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The aetiology of schizophrenia: what have the Swedish Medical Registers taught us?

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Abstract

Objective

To review the last thirty years of studies that, using Swedish population registers, have added to our understanding of the aetiology of schizophrenia

Sample Included/Methods

A literature search was performed to systematically review all studies that using Swedish Population based registers have investigated the aetiology of schizophrenia. Key authors in the field, predominately from Swedish institutions, were additionally contacted and key journals hand searched, for missing references. A quality assessment methodological review was then conducted on each study. Data was extracted and tabulated on identified aetiological themes

Results

61 articles were included corresponding to 10 identified aetiological themes. Although the majority of included studies were retrospective cohort studies, case control studies were also included where they used population based registers. Confirming previous research, schizophrenia was found to have a multi-factorial aetiological basis with pregnancy and birth factors, parental age, social adversity, genetics, substance misuse, migration and ethnicity, personality, non-psychiatric co-morbidity, psychiatric history and poor cognitive performance all found to be significantly associated with an increased risk of later schizophrenia.

Conclusions

Although some difficulties exist in analysing the interplay between each of these factors, the Swedish population registers have added considerably to our understanding of each of the presented individual aetiological themes. The ability to study the whole population over several decades has been particularly useful in determining the timing of exposures.

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Notes

  1. Body Mass Index.

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Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Psychological Medicine, King’s College London, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK

    Sarah Harper

  2. Brunel University, Kingston Lane, Uxbridge, Middlesex, UB8 3PH, UK

    Helen Towers-Evans

  3. Institute of Psychiatry, King’s College London, 16 De Crespigny Park, London, SE5 8AF, UK

    James MacCabe

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  1. Sarah Harper
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  2. Helen Towers-Evans
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  3. James MacCabe
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Correspondence to Sarah Harper.

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Harper, S., Towers-Evans, H. & MacCabe, J. The aetiology of schizophrenia: what have the Swedish Medical Registers taught us?. Soc Psychiatry Psychiatr Epidemiol 50, 1471–1479 (2015). https://doi.org/10.1007/s00127-015-1081-7

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