Psychological Medicine

Original Articles

Both low birthweight and high birthweight are associated with cognitive impairment in persons with schizophrenia and their first-degree relatives

M. Torniainena1a2 c1, A. Wegeliusa1a3, A. Tuulio-Henrikssona1a2a4, J. Lönnqvista1a2a5 and J. Suvisaaria1a6

a1 Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland

a2 Institute of Behavioral Sciences, University of Helsinki, Finland

a3 Department of Psychiatry, Helsinki University Central Hospital, Finland

a4 Social Insurance Institution of Finland, Helsinki, Finland

a5 Department of Psychiatry, University of Helsinki, Finland

a6 Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Finland

Abstract

Background Both low birthweight and high birthweight have been associated with an increased risk for schizophrenia and cognitive impairments in the general population. We assessed the association between birthweight and cognitive performance in persons with schizophrenia and their unaffected first-degree relatives.

Method We investigated a population-based family sample comprising persons with schizophrenia (n = 142) and their unaffected first-degree relatives (n = 277). Both patients and relatives were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) and a comprehensive neuropsychological test battery was administered. Information on birthweight was obtained from obstetric records. We used generalized estimating equation (GEE) models to investigate the effect of birthweight, as a continuous variable, on cognitive functioning, adjusting for within-family correlation and relevant covariates.

Results Both low birthweight and high birthweight were associated with lower performance in visuospatial reasoning, processing speed, set-shifting and verbal and visual working memory among persons with schizophrenia and their unaffected first-degree relatives compared to individuals with birthweight in the intermediate range. The group × birthweight interactions were non-significant.

Conclusions Both low birthweight and high birthweight are associated with deficits in cognition later in life. Schizophrenia does not seem to modify the relationship between birthweight and cognition in families with schizophrenia.

(Received June 26 2012)

(Revised December 17 2012)

(Accepted December 19 2012)

(Online publication January 29 2013)

Key words

  • Birthweight;
  • cognition;
  • neuropsychology;
  • relatives;
  • schizophrenia

Correspondence

c1 Address for correspondence: M. Torniainen, M.Psych., Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. (Email: minna.torniainen@thl.fi)

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