All Life
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Digital-palmar dermatoglyphics characteristics of
patients living with schizophrenia in Ghana
Niena Samira Majeed, Benjamin Arko-Boham, Delali Kudzo Fiagbe, Kevin
Kofi Adutwum-Ofosu, Nii Koney-Kwaku Koney, Bismarck Afedo Hottor,
Richard Michael Blay, Mubarak Abdul-Rahman & John Ahenkorah
To cite this article: Niena Samira Majeed, Benjamin Arko-Boham, Delali Kudzo Fiagbe, Kevin
Kofi Adutwum-Ofosu, Nii Koney-Kwaku Koney, Bismarck Afedo Hottor, Richard Michael
Blay, Mubarak Abdul-Rahman & John Ahenkorah (2023) Digital-palmar dermatoglyphics
characteristics of patients living with schizophrenia in Ghana, All Life, 16:1, 2224937, DOI:
10.1080/26895293.2023.2224937
To link to this article:  https://doi.org/10.1080/26895293.2023.2224937
© 2023 The Author(s). Published by Informa Published online: 18 Jun 2023.
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ALL LIFE
2023, VOL. 16, NO. 1, 2224937
https://doi.org/10.1080/26895293.2023.2224937
Digital-palmar dermatoglyphics characteristics of patients living with
schizophrenia in Ghana
Niena Samira Majeeda,b∗, Benjamin Arko-Bohama∗, Delali Kudzo Fiagbec, Kevin Kofi Adutwum-Ofosua,
Nii Koney-Kwaku Koneya, Bismarck Afedo Hottora, Richard Michael Blaya, Mubarak Abdul-Rahmand and
John Ahenkoraha
aDepartment of Anatomy, University of Ghana Medical School, University of Ghana, Accra, Ghana; bDepartment of Psychiatry, Korle-Bu
Teaching Hospital, Accra, Ghana; cDepartment of Psychiatry, University of Ghana Medical School, University of Ghana, Accra, Ghana;
dDepartment of Pathology, University of Ghana Medical School, University of Ghana, Accra, Ghana
ABSTRACT ARTICLE HISTORY
The World Health Organization has acknowledged the gap in schizophrenia diagnoses and recom- Received 20 October 2022
mended further research to identify tools and biomarkers for the disease’s early detection. Because Accepted 4 April 2023
the skin and brain have a common ectodermal origin, dermatoglyphics are hypothesized to serve as KEYWORDS
a potential mirror for the identification of risks and characteristics of neuropsychiatric diseases. This Schizophrenia;
study aimed to determine the digito-palmar dermatoglyphic patterns of schizophrenia patients in dermatoglyphics; a–b ridge
Ghana. Digito-palmar dermatoglyphics were obtained using a digital scanner, and the details stud- count; atd angle; total triradii
ied. Individuals living with schizophrenia in Ghana were significantly characterized by low odds of count
vestige pattern in the hypothenar region, low odds of palmar creases 300, and high and low odds of
radial loop (RL) and plain arch (PA) respectively at the finger patterns relative to the control group
[OR (95%CI): vestige, 0.2 (0.06–0.69), P = 0.01; palmar creases 300, 0.1 (0.01–0.99), P = 0.049; PA, 0.4
(0.3–0.7), P < 0.001; RL, 1.9 (1.0–3.7), P = 0.044]. Individualswith schizophreniawere also character-
ized by low mean left-hand a-b ridge count and mean right hand atd angle compared to controls.
These differences could be explored as a potential biomarker in diagnosing and early detection of
schizophrenia in Ghanaians.
