It is well-known that the fertility of schizophrenic patients, particularly males, is below the population average. The main measures of fertility (reproductivity) are marriage rate, marital fertility, and rate of reproduction. A review of the literature reveals the rate of reproduction of schizophrenic patients to be 30% to 80% of the general population, the reduction being mainly due to reduced probability of marriage. At least one investigation presented evidence for an increase in marriage rate and rate of reproduction in schizophrenic patients relative to the general population in recent time. If this increase were to be confirmed it would undoubtedly have practical as well as theoretical implications. The hypothesis of a compensatory higher fertility of healthy relatives of schizophrenics based on a physiological advantage is empirically unproven. Additionally, the concept of a balanced polymorphism in schizophrenia rests on a superficial analogy with Mendelian traits.

The results of this study demonstrate, that the percentage of trauma, severely ill/injured or unconscious patients is lower than in previous years. However, the higher absolute numbers of patients demonstrate that the emergency physician now encounters more critically ill/injured, unconscious and trauma patients. It does not seem necessary to question the qualifications for an emergency physician, which have previously been considered essential for the management of acute life-threatening situations.

For an investigation on the question of whether fertility rates of schizophrenics have been increasing in recent times, two cohorts of patients were defined on an epidemiological basis. The patients were first admissions during either 1949-50 (n = 183) or 1965-67 (n = 228). The conditions of case definition as well as their demographic and psychiatric characteristics are described. These data are necessary for the evaluation of reproductive rates observed in the patient sample. Furthermore, the two cohorts of patients may be of general interest, because they comprise patients first admitted to a hospital who were completely ascertained in a certain region and time period. They reflect certain changes in hospitalization practice in Germany.

Two cohorts of schizophrenic patients admitted to a psychiatric hospital for the first time either during 1949-50 or 1965-67 were compared with matched controls for reproductive rates before and 13 years after onset of psychosis. Patients of both admission periods had reduced marriage rates. After onset of the disease the rate of reproduction was decreased in males of both periods, but not in females. Patients of both periods did not differ from control values with respect to marital fertility. It has repeatedly been reported that fertility of schizophrenics has been increasing in recent times. Comparison of total reproduction, rate of marriage and marital fertility in patients of the two admission periods and matched controls did not yield any evidence for increasing rates. Instead, the results favour the idea that the patients parallel at a lower level the general decline of birth rates observed in Western Germany.