CENTER ON BEHAVIORAL MEDICINE

BODY-MIND CONNECTION

ESSENTIAL NUTRIENTS

Essential Nutrients-Mood:  Research Article

Essential Nutrients Menu

Relation between Prenatal Famine and Major Affective Disordes

CITATION:  Brown, A.S., van Os, J/, et al.  (2000)  Relation Between Prenatal Famine And Major Affective Disorde.  Am J Psychiatry; 157, 2.

ABSTRACT: 

Objective: In a previous study, the authors demonstrated an association between prenatal famine in middle to late gestation and major affective disorders requiring hospitalization. In this study, they sought to examine the association by using newly identified cases from the Dutch birth cohort used previously to examine the gender specificity of the association and to assess whether this relation is present for both unipolar and bipolar affective disorders.

Method: The authors compared the risk of major affective disorder requiring hospitalization in birth cohorts who were and were not exposed, in each trimester of gestation, to famine during the Dutch Hunger Winter of 1944-1945. These cases of major affective disorder requiring hospitalization were newly ascertained from a national psychiatric registry. A larger data set from this registry was used for analysis by gender and diagnostic subtype.

Results: For the newly ascertained cases, the risk of developing major affective disorder requiring hospitalization was increased for subjects with exposure to famine in the second trimester and was increased significantly for subjects with exposure in the third trimester, relative to unexposed subjects. For the cases from the entire period of ascertainment, the risk of developing affective disorder was significantly increased for those exposed to famine during the second and the third trimesters of gestation. The effects were demonstrated for men and women and for unipolar and bipolar affective disorders.

Conclusions: These results provide support for the authors' previous findings on the association between middle to late gestational famine and affective disorder.

References

1. Brown AS, Susser ES, Lin SP, Neugebauer R, Gorman JM: Increased risk of affective disorder in males after second trimester prenatal exposure to the Dutch Hunger Winter of 1944-1945. Br J Psychiatry 1995; 166:601-606

2. van Os J, Jones P, Lewis G, Wadsworth M, Murray R: Developmental precursors of affective illness in a general population birth cohort. Arch Gen Psychiatry 1997; 54:625-631

3. Elkis H, Friedman L, Wise A, Meltzer H: Meta-analysis of studies of ventricular enlargement and cortical sulcal prominence in

mood disorder: comparisons with controls or patients with schizophrenia. Arch Gen Psychiatry 1995; 52:735-746

4. Torrey E, Rawlings R. Ennis J, Merrill D, Flores D: Birth seasonality in bipolar disorder, schizophrenia, schizoaffective disorder and stillbirths. Schizophr Res 1996; 21:141-149

5. Machon R, Mednick S, Huttunen M: Adult major affective disorder after prenatal exposure to an influenza epidemic. Arch Gen Psychiatry 1997; 54:322-328

6. Cannon M, Cotter D, Coffey V, Sham P, Takei N, Larkin C, Murray R, O'Callaghan E: Prenatal exposure to the 1957 influenza epidemic and adult schizophrenia: a follow-up study. Br J Psychiatry 1996; 168:368-371

7. Sacker A, Done D, Crow T, Golding J: Antecedents of schizophrenia and affective illness: obstetric complications. Br J Psychiatry 1995; 166:734-741

8. Done D, Johnstone E, Frith C, Golding J, Shepherd PM, Crow TJ: Complications of pregnancy and delivery in relation to psychosis in adult life: data from the British Perinatal Mortality Survey sample. Br Med J 1991; 302:1576-1580

9. Stein Z, Susser M, Saenger G, Marolla F: Famine and Human Development: The Dutch Hunger Winter of 1944-45. New York, Oxford University Press, 1975

10. Susser ES, Lin SP: Schizophrenia after prenatal exposure to the Dutch Hunger Winter of 1944-1945. Arch Gen Psychiatry 1992; 49:983-988

11. Susser E, Neugebauer R, Hoek H, Brown AS, Lin S, Labovitz D, Gorman JM: Schizophrenia after prenatal famine: further evidence. Arch Gen Psychiatry 1996; 53:25-31

12. Susser E, Hoek HW, Brown A: Neurodevelopmental disorder after prenatal famine: the story of the Dutch Famine Study. Am J Epidemiol 1998; 147:213-216

13. World Health Organization: Mental Disorders: Glossary and Guide to Their Classification in Accordance With the Ninth Revision of the International Classification of Diseases. Geneva, WHO, 1978

14. Fleiss J: Statistical Methods for Rates and Proportions, 2nd ed. New York, John Wiley & Sons, 1981

15. Kline J, Stein Z, Susser M: Conception to Birth: Epidemiology of Prenatal Development: Monographs in Epidemiology and Biostatistics, vol 1. New York, Oxford University Press, 1989

16. Brown AS, Susser ES, Butler PD, Richardson-Andrews R, Kaufmann CA, Gorman JM: Neurobiological plausibility of prenatal nutritional deprivation as a risk factor for schizophrenia. J Nerv Ment Dis 1996; 184:71-85

17. Butler PD, Susser ES, Brown AS, Kaufmann CA, Gorman JM: Prenatal nutritional deprivation as a risk factor in schizophrenia: preclinical evidence. Neuropsychopharmacology 1994; 11: 227-235

18. Rakic P: Defects of neuronal migration and the pathogenesis of cortical malformations. Prog Brain Res 1988; 73:15-37

19. Nowakowski RS: Prenatal development of the brain, in Prenatal Exposures in Schizophrenia. Edited by Susser ES, Brown AS, Gorman JM. Washington. DC. American Psychiatric Press, 1999, pp 61-85

20. Akbarian S, Bunney W. Potkin S, Wigal S, Hagman J, Sand-man C, Jones E: Altered distribution of nicotinamide-adenine dinucleotide phosphate-diaphorase cells in frontal lobe of schizophrenics implies disturbances of cortical development. Arch Gen Psychiatry 1993; 50:169-177

21. Jakob J, Beckman H: Prenatal developmental disturbances in the limbic allocortex in schizophrenics. J Neural Transm 1986; 65:303-326

22. Beckman H, Jakob J: Prenatal disturbances of nerve cell migration in the entorhinal region: a common vulnerability factor in functional psychoses? J Neural Transm Gen Sect 1991; 84: 155-164

23. Heim C, Owens M, Plotsky P, Nemeroff C: Persistent changes in corticotropin-releasing factor systems due to early life stress: relationship to the pathophysiology of major depression and posttraumatic stress disorder. Psychopharmacol Bull 1997; 33:185-192

24. Crow TJ: The continuum of psychosis and its implication for the structure of the gene. Br J Psychiatry 1986; 149:419-429