Background sub-classification and recommended further research
Schizophrenia is a neuropsychiatric condition with a to identify tools and biomarkers that could help in the
global prevalence of 0.3–0.7%, and a global annual early detection and sub-classification of schizophre-
incidence from 7.7 to 43/100,000 per year (Farah 2018; nia (Saraceno 1998). Several studies have unsuccess-
Lin et al. 2022). Although the cause is not fully under- fully explored identifying biomarkers for diagnosing
stood, it involves the brain and is associated with schizophrenia (Wang et al. 2008; Ahmed-Popova et al.
congenital malformations or distortion of the corpus 2014; Norovsambuu et al. 2021), limiting diagnoses of
callosum and septum cavum pellucidum in the brain schizophrenia to heavy dependence on clinical inter-
(Innocenti et al. 2003; Flashman et al. 2007; Achalia views, observation of patient behavior, and clusters of
et al. 2014). The burden ofmental health in Ghana and symptoms over a period of time. Globally, two pri-
Africa has sharply risen in the last decade. In Ghana mary documents are used to diagnose schizophrenia:
alone, it was estimated in the year 2021 that 3.1million The World Health Organization’s International Sta-
of 31 million people living in Ghana had a mental ill- tistical Classification of Diseases and Related Health
ness (CITINEWSROOM2021). Schizophrenia, which Problems (ICD) and the American Psychiatric Asso-
is the leading cause of admissions to psychiatric hospi- ciation’s Diagnostic and Statistical Manual of Mental
tals in Ghana, constitutes 32% of the total number of Disorders (DSM). Studies have acknowledged the gaps
hospital admissions (Roberts et al. 2014). The World in the diagnostic accuracy of these contemporary tools
Health Organization (WHO) about 2 decades ago, in schizophrenia and recommend further research
acknowledged the gap in schizophrenia diagnoses and for improvement (Valle 2020). This gap includes the
CONTACT John Ahenkorah jahenkorah@ug.edu.gh
∗Co-first author.
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
This is anOpenAccess article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits
unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow
the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
2 N. S. MAJEED ET AL.
absence of a defined boundary between schizophrenia schizophrenia from Accra Psychiatry Hospital (APH)
and other psychotic disorders and the lack of suffi- and simple random sampling of individuals with no
cient information for subcategorization of schizophre- family history of psychiatric illness from a community
nia and treatment planning (Ahmed-Popova et al. as control.
2014; Valle 2020). Although the 11th revision of ICD
i.e. ICD11 has addressed some of these limitations, the Study sites
need for continuing research for the identification of The studywas conducted at the Accra PsychiatricHos-
biomarkers to improve the diagnoses and early detec- pital (APH). The Accra Psychiatric Hospital is a spe-
tion of schizophrenia and mental health at large is cialized health facility located in Accra, the capital of
still recommended. The brain is a crucial organ com- Ghana. The primary healthcare in this facility is the
monly affected in psychotic disorders. However, the rehabilitation andmanagement of personswithmental
difficulty in obtaining brain tissues from living donors illnesses. It has about six hundred (600) beds with an
and the lack of accurate experimental animal models average in-patient population of about 1200 (Fournier
are significant barriers in neuropsychiatric research. 2011). The hospital specializes in the treatment of
Attempts have therefore been made to explore alter- severemental disorders, such as schizophrenia, bipolar
native options as proxies for predicting brain health, disorder, and major depressive disorder.
one of which is the skin. Embryonically, the skin and
brain originate from the same ectoderm, hence, the Ethical issues
patterns of epidermal ridges on the feet, fingers, palms,
toes, and soles termed dermatoglyphics, are hypoth- Approval for the study was obtained from the Ethi-
esized to serve as a potential mirror for the identifi- cal and Protocol Review Committee of the College of
cation of risk and characteristics of neuropsychiatric Health Sciences, the University of Ghana, with Pro-
disorders and being explored as potential biomark- tocol Identification Number: CHS-Et/M.4-P4.7/2020-
ers for schizophrenia (Haroun 2019). Dermatoglyph- 2021. The Accra Psychiatric Hospital gave full admin-
ics development occurs between the 10th and 13th istrative permission for the conduct of the study.
weeks of gestation and is fully formed by 21 weeks of
fetal life (Kumbnani 2007; Singh et al. 2016). These Sample size determination
epidermal ridge imprints are known to have polygenic The sample size for the control group was determined
inheritance and remain stable throughout life in the using Cochran’s formula (n = z2pq/e2) (Israel 1992);
absence of any mechanical injury (Kumbnani 2007). where n is the sample size, z is the selected critical
Therefore we hypothesize that digito-palmar dermato- value of desired confidence level, p is the estimated
glyphic patterns of individuals living with schizophre- proportion of the attribute of interest in the popula-
nia will not be the same when compared to those tion, q = 1 – p, and e is the desired allowable error.
