Increased risk of psychosis in rural-born individuals: An Australian catchment-area study

The aim of the Brisbane Psychosis Study was to examine a range of candidate genetic and nongenetic risk factors in a large, representative sample of patients with psychosis and well controls. The patients (n=310) were drawn from a census conducted as part of the National Survey of Mental Health and Wellbeing. An age and sex-matched well control group (n = 303) was drawn from the same catchment area. Candidate risk factors assessed included migrant status of proband and proband's parents, occupation of father at time of proband's birth, place of birth and place of residence during the first 5 years of life (urbanicity), self-reported pregnancy and birth complications, season of birth and family history. The main analyses were group (cases versus controls) comparisons, with planned subgroup analyses (1) group comparisons for Australian-born subjects only, (2) within-patient comparisons of affective versus nonaffective psychoses. Of the individuals with psychosis, 68% had DSMIII-R schizophrenia. In the main analyses, there were no significant group differences on season of birth, place of birth, place of residency in the first 5 years, occupation of fathers at time of birth or pregnancy and birth complications. Patients had significantly more family members with schizophrenia. Significantly fewer of the patients were migrants or offspring of migrants compared to the controls. When only Australianborn subjects were assessed (n=457), the findings were essentially unchanged apart from a significant excess of cases born in rural sites (chi-square=9.54, df3, p=0.02). There were no significant differences in the risk factors for the comparison involving affective versus nonaffective psychoses. Potential explanations for the inverse urban-rural risk gradient are reviewed. The Stanley Foundation supported this project

Urban birth and migrant status as risk factors for psychosis: An Australian case-control study

Background Urban birth and migrant status have been identified as risk factors for psychosis in North American and European studies. The aim of this study was to explore these variables in an Australian case-control study. Method Country of birth of subjects and their parents, and place of birth of Australian-born subjects, were examined in individuals with psychosis drawn from a prevalence study (n = 310) and well controls recruited from the same catchment area (n = 303). Results Migrant status was associated with a significantly decreased odds of having a psychotic disorder. For those born in Australia, neither migrant status of parents nor urban birth was associated with having a psychotic disorder. Conclusions The lack of effect for urban birth and second-generation migrant status may help generate candidate environmental risk factors that operate in Europe but not in Australia.

Spectral properties of the tandem Jackson network, seen as a quasi-birth-and-death process

Quasi-birth-and-death (QBD) processes with infinite “phase spaces” can exhibit unusual and interesting behavior. One of the simplest examples of such a process is the two-node tandem Jackson network, with the “phase” giving the state of the first queue and the “level” giving the state of the second queue. In this paper, we undertake an extensive analysis of the properties of this QBD. In particular, we investigate the spectral properties of Neuts’s R-matrix and show that the decay rate of the stationary distribution of the “level” process is not always equal to the convergence norm of R. In fact, we show that we can obtain any decay rate from a certain range by controlling only the transition structure at level zero, which is independent of R. We also consider the sequence of tandem queues that is constructed by restricting the waiting room of the first queue to some finite capacity, and then allowing this capacity to increase to infinity. We show that the decay rates for the finite truncations converge to a value, which is not necessarily the decay rate in the infinite waiting room case. Finally, we show that the probability that the process hits level n before level 0 given that it starts in level 1 decays at a rate which is not necessarily the same as the decay rate for the stationary distribution.

The relationship between multiple birth children's early phonological skills and later literacy

Previous studies have shown that multiple ; birth children (MBC) are prone to early phonological ;difficulties and later literacy problems. However, to date, ;there has been no systematic long-term follow-up of MBC with phonological difficulties in the preschool years to determine whether these difficulties predict later literacy problems. In this study, 20 MBC whose early speech and language skills had been previously documented were compared to normative data and 20 singleton controls on tasks assessing phonological ; processing and literacy. The major findings indicated that MBC performed significantly more poorly on some tasks :df phonological processing than singleton controls did. Further, the early phonological skills of MBC (i.e., the number of inappropriate phonological processes used) correlated with poor performance on visual rhyme recognition, word repetition, and phoneme detection tasks 5 years later. There was no significant relationship between early biological factors (birth weight and gestation period) and performance on the phonological processing and literacy-related subtests. These results cl-support the hypothesis that MBC's early speech and language difficulties are not merely a transient phase;of; development, but a real disorder, with consequences for later academic achievement.

The meeting place problem: Salience and search.

