Age of onset in familial and sporadic schizoph4.4.renia

We have studied the gender and family history differences with regard to age of onset of schizophrenia. These differences have often been viewed as an important clue to the aetiology of the illness. Patients from three centres in Europe and Canada were included in the study. A sample of 1089 subjects was categorized according to the subject's sex, family history of schizophrenia, and the centre. The principal statistical method was analysis of variance. Patients with no family history of schizophrenia had a consistently higher average age of onset. This effect was seen in both male and female subjects across all three groups. These results support the relationship between familial risk and early onset, but no interaction of gender and family history was found.     

The criteria of Cloninger et al. and von Knorring et al. for subgrouping alcoholics: a comparison in a clinical population.

There is increasing evidence that meaningful subgroups of alcoholics may exist. Cloninger et al. and von Knorring et al. have developed criteria to delineate what both call type 1 and type 2 alcoholism. However, when we compared their criteria in a predominantly inpatient sample of male alcoholics, we found large differences between the approaches in identifying type 1 and type 2 alcoholism. Concordance was equally low in a subsample of 34 alcoholics exhibiting antisocial behavior and when subjects were divided by whether the first alcohol-related problem began before or after 20 years of age. Similar findings emerged when we limited our analyses to primary alcoholics and alcoholics with no other mental disorders.     

Associations of phenylthiocarbamide tasting to alcohol problems and family history of alcoholism differ by gender

Past research associating phenylthiocarbamide/propylthiouracil (PTC/PROP) taste status with alcoholism has produced equivocal results. Some have found higher proportions of nontasters among those with a family history of alcoholism than controls, whereas others have not. The purpose of this study was to investigate the relationship between PTC taste status, alcohol problems, and family history of alcoholism. A total of 244 undergraduate students participated in this study, with a gender distribution of 75% female and 25% male. We found support for our hypothesis that male supertasters would report fewer problems with alcohol and a less significant family history of alcoholism. Interestingly, we also found that female supertasters had a greater family history of alcoholism and more current problems associated with alcohol use. Implications for the genetic link between PTC taste status and alcoholism are discussed.     

Clinical and temperamental differences between early- and late-onset alcoholism in Korean men

OBJECTIVES: The aims of this study were to elucidate the clinical and temperamental differences between early- and late-onset alcoholism among Korean men and to ascertain the validity of Cloninger's typology model of alcoholism for Koreans. METHODS: All of the subjects were screened after a detoxification period of at least 2 weeks using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders for diagnosing alcohol dependence and identifying psychiatric comorbidities. The Korean version of the tridimensional personality questionnaire was then administered to 173 male alcoholic inpatients; and information regarding their criminality, family history of alcoholism, and age at the onset of alcohol-related problems was gathered. We divided the patients into 2 groups based on the age at the onset of alcoholism: (1) early onset (n = 80), when they were up to 25 years old at the onset, and (2) late onset (n = 93), when they were older than 25 years at the onset. RESULTS: Early-onset patients exhibited more criminality (chi2 = 15.45, df = 1, P < .001, odds ratio [OR] = 3.84, 95% confidence interval [CI] = 1.93-7.65), suicide attempts (chi2 = 7.92, df = 1, P = .005, OR [95% CI] = 3.14 [1.38-7.15]), and family history of alcoholism (chi2 = 24.75, df = 1, P < .001, OR [95% CI] = 5.27 [2.67-10.37]). With regard to the tridimensional personality questionnaire profile, the early-onset patients exhibited a higher score of novelty seeking (t = 3.42, P = .001), with the difference still being significant after adjusting for age by analysis of covariance (using age as a covariate) (F = 5.928, P = .016). However, harm avoidance (t = -0.13, P = .89), reward dependence (t = -0.19, P = .85), and persistence (t = -0.62, P = .54) did not differ between the 2 groups. CONCLUSIONS: There were several distinct clinical and temperamental differences between early- and late-onset alcoholism among Korean male alcoholic patients. It is suggested that the age at the onset of alcoholism can be used to discriminate alcoholic subtypes. Our data also partly support Cloninger's typology of 2 types of alcoholic individuals.     