without schizophrenia in the Ghanaian population. If the estimated proportion of the attribute of inter-
Although there are several studies on the associa- est in the population is unknown, a prevalence of 50%
tion between dermatoglyphics and schizophrenia, the is assumed. Therefore, an estimated proportion of not
inconsistency of the results is influenced by method- having any psychiatric condition of 50% was assumed.
ological differences, and genetic characteristics of the At a 95% confidence level, the z value for the area
studied populations. These reports suggest the impor- under the normal curve is 1.96. At± 9.6% precision, a
tance of exploring dermatoglyphic patterns of individ- minimum sample size of 104 was obtained for the con-
uals living with schizophrenia among the Ghanaian trol group: n ≥ [(1.96)2∗0.5∗0.5 /(0.096)2]. Therefore
population. Therefore, this study aimed at assessing 106 apparently healthy individuals from the commu-
the digito-palmar dermatoglyphic patterns of patients nity were randomly recruited as controls. A total of 69
living with schizophrenia in Ghana. schizophrenia patients consented and were recruited
purposively for the study.
Methodology
Study design Study population
The study was a cross-sectional study involving All the study participants were recruited from a
purposive recruitment of patients diagnosed with multiethnic Ghanaian population. The Ghanaian
ALL LIFE 3
population is predominantly of black Africans and is
made up of diverse ethnic groups. Akan, Dagomba,
Ewe, Ga-Adangbe, Gurma, Guan, Gurunsi, and Bissa
are the major ethnic groups in Ghana, among many.
Participant selection
Individuals living with schizophrenia were recruited
purposively from the Accra Psychiatry Hospital.
They were inpatients who were already diagnosed
by a specialist psychiatrist and were being managed
for schizophrenia. Schizophrenia patients who were
assessed by the consultant psychiatrist as being fit to Figure 1. Diagram showing a straight line drawn between a core
(A) and a triradius (B) for finger ridge count. Adopted fromGnana-
participate and being able to provide consent willingly sivam and Vijayarajan (2019).
were recruited into the study. Schizophrenic patients
with current mania and those who declined to par-
ticipate in the study after explanation were excluded. images were read using Adobe Reader 9.0 at 100 to
Also, patients were able to withdraw their consent at 150% magnification. The scanned images were ana-
any point of the assessment. The apparently healthy lyzed for the following dermatoglyphic parameters;
controls were randomly recruited from communities fingertip patterns (whorls, loops, and arches), total fin-
in Ghana. Individuals who had no history of psychi- ger ridge count (TFRC), palmar patterns (thenar and
atric illness and no family history of psychiatric illness hypothenar), palmar creases, a-b ridge count, atd angle
up to second-generation were included in the study and total triradii count with the aid of OnScreen Pro-
as controls. The Brief Psychiatric Rating Scale (BPRS) tractor version 0.4. The parameters were read twice
was used to assess the controls for any psychiatric each by two independent scorers, and the concordance
symptoms. Individuals with physical damage or defor- was assessed using the Kappa test in IBM SPSS ver-
mation of the palmar skin of the hand were excluded sion 20. For the continuous variables, the average of
from the study. the readings from the two individuals was recorded as
the final value for the parameter.
