To the Editor.—
The smaller brain, head, and frontal lobe size in patients with schizophrenia reported by Andreasen et al1 may result from mismatch of patients and controls in their study. Craniometry of several thousand North American men carried out by Hooton2 some 50 years ago demonstrated a correlation between occupational status and both cranial circumference and frontal diameter. As the accompanying Table reproduced from his study shows, professionals have a larger cranial circumference and fromtal diameter than those who work in other fields. Since there is little correlation between cranial size and intelligence,3 it is likely that the larger head size of professionals may relate to better prenatal and early-life nutrition. Whatever the cause, the professional staff used by Andreasen and colleagues1 as controls should not be so used for comparison with individuals from quite different educational-occupational backgrounds. Similar factors may also influence the correlation they reported
Stevens JR, Waldmon IN. Hat Size in Schizophrenia. Arch Gen Psychiatry. 1987;44(7):673. doi:10.1001/archpsyc.1987.01800190093016
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