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Wheat

Consumption

Admissions

and

for

During

Schizophrenia

World

War

A Preliminary
F.

possibility

HE

of a positive

Report

C.

correlation

DOHAN,

be-

M.D.*

ninety-four

tween
changes
in wheat
consumption
and
changes
in the number
of hospital
admissions

The

for

schizophrenia

alleviated

( 1)

the

missions

investigated

decrease

to

wars,
in kinds
ing

was

reported

mental

wartime,

and

latter

disease

adults

(3)

the

and

in

after

the

and,

Sleisenger4
a group

and

of

Bossak,
psychotic

first

symtoms

or
rye,

from

the

Wang
and
patients

Adlersberg
discovered
(type
unspecified)

first

From

the

Department

University

vania,

and

the

Coatesville,
*

was

Support
Health

Grant
Service

School

of

diet.

report

having

its

either

the

some

other

The

number
of

and

A merican

World

grant

from

U. S. Public
Pennsylvania,
Nutrition

amount

available

measure

used

such
(see

herein

reporters,
Journal

consumption
at
as

footnotes
in

the

may
the

that

by

to Table
fashions

it appears

in quotation

of Clinical

Nutrition

level
the

i).

be

cehiac
of a

assessed

and

three

to

by

eight

in

births

the

cases

of

Glasgow.

the

\Var

ii

sources

indicated
per

women

admitted

United
and

the

(Table

cent

each

of

war

mean

the

five

the

consumption

was

mental

of

were

Can-

and

during

wheat

collected

and

from

the

i).

change
for

before

consumption
periods

the

Sweden,2

States4

these

admissions

to

Norway,

in the

mean

annual

schizophrenia

countries

to
from

compared

to
of

wheat

the

number

of

hospital

in

the

respective

per

cent

change

wheat

plus

the
and

prein
rye

1).

indicate

consumer
used

of

during

first

Research

the

may

live

a one

history
of
possibilities

practice

10,000

Finland,0

rye58

(Fig.
word

countries
is

Medi-

Inc.
The

NOTE:

original

the
of

per

hospitals

The

from

clinical

of about

disease

in
the
for

METHODS

Pennsyl-

General

in

of Black9

cehiac

Hospital,

by

180-FR-05415-01
to the
University
and

paucity

that

during

a
The

such

the

admitted
to
Hospital

schizophrenia,

by

of Medicine.
in part

with

be

reported

barley,

of

Administration

supported

Health,

Foundation,

term

School

time

gluten-

Furthermore,

have

a history

five
among

Philadelphia,

Veterans

Professor

work

navian

Medicine,

Handford8

are

to

disappear.7

patient

Pennsylvania.

Assistant

This

of

of Pennsylvania,

to

of

reported

months

ada3
cine,

been

so

disease

institution

was

schizophrenics
among
adults
with cehiac disease
gluten
enteropathy).

sprue,

the

have

occur

cehiac

year
period,
there
disease
in childhood.

three

thirty-two

with

and

and

the

in

becomes

weeks

oats

The

occurs

wheat,

possibly,

Graff

patients

after

sprue.

which

four of the thirty-seven


men
Institute
of the
Pennsylvania

relationship
disease.

usually

of

of

found

(nontropical

some

celiac

a period

elimination

buckwheat

during

hereditary,

children,
in

diet6

possible

and

is probably

asymptomatic

free

experience
of changes
of food consumed
dur-

schizophrenia

in

of ad-

nontropical

disturbances

frequently

of

with

patients

emotional

number

hospitals

(2) the common


and quantities

between

because

in the

II

RESULTS

or

ScandiWhen

employed

by

The

the

data

Figure
1.
Available

the

marks.
7

are
data

summarized
on

in

Table

Norway,
Vol.

Sweden
18,

January

and
and
1966

Downloaded from ajcn.nutrition.org by guest on December 5, 2014

Hospital

Dohan

8
Canada

indicated

changes

in the

for

schizophrenia

the

first

first

that

number
than

time.