Sample collection
Parameter description
Following written informed consent, the patient’s
demographic data and clinical history, such as past Finger ridge count and fingerprint patterns
psychiatry history, family history, past medical and Finger ridge count (FRC)was obtained by counting the
surgical history, drug history, and forensic history, number of ridgeswhen a straight line is drawnbetween
were obtained from the patient’s hospital folder. A a core and a triradius (delta), as shown in Figure 1,
structured questionnaire and BPRS were used to doc- without counting the point of the triradius and the
ument the biodata, family history of psychiatric illness point of the core. To obtain a TFRC, the individual
and measure psychotic symptoms among the control finger ridge counts of the ten fingers were summed
study participants. The digito-palmar dermatoglyph- together as reported by others (Sharma et al. 2018;
ics of each study participant was obtained using a Modiano 2019). The patterns at the distal ends of the
digital scanner as reported by Igbigbi et al. (2018) palmar surface of the fingers were determined as an
with slight modification. A CanoScan LiDE220 scan- arch, a whorl, or a loop and their various subclassifica-
ner was used to obtain the palmar and fingerprint tions according to Galton and the FBI classification as
patterns of the study participants. The palms and dig- reported by Singh et al. (2016).
its were placed flat on the scanner and scanned, after
which the thumb was also placed in the scanner and Palmar creases
scanned. The images were then recorded in PDF for- The pattern of the palmar creases was described in
mat on an HP laptop. To ensure uniformity, all the a three-digit format according to the PIC model as
4 N. S. MAJEED ET AL.
reported by Ali et al. (2021). The first digit represented Results
the number of the primary creases, which ranges
from 1 to 3; the middle digit represented the number Demographic characteristics of the study
of intersections between the primary creases, which participants
ranges from 0 to 2; and the last digit represented the A total of one hundred and seventy-five (175) study
number of complete transverse creases which ranges participants of Ghanaian descent were recruited for
from 0 to 2. this study. This included sixty-nine (69) schizophrenic
patients with a mean age of 45± 1.8 years and a
Palmprints hundred and six (106) controls with a mean age of
The palmar surface was divided into six anatomically 23.7± 0.7 years (mean± standard error of the mean).
defined dermatoglyphic areas: hypothenar, thenar, and Of the 69 schizophrenic participants, 11.6% (8) were
the four inter-digital areas as reported by Singh et al. females, and 88.4% (61) weremales. The control group
(2016). Triradius is the basic landmark of digito- consisted of 63.2% (67) females and 36.8% (39) males.
palmar dermatoglyphics. The palm has four digital
triradii (a, b, c, d) located in proximal relation to
the bases of the digits I, II, III, and IV (index finger Clinical characteristics of the schizophrenic study
to the little finger, respectively), as shown in Figure participants
2. The axial triradius (t) is located at the base of About 79.8% of the patients had lived with schizophre-
the palm, distal to the wrist, and in the depression nia for between 1 and 20 years, while the remaining
between the thenar and hypothenar eminences. The a- 20.2% had lived with schizophrenia for more than
b ridge count was obtained by counting the number 20 years. The age of onset of schizophrenia ranged
of ridges between triradius ‘a’ and triradius ‘b’. The between 10 and 70 years. The majority (71%) reported
angle between straight lines drawn from the distal ‘t’ onset within the ages 20–50 years while for 17.4% and
triradius to the medial ‘a’ triradius and the lateral ‘d’ 11.6% of them, the age of onset was below 20 years and
triradius was determined as the atd angle as demon- above 50 years, respectively. The modal age of onset of
strated in Figure 2. The hypothenar and thenar areas schizophrenia was within the age range 31 to 40 years
were examined for patterns. Straight ridges that did not and themodal number of years livingwith schizophre-
form any pattern were recorded as open fields (O) and nia was within the range 1 to 10 years (age of onset;
poorly arranged ridges such that they did not form a 31–40 = 26.1%, years living with schizophrenia; 1–10
true pattern were recorded as vestige (V) according to years = 44.9%).
Sharma et al. (2018).
Comparison of finger and palmar patterns between
Statistical analysis patients with schizophrenia and control
Statistical analysis was performed using IBM SPSS The prevalence of finger patterns assessed was not
Statistics for Windows version 20. The normality significantly different when compared between the
of the continuous data was assessed using Kol- schizophrenic group and the control except for radial
mogorov–Smirnov. Means of total and absolute fin- loop (RL), ulnar loop (UL), and plain arch (PA). The
ger ridge count, a-b ridge count, and atd angles prevalence of RL and the UL were found to be signif-
between individuals with schizophrenia and the con- icantly higher while PA was significantly lower in the
trol were compared using the T-test / Mann–Whitney schizophrenic group compared to the control group.
