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To the Editor: In their study on the rates of adult schizophrenia in China, Dr St Clair and colleagues¹ found that in the Chinese provinces most affected by a massive famine in 1960-1961 the relative risk of developing schizophrenia that was conferred by prenatal maternal exposure to famine was 2.30 in 1960 and 1.93 in 1961 compared with nonfamine years. These results replicate a similar finding from the Dutch Hunger Winter of 1944-1945,² and the implications of both studies are discussed by Dr Neugebauer in an Editorial.³ Given these results, it is likely that such exposure does play a pathogenic role in schizophrenia, along with other factors such as genetic susceptibility.

But if exposure to famine is an important risk factor for developing schizophrenia, then with the evidence that schizophrenia has only been present for approximately the last 200 years⁴ there may be yet at least 1 more significant unknown . . . [Full Text of this Article]

Eric Lewin Altschuler, MD, PhD
eric.altschuler@umdnj.edu
Department of Physical Medicine & Rehabilitation
University of Medicine & Dentistry of New Jersey
Newark

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