Minor physical anomalies and obstetric complications in schizophrenia

Objective: To evaluate the possibility of using congenital minor physical a nomalies (MPA) and obstetric complications (OC) as individual-orientated, e arly life markers signalling increased risk for schizophrenia. Method: Previous findings using Waldrop and colleagues' MPA scale land addi tional items) and systematic study of OC history are summarised concerning schizophrenia patients and individuals at heightened genetic risk for schiz ophrenia. Results: Significantly increased rates of both MPA and OC are consistently found in patients with schizophrenia. Minor physical anomalies are stable c haracteristics over time and can be studied efficiently from early childhoo d onward, Minor physical anomalies predict a variety of mental disorders in normal-risk children, but the predictive efficiency of MPA for schizophren ia in genetic high-risk samples and in the general population is unknown, O bstetric complications predict serious mental disturbance and neurodisorder in genetic high-risk cases, as well as doubling or tripling the individual 's risk for schizophrenia in the general population. Obstetric complication results are sensitive to methodology and are best investigated using prosp ectively recorded information and an efficient OC scale for scoring the inf ormation. Conclusions: Both MPA and OC should be included in batteries of methods for identifying individuals at an increased risk for schizophrenia. However, i ncreased rates of MPA and OC are not pathognomonic for schizophrenia, but r ather characterise individuals at risk of a much broader range of mental an d physical abnormality, as well as normality. Minor physical anomalies and OC are not in themselves stigmatising, but their possible identification as markers for 'increased risk for schizophrenia' should be used judiciously. Further research is recommended regarding the MPA and OC patterns related to schizophrenia.