U test for statistical significance. The proportion Moreover, schizophrenia was found to be associated
of digito-palmar dermatoglyphic patterns between with high and low odds of RL and PA respectively rela-
schizophrenia and control was compared using Chi- tive to the control group (Table 1). Also, no significant
square test. Multinomial logistic regression was used difference was observed when the proportion of the
to calculate odds ratio to determine the association palmar patterns assessed was compared between the
between the digito-palmar dermatoglyphic patterns schizophrenic group and the control group except the
and schizophrenia. P-value < 0.05 was considered proportion of vestige in the hypothenar region and
statistically significant. palmar crease 300 that were found to be significantly
ALL LIFE 5
Figure 2. A diagram showing the palmar surface and method of determining the atd angle of the right and left hands. Demonstrated
are the four digital triradii (a, b, c, d) located in proximal relation to the bases of the digits I, II, III, and IV (index finger to the little finger,
respectively). The lines drawn from the distal ‘t’ triradius to the medial ‘a’ triradius and the lateral ‘d’ triradius form the atd angle (t°).
Adapted from Singh et al. (2016).
Table 1. Comparison of digito-palmar dermatoglyphic patterns between schizophrenia and control groups and its association with
schizophrenia.
Palmar patterns Control n = 212 (%) Schizophrenia n = 138 (%) P-value Schizophrenia OR (95% CI) P-value
Hypothenar
Vestige 21 (9.90) 3 (2.20) 0.005 0.20 (0.06–0.69) 0.010
Loop pattern 10 (4.70) 6 (4.30) 0.900 0.84 (0.30–2.38) 0.745
Open field 181 (85.40) 129 (93.50) 0.020 .
Palmar creases
200 2 (0.90) 2 (1.40) 0.661 0.25 (0.01–4.73) 0.355
300 109 (51.40) 47 (34.10) 0.002 0.11 (0.01–0.99) 0.049
310 100 (47.20) 85 (61.60) 0.008 0.21 (0.02–1.94) 0.170
320 1 (0.50) 4 (2.90) 0.067
Control Reference category
Thenar pattern
Vestige 13 (6.10) 6 (4.30) 0.467 0.74 (0.27–1.99) 0.543
Loop pattern 8 (3.80) 12 (8.70) 0.054 2.39 (0.95–6.01) 0.065
Open field 191 (90.10) 120 (87.00) 0.368 .
Finger patterns Control Schizophrenia P-value Schizophrenia P-value
n = 1060 (%) n = 690 (%) OR (95% CI)
DLW 19 (1.80) 0 –
TA 14 (1.30) 3 (0.40) 0.057 0.31 (0.09–1.07) 0.063
CPLW 17 (1.60) 15 (2.20) 0.361 1.26 (0.62–2.54) 0.525
RL 17 (1.60) 23 (3.30) 0.0197 1.93 (1.02–3.65) 0.044
PA 84 (7.90) 24 (3.50) 0.0002 0.41 (0.26–0.65) < 0.001
PW 248 (23.40) 161 (23.30) 0.9615 0.93 (0.73–1.17) 0.508
UL 661 (62.40) 464 (67.20) 0.041
Control Reference category
lower in patients with schizophrenia compared to the category. Palmar creases: the pattern of the palmar
controls (Table 1). creases was described in three-digit according to the
The sample size for the palmar patternwas obtained PIC model; the first number represents the number
by adding the two palms per individual and multi- of the primary creases, which ranges from 1 to 3, and
plying by the number of individuals per study cate- the middle number represents the number of intersec-
gory while the sample size for the finger pattern was tions between the primary creases, which ranges from
obtained by adding the five fingers per individual and 0 to 2, and the last number represents the number of
multiplying by the number of individuals per study complete transverse creases which ranges from 0 to 2.
