Family History of Psychiatric Illness as a Risk Factor for Schizoaffective Disorder: A Danish Register-Based Cohort Study
Abstract
BACKGROUND: Schizoaffective disorder may be related to both schizophrenia and bipolar disorders, but no population-based studies, to our knowledge, have investigated this association in families. OBJECTIVES: To determine whether a psychiatric history of schizoaffective disorder, bipolar disorder, or schizophrenia among parents and siblings is a risk factor for developing a schizoaffective disorder, and whether a specific pattern of family history of psychiatric illness exists in persons with schizoaffective disorder compared with persons with bipolar disorder or schizophrenia. DESIGN: Register-based cohort study. SETTING: Denmark. COHORT: The 2.4 million persons born in Denmark after 1952. MAIN OUTCOME MEASURES: Relative risks of the 3 illnesses estimated by Poisson regression. RESULTS: In total, 1925 persons had a schizoaffective disorder, 3721 had a bipolar disorder, and 12 501 had schizophrenia. The relative risk of schizoaffective disorder was 2.76 (95% confidence interval, 2.49-3.06) if a first-degree relative had a history of mental illness compared with a person with no first-degree relatives with such a history. There was an additional risk (95% confidence interval) of 2.57 (2.11-3.13), 3.23 (2.63-3.95), or 1.92 (1.43-2.57) if the first-degree relative had schizophrenia, bipolar disorder, or schizoaffective disorder, respectively, compared with other psychiatric admissions. When bipolar disorder was the outcome, bipolar disorder in first-degree relatives was by far the significantly strongest risk factor. When schizophrenia was the outcome, the significantly strongest risk factor was schizophrenia among first-degree relatives. CONCLUSION: Schizoaffective disorder is not simply a subgroup of either bipolar disorder or schizophrenia but may be genetically linked to both, with schizoaffective disorder being a subtype of each or a genetic intermediate form.
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Laursen et al. (2005) have documented an excess mortality in the parents of patients with schizophrenia.
“Laursen et al. (2005) have documented an excess mortality in the parents of patients with schizophrenia, a finding that could suggest both shared environmental and genetic factors but may also reflect an impact of the stress associated with caring for a severely ill family member.”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Laursen et al. 2005
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- Authors
- Laursen, T. M., Labouriau, R., Licht, R. W., Bertelsen, A., Munk-Olsen, T., & Mortensen, P. B.
- Affiliations
- Aarhus University (DK)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2005-08-01
- Volume
- 62
- Issue
- 8
- Pages
- 841
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2110680655
- Cited by
- 138
- References
- 21
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2022: 7 · 2021: 9 · 2020: 6 · 2019: 2 · 2018: 3 · 2017: 9 · 2016: 7 · 2015: 7 · 2014: 8 · 2013: 10 · 2012: 7
- FWCI
- 5.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Research Foundation
- Danmarks Grundforskningsfond
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- schizoaffective disorder, bipolar disorder, schizophrenia, family history of mental illness, first-degree relatives, genetic risk factors, psychiatric hospital admissions
- MeSH terms
- Mental Disorders, Bipolar Disorder, Denmark, Family Health, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Pedigree, Psychotic Disorders, Registries, Risk, Risk Factors, Schizophrenia, Cohort Studies, Poisson Distribution, Linear Models, Genetic Predisposition to Disease, International Classification of Diseases
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