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Dr Jones asks for clarification of case ascertainment, suggesting that there may have been an undetected effect in men as well as in women because of low statistical power, ie, a type II error.Our numerators are the number of individuals who were hospitalized for schizophrenia during the period 1978 through 1989 in the birth cohorts exposed and unexposed to famine in the first trimester. No individual is counted twice (ie, an individual with five admissions during 1978 through 1989 is still counted as one case). This is not a true incident sample of cases of new onset because some individuals may also have had hospitalizations prior to the study period (these birth cohorts were from 32 to 45 years of age). As noted by Dr Jones, an effect of prenatal exposure to famine on the course of illness as well as on incidence could conceivably produce an increase in
Susser E, Lin SP. Schizophrenia After Prenatal Exposure to the Dutch Hunger Winter of 1944-1945-Reply. Arch Gen Psychiatry. 1994;51(4):333–334. doi:10.1001/archpsyc.1994.03950040077011
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