Article open access publication

Is an Early Age at Illness Onset in Schizophrenia Associated With Increased Genetic Susceptibility? Analysis of Data From the Nationwide Danish Twin Register

EBioMedicine, Elsevier, ISSN 2352-3964

Volume 18, 2017

DOI:10.1016/j.ebiom.2017.04.002, Dimensions: pub.1084525383, PMC: PMC5405190, PMID: 28427946,


Hilker, Rikke * (1) (2)
Helenius, Dorte (1) (3)
Nordentoft, Merete (1) (2) (5)

* Corresponding author



  1. (1) Lundbeck Foundation, grid.452548.a
  2. (2) University of Copenhagen, grid.5254.6, KU
  3. (3) Mental Health Center Sct. Hans, Mental Health Services, Capital Region Denmark, DK-4000, Roskilde, Denmark
  4. (4) University of Southern Denmark, grid.10825.3e, SDU
  5. (5) Mental Health Services, grid.466916.a, Central Denmark Region






BACKGROUND: Early age at illness onset has been viewed as an important liability marker for schizophrenia, which may be associated with an increased genetic vulnerability. A twin approach can be valuable, because it allows for the investigation of specific illness markers in individuals with a shared genetic background. METHODS: We linked nationwide registers to identify a cohort of twin pairs born in Denmark from 1951 to 2000 (N=31,524 pairs), where one or both twins had a diagnosis in the schizophrenia spectrum. We defined two groups consisting of; N=788 twin pairs (affected with schizophrenia spectrum) and a subsample of N=448 (affected with schizophrenia). Survival analysis was applied to investigate the effect of age at illness onset. FINDINGS: We found that early age at illness onset compared to later onset in the first diagnosed twin can be considered a major risk factor for developing schizophrenia in the second twin. Additionally, we found that the stronger genetic component in MZ twins compared to DZ twins is manifested in the proximity of assigned diagnosis within pairs. DISCUSSION: Early onset schizophrenia could be linked to a more severe genetic predisposition, indicating that age might be perceived as a clinical marker for genetic vulnerability for the illness.

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University of Copenhagen

University of Southern Denmark

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2017: Realized

Research area: Medicine

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Times Cited: 6

Field Citation Ratio (FCR): 3.34

Relative Citation ratio (RCR): 0.56

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