The

admissions

there

in

the

for

listed
States

sum

of

only

and

the

of

for

and
Schizophrenia

Summary

Hospital

of Original

Admissions

relationship

sions

for

schizophrenia

the

number
and

culated

values

means

of the

shown
in

in

the
also

(prewar)

1,217
1,107
832

The

332
201

(299.6)
(123.4)

Sweden
1937-1939
1940-1942

938
654

(737.2)
(481.3)

608

(458.5)

per

1943-1945

cent

1943-1945

871

admissions
The

9,557

1940-1942
1943-1945

30 to
tion

70.5

10,230
10,943

70.1
74.6

Admission

statistics

were

reported

by

the

period

calendar

in

the

in

year

periods

t Wheat

1936-1940

and

during

the

two

five-

and

the

United

sumed

to be

zero

because

194 1-1945.

The
sions

cent

United

of rye

in

considered.
about

consumpthe
prewar

have

of the

small

these

countries

number

with

rye

in

been

as-

amount

equation

in the

women

first

of

States

regression

change

of

consumption
for
Finland
is expressed
as
grain
in kilogram
per caput
per harvest
year;
that
for
Norway
and for Sweden
as grain
in ten million
kilograms
per country
per harvest
year
(figures
in parentheses).
The
statistics
for
these
countries
are
gross,
are
reported
by the harvest
year
and
refer
to the
net value
obtained
from
production
plus
imports,
minus
seed
and exports.
The
harvest
year
ended
in Finland
on
August
31, in Norway
on September
30 and in Sweden,
July 31.
The
consumption
data
for Canada
and
the

States

multiple

cent

less

of

constituted

consumption

Canada

per

admissions

but

number
was

the

shown)

Scandinavian

the

ported

first

in

not

statistically,
the

the

admis7 d.f.,

changes

consumed

three

changes

cent

with

0.908,

schizophrenia

of rye flour
consumed
footnotet,
Table

total

(date

in

of rye

per

of first

that

rye7

year.
All
the
data
available
for
the
prewar
period
( 1936-1939)
were
used
in calculating
the means
for that
period.
Admission
statistics
for Finland
were published
as the sum
of first admissions
plus readmissions
and are
used
here.
Admission
statistics
for Norway
were
re-

as

number

related

for

School

the

60 per cent of the combined


of wheat
and
rye
during

The
S

of

is

changes

amount

Johannes

Statistics,

possibility
be

to

calcula-

Dr.

of wheat

in the

of

also

Finland

of Pennsylvania.

schizophrenia

strongly

by

Medical

are

decreases
in

coefficient

The

periods

statistical

consumption

consumption

U.S.A.

1939

of

change

for

these

made

calthe

admissions

University

P<0.01.

84.0
75.0
84.6

estimated

kindly

correlation

might
814
721

for

The

and

These
1 and

Figure

in the

was

1940-1942

data
first

were

in the

sions

Canada
1937-1939
1942-1942

i.

Professor

change

1936-1940
1941-1945

in

of

of Medicine,

Norway5

shown

of

mean

in

are

employed

which

Ipsen,

69.5
60.9
48.0

cent

Finland

number

prewar

1943-1945.

in

Norway,
in

the

in

original

been

that

the

19 per

Table

change

in

in

in

readmis-

cent

cent

number

have
tions

Finland5
1936-1939
1940-1942
1943-1945

from

per

per

admissions

decrease

about

change

plus

indicate

annual

45

cent

shown)

(see
for

of first

schizophrenia

the

admis(zS)
as

are for flour

at the consumer
than
1.4 per cent
text),
is included.

level.
of the

(kilograms
Rye
total

per caput

per year)
less

flour, which
composed
of wheat
and rye flour

(see

related

to the

tion

of

wheat

expressed
0.48

per

cent

change

(SW)

as S

and
+5

per

in the
of rye
cent

consump-

(z\R)

may

be

1.04

(zW)

(SR).

The

correlation

in the

number
change
is r

coefficient

of first
in the
0.961,6

assumes

homogeneity

of

assumption

this

of per

admissions

consumption
d.f., P<0.01.
of material.
is

impossible

cent

with

change

the

per

of wheat
and
The analysis
The
to

validity
estimate.

