The investigators propose to supplement existing data from the Providence and Boston cohorts of the National Collaborative Perinatal Project (NCPP) in this first of a two-phase project. In the first of four major aims listed, the investigators will test a hypothesis that prenatal and perinatal complications require a familial predisposition to schizophrenia (or to psychosis) for the development of characteristic neurobehavioral deficits at age 7.
The second aim will further explore the importance of diagnostic specificity (schizophrenia versus affective psychosis) in this effect.The third and fourth of these aims will require the full data set generated by phase 2.
Aim 3 will determine the relative risks for specific disorders among offspring as functions of prenatal and perinatal complications, familial predisposition, and neurobehavioral deficits manifested in childhood.
Aim 4 will further explore the interactions between these predisposing factors and adult psychopathology. The investigators will begin with the results of screening questions obtained at the time of the 7-year followup to locate and diagnostically evaluate 125 parents with a lifetime history of psychosis leading to hospitalization. Based on pilot data, they expect that 50 of these individuals will have DSM-III-R schizophrenia, 50 will have affective psychoses, and 25 will have other DSM-III-R diagnoses. Control NCPP parents will be matched to these psychotic NCPP parents on the basis of age, sex, ethnicity, socioeconomic status, site, parity, sex of offspring, and the presence or absence of prenatal and perinatal complications (PPCs) in offspring. Normal controls will lack Axis I (except adjustment disorders) or Axis II disorders. Phase 2 is to add an additional 75 parents to each group for a total of 200. For each group of parents studied in phase 1, 100 offspring will be evaluated; phase 2 will add another 150 parents in each group for a total of 250. The Diagnostic Interview for Genetic Studies (DIGS) will be the core diagnostic instrument. Various measures of attention, short-term memory, concept formation, and neuromotor function will be used as probes of genetic risk factors; various measures of long-term memory and olfaction are intended to quantify the sequelae of specific perinatal complications. Finally, measures of cerebral laterality will be used to contrast subjects with schizophrenia and subjects with affective disorder.
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