6 N. S. MAJEED ET AL.
DLW: double loop whorl, TA: tented arch, CPLW: cen- the results in different populations necessitated the
tral pocket loop whorl, RL: radial loop, PA: plain arch, exploration of the association of dermatoglyphic pat-
PW: plain whorl, UL: ulnar loop. Regression analysis, terns among people living with schizophrenia in the
open field in the hypothenar and thenar region, palmar Ghanaian population.
creases 320, and ulnar loop in the finger patterns were
the categories of comparison with control as the refer- Characteristic of digito-palmar dermatoglyphic
ence category. OR: odds ratio, CI: confidence interval; patterns of patients with schizophrenia
the odds of schizophrenia relative to the control group
(reference category). In this study, the finger dermatoglyphic patterns of
patients with schizophrenia were characterized by sig-
nificantly high prevalence of RL, UL and low preva-
Comparison of finger ridge counts, triradii, a–b ridge lence of PA with a significant association between
count, and atd angle between patients with RL and schizophrenia [RL, control = 17 (1.6) versus
schizophrenia and controls schizophrenia = 23 (3.3), X2 = 5, P = 0.02; UL, con-
No significant difference was observed when the fin- trol = 661(62.4) versus schizophrenia = 464 (67.2),
ger ridge counts and triradii were compared between X2 = 4.2, P = 0.04; PA, control = 84 (7.9) versus
the controls and the participants with schizophre- schizophrenia = 24 (3.5), X2 = 14, P = 0.0002. RL,
nia (Mann–Whitney U-test: P > 0.05) (Table 2). OR (95% CI) = 1.9 (1.0–3.6), P = 0.04]. This obser-
However, the mean left-hand a-b ridge count was vation agrees with Igbigbi et al. (2018) who reported
significantly higher in the control group than in a significant increase in loops and a decrease in
the schizophrenia group (Mann–Whitney U-test: arches in the schizophrenic group compared to the
P = 0.01). Additionally, the mean right atd angle was control group in the Nigerian population. In con-
significantly higher in controls than in the schizophre- trast, no significant difference was observed in the
nia group (Mann–Whitney U-test: right, P = 0.02) frequency of fingerprint patterns when compared
(Table 2). between schizophrenia and the controls in Chilean
and Indian populations (Rothhammer et al. 1971;
Ponnudurai et al. 1997) suggesting that the digito-
Discussion palmar dermatoglyphic patterns may be influenced by
Dermatoglyphics is one of the areas being explored by the genetic makeup of a specified population. Sev-
many scientists as a tool for understanding the genetic eral studies have reported the influence of genetic
associationwith psychiatric illness (Markow andWan- makeup of a specified population on dermatoglyph-
dler 1986;Golembo-Smith et al. 2012;Akbarova 2018). ics patterns and the significance of dermatoglyphics
This is because of the close association between patterns as a tool to identify a person’s specific pop-
intrauterine development of dermatoglyphic patterns ulation (Sunderland and Coope 1973; Awuah et al.
and the brain, both of which develop at the same 2017; de Jongh et al. 2018; Jaiyeoba-Ojigho et al. 2019;
time and have a common ectodermal origin (Ahmed- Baryah and Krishan 2020). This variability could be
Popova et al. 2014). A hypothesis, therefore, exists that because of environmental influence during the differ-
any congenital disturbances in the development of the entiation of the ridges in utero. Environmental factors
brain that may lead to any psychiatric illness could such as exposure to infectious pathogens and lifestyles
potentially reflect in dermatoglyphics. An example is such as alcohol use and stress have been associated
the single palmar crease associated with Down’s syn- with disturbances in the formation of dermatoglyph-
drome (Rignell 1987; Afework 2019). Moreover, the ics (Wang et al. 2008). Some studies have specifi-
stability of dermatoglyphic patterns after development cally documented the association between embryonic
makes them a good marker to track any abnormality stress and low ridge count formation, the association
that could have happened during development (Babler between schizophrenia and stress (Babler 1978), and
1991) as they remain unchanged throughout life. the association between schizophrenia and develop-
Although several studies have reported associations mental stress (Özyurt et al. 2010). These pieces of
between dermatoglyphic patterns and schizophrenia evidence could explain why stress and some infec-
(Wang et al. 2008; Özyurt et al. 2010; Igbigbi et al. tions can trigger schizophrenia in high-risk individ-
2018; Norovsambuu et al. 2021), the inconsistency of uals. Thus, it is likely that the damage to the brain
ALL LIFE 7
Table 2. Comparison of finger ridge count (FRC), triradius, a–b ridge count, and atd angle between patients with schizophrenia and
control group.