Downloaded from ajcn.nutrition.org by guest on December 5, 2014

Country
and
Period

Mean
Annual
Consumption
of Wheatt

to

first

admissions

about

per

for

(not

admissions

Canada

mean

readmissions

a plot

the

first

of

probably

Mean
Annual
No.
of First
Admissions
for Schizophrenia*

of

of

first

Data

plus
from

number

Sweden

Data

Consumption

admissions
Estimates

the

the

the
Wheat

first

Finland.

admitted

reports

United

TABLE

fewer

readmitted

those

official

for

were

of patients

Wheat

Consumption

and

COMMENTS
The

internal

ports

on

the

hospitals

the

of

increases

in
the

status

of

bat

on

the

; atwar

of
data)

first

admissions

The

( women

age)
during
was less than
per

and

8 per

Psychotic
navian

accord
in

with
number

due

to

personnel
were

in

patients
in

schizophrenia

we

because

to

hospitalization

far

less.
of

wheat

are

degree
human

the

data

be

for

for
in

three

Norway)

mdi-

1 1 ,442

estimated

mor-

(<0.27
or less

is one-third

consume

per
than

cent)
that

wheat

and

+20
/U2

(nil.

the
_2:

thus

/
-40

annual

and

on

women

a fairly

to

are
index

periods

were
between

the

of first

of

available

particularly
year

mis-

reported
amounts

(five

the

per

admissions

Per

.-4--.I.

20I

/,CHANGE

FROM

WHEAT

CONSUMPTION

in

the

number

of

been

PREWAR

have

+20

MEAN

for

The

States

cent

missions
for
of estimating
from

Norway
(U)

(N),

the original

per
These

the period

Norway

of first
(S),

line).
number

Finland.

(C)
number
See text
of first

two

1943-

is Period
The

I).

admissions

Canada

estimated

for

Table

Ii

the
froni

Period

footnote,5

(dashed
in the

(derived

and

of

data

values

War
from

of the

case

Sweden

World

change
means

(see

in
to

for the

1940-1942

for the

The

admitted

during
cent

first

and

schizophrenia

plotted

Finland
changes

of

consumed

in the number
and

of

number

for schizophrenia.

wheat

means.

1941-1945

cent change

the

of

as the

consumption

in

hospitals
with

been

periods:
Period
1
1945, except in the
=

the

in five countries

prewar

i)

in
change

women

expressed

respective
Table

cent
amount

hospitals

have

change

per

to mental

changes

year

for

cent

versus

admissions

1-2

since

compared.

1.

wheat

mental

consump-

accurate

in the

5$2

-50

FIG.

due

was

subject

changes

similar

installations

the

S2

Changes
hospitals

data

C2

SI

these

of statistics

correlations

number

inactive

reported
to eat
millet
with some

The

who

Taiwan

six

among

were
and

Europeans

of
of

151 4

in

and

were

the

consumption;

statistical

change

used

crude

of change

for
periods

to

in

plus

rice.22

to

study

hospitalized

wartime

on

the

enough

confined
amounts

23

the
statistics
to civilian
or

distortion

data

interpretation,2o
the

in

in military
the

is not

large

aborigines

schizophrenia

subjects

correla-

thorough

active,

upland
for

in these

the

Although

large

and

rye.

the

schizophrenia

risk

patho-

considered

WIsE

civilian

included

hospitals.
admitted
to the

during

in women;
report

of

These
tribes
sweet
potatoes

in northern
of

eat
the

four

of

corn

Scandi-

in

Canada

included
transferred

Veterans
Administration
in the number
of men

tion

cases

bid

in the

the

are

However,

were
not
they
were

in this

of

changes

years

hospitalized

these

statistics.

to those

the

of schizophrenia

forty-five

Lin2

viduals.
mainly

(un-

the

United
States,
these
patients
were
at military
installations
initially;

with

in-

and

demonstrated

the

be

data.

which
example,

con-

in Canada.

service
thus

patients
unless

to

increase
risk

to

cent

countries

hospitals,

in

primarily

fifteen

due

schizophrenia

Rin

in

wartime

addition,
For

in

epidemiologic

other

the

rye

implications

cereals

any

by

in

plus

should

as with

wheat.

