Skip to main content Accessibility help

Age at Onset in Schizophrenia and Risk of Illness in Relatives: Results from the Roscommon Family Study

  • Kenneth S. Kendler (a1), Laura Karkowski-Shuman (a2) and Dermot Walsh (a3)



For many common medical and neuropsychiatric disorders, early age at onset reflects high familial liability to illness. However, for schizophrenia, most studies do not find such a relationship.


Using Cox proportional hazard models, we investigate this question in the epidemiologically-based Roscommon family study.


No relationship was found between age at onset in schizophrenic probands and the hazard rate for schizophrenia in their relatives. Similar results were obtained when the definition of illness was expanded to include schizoaffective disorder and other non-affective psychoses.


For schizophrenia, a ‘common-sense’ model for age of onset (i.e. those with highest familial liability to illness succumb first while those with lower liability survive longer before falling ill) does not seem to apply. Our results are more consistent with a model in which variation in age at onset of schizophrenia is due to random developmental effects or to environmental experiences unique to the individual.


Corresponding author

Professor K. S. Kendler, Department of Psychiatry, Medical College of Virginia, Box 980710, Richmond VA 23298-0710, USA


Hide All
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.
Baron, M., Mendlewicz, J. & Klotz, J. (1981) Age-of-onset and genetic transmission in affective disorders. Acta Psychiatrica Scandinavica, 64, 373380.
Cadoret, R. J., Woolson, R. & Winokur, G. (1977) The relationship of age of onset in unipolar affective disorder to risk of alcoholism and depression in parents. Journal of Psychiatric Research, 13, 137142.
Childs, B. & Scriver, C. R. (1986) Age at onset and causes of disease. Perspectives in Biology and Medicine, 29, 437460.
Cloninger, C. R., Bohman, M. & Sigvardsson, S. (1981) Inheritance of alcohol abuse: cross-fostering analysis of adopted men. Archives of General Psychiatry, 38, 861868.
Crow, J. F. (1965) Problems of ascertainment in the analysis of family data. In Genetics and the Epidemiology of Chronic Diseases (eds Neel, J. V., Shaw, M. W. & Schull, W. J.), pp. 2344. Washington, DC: US Department of Health, Education and Welfare.
Hesselbrock, M. N. (1995) Genetic determinants of alcoholic subtypes. In The Genetics of Alcoholism (eds Begleiter, H. & Kissin, B.), pp. 4069. New York: Oxford University Press.
Heston, L. L., Mastri, A. R., Anderson, V. E., et al (1981) Dementia of the Alzheimer type: Clinical genetics, natural history and associated conditions. Archives of General Psychiatry, 38, 10851090.
Kendler, K. S., Gruenberg, A. M. & Tsuang, M. T. (1985) Psychiatric illness in first-degree relatives of schizophrenic and surgical control patients: a family study using DSM–III criteria. Archives of General Psychiatry, 42, 770779.
Kendler, K. S., Tsuang, M. T. & Hays, P. (1987) Age at onset in schizophrenia: a familial perspective. Archives of General Psychiatry, 44, 881890.
Kendler, K. S., Lieberman, J. A. & Walsh, D. (1989) The Structured Interview for Schizotypy (SIS): A preliminary report Schizophrenia Bulletin, 15, 559571.
Kendler, K. S., & Maclean, C. J. (1990) Estimating familial effects on age at onset and liability to schizophrenia. I. Results of a large sample family study. Genetic Epidemiology, 7, 409417.
Kendler, K. S., McGuire, M., Gruenberg, A. M., et al (1993) The Roscommon Family Study: I. Methods, diagnosis of probands and risk of schizophrenia in relatives. Archives of General Psychiatry, 50, 527540.
