University of Oulu

Korpela H, Miettunen J, Rautio N, Isohanni M, Järvelin M-R, Jääskeläinen E, Auvinen J, Keinänen-Kiukaanniemi S, Nordström T, Seppälä J (2020). Early environmental factors and somatic comorbidity in schizophrenia and nonschizophrenic psychoses: A 50-year follow-up of the Northern Finland Birth Cohort 1966. European Psychiatry, 63(1), E24. doi:10.1192/j.eurpsy.2020.25

Early environmental factors and somatic comorbidity in schizophrenia and nonschizophrenic psychoses : a 50-year follow-up of the Northern Finland Birth Cohort 1966

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Author: Korpela, Hanna1,2,1; Miettunen, Jouko1,1; Rautio, Nina1,3;
Organizations: 1Center for Life Course Health Research, University of Oulu, Oulu, Finland
2Cancer Research and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
3Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
4Department of Epidemiology and Biostatistics, MRC–PHE Center for Environment & Health, School of Public Health, Imperial College London, London, United Kindom
5Biocenter Oulu, University of Oulu, Oulu, Finland
6Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
7Department of Psychiatry, Oulu University Hospital, Oulu, Finland
8Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
9Department of Psychiatry and Substance Use, South Karelia Social and Health Care District, Lappeenranta, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Elsevier, 2020
Publish Date: 2020-05-14


Background: We studied the cumulative incidence of physical illnesses, and the effect of early environmental factors (EEFs) on somatic comorbidity in schizophrenia, in nonschizophrenic psychosis and among nonpsychotic controls from birth up to the age of 50 years.

Methods: The sample included 10,933 members of the Northern Finland Birth Cohort 1966, of whom, 227 had schizophrenia and 205 had nonschizophrenic psychosis. Diagnoses concerning physical illnesses were based on nationwide registers followed up to the end of 2016 and classified into 13 illness categories. Maternal education and age, family type at birth and paternal socioeconomic status were studied as EEFs of somatic illnesses.

Results: When adjusted by gender and education, individuals and especially women with nonschizophrenic psychosis had higher risk of morbidity in almost all somatic illness categories compared to controls, and in some categories, compared to individuals with schizophrenia. The statistically significant adjusted hazard ratios varied from 1.27 to 2.42 in nonschizophrenic psychosis. Regarding EEFs, single-parent family as the family type at birth was a risk factor for a higher somatic score among men with schizophrenia and women with nonschizophrenic psychosis. Maternal age over 35 years was associated with lower somatic score among women with nonschizophrenic psychosis.

Conclusions: Persons with nonschizophrenic psychoses have higher incidence of somatic diseases compared to people with schizophrenia and nonpsychotic controls, and this should be noted in clinical work. EEFs have mostly weak association with somatic comorbidity in our study.

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Series: European psychiatry
ISSN: 0924-9338
ISSN-E: 1778-3585
ISSN-L: 0924-9338
Volume: 63
Issue: 1
Article number: e24
DOI: 10.1192/j.eurpsy.2020.25
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
3142 Public health care science, environmental and occupational health
3112 Neurosciences
Funding: This study has been funded by the Academy of Finland (268336 and 278286), NARSAD: The Brain and Behavior Research Foundation, the Sigrid Jusélius Foundation, the Northern Finland Health Care Support Foundation, and the European Union’s Horizon 2020 Research and Innovation Program under grant agreement no. 643552 and innovation program under grant agreement no. 633595 for the DynaHEALTH action. The funders had no role in preparing the manuscript.
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(643552) m-RESIST - Mobile Therapeutic Attention for Patients with Treatment Resistant Schizophrenia
Academy of Finland Grant Number: 268336
Detailed Information: 268336 (Academy of Finland Funding decision)
278286 (Academy of Finland Funding decision)
Copyright information: © The Author(s) 2020. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.