Preventing Schizophrenia - Risk Reduction Approaches


Note - for people outside the USA who cannot obtain or afford the books listed below, you may, in many cases, be able to download these books and interviews (or audio books) for free via the emule private file sharing network. To access this network (illegal, in the US) - go to the emule web site, and download the latest "Installer" version of software for your PC, then do searches in the "name" field - on for key words in the title of the book or the author's last name. Where it says "Type" - specify "document", "archive" and "audio" files, in three different searches for each item you're looking for. Specify the "method" to be "global servers". Most of the files being shared on these networks are being made available by millions of high school and university students (and others) around the world. While we have heard that some industry organizations are taking legal action against students who have downloaded music via the emule network, we have not heard of any actions against people who download books and audio books. If you need help in understanding how to use emule - go to the help section of the emule web site. To open .rar files - use the WinRAR application available for download from here.


Schizophrenia Risk Reduction Actions for Parents and Future Parents

The following schizophrenia prevention strategies are identified to help parents potentially lower the risk of mental illness in their children. While researchers we've talked to believe that it is likely that each of these actions would be helpful in risk reduction for mental illness, definative proof of their effectiveness is not yet available. Given this, the approach for the family members at this web site has been to take the actions that we can to lower the risk of mental illness in our children - but we don't worry about things that we can't do, or haven't done in the past. Its doubtful that anyone will take all the actions identified below. Our focus is instead on taking actions in areas we reasonably can, and looking positively towards the future with the knowledge that we've taken some significant actions to lower risk of mental health problems for our children in the future.

Build a relationship, or marry, a person with whom you can have a stable, loving and (mostly) low-stress relationship and a healthy family life. Some characteristics of healthy families as stated by family relationship expert Dr. D. Reiss, of George Washington University:

  • Healthy families speak clearly. They are not rigid in their discussions, nor are they confused and chaotic.
  • They tend to agree more often than disagree and are able to assert themselves without offending others.
  • They have a friendly environment and are able to disagree without upsetting other members.
  • They show variation in affect (mood) ; they can express happiness or sadness to each other.
  • They have a good sense of humor and have the ability to laugh at themselves.
  • They respect each other's need for privacy and do not engage in mind reading (thinking that they can tell exactly what a person is thinking).
  • They negotiate and compromise.
  • In families that function effectively, grudges are not held very long. Arguments are short and followed by more friendly interactions.

The Finnish Adoptive Family Study of Schizophrenia has confirmed that genetics plays a major role in the risk of development of schizophrenia. It also found that persons with a genetic risk of schizophrenia are especially sensitive to the emotional climate of their family environment. A child-rearing environment that is sensitive and nurturing, with infrequent criticism and clear, straightforward communication appears to be protective against the triggering of this genetic risk.

As Dr. John Gottman, a psychologist and researcher who focuses on marriage and relationships, says:

"When a marriage goes sour, husband and wife are not the only ones to suffer--the children do, too. In a study I conducted of sixty-three preschoolers, those being raised in homes where there was great marital hostility had chronically elevated levels of stress hormones compared with the other children studied. ... we know that this biological indication of extreme stress was echoed in their behavior. We followed them through age fifteen and found that, compared with other children their age, these kids suffered far more from truancy, depression, peer rejection, behavioral problems (especially aggression), low achievement at school, and even school failure.

One important message of these findings is that it is not wise to stay in a bad marriage for the sake of your children. It is clearly harmful to raise kids in a home that is subsumed by hostility between the parents. A peaceful divorce is better than a warlike marriage. Unfortunately, divorces are rarely peaceful. The mutual hostility between the parents usually continues after the breakup and continues its negative impact on children as the parents share the child care over the following years.

For that reason, children of divorce often fare just as poorly as those caught in the crossfire of a miserable marriage. "

To learn more about the impact of high levels of stress on a child's brain - click here.