Kendler, K. S., McGuire, M., Gruenberg, A. M., et al (1994) Clinical heterogeneity in schizophrenia and the pattern of psychopathology in relatives: results from an epidemiologically based family study. Acta Psychiatrica Scandinavica, 89, 294300.
Kendler, K. S., O'Neill, F. A., Burke, J., et al (1996) The Irish study of high-density schizophrenia families: field methods and power to detect linkage. American Journal of Medical Genetics (Neuropsychiatric Genetics), 67, 179190.
Liang, K.-Y. (1991) Estimating effects of probands' characteristics on familial risk: I. Adjustment for censoring and correlated ages of onset Genetic Epidemiology, 8, 329338.
Lindelius, R. (ed.) (1970) A study of schizophrenia. A clinical, prognostic, and family investigation. Acta Psychiatrica Scandinavica (Suppl), 216, 1 125.
Maclean, C. J., Neale, M. C., Meyer, J. M., et al (1990) Estimating familial effects on age at onset and liability to schizophrenia. II. Adjustment for censored data. Genetic Epidemiology, 7, 419426.
McGue, M., Gottesman, I. I. & Rao, D. C. (1983) The transmission of schizophrenia under a multifactorial threshold model American Journal of Human Genetics, 35, 11611178.
McGue, M., Pickens, R. W. & Svikis, D. S. (1992) Sex and age effects on the inheritance of alcohol problems: A twin study. Journal of Abnormal Psychology, 101, 317.
McNeil, T. F. (1988) Obstetric factors and perinatal injuries. In Handbook of Schizophrenia, Volume 3. Nosology, Epidemiology and Genetics of Schizophrenia (eds Tsuang, M. T. & Simpson, J. C.), pp. 319344. Amsterdam: Elsevier.
Mendlewicz, J. & Baron, M. (1981) Morbidity risks in subtypes of unipolar depressive illness: differences between early and late onset forms. British Journal of Psychiatry, 139, 463466.
Pulver, A. E., Brown, C. H., Wolyniec, P., et al (1990) Schizophrenia: age at onset, gender and familial risk. Acta Psychiatrica Scandinavica, 82, 344351.
Pulver, A. E., & Liang, K.-Y. (1991) Estimating effects of proband characteristics on familial risk: II. The association between age at onset and familial risk in the Maryland Schizophrenia Sample. Genetic Epidemiology, 8, 339350.
Rice, J., Reich, T., Andreasen, N. C., et al (1987) The familial transmission of bipolar illness. Archives of General Psychiatry, 44, 441447.
Ridley, R. M., Baker, H. F. & Crow, T. J. (1986) Transmissible and non-transmissible neurodegenerative disease: similarities in age of onset and genetics in relation to aetiology. Psychological Medicine, 16, 199207.
Rissanen, A. M. (1979) Familial occurrence of coronary heart disease. American Journal of Cardiology, 44, 6066.
SAS Institute (1992) SAS Technical Report P-229 SAS/STAT Software: Changes and Enhancements. Release 6.07. Cary, NC: SAS Institute.
Schulz, B. (1932) Zur Erbpathologie der Schizophrenic (On the hereditary pathology of schizophrenia). Zeitschrift far die gesamte Neurologic und Psychiatrie, 143, 175293.
Spitzer, R. L., Williams, J. B. & Gibbon, M. (1987) Structured Clinical Interview for DSM–III–R. New York: Biometrics Research Department, New York State Psychiatric Institute.
Walsh, D., O'Hare, A., Blake, B., et al (1980) The treated prevalence of mental illness in the Republic of Ireland – the three county case register study. Psychological Medicine, 10, 465470.
Weissman, M. M., Merikangas, K. R., Wickramaratne, P., et al (1986) Understanding the clinical heterogeneity of major depression using family data. Archives of General Psychiatry, 43, 430434.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Age at Onset in Schizophrenia and Risk of Illness in Relatives: Results from the Roscommon Family Study

  • Kenneth S. Kendler (a1), Laura Karkowski-Shuman (a2) and Dermot Walsh (a3)
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *