Childhood social functioning predicts schizophrenia risk

By Lucy Piper, Senior medwireNews Reporter

Poor social functioning in childhood predicts an increased risk for schizophrenia later in life, suggest researchers.

They found that premorbid social functioning, as rated by teachers on a Likert-type scale, significantly differentiated children who developed schizophrenia-spectrum disorder from those who did not develop mental illness and those who developed other psychiatric disorders.

Also, social functioning appeared to predict the risk for schizophrenia independently of genetic risk, and with little interaction between these two factors.

“[R]esults from this 48-year longitudinal record suggest that children on a trajectory toward schizophrenia-spectrum disorders demonstrate interpersonal deficits early in life, and that teachers provide valuable information regarding children’s social functioning,” write lead researcher Jason Schiffman (University of Maryland, Baltimore, USA) and colleagues in Schizophrenia Research.

Among the 244 participants, 33 were diagnosed with schizophrenia-spectrum disorders, 78 with other psychiatric disorders, and 133 with no mental health disorders when aged 31–33 years.

The patients with schizophrenia-spectrum disorders had the worst social functioning scores at the age of 10–13 years, at an average of 17.5 out of a possible 25.0, compared with 20.7 for those with other psychiatric disorders, and 21.7 for those with no mental health disorders.

Although most of the patients who went on to develop schizophrenia-spectrum disorders were at high risk for the disorder due to having a parent who was hospitalized with the condition, this genetic risk did not significantly alter the strength of the relationship between social functioning and psychiatric outcome. It was also not affected by gender or socioeconomic status.

Schiffman and colleagues say that social functioning is likely to have a “two-hit” effect in predicting the risk for schizophrenia: as well as representing an observable marker of illness susceptibility that is present years before the onset of psychopathology, it may also contribute to chronic stress, potentially exacerbating the risk for schizophrenia.

“Thus social functioning can be viewed as a potential marker of a ‘first-hit,’ as well as a possible contributor to a ‘second-hit,’ ” they write.

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