Recommended Reading:

How Stress May Trigger Psychiatric Disorders - The Link Between Nature and Nuture

A Healthy Family Social Environment May Reduce Schizophrenia Risk by 86% for High Genetic Risk Groups (Finnish Adoptive Family Study of Schizophrenia)

Schizophrenia: Psychological and Social Causes and Treatment

Child and Teen Brains Very Sensitive to Stress, Likely a Key Factor in Mental Illness

Social Intelligence More Useful Than IQ? Important for Mental Health

Early Family Experience Can Eliminate the Effects of Genes, Minimize Risk of Mental Illness

Social Factors in the Development of Schizophrenia: A Review of Recent Findings

Broken Homes Linked to Increased Risk of Psychosis, Schizophrenia

Family Dysfunction Influences Psychosis Risk

Chronic Mild Stress During Pregnancy May Increase Risk of Brain Disorders in Child

The Psychology of Relationships - our relationships have important effects on our psychological well-being

Dysfunctional families: What exactly does that mean?

The Beach Boys - Brian and Murray Wilson, Family Dysfunction and Schizophrenia

Learn about emotional intelligence here. Read the book: Emotional Intelligence by Daniel Goleman, PHD

Make effort to learn good relationship skills. A couple should make an extra effort to learn the positive relationship skills that are the key to a happy and loving family. A positive family environment is very helpful in the healthy mental and emotional development of children because it lowers stress, and children learn the positive relationship skills from their parents, which improves their social functioning in the world.

Recommended Relationship Books to Help Create a Healthy Family Environment

The Seven Principles for Making Marriage Work - By Dr. John M. Gottmann

The Relationship Cure: A 5 Step Guide to Strengthening Your Marriage, Family, and Friendships - By Dr. John M. Gottmann

And Baby Makes Three: The Six-Step Plan for Preserving Marital Intimacy and Rekindling Romance After Baby Arrives by Dr. John M. Gottmann

Love Is Never Enough: How Couples Can Overcome Misunderstandings, Resolve Conflicts - By Dr. Aaron T. Beck

20 Communication Tips for Families: A 30-Minute Guide to a Better Family Relationship - this is a simple book of short tips for getting along better as a family.  It's a solution-focused way of addressing communications issues.

A book with a more academic flavor:

A General Theory of Love By Thomas Lewis, Fari Amini, Richard Lannon - This book discusses the science of human emotions and how love changes and guides who we are and what we become.  It explains how relationships function and how parents shape a child’s developing self, with emphasis on the idea that our emotional ties determine our mood, stabilize and maintain our health, and change the structure of our brains.


Maximize your own mental health, learn to lower stress, and eliminate anxiety and depression

Research in the area of social neurscience has indicated that children's brains are very sensitive to ongoing stress in their social environment (their home, school, neighborhood and circle of friends). Because children spend most of their time during their earliest development with their parents, it is believed by most researchers that the social environment that parents create in the home generally has a very significantimpact on child development. Therefore, one of the most important things a parent can do to ensure the mental health of their children, is make sure their own mental health, and the family environment they create, is low stress and positive.

Research also suggests that if parents suffer from ongoing moderate to high levels of stress, anxiety (excessive worry or fear) or depression, the interactions with the child will be negatively impacted, resulting in the transfer of stress to the child. By their actions and also by their communication - parents teach young children how to function in the world and also how to interpret events in their life. Additional to the direct impact of the stressful interactions with the parent, if a parent has a negative, stressfull or anxiety-oriented mindset, over the longer term the child is more likely to learn to think in the same manner and research suggests that this has the potential to impact the development of the brain due the ongoing release of stress hormones (called cortisol and glucocorticoids). Research further suggests that if a child has a genetic or biological predisposition to mental illness (due to genes, prenatal nutrition, etc.) then these psycho-social stresses can increase the risk of schizophrenia or other mental illness.

For all of these reasons it is important for the mental health of the child for parents to learn how to lower their stress levels, and to minimize any tendancies toward depression or anxiety.

Additionally, if either person in the relationship has any type of mental illness, including depression, anxiety (excessive worry or fears), Obsessive-Compulsive Disorder (OCD), Post Traumatic Stress Disorder, etc.) its important that the person get treatment and become as well as possible prior to getting pregnant and having children (this is true for the woman as well as the man). See a qualified family therapist, psychologist or psychiatrist if the problems continue. Maternal depression during pregnancy is very harmful and is associated with approximately a 200% increase in risk for the child developing schizophrenia as well as many other mental illnesses and cognitive development problems.

