Familial risks of psychotic disorders and schizophrenia among siblings based on hospitalizations in Sweden

Abstract Familial risks of psychotic disorders and schizophrenia have been assessed in previous studies. However, the degree of familial clustering in large population datasets remains to be established. We conducted a study on familial risks of psychotic disorders and schizophrenia by linking the Multigeneration Register to the nationwide Swedish Hospital Discharge Register. All patients younger than 72 years hospitalized for psychotic disorders or schizophrenia between 1987 and 2004 were included. Standardized incidence ratios (SIRs) were calculated for individuals with affected singleton siblings, twins or spouses compared with individuals whose siblings or spouses had no hospitalization for psychotic disorders or schizophrenia. A total of 40,228 hospitalized cases were identified of which 3006 were affected sibling pairs. The overall significant familial SIRs were 4.82 for psychotic disorders and 7.34 for schizophrenia. The highest SIRs were found in the younger ages. There were no significant gender differences. The significant SIR for psychotic disorders among twin pairs was 6.40 and the significant SIRs for psychotic disorders among spouses varied between 3.17 and 3.29. Age difference between siblings had no effect on the magnitude of the SIRs. The findings of the present large-scale study suggest that heritable factors have a stronger effect on psychotic disorders and schizophrenia than environmental factors. Future studies could coordinate epidemiological studies of large populations with molecular biology resources.