The notion of salience was developed by Schelling in the context of the meeting-place problem of locating a partner in the absence of a pre-agreed meeting place. In this paper, we argue that a realistic specification of the meeting place problem involves allowing a strategy of active search over a range of possible meeting places. We solve this extended problem, allowing for extensions such as repeated play, search costs and asymmetric payoffs. The result is a considerably richer, but more complex, notion of salience. (C) 1998 Elsevier Science B.V.

Opioid overdose mortality in Australia, 1964-1997: birth-cohort trends

Objective: To examine trends in rates of opioid overdose deaths from 1964 to 1997 in different birth cohorts. Design: Age-period-cohort analysis of national data from the Australian Bureau of Statistics. Main outcome measures: Annual population rates of death attributed to opioid dependence or accidental opioid poisoning in people aged 15-44 years, by sex and birth cohort tin five-year intervals, 1940-1944 to 1975-1979). Results: The rate of opioid overdose deaths increased 55-fold between 1964 and 1997, from 1.3 to 71.5 per million population aged 15-44 years. The rate of opioid overdose deaths also increased substantially over the eight birth cohorts, with an incidence rate ratio of 20.70 (95% confidence interval, 13.60-31.46) in the 1975-1979 cohort compared with the 1940-1944 cohort. The age at which the cumulative rate of opioid overdose deaths reached 300 per million fell in successive cohorts (for men, from 28 years among those born 1955-1959 to 22 years among those born 1965-1974; for women, from 33 years among those born 1955-1959 to 27 years among those born 1965-1969). Conclusions: Heroin use in Australia largely began in the early 1970s and rates of heroin use have markedly increased in birth cohorts born since 1950.

Is there change over time in the season-of-birth effect for schizophrenia? Data from the southern hemisphere

The aim of this paper is to examine distributions of schizophrenia and general population births over time in order to determine whether (a) the pattern has changed over time, (b) any pattern was similar for both males and females, and (c) whether there is any indication that there is any relationship between the changes in pattern between schizophrenia and general population births. Birth month and year for 7807 individuals with ICD8/9 schizophrenia were gained from the Queensland Mental Health Statistical System for 1914-1975. Monthly births for the general population in Queensland for the same period were obtained from the Australian Bureau of Statistics. For each decade we obtained two comparisons, (1) between two 'seasons' (summer-autumn/winter-spring), and (2) between the third (coldest) quarter and the remaining quarters. Based on expected contrasts from general population proportions, odds ratios and their confidence intervals were used to analyse these comparisons for all subjects, and for males and females separately. The seasonality found in our previous studies was again evident (OR 1.09; 95% CI= 1.01-1.17). However there was no significant change in its pattern over time either for the total group or for males and females separately. When the general population births alone were examined using the same contrasts, seasonality was also observed, but here there were fluctuations over time. These results suggest that exposures linked to changes in general population births over time should be examined in disorders such as schizophrenia which demonstrate seasonality in births. The Stanley Foundation supported this project.

Between-year fluctuations in schizophrenia birth rate and associations with the Southern Oscillation Index, cloud cover and sunshine

Our group have recently proposed that low prenatal vitamin D may be a risk-modifying factor for schizophrenia. Climate variability impacts on vitamin D levels in a population via fluctuations in the amount of available UV radiation. In order to explore this hypothesis, we examined fluctuations in the birthrates for people with schizophrenia born between 1920 and 1967 and three sets of variables strongly associated with UV radiation. These included: (a) the Southern Oscillation Index (SOI), a marker of El Nino which is the most prominent meteorological factor that influences Queensland weather: (b) measures of cloud cover and (c) measures of sunshine. Schizophrenia births were extracted from the Queensland Mental Health register and corrected for background population birth rates. Schizophrenia birth rates had several apparently non-random features in common with the SO1. The prominent SO1 fluctuation event that occurred between 1937 and 1943 is congruent with the most prominent fluctuation in schizophrenia birth rates. The relatively flat profile of SOI activity between 1927 and 1936 also corresponds to the flattest period in the schizophrenia time series. Both time series have prominent oscillations in the 3 ~, year range between 1946 and 1960. Significant associations between schizophrenia birth rates and measures of both sunshine and cloud cover were identified,and all three time series shared periodicity in the 3-4 year range. The analyses suggest that the risk of schizophrenia is higher for those born during times of increased cloud cover,reduced sunshine and positive SO1. These ecological analyses provide initial support for the vitamin D hypothesis, however alternative non-genetic candidate exposures also need to be considered. Other sites with year-to-year fluctuations in cloud cover and sunshine should examine patterns of association between these climate variables and schizophrenia birth rates. The Stanley Foundation supported this project.