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Schizophrenia Bulletin Advance Access originally published online on March 13, 2008
Schizophrenia Bulletin 2009 35(3):655-657; doi:10.1093/schbul/sbn012
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Better Outcome of Schizophrenia in India: A Natural Selection Against Severe Forms?

Jagadisha Thirthalli2 and Sanjeev Jain1,2
2 National Institute of Mental Health and Neurosciences, Bangalore, India

1 To whom correspondence should be addressed; Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India; tel: 00918026995262, fax: 00918026564830, e-mail: sjain.nimhans{at}gmail.com.

Regional variations are observed in outcome of schizophrenia, but reasons remain unclear. Outcome of schizophrenia is reported to be better in India. In this report based on census data, we highlight substantially greater mortality observed among the mentally ill than among the general population during famines in India in the 19th century. A possible selection against the most severe forms of schizophrenia could account for greater occurrence of better-outcome phenotypes. Population histories and environmental influences, including epigenetics, need to be considered to further investigate differences between schizophrenia phenotypes.

Keywords: famine / phenotype / epigenetics


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