Right Left
FRC Control Schizophrenia P-value Control Schizophrenia P-value
Thumb 13.8± 0.7 13.7± 0.8 0.76 12.8± 0.7 13.0± 0.9 0.96
Index 10.8± 0.6 12.0± 0.5 0.41 10.3± 0.6 11.2± 0.7 0.62
Middle 10.2± 0.6 11.0± 0.6 0.60 11.1± 0.6 11.9± 0.6 0.69
Ring 13.5± 0.5 14.1± 0.6 1.00 14.0± 0.6 14.0± 0.6 0.48
Little 12.4± 0.4 12.0± 0.5 0.41 12.4± 0.5 12.3± 0.5 0.70
Total FRC 60.8± 2.1 62.7± 2.4 0.86 60.5± 2.4 62.4± 2.5 0.87
Triradius
Thumb 1.3± 0.1 1.3± 0.1 0.91 1.3± 0.1 1.2± 0.1 0.36
Index 1.2± 0.1 1.3± 0.1 0.66 1.2± 0.1 1.1± 0.1 0.59
Middle 1.0± 0.1 1.2± 0.1 0.10 1.1± 0.1 1.2± 0.1 0.14
Ring 1.3± 0.1 1.4± 0.1 0.20 1.3± 0.1 1.3± 0.1 0.66
Little 1.1± 0.03 1.1± 0.1 0.22 1.1± 0.03 1.1± 0.03 0.91
Total triradius 5.9± 0.2 6.3± 0.2 0.28 5.8± 0.2 5.8± 0.2 0.80
a–b ridge count 37.1± 0.5 36.0± 0.7 0.18 37.5± 0.5 35.4± 0.6 0.01
atd angle 44.1± 0.5 42.1± 0.6 0.02 44.8± 2.0 41.6± 0.6 0.06
in-utero leads to future risk of schizophrenia caused entity rather than the subcategories of schizophrenia,
by the infection or stress that happens at the same which may have affected some of the findings. More-
time the brain and the dermatoglyphics are devel- over, the representative of the heterogeneous popula-
oping. This may also cause disturbances in the for- tion of Ghana was not considered. These limitations
mation of the dermatoglyphics reflecting the dam- could have affected some of the results obtained since
age in the brain since both the brain and the der- the subclassification of schizophrenia, genetic makeup
matoglyphics develop from the same ectoderm. Some of a specified population and sample size have been
of these disturbances in the dermatoglyphics may reported to be a source of variations in digito-palmar
include low a-b ridge counts and atd angles in patients dermatoglyphics patterns (Igbigbi et al. 2018).
with schizophrenia as observed in this study and
reported by several studies (Fananas et al. 1996;Özyurt
et al. 2010; Norovsambuu et al. 2021). Moreover, Recommendation
this may also account for low prevalence of ves- Further studies should be conducted to evaluate
tige pattern in the hypothenar region and palmar the finger and the palmar patterns associated with
crease 300, with schizophrenic patients significantly schizophrenia among Ghanaians using amatched case
less likely to have vestige pattern in the hypothenar control studywith consideration to the sample size and
region and palmar crease 300 [OR (95% CI); vestige the heterogeneous population of Ghana.
