Prenatal rubella, premorbid abnormalities, and adult schizophrenia

Background: Premorbid neurocognitive, neuromotor, and behavioral function t ends to be disturbed in schizophrenia. We previously demonstrated that a bi rth cohort clinically and serologically documented with prenatal rubella ev idenced a marked increase in risk of nonaffective psychosis. In our study, we examined whether rubella-exposed subjects destined to develop schizophre nia and other schizophrenia spectrum disorders (SSD), compared with exposed control subjects, had greater impairment in several premorbid functions. Methods: Subjects were interviewed using a direct, comprehensive research a ssessment and diagnosed by consensus. We compared the degree of IQ decline, as well as premorbid neuromotor and behavioral dysfunction, between rubell a-exposed subjects who developed schizophrenia spectrum psychosis (SSP) and exposed control subjects from the cohort. We also compared the gestational timing of rubella infection between the cases and control subjects. Results: This rubella-exposed birth cohort evidenced a markedly increased r isk of SSD (20.4% or 11/53). Rubella-exposed SSP cases, compared with rubel la-exposed Control subjects, demonstrated a decline in Ie from childhood to adolescence, and increased premorbid neuromotor and behavioral abnormaliti es Moreover, it appears that early gestational rubella exposure may represe nt a period of increased vulnerability for SSD. Conclusions: These findings link a known prenatal exposure, a deviant neuro developmental trajectory in childhood and adolescence, and SSP in adulthood within the same individuals. Biol Psychiatry 2001;49:473-486 (C) 2001 Soci ety of Biological Psychiatry.