The anthropometric assessment of dysmorphic features in schizophrenia as an index of its developmental origins
A. LANE a1 , A. KINSELLA a1 , P. MURPHY a1 , M. BYRNE a1 , J. KEENAN a1 , K. COLGAN a1 , B. CASSIDY a1 , N. SHEPPARD a1 , R. HORGAN a1 , J. L. WADDINGTON a1 , C. LARKIN a1 and E. O'CALLAGHAN a1
a1 From Cluain Mhuire Family Centre, Blackrock, Co. Dublin; Department of Mathematics, Dublin Institute of Technology, and Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin; St Loman's Hospital, Mullingar; and St. Otteran's Hospital, Waterford, Ireland
Background. Evidence suggests that schizophrenia may be a disorder with origins in early intrauterine mal-development. We have constructed a comprehensive anthropometric scale for the evaluation of dysmorphic features as an index of the nature and timing of developmental disturbance.
Method. A detailed set of craniofacial and bodily measures was compiled and applied to 174 patients with schizophrenia and 80 matched control subjects.
Results. Patients had significantly higher scores on this scale and displayed multiple anomalies of the craniofacial region with an overall narrowing and elongation of the mid-face and lower face. Twelve craniofacial anomalies independently distinguished patients from controls and these variables correctly classified 95% of patients and 80% of control subjects.
Conclusions. This new scale, while procedurally more exacting than the Waldrop scale, more clearly defines the topography of anomalies previously suspected in individuals with schizophrenia. These findings constitute direct evidence for disturbed craniofacial development in schizophrenia and indicate origins in the foetal period during which the characteristic human facial pattern evolves in close association with brain differentiation.
Address for correspondence: Dr E. O'Callaghan, Cluain Mhuire Family Centre, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland.