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The mental health dangers of birth hypoxia

October 27, 2008

Philadelphia, PA, October 27, 2008 - Complications during pregnancy and birth, such as birth hypoxia - the shortage of oxygen in the body - are associated with an increased risk for schizophrenia. However, it is not clear why hypoxia increases the risk for schizophrenia. The November 1st issue of Biological Psychiatry includes an article by researchers who show that the presence of a specific indicator of fetal distress following hypoxia was more likely to be present among people who later develop schizophrenia. Their findings suggest that the inability of a high-risk fetus to respond adequately to metabolic stresses that it faces in the womb may contribute to its later risk for developing schizophrenia.

Specifically, the authors analyzed levels of an important neuroprotective protein - brain-derived neurotrophic factor (BDNF) - in umbilical cord and maternal blood serum samples obtained at the time of birth and stored in a repository for 45-50 years. They then compared the levels of BDNF found among those individuals who had developed schizophrenia during their lifetime to control subjects, i.e., those individuals who did not develop the disorder. Dr. Tyrone Cannon, the corresponding author, explains the findings: "We found that while BDNF was increased (by 10%) among controls exposed to birth hypoxia, it was significantly decreased (by 20%) among [people later diagnosed with schizophrenia who were] exposed to birth hypoxia." John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, comments that this data "suggests that schizophrenia is not simply associated with deficits in BDNF, but rather it is associated with BDNF reductions at a critical moment in the development of the brain when it needs BDNF to cope with a serious metabolic challenge."

Although this is a preliminary study, and the results need replication, the authors note that this may lead to the study of "novel molecular targets for preventive intervention." The idea of prevention is an important target, as these findings promote "the public health message that maintaining maternal health during pregnancy and reducing the factors that might contribute to the metabolic compromise of the fetus might have real payoff in reducing the later risk for schizophrenia of that fetus," posits Dr. Krystal. That science may one day have the ability to identify these high-risk individuals from birth would be a tremendous advantage in the struggle against this disabling condition.
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Notes to Editors:

The article is "Decreased Neurotrophic Response to Birth Hypoxia in the Etiology of Schizophrenia" by Tyrone D. Cannon, Robert Yolken, Stephen Buka, E. Fuller Torrey, and the Collaborative Study Group on the Perinatal Origins of Severe Psychiatric Disorders. Dr. Cannon is affiliated with the Departments of Psychology, Psychiatry and Biobehavioral Sciences at the University of California Los Angeles, Los Angeles, California. Dr. Yolken is from the Stanley Neurovirology Laboratory, Johns Hopkins University, Baltimore, Maryland. Dr. Buka is with the Department of Epidemiology, Brown University, Providence, Rhode Island. Dr. Torrey is affiliated with the Stanley Medical Research Institute, Chevy Chase, Maryland. The full list of investigators in the Collaborative Study Group on the Perinatal Origins of Severe Psychiatric Disorders is available in the article. The article appears in Biological Psychiatry, Volume 64, Issue 9 (November 1, 2008), published by Elsevier.

The authors' disclosures of financial and conflicts of interests are available in the article. Dr. Krystal's disclosures of financial and conflicts of interests are available at http://journals.elsevierhealth.com/webfiles/images/journals/bps/Biological_Psychiatry_Editorial_Disclosures_08_01_08.pdf.

Full text of the article mentioned above is available upon request. Contact Jayne M. Dawkins at (215) 239-3674 or ja.dawkins@elsevier.com to obtain a copy or to schedule an interview.

About Biological Psychiatry

This international rapid-publication journal is the official journal of the Society of Biological Psychiatry. It covers a broad range of topics in psychiatric neuroscience and therapeutics. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and treatment of major neuropsychiatric disorders. Full-length and Brief Reports of novel results, Commentaries, Case Studies of unusual significance, and Correspondence and Comments judged to be of high impact to the field are published, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Concise Reviews and Editorials that focus on topics of current research and interest are also published rapidly.

Biological Psychiatry (http://www.sobp.org/journal) is ranked 4th out of the 95 Psychiatry titles and 16th out of 199 Neurosciences titles on the 2006 ISI Journal Citations Reports® published by Thomson Scientific.

About Elsevier

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier's 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (http://www.sciencedirect.com/), MD Consult (http://www.mdconsult.com/), Scopus (http://www.info.scopus.com/), bibliographic databases, and online reference works.

Elsevier (http://www.elsevier.com/) is a global business headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is part of Reed Elsevier Group plc (http://www.reedelsevier.com/), a world-leading publisher and information provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier's ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

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