pattern = 0.2 (0.06–0.69), P = 0.01; palmar crease
300 = 0.1 (0.01–0.99), P = 0.049] as observed in this
study. Since Africa is characterized by a high burden Conclusion
of infectious pathogens, patients with schizophrenia In this study, the finger dermatoglyphic patterns of
may likely have been exposed to someof these environ- patients with schizophrenia were characterized by a
mental factors in-utero leading to low levels of these significantly high prevalence of RL,UL, and low preva-
parameters among patients with schizophrenia. This lence of PA, with a significant association between
observation also suggests that these disturbances in the RL and schizophrenia, while the palmar patterns were
dermatoglyphics may be explored for their diagnostic characterized by a significantly low prevalence of ves-
significance in schizophrenia. tige pattern in the hypothenar region, and palmar
crease 300. Also, the mean left-hand a-b ridge count
and the atd angle on the right handwas found to be sig-
Limitations nificantly low in patientswith schizophrenia compared
The composition of the two study categories, the to controls. These observations could be explored fur-
control and schizophrenia groups, were not closely ther as a potential biomarker in diagnosing and early
matched in terms of sample size, gender and age. detection of schizophrenia similar to the association
Also schizophrenia was considered a single disease between single palmar creases and Down’s syndrome.
8 N. S. MAJEED ET AL.
Acknowledgements Babler WJ. 1991. Embryologic development of epidermal
We thank the staff of the Accra Psychiatry Hospital who pro- ridges and their configurations. Birth Defects Orig Artic Ser.
vided guidance and support for participant recruitment. Spe- 27(2):95–112.
cial mention is made of Dr. Susan Seffah, Dr. Pinaman Appau Baryah N, Krishan K. 2020. Exploration of digital der-
andDr. Emmanuel Azusong.We also say a big ‘thank you’ to all matoglyphics of two ethnicities of North India-forensic
the study participants. A special thanks to the technical support and anthropological aspects. Forensic Sci Int Reports. 2:
staff of the Department of Anatomy, UGMS, for their rele- 100055.
vant support. Conceptualization: SNM,BAB,DF.Design&data CITI NEWSROOM. 2021. Ghana: CITI; [cited 2021 July
generation: SNM, BAB, NKKK, KAO, RMB, BAH, JA, MAR, 8]. Available from: https://citinewsroom.com/2021/07/3-1-
DF. Data analysis & interpretation: SNM, BAB, NKKK, KAO, million-ghanaians-suffering-from-mental-health-issues-
RMB, BAH, JA, MAR, DF. Manuscript development: SNM, health-minister/.
BAB, NKKK, JA. All authors critically reviewed and approved de Jongh A, Lubach AR, Kwie SLL, Alberink I. 2018. Mea-
the final manuscript. SNM & BAB are co-first Authors. suring the rarity of fingerprints patterns in the Dutch pop-ulation using an extended classification set. J Forensic Sci.
64(1):108–119.
Disclosure statement Fananas L, Van Os J, Hoyos C, McGrath J, Mellor CS, Mur-
ray R. 1996. Dermatoglyphic a-b ridge count as a possi-
No potential conflict of interest was reported by the author(s). ble marker for developmental disturbance in schizophre-
nia: replication in two samples. Schizophr Res. 20(3):
307–314.
Funding Farah FH. 2018. Schizophrenia: an overview. Asian J Pharm.
The Department of Anatomy of the University of GhanaMedi- 12(2):77–87.
cal School partly funded the research through its postgraduate Flashman LA, Roth RM, Pixley HS, Cleavinger HB, McAllister
research support fund. TW, Vidaver R, Saykin AJ. 2007. Cavum septum pellucidum
in schizophrenia: clinical and neuropsychological correlates.
Psychiatry Res. 154(2):147–155.
Data availability statement Fournier O. 2011. The status of mental health care in Ghana,
West Africa and signs of progress in the Greater Accra
Supporting source files and raw data are deposited in Region. Berkeley Undergrad J. 24(3):9–34.
Mendeley Data repository as Arko-Boham, Benjamin (2022), Gnanasivam P, Vijayarajan R. 2019. Gender classification from
‘Schizophrenia and Digital-Palmar Dermatoglyphics’, Mende- fingerprint ridge count and fingertip size using optimal score
ley Data, V6. https://doi.org/10.17632/p2hds3wj2h.6. assignment. Complex Intell Syst. 5:343–352.
Golembo-Smith S, Walder DJ, Daly MP, Mittal VA, Kline
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