Following are some related reading and resources. We also recommend you review the section on how your mindset impacts your levels of stress and anxiety.

Recommended Reading:

Schizophrenia: Psychological and Social Causes and Treatments

Schizophrenia: The Value of Realizing Risk Factors Before Becoming a Parent

Child and Teen Brains Very Sensitive to Stress, Likely a Key Factor in Mental Illness

Parenting Style, Maternal Care and Schizophrenia Risk

Studies Show How Stress Damages Young Brains

High Stress Early in Life Changes Stress Response for Many Years Afterward

Anxiety, Depression and Stress During Pregnancy Results in Sensitive Children, Mental Health Problems

To help maintain your mental health be sure to get regular excercise (30 minutes of vigorous excercise three to five times a week).

Exercise Is a State of Mind - Researchers are learning more about how physical activity affects our moods. (MSNBC)

Treat depression during pregnancy (if not earlier), researchers urge (New Scientist)


How to Lower Your Stress, Anxiety and Depression

Recommended Internet Software (Free): MoodGym - For Prevention of Depression For this software to be most effective, you must work through all the modules of the software.

Some very good "for-pay" internet software therapy for the treatment of depression and anxiety can be found here (Depression Relief) and here (Anxiety / Worry Relief) . Read more about the software here: Beating the Blues.

Web psychotherapy 'just as good' as face to face therapy (BBC) - this story suggests that some web therapy may be as helpful as therapy with a psychologist - so it seems like a good idea to try web therapy (as in the above links).

When Panic Attacks: The New Anxiety Therapy That Can Change Your Life by Dr. David Burns

Feeling Good and The Feeling Good Handbook - By Dr. David Burns


Pre-Pregnancy Planning - The following list identifies actions that you can do prior to pregnancy that research suggests may lower risk of the child developing schizophrenia or other mental illness.

Causes of Schizophrenia - Roots may lie in Development of Fetal Brain

Begin prenatal planning at least three months prior to pregnancy - get a pre-pregnancy checkup well in advance of conception. According to a National Center for Health Statistics survey, more than one in four expectant mothers in the US received inadequate prenatal care. Its also important to discuss with the doctor any medications you may have taken in the recent past, or are taking.

Prenatal Doctor's Visit may be Three Months Too Late

Elevated Prenatal Homocysteine May Raise Schizophrenia Risk

Pregnancy / Prenatal Care Judged Poor in USA, Increasing Schizophrenia Risks

Recommended Online Video: Prenatal Care / Preventing Premature Birth

Recommended Books:

The Prenatal Prescription: A State-of-the-art Program for Prenatal Health

Before Your Pregnancy: A 90 Day Guide for Couples on How to Prepare for a Healthy Conception


Plan your pregnancy; Have a child when you want one, and don't have a child if you don't want one

Research suggests that children from unwanted pregnancies have a 250% to 300% higher than average risk of schizophrenia, when compared to children that are planned and desired by its parents. Researchers believe that this higher risk may be due to the mental stress that the mother of an unwanted child is experiencing, or poorer prenatal care that typically takes place with unwanted pregnancies. In unwanted pregnancies mothers may pay less attention to getting the proper nutrition and care during the pregnancy and during early childhood. (Source: British Medical Journal). For more information on how stress impacts pregnancy read: The Importance of Low Stress during Pregnancy for Healthy Brain Development.


Take a multivitamin daily for 1 to 3 months prior to conception. Research suggests that taking multivitamins may reduce risk of pre-term birth. Pre-term birth is the leading cause of low-weight births (which is linked to increased risk of schizophrenia)

A (2004) study results suggest that use of multivitamins prior to conception may reduce the risk of preterm birth. Dr. A. Vahratian and colleagues at the University of Michigan wrote, "Previous research suggests that multivitamin use before and during pregnancy can diminish diet-related deficiencies of certain micronutrients and potentially prevent preterm birth."

In their study they found that "results suggest that, compared with nonusers, women who take multivitamin supplements prior to conception may have a reduced risk of preterm birth" (a known risk factor in schizophrenia).

