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Family History of Psychiatric Illness as a Risk Factor for Schizoaffective Disorder
A Danish Register-Based Cohort Study
Thomas Munk Laursen, MSc;
Rodrigo Labouriau, PhD;
Rasmus W. Licht, MD, PhD;
Aksel Bertelsen, MD, PhD;
Trine Munk-Olsen, MSc;
Preben Bo Mortensen, DrMedSc
Arch Gen Psychiatry. 2005;62:841-848.
Background Schizoaffective disorder may be related to both schizophrenia and bipolar disorders, but no population-based studies, to our knowledge, have investigated this association in families.
Objectives To determine whether a psychiatric history of schizoaffective disorder, bipolar disorder, or schizophrenia among parents and siblings is a risk factor for developing a schizoaffective disorder, and whether a specific pattern of family history of psychiatric illness exists in persons with schizoaffective disorder compared with persons with bipolar disorder or schizophrenia.
Design Register-based cohort study.
Setting Denmark.
Cohort The 2.4 million persons born in Denmark after 1952.
Main Outcome Measures Relative risks of the 3 illnesses estimated by Poisson regression.
Results In total, 1925 persons had a schizoaffective disorder, 3721 had a bipolar disorder, and 12 501 had schizophrenia. The relative risk of schizoaffective disorder was 2.76 (95% confidence interval, 2.49-3.06) if a first-degree relative had a history of mental illness compared with a person with no first-degree relatives with such a history. There was an additional risk (95% confidence interval) of 2.57 (2.11-3.13), 3.23 (2.63-3.95), or 1.92 (1.43-2.57) if the first-degree relative had schizophrenia, bipolar disorder, or schizoaffective disorder, respectively, compared with other psychiatric admissions. When bipolar disorder was the outcome, bipolar disorder in first-degree relatives was by far the significantly strongest risk factor. When schizophrenia was the outcome, the significantly strongest risk factor was schizophrenia among first-degree relatives.
Conclusion Schizoaffective disorder is not simply a subgroup of either bipolar disorder or schizophrenia but may be genetically linked to both, with schizoaffective disorder being a subtype of each or a genetic intermediate form.
Author Affiliations: National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark (Mr Laursen, Drs Labouriau and Mortensen, and Ms Munk-Olsen); Mood Disorders Research Unit (Dr Licht) and World Health Organization Collaborating Centre for Research and Training in Mental Health, Department of Psychiatric Demography (Dr Bertelsen), Aarhus University Psychiatric Hospital, Risskov, Denmark; and Department of Animal Breeding and Genetics, Biometry Research Unit, Danish Institute of Agricultural Sciences, Tjele (Dr Labouriau).
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