Relationship between childhood behavioral disturbance and later schizophrenia in the New York High-Risk Project

Objective: An association between childhood behavioral disturbance and adul thood schizophrenia has been seen previously in retrospective or follow-bac k studies and in prospective studies. The authors examined the relationship between childhood behavioral problems and adulthood schizophrenia-related psychoses. Because a high rate of childhood behavioral problems is known to be associated with adult substance abuse, these analyses controlled for su bstance abuse. Method: The subjects of this investigation (N=185) were offs pring of parents with schizophrenia or affective disorder and of normal par ents from the New York High-Risk Project (sample A). Data on childhood beha vioral problems were obtained in a parent interview at initial assessment i n 1971-1972. Adulthood outcomes (schizophrenia-related psychoses, affective disorders, anxiety disorders, substance abuse) were based on lifetime axis I diagnoses according to the Research Diagnostic Criteria. Results: Substa nce abuse had a significant interaction with the clinical outcome groups. I n subjects without substance abuse, those with schizophrenia-related psycho ses had exhibited significantly more behavioral problems as children than h ad adult offspring with affective or anxiety disorder or with substance abu se only or no disorder. Conclusions: These results support the view that sc hizophrenia-related psychoses can be followed back to early behavioral dist urbances. The confounding effects of substance abuse should be statisticall y controlled in studies of longitudinal associations between childhood beha vioral disturbance and axis I outcomes.