Source: American Journal of Epidemiology (Multivitamin use and the risk of preterm birth. American Journal of Epidemiology, 2004;160(9):886-892).


Make an extra effort to be at a healthy weight (Body Mass Index between 18.5 and 24.9) prior to pregnancy - Research suggests that being at a healthy weight prior to pregnancy increases the health of the baby. However, just as having too much weight is not healthy for the mother or baby, research also suggests that being too slim can also be a negative. An optimal weight is approximately a BMI of 22 or 23. (Use the online BMI calculator here to calculate your BMI)

Excess Body Weight of a Mother during pregnancy (above normal healthy pregnancy rates) is associated with a higher risk of the child developing schizophrenia.

Study Says Womb Time Drops When Hungry Mother Conceives

Recommended Weight Loss Book (focused on the mental aspects of weight loss):

The Beck Diet Solution: Train Your Brain to Think Like a Thin Person


Make sure that any sexually transmitted diseases (eg. Herpes, Chlamydia, etc.) have been treated by a medical professional.

Genital Herpes (in a mother) during pregnancy is associated with increased risk of schizophrenia in child

Prenatal Exposure to Maternal Sexually Transmitted Diseases Raises Risk of Schizophrenia

Researchers Identify Risk Gene for Schizophrenia and Immune System (PAR1)

Schizophrenia Linked to Immune System/Infection

Prenatal Exposure to Maternal Infections increase Child's Risk of Schizophrenia

Schizophrenia Linked to Immune System and Infection


Consider the Timing of Your Pregnancy for an August or September Birth: The research suggests that if you live in the Northern hemisphere, consider avoiding becoming pregnant during April and May, which would result in a child birth in February or March - because children born during the winter months tend to have an average 10% higher rate of schizophrenia. The ideal months to become pregnant if you want the lowest possible risk of schizophrenia are November and December - for a birth in August or September. This is a relatively low-risk element in the environmental factors linked to schizophrenia risk so we don't recommend people worry about it too much. Instead of timing your pregnancy, perhaps a better strategy is to focus on getting enough vitamin D, and avoiding infections as outline in other parts of this document.

Season of Birth - Low Sunlight Exposure/Vitamin D deficiency is associated with higher risk of schizophrenia

Schizophrenia And Summer and Winter Births


Make extra efforts to avoid alcohol and lead exposure during Pregnancy and in the Months Prior to Pregnancy - Compounds that have been identified as potentially toxic compounds for developing baby brains include lead and alcohol. Alcohol should be avoided as early as possible when a woman starts planning for a pregnancy, and by mothers during pregnancy - especially when there is a history of mental illness in the mother or father's family. For maximum safety women may want to stop drinking several months prior to pregnancy as alcohol may damage embryos during early pregnancy. Alcohol even at moderate intakes raises the risk of birth defects and breast cancer, possibly because it interferes with folate (folic acid), an essential B vitamin.

Rapidly growing bodies and unborn children are far more likely to absorb lead that has been swallowed or inhaled, and it poses a grave threat to their long-term health and well-being, experts say.

Children who ingest lead -- usually in the form of dust from deteriorating lead-based paint or from water tainted with lead leached from plumbing -- have reduced potential for lifetime achievement and increased risk of socialization and behavioral problems, according to numerous studies.

Similarly, fetuses that absorb lead from the mother are at a high risk of many types of developmental problems. Epidemiologists report evidence that lead's effects on children can remain undetected for decades until emerging in adulthood in the form of psychiatric diseases such as schizophrenia.

Lead and other Toxic Exposures for Pregnant Women May Triple Risk of Schizophrenia for Child

Prenatal Alcohol Exposure Linked to Increased Social Stress in Children

Fetal Alcohol Exposure Changes Dopamine System

Studies suggest brain injury results from developmental exposure to alcohol, anesthesia, and lead


Men should make an effort to have children when they are younger, rather than older, and make efforts to maintain their reproductive health.

Read the full story: Older Age of Father increases risk of Schizophrenia

Women may want to consider having a longer (greater than 27 months) interval between pregnancies, to maximize mental health of children

Read the full story: Association between short birth intervals and schizophrenia in the offspring








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