PREGNANCY AND THE FLU: A LINK TO SCHIZOPHRENIA

Cognitive Problems Revealed in Those Who Later Develop Psychosis

Philadelphia, PA, 9 June 2009 – When mothers become infected with influenza during their pregnancy, it may increase the risk for schizophrenia in their offspring. Influenza is a very common virus and so there has been substantial concern about this association. A new study in the June 15th issue of Biological Psychiatry, published by Elsevier suggests that the observed association depends upon a pre-existing vulnerability in the fetus.

Specifically, Dr. Lauren Ellman and colleagues determined that fetal exposure to influenza leads to cognitive problems at age 7 among children who later develop a psychotic disorder in adulthood, but fetal exposure to influenza does not lead to cognitive problems among children who do not later develop a psychotic disorder. It is important to note that these results were dependent upon the type of influenza, with this association present only after fetal exposure to influenza B as opposed to influenza A.

This research was conducted as part of the Collaborative Perinatal Project, which followed pregnant women and their offspring in the 1950’s and 60’s, collecting blood throughout pregnancies for later analyses. A series of cognitive assessments were conducted with the children of study participants and then psychotic diagnoses were determined in adulthood.

The findings from this study suggest that a genetic and/or an additional environmental factor associated with psychosis likely is necessary for the fetal brain to be vulnerable to the effects of influenza, given that decreases in cognitive performance were only observed in influenza-exposed children who developed a psychotic disorder in adulthood.

“The good news is that most fetuses exposed to influenza virus while in the womb will not go on to develop schizophrenia. The bad news is that the prior association between influenza infection and later development of psychotic disorders was supported,” comments John Krystal, M.D., the editor of Biological Psychiatry.

This finding has the potential to influence efforts to develop prevention, early intervention and treatment strategies, such as taking steps to maintain careful hygiene and, if clinically appropriate, administration of the influenza vaccination to reduce infection among women prior to pregnancy. Dr. Krystal notes, “It also raises an important unanswered question: How does influenza virus affect the vulnerable developing brain and how can we prevent or reverse the consequence of fetal influenza infection in vulnerable individuals before they develop schizophrenia?” More research is needed to elicit answers to these vital issues.

# # #

Notes to Editors: 
The article is “Cognitive Functioning Prior to the Onset of Psychosis: The Role of Fetal Exposure to Serologically Determined Influenza Infection” by Lauren M. Ellman, Robert H. Yolken, Stephen L. Buka, E. Fuller Torrey, Tyrone D. Cannon. Dr. Ellman is affiliated with the Department of Psychiatry at Columbia University, New York, New York and the Department of Psychology at Temple University, Philadelphia, Pennsylvania. Dr. Yolken is from the Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Dr. Buka is from the Department of Community Health, Brown University Division of Biology and Medicine, Providence, Rhode Island. Dr. Torrey is affiliated with the Stanley Medical Research Institute, Chevy Chase, Maryland. Dr. Cannon is with the Departments of Psychology, Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California. The article appears in Biological Psychiatry, Volume 65, Issue 12 (June 15, 2009), published by Elsevier.

The authors’ disclosures of financial and conflicts of interests are available in the article.

John H. Krystal, M.D. is affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, and his 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 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 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 provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence,and ClinicalKey—and publishes over 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media Contact: 
Jayne Dawkins
Elsevier
+1 215 239 3674
Ja.dawkins@elsevier.com