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The recent reformulation of schizophrenia as a neurodevelop- ment disorder has focused on prenatal development. We com- pared birthweight and head circumference (HC) at birth between 67 Japanese DSM-III-R schizophrenics (35 males) and the general population (n = 1640). Information on body mea- sures and gestational age at delivery (weeks) was obtained by birth records. When gestational age and gender were controlled for, birthweight in the schizophrenics was not significantly different from average birthweight in the general population (t = -- 0.24; df= 66; p = 0.81 ). However, HC in the schizophrenic neonates was significantly smaller ( t = - 2 . 7 5 ; df=66; p = 0.008). We examined the effects of family history of psychosis (in first or second degree relatives) and season of birth (January`April vs May-December) on the smaller HC. Analyses using ANCOVA, where the effects of gestational age, gender, birth year, and maternal age were adjusted, revealed that individuals with a family history (n = 13) had significantly smaller HC compared with those without a family history (n = 54) (F=9.7; df=l, p=0.003), and that individuals born in January April (n = 19) had significantly smaller HC compared with the others (n=35) among those without a family history (F= 6. l; df= 1; p = 0.015). These results suggest that both family history of psychosis, and birth in winter or early spring are independently associated with the smaller HC possibly resulting from slower brain growth in the preschizophrenic fetus.

F A C T O R S I N F L U E N C I N G R E A D M I S S I O N S

O F S C H I Z O P H R E N I C S T O P S Y C H I A T R I C

H O S P I T A L

R a m m o h a n Rao Malesu

Psychiatric Hospital Black Rock, St. Michael Barbados ( W.L )

The progressive increase in readmissions of patients with schizophrenia in Barbados is a cause of concern. Readmissions of schizophrenics constituted over 70% of the total admissions. In a prospective study of 208 patients of functional psychosis, it was found that male schizophrenics accounted for 62% of the total readmissions. Besides male gender the other demo- graphic characteristics which were strong predictors of readmis- sion were age, unemployment, lower socioeconomic class and homelessness. There was a significant increase of drug abuse, criminal behavior and poor compliance with medication amongst male schizophrenics. Moreover, readmissions occurred overwhelmingly in short-stay patients and patients not included in the community psychiatric services. This study stresses the need for drug rehabilitation for patients with drug abuse, adequate aftercare, rehabilitation facilities in the community, housing facilities including half-way houses to keep readmis- sions to a minimum.

R A I S E D I N C I D E N C E O F S C H I Z O P H R E N I A

I N U K A F R O - C A R I B B E A N S - - C L U E S T O

A E T I O L O G Y

J. Left*, D. Bhugra, R. Mallet t

Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK

Previous studies have found a high incidence of schizophrenia in Afro-Caribbeans in the UK. We have confirmed this finding in an epidemiological study in London comparing the incidence of psychoses in whites, Asians and Afro-Caribbeans. Our rates are likely to be more reliable than previous estimates as we used population figures from the 1991 census, which was the first to include a question on self-ascribed ethnicity. For Schneiderian schizophrenia whites and Asians had similar rates, while Afro-Caribbeans were significantly higher. However, the variation in rates was much greater for non-Schneiderian schizophrenia. Furthermore non-Schneiderian schizophrenia and Afro-Caribbean ethnicity were independently associated with a higher relapse rate during a one year follow-up.

A parallel study in Trinidad using identical methods found low rates of Schneiderian and non-Schneiderian schizophrenia.

These findings suggest that the high incidence of schizophre- nia in UK Afro-Caribbeans is unlikely to be explained geneti- cally. Factors in the social and/or physical environment are likely to be involved. Identification of these could illuminate the aetiology of schizophrenia. The results also suggest that Schneiderian and non-Schneiderian schizophrenia may repre- sent different diagnostic categories.

H A N D E D N E S S I N P A T I E N T S W I T H

F U N C T I O N A L P S Y C H O S I S

R a m m o h a n Rao Malesu*, M. Cannon , K.J. McKenzie, K.M. Gilvarry, P. Jones, R.M. M u r r a y

Genetics Section, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK

Previous studies on the association between patterns of handedness and mental disorders have yielded varying results. Difference in the choice of handedness questionnaires or incon- sistencies in the criteria used to classify handedness could account for the differences. We report a study on the association between patterns of hand preferences and functional psychosis in a large sample of RDC diagnosed patients using the revised Annett's Questionnaire of Hand Preference Classes. The study group consisted of 216 patients (120 with schizophrenia, 41 with schizoaffective disorder and 55 with affective disorder) and 86 normal controls. There was no significant difference between the proportions of right, left and mixed handedness between the patient groups and controls, or within the patient group. No significant correlation was found between handed- ness and gender, IQ, family history of mental illness, obstetric complications, chronicity or ethnicity. We also found no associ- ation of handedness with symptomatology when we examined the 38 Present State Examination (PSE) Clinical Syndromes. We conclude that there is no significant association between anomalous patterns of handedness and functional psychotic illness.