Longitudinal, Whole-population Data Examining Pathways of Risk from Conception to Disease: The Western Australian Schizophrenia High-risk e-Cohort

Abstract

This database has been constructed to support a program of work designed to untangle genetic and environmental contributions to the risk for schizophrenia and other adverse outcomes in the offspring of mothers with schizophrenia and other severe mental illness. To do this, it utilises Western Australian whole-population health and social services databases. Records on the Western Australian psychiatric case register have been linked to Midwives’ Notification of Birth records and to Registrations of Births (for paternal links) as well as to other data sets. Maternal links identify women with psychosis who gave birth in Western Australia between 1980 and 2001. Comparison mothers are those with no record of psychiatric illness who gave birth in Western Australia over the same period. The study database comprises 246,873 mothers and 467,945 children: 889 mothers with schizophrenia (1,672 children); 1,644 mothers with bipolar disorder (3,358 children); 4,200 mothers with unipolar major depression (8,864 children); 775 mothers with other psychoses (1,592 children); and 239,365 comparison mothers (452,459 children). Full psychiatric histories for mothers, fathers and children have been extracted. At the time of the most recent update to the psychiatric data on children, 33,363 children had a history of psychiatric illness; 5,500 of these had had at least one contact with mental health services at which a diagnosis of a psychotic disorder had been recorded. Data have also been collected on obstetric complications and a range of infant and childhood morbidities including birth defects, intellectual disability, educational achievement, childhood abuse, criminal offending. The program aims are to: (i) determine the frequency and distribution of obstetric complications in women with schizophrenia compared to a non-psychiatric comparison group of mothers; (ii) explore the spectrum of outcomes for the children born to women with schizophrenia compared to comparison children, and to assess the specificity of these findings to maternal schizophrenia compared to maternal bipolar disorder, unipolar major depression and other psychotic illness; and (iii) examine the relationship between familial psychiatric status, obstetric complications and mental health outcomes for children. The data sit in an Ingres relational database. A full description of the database and its elements has been published [1]. Numbers in this article differ from previously published numbers as a result of new linkages and updates to the database.