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The UCLA Family Study

Robert F. Asarnow, PhD; Keith H. Nuechterlein, PhD; David Fogelson, MD; Kenneth L. Subotnik, PhD; Diana A. Payne, PhD; Andrew T. Russell, MD; Joy Asamen, PhD; Heidi Kuppinger, PhD; Kenneth S. Kendler, MD

Arch Gen Psychiatry. 2001;58:581-588.

Background  This study tested the hypothesis that childhood-onset schizophrenia (COS) is a variant of adult-onset schizophrenia (AOS) by determining if first-degree relatives of COS probands have an increased risk for schizophrenia and schizotypal and paranoid personality disorders.

Methods  Relatives of COS probands (n = 148) were compared with relatives of attention-deficit/hyperactivity disorder (ADHD) (n = 368) and community control (n = 206) probands. Age-appropriate structured diagnostic interviews were used to assign DSM-III-R diagnoses to probands and their relatives. Family psychiatric history was elicited from multiple informants. Diagnoses of relatives were made blind to information about probands' diagnoses. Final consensus diagnoses, which integrated family history, direct interview information, and medical records, are reported in this article.

Results  There was an increased lifetime morbid risk for schizophrenia (4.95% ± 2.16%) and schizotypal personality disorder (4.20% ± 2.06%) in the parents of COS probands compared with parents of ADHD (0.45% ± 0.45%, 0.91% ± 0.63%) and community control (0%) probands. The parents of COS probands diagnosed as having schizophrenia had an early age of first onset of schizophrenia. Risk for avoidant personality disorder (9.41% ± 3.17%) was increased in the parents of COS probands compared with parents of community controls (1.67% ± 1.17%).

Conclusions  The psychiatric disorders that do and do not aggregate in the parents of COS probands are remarkably similar to the disorders that do and do not aggregate in the parents of adults with schizophrenia in modern family studies. These findings provide compelling support for the hypothesis of etiological continuity between COS and AOS.

From the Neuropsychiatric Institute and Departments of Psychiatry (Drs Asarnow, Nuechterlein, Fogelson, Subotnik, Payne, Russell, and Kuppinger) and Psychology (Drs Asarnow, Nuechterlein, and Asamen), University of California at Los Angeles; Department of Psychology, Pepperdine University, Malibu, Calif (Dr Asamen); Departments of Psychiatry and Human Genetics, Virginia Commonwealth University, Richmond (Dr Kendler); and the Virginia Institute of Psychiatric Genetics, Richmond (Dr Kendler).

Corresponding author: Robert F. Asarnow, PhD, Della Martin Professor of Psychiatry and Biobehavioral Science, UCLA Department of Psychiatry, 48-240C NPI, 760 Westwood Plaza, Los Angeles, CA 90024-1759.

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