 0.02), but not affective (OR 0.9, p  = 0.90), disorders in young adulthood. Pandysmaturation was more strongly associated than was retarded cranial development, motor milestone delay, or social/cognitive milestone delay by itself. Pandysmaturation has efficacy as an early life risk-indicator of schizophrenia-spectrum disorder in young adulthood at least in subjects at genetic risk, strengthening the evidence for a generally genetic-based neurodevelopmental model of schizophrenia-spectrum (as contrasted with affective) disorders. Pandysmaturation is a risk-indicator for future schizophrenia-spectrum disorder, for potential use in scientific studies and clinical practice.