But autumn birth comes with a greater likelihood of panic attacks, say studies that link birth seasons to health problems
BY ALISON MOTLUK
New Scientist Magazine
Posted Monday, March 12, 2007
The star you were born under influences the person you become. This is not something you expect to hear from scientists but, incredibly, it seems to be true.
There’s firm evidence that the time of year you are born affects not just your personality, but also your health, specifically your chances of developing serious mental illness. But don’t expect to find clues in your horoscopes. The star in question is the star we were all born under - the sun.
Being born at certain times of year gives a small but significantly increased risk of problems such as depression, schizophrenia and anorexia nervosa. The question is no longer if the seasons affect mental health, but how. Pinning this down could yield vital clues on how to intervene to prevent mental illness.
The effect was first noticed in 1929, when Swiss psychologist Moritz Tramer reported that people born in late winter were more likely to develop schizophrenia. We now know that for people born in the Northern Hemisphere in February, March and April, the risk of developing schizophrenia is between 5 percent and 10 percent greater than for those born at other times of the year. The effect has been replicated numerous times over the decades and is far from trivial.
According to a study carried out at Aarhus University Hospital, Denmark, the increased risk of schizophrenia that comes with a winter birthday is almost twice the increase in risk linked to having a parent or sibling with the disorder.
Season of birth seems to be linked to other conditions, too. A recent study of more than 25,000 suicides in England and Wales found that 17 percent more people who had committed suicide had birthdays in April, May and June than in the rest of the year.
Similarly, people with anorexia in the Northern Hemisphere are 13 percent more likely to have been born between April and June than in other months. That doesn’t necessarily mean that it’s best to be born later in the year, however.
Autumn birthdays are associated with an 8 percent increase in the likelihood of suffering panic attacks, for example, and a small but significant increase in alcoholism in men.
Finding out just how the changing seasons change the risk of certain psychiatric conditions is proving a daunting task for epidemiologists. Until recently, the leading hypothesis on why winter and spring births increase the risk of both schizophrenia and anorexia centered on the health of a mother during pregnancy. Perhaps a viral infection in the mother at a key stage of the baby’s development could somehow interfere with brain development.
Several studies in the 1980s seemed to have found spikes in the number of schizophrenia cases in people born in the months following outbreaks of viral diseases such as flu and measles. But several large studies, in particular one in 1999 by Stephen Miller at the University of Georgia, Athens, which looked in detail at patient records for 750,000 people, failed to find a similar correlation between epidemics and rates of schizophrenia.
Seasonal fertility
More recent explanations have concentrated on the more direct effects of the seasons on the mother: how much sunshine a pregnant woman is exposed to, for example, or the effects of temperature.
The hormone melatonin, which regulates the sleep-wake cycle and is suppressed by sunshine, could play a role during gestation or early life, says British consultant psychiatrist Emad Salib. Salib was lead author on the study linking birth in late spring to suicide, published in the British Journal of Psychiatry in 2006. Salib reasons that as people born in April, May and June were conceived in July, August and September, high melatonin levels during crucial months of development could prompt changes in the brain, and then stimulate suicide later in life.
Beth Watkins, an eating disorder researcher at St. George’s Hospital Medical School, London, has suggested a more subtle reason for the season-of-birth link to anorexia, which follows a similar pattern to that for suicide. Her idea is not that the seasons cause changes in the fetus, but rather that seasonal effects allow babies vulnerable to the condition to be conceived and born only at certain times of the year.
People with anorexia are eight times as likely as the general population to have a parent or sibling with the disorder. Often that relative is the mother, and this got Watkins thinking. Was there something about overly thin mothers that might vary by season? “Their actual fertility is on a knife-edge,” she says, and babies born in the months most strongly linked to anorexia were conceived in July to September. Could the higher temperature allow an anorexic mother to conserve just enough energy to tip her into a fertile state?
Watkins and colleague Kate Willoughby looked at a sample of nearly 400 women in the United Kingdom with anorexia and other eating disorders. In the UK, only in the summer months of July and August does the average monthly temperature tend to rise above 60 degrees, and in keeping with Watkins’s hypothesis, significantly more people with anorexia had been conceived during these warmest months.
They then collected data on 200 patients in Australia living in and around Sydney, where average temperatures drop below 60 degrees only in the winter months of June, July and August. Sure enough, they found that fewer had been conceived in these cooler months.
Finally, they looked at a sample of people with anorexia from Singapore, where the temperature remains constant at about 80 degrees all year round. There they found no season-of-birth effect at all.
Watkins accepts that the effect could just as well be explained by prenatal exposure to sunlight, now a leading theory in explaining the season-of-birth effect in schizophrenia.
In 2005, John McGrath and his colleagues at the Queensland Center for Mental Health Research, Wacol, Australia, reported that the higher the latitude, the greater the excess incidence of schizophrenia among people born in winter. Between 30 degrees and 60 degrees north (Chicago is 42), the excess is about 5 percent; at latitudes above 60 degrees north it is 10 percent.
A sunny disposition
Not convinced by the idea that winter infections are the cause, McGrath focused on the effects of a seasonal lack of sunlight. He was intrigued by a study in Brazil by Erick de Messias of the Maryland Psychiatric Research Center in Baltimore, which found a raised incidence of schizophrenia in people born three months after the rainy season.
One way sunlight is known to influence the body is by stimulating the production of vitamin D, which fetuses need for brain development. Trouble is, in northern latitudes, there isn’t enough sun around in the winter.
McGrath suspects vitamin D deficiency might link birth date to an elevated risk of schizophrenia. Working with neuroscientist Darryl Eyles, he’s established that the brains of rats deprived of vitamin D during gestation have abnormally large lateral ventricles. People with schizophrenia also have enlarged lateral ventricles.
The rats with enlarged lateral venticles run around more than is normal, and this behavior can be rectified by the antipsychotic drug haloperidol, which is thought to block the neurotransmitter dopamine and is used to treat schizophrenia. The link between vitamin D deficiency and neurodevelopmental abnormalities is a “done deal,” says McGrath, at least in rats. Does that mean the same applies to humans? “We’re still working on that,” he says.
The reassuring fact is that most winter babies escape schizophrenia, and spring babies by and large do not grow up with eating disorders. What we can hope for is that we may some day understand the biological basis for this seasonal blip in the incidence of mental disorder. And if we can do that, we may then be able to fix it.