July 1993

The Roscommon Family StudyI. Methods, Diagnosis of Probands, and Risk of Schizophrenia in Relatives

Arch Gen Psychiatry. 1993;50(7):527-540. doi:10.1001/archpsyc.1993.01820190029004

Objectives:  We sought to examine, in a rural county in the West of Ireland, the degree of familial relationship between schizophrenia and other nonaffective psychoses and affective illness (AI).

Design:  A case-controlled epidemiologic family study using DSM-III-R criteria.

Participants:  This study incuded three proband groups: (1) all cases with a clinical diagnosis of schizophrenia from the Roscommon County Case Register born from 1930 onward (n=285); (2) a random sample of cases from the register with a clinical diagnosis of severe AI (n=99); and (3) a matched, random sample of Roscommon residents ascertained from the electoral register (n=150). Face-toface structured interviews were conducted with 86% of traceable, living relatives (n=1, 753) and 88% of traceable, living probands (n=415).

Results:  In interviewed relatives, the lifetime risks (±SE) for schizophrenia, as a function of the "blind" proband di- agnosis, were as follows: schizophrenia, 6.5% ± 1.6%; schizoaffective disorder, 6.8%±2.5%; schizotypal personality disorder, 6.9%±3.9%; other nonaffective psychoses, 5.1%±2.4%; psychotic AI, 2.8%±1.2%; nonpsychotic AI, 0.6%±0.6%; and control, 0.5%±0.3%. Individuals with schizophrenia reproduced at a rate about one quarter that of controls and the risk for schizophrenia in parents of probands was much less than that found in siblings.

Conclusions:  These results support the following hypotheses: (1) in the West of Ireland, as in other populations, schizophrenia is a strongly familial disorder; (2) schizophrenia shares a familial predisposition with a spectrum of clinical syndromes that includes schizoaffective disorder, other nonaffective psychoses, schizotypal personality disorder, and probably psychotic AI, but not nonpsychotic AI; and (3) the diminished reproductive rates associated with schizophrenia have a large impact on the pattern of risk of illness in relatives.