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Prenatal malnutrition and adult schizophrenia: further evidence from the 1959-1961 Chinese famine.

Abstract

OBJECTIVE

Evidence from the 1944-1995 Dutch Hunger Winter and the 1959-1961 Chinese famines suggests that those conceived or in early gestation during famines, have a 2-fold increased risk of developing schizophrenia in adult life. We tested the hypothesis in a second Chinese population and also determined whether risk differed between urban and rural areas.

METHOD

The risk of schizophrenia was examined in Liuzhou prefecture of Guangxi autonomous region. Rates were compared among those conceived before, during, and after the famine years. Based on the decline in birth rates, we predicted that those born in 1960 and 1961 would have been exposed to the famine during conception or early gestation. All psychiatric case records in Liuzhou psychiatric hospital for the years 1971 through 2001 were examined and clinical/sociodemographic data extracted by psychiatrists blind to exposure status. Data on births and deaths in the famine years were also available, and cumulative mortality was estimated from later demographic surveys. Evidence of famine was verified, and results were adjusted for mortality. Relative risks (RRs) for schizophrenia were calculated for the region as a whole and for urban and rural areas separately.

RESULTS

Mortality-adjusted RR for schizophrenia was 1.5 (1960) and 2.05 (1961), respectively. However, the effect was exclusively from the rural areas RR = 1.68 (1960) and RR = 2.25 (1961).

CONCLUSIONS

We observe a 2-fold increased risk of schizophrenia among those conceived or in early gestation at the height of famine with risk related to severity of famine conditions.

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  • Authors+Show Affiliations

    ,

    Bio-X Life Science Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, PR China.

    , , , , , , , , ,

    Source

    Schizophrenia bulletin 35:3 2009 May pg 568-76

    MeSH

    Adult
    Birth Rate
    China
    Cross-Sectional Studies
    Disasters
    Female
    Gestational Age
    Humans
    Infant, Newborn
    Male
    Malnutrition
    Mortality
    Pregnancy
    Prenatal Exposure Delayed Effects
    Risk
    Rural Population
    Schizophrenia
    Starvation
    Survival Analysis
    Urban Population

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19155344

    Citation

    Xu, Ming-Qing, et al. "Prenatal Malnutrition and Adult Schizophrenia: Further Evidence From the 1959-1961 Chinese Famine." Schizophrenia Bulletin, vol. 35, no. 3, 2009, pp. 568-76.
    Xu MQ, Sun WS, Liu BX, et al. Prenatal malnutrition and adult schizophrenia: further evidence from the 1959-1961 Chinese famine. Schizophr Bull. 2009;35(3):568-76.
    Xu, M. Q., Sun, W. S., Liu, B. X., Feng, G. Y., Yu, L., Yang, L., ... He, L. (2009). Prenatal malnutrition and adult schizophrenia: further evidence from the 1959-1961 Chinese famine. Schizophrenia Bulletin, 35(3), pp. 568-76. doi:10.1093/schbul/sbn168.
    Xu MQ, et al. Prenatal Malnutrition and Adult Schizophrenia: Further Evidence From the 1959-1961 Chinese Famine. Schizophr Bull. 2009;35(3):568-76. PubMed PMID: 19155344.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prenatal malnutrition and adult schizophrenia: further evidence from the 1959-1961 Chinese famine. AU - Xu,Ming-Qing, AU - Sun,Wen-Sheng, AU - Liu,Ben-Xiu, AU - Feng,Guo-Yin, AU - Yu,Lan, AU - Yang,Lawrence, AU - He,Guang, AU - Sham,Pak, AU - Susser,Ezra, AU - St Clair,David, AU - He,Lin, Y1 - 2009/01/20/ PY - 2009/1/22/entrez PY - 2009/1/22/pubmed PY - 2009/6/12/medline SP - 568 EP - 76 JF - Schizophrenia bulletin JO - Schizophr Bull VL - 35 IS - 3 N2 - OBJECTIVE: Evidence from the 1944-1995 Dutch Hunger Winter and the 1959-1961 Chinese famines suggests that those conceived or in early gestation during famines, have a 2-fold increased risk of developing schizophrenia in adult life. We tested the hypothesis in a second Chinese population and also determined whether risk differed between urban and rural areas. METHOD: The risk of schizophrenia was examined in Liuzhou prefecture of Guangxi autonomous region. Rates were compared among those conceived before, during, and after the famine years. Based on the decline in birth rates, we predicted that those born in 1960 and 1961 would have been exposed to the famine during conception or early gestation. All psychiatric case records in Liuzhou psychiatric hospital for the years 1971 through 2001 were examined and clinical/sociodemographic data extracted by psychiatrists blind to exposure status. Data on births and deaths in the famine years were also available, and cumulative mortality was estimated from later demographic surveys. Evidence of famine was verified, and results were adjusted for mortality. Relative risks (RRs) for schizophrenia were calculated for the region as a whole and for urban and rural areas separately. RESULTS: Mortality-adjusted RR for schizophrenia was 1.5 (1960) and 2.05 (1961), respectively. However, the effect was exclusively from the rural areas RR = 1.68 (1960) and RR = 2.25 (1961). CONCLUSIONS: We observe a 2-fold increased risk of schizophrenia among those conceived or in early gestation at the height of famine with risk related to severity of famine conditions. SN - 0586-7614 UR - https://www.unboundmedicine.com/medline/citation/19155344/Prenatal_malnutrition_and_adult_schizophrenia:_further_evidence_from_the_1959_1961_Chinese_famine_ L2 - https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/sbn168 DB - PRIME DP - Unbound Medicine ER -