change

Nevertheless,
of these

unsupported
populations

cent
wheat

schizophrenia

those

the
six years
of World
War
ii
1 per cent in Norway
and Sweden,
in the United
States,
5 per cent
in

cent

Finland

are

at major

from

not

approximate

population

the

are

changes
were

in incidence.
female

all

the

and

decreases

during

that

invaded,

per
of

Downloaded from ajcn.nutrition.org by guest on December 5, 2014

published

not

corn-

the
and

high.
a role

of

In

of

wartime

active

that

admissions

employment

concept

3.5

but

evidence

are

tion

number
the

sumed

wheat

speculative,

psychogenic

a relationship

in the

of

genesis

of
and

and

amount
concerning

relationships

(occupied,

clear

mental

capacity,

for

lack

of change

soil

number

creased

the

country

the

time

schizophrenia

the

home

neutral)

re-

to

(bed

the

degree
for

statistical

admissions

admissions

etc.)

admissions

the

countries

physicians,

psychoses,
between

of

five

schizophrenia

in

number

in

number
of

evidence

Schizophrenia

per

is plotted
and

United

of first adfor method


admissions

10

Dohan
AND

SUMMARY

The

per

during

cent

World

admitted
significantly
rye

the

the

amount

was

coeliac
10.

women

time

to

be

the

per

cent

and

wheat

plus

between
(gluten

herein,

suggests

and

with

that

kind

possible

rela-

and

celiac

schizophrenia
enteropathy)

briefly

further

relationship

the

the

investigation

between

and

quantity

1952
14.

schizophrenia

of foods

ingested

Rome,

L.

Sibelius;

Bergstr#{216}m,
Arvid
W.

A.

Acht#{233}, Bo

Sweden,

Erik

Soop,

Wretlind;

Rolf
Bo

United

MacMahon,

Wayne

of the
Paavo

I. Andreasson,

Sigurd

Qrnulv

States,

help

Johansson,

Vahlquist,

Norway,

Bluger;

of the

is made

K.

S.

I.

Charles

17.

Health.
of

Epidemiological

1961.
2.

X.

pendant
227,

3.
4.
5.

de

19.

mentale

Med.,

52: 179

A.
17,

e psicosi.

M. H.

20.

Psichiat.,

Personal
communication.
C. I. and ADLER5BERG,

WANG,

aspects

of

(idiopathic

sprue).

Syndrome.

Edited

1957.
W.

SHELDON,

Riv.

the

malabsorption

The

In:

by Adlersberg,
& Stratton,

Grune

Celiac

disease.

syndrome
21.

I.,

132,

22.

1959.
7.

S.

HAA5,

V.

Lippincott
GR.AFF,
in

and

Disease.

the

M.

P.

Philadelphia,

Management
1951.

J.

Co.
H.

Psychiat.

Hts,

and
case
Quart.,

histories

35: 306,

of

five

1961.

Cehiac

syndrome

schizophrenics.

States,
Third

set

Re-

up

by

the

D.
P.

Rome,
of the
Defects,
and

V.

1960.
United

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Food

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of

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2, p.

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(Translated

B.

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J. A.

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179.

University

the

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Chinese
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Chinese

genetic

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Ment.

1957.

from

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compared

K-t.

PANG,

Taipei,

vestigation
1953.

Mental
as

in Taiwan.

p.

BOOK,

T-y.

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Aborigines

of
23.

A.

HANDFORD,

and

T-w.

HSU,

1,

Celiac
8.

H.

RIN,

Chinese
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Washington,

Institute

Formosan

New

Inc.

Pediatrics,

the

75),

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Malabsorption
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acknowledgment

of mental
War

1940, 1941, 1942, 1943,


D. C. , U. S. Department
of the Census.
15.

Finland,

Finlands

Medical

data.

Patients

is

ACKNOWLEDGMENT

Grateful

Scand.,

National
C. E.

BALDWIN,

incidence
World

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of

Board.

and
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Statistisk.

Kungl.

13.

The

during

Officiehla

warranted.

following:

Q.

QDEGARD,

Norway

discussed

Medical

Health

of

Health.
11.

with
of wheat

association

Central
Helsinki.

et Neurol.

disease

possible

the

factors
in the incidence
Pae4ial.,
53 : 109, 1964.

Statistics.

1936-1953.

12.

in

tionship

of

Official

consumed.
This,

Reports

with

found

J. A.
Possible
disease.
Acta

BLACK,

values
of

first

countries

correlated
in the

prewar

number

for

in five

9.

from

II in

hospitals

schizophrenia
change

change

War

to

CONCLUSION