Patterns of familial alcoholism, alcoholism severity, and psychopathology

The interrelationships among the severity of alcoholism, psychopathology/personality, and the degree of familial alcoholism were examined using the following four familial alcoholism classification schemes, which each differentiated three degrees of familial alcoholism: 1) conventional, compared alcoholics with no, nonparental, and parental alcoholic relatives; 2) lineality, distinguished between subgroups with alcoholism in neither, one, or both sides of their family; 3) generational, compared alcoholics having no, one, or two generations of familial alcoholism; 4) quantitative, credited one point for each first-degree and 1/2 point for each second-degree alcoholic relative. The subjects were 83 male alcoholic Veterans Administration inpatients 50 years of age or under. The Alcohol Use Inventory, various alcohol-related symptoms and behaviors, and laboratory values were used to evaluate the severity/pattern of alcoholism. Psychopathology/personality were measured by the MMPI, the Psychopathic State Inventory, the MacAndrew Alcoholism Scale, the Childhood Problem Behaviors Questionnaire, and the percentage of patients with an antisocial personality disorder (ASP) diagnosis. Surprisingly few subgroup differences were revealed in the severity/pattern of alcoholism. Only age at time of treatment and use of nonalcoholic drugs were associated with increasing familial alcoholism. On the other hand, childhood behavior problems, particularly antisocial behavior, and an ASP diagnosis were found to be associated with an increasing degree of familial alcoholism. The diagnosis of ASP was most apparent in the two-generational and bilineal alcoholics, while an increased degree of familial alcoholism was not associated with ASP for the conventional classification. Bilineal familial alcoholics also exhibited an MMPI profile reflective of a characterological disorder.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prevalence and profile of methamphetamine users in adolescents at a juvenile classification home

The objective of the present study was to investigate the prevalence and risk factors of methamphetamine use in adolescents at a juvenile classification home. The present subjects were 1362 adolescents (1172 male and 190 female) who had been admitted to the Nagoya Juvenile Classification Home. The participants were divided into two groups, a methamphetamine user group and a control group, based on history of methamphetamine use. The presence of methamphetamine use was analyzed in terms of gender, age, number of admissions, violence (types of crime), history of psychiatric treatment, family history (crime, drug misuse and/or alcohol-related disorder), and experience of being abused by their parents or by the persons who were responsible for raising them. The prevalence of methamphetamine use was 6.8% (93/1362). Multivariate logistic regression analyses indicated that gender (female; odds ratio [OR]: 8.1; 95% confidence interval [CI]: 4.6-14.3), age (OR: 1.8, 95%CI: 1.5-2.1), number of admissions (>2, OR: 2.9, 95%CI: 1.8-4.8), violence (OR: 0.4, 95%CI: 0.2-0.7), history of psychiatric treatment (OR: 8.7, 95%CI: 4.0-19.0), and family history of drug misuse (OR: 4.0, 95%CI: 1.6-9.6) were all significantly associated with methamphetamine use. Approximately 7% of participants used methamphetamine. Female gender was a risk factor. Higher age and multiple admissions suggest the persistency and repetition of delinquency. Methamphetamine users were less violent than control subjects. Psychosocial environment (family history of drug misuse) and psychiatric problems (history of psychiatric treatment) were also related to methamphetamine use.     

Suicide-related phenomena and mental health status in alcoholics: a survey of Danshu-kai

Alcohol abuse is a well-known risk factor for suicide, as alcohol-related problems can deteriorate the medical and psychosocial conditions of individuals. Furthermore, the pharmacological effect of alcohol can cause impulsive behavior. However, few studies have investigated the association of alcohol-related problems with suicide or suicide-related mental health problems in a Japanese population. This study aimed to investigate suicidal behavior and factors influencing the mental health of people with alcohol-related problems. We conducted a self-reporting survey of members of alcohol abstinence self-help groups in Japan, "Danshu-kai". Of those members who attended meetings held during April and June 2009, 4,616 (rate of consent, 85.1%; 4064 males, 518 females, and 34 undetermined; mean age +/- SD, 60.2 +/- 10.9 years) participated in our study. The questionnaire sought the following information: gender, age, living with someone, marriage, jobs, present family relationships, health condition, history of attending the Danshu-kai meeting, family histories of alcohol-related problems, duration of abstinence, and history of suicide-related phenomena. A total of 44.2% of the subjects reported they had experienced suicidal thoughts, 24.6% had planned suicide, with 21.6% having attempted suicide. Seventy parcent of these phenomena occurred before participation in Danshu-kai. We also collected Kessler 10 (K10) scores, the self reporting scale for screening depressive and anxiety disorders. We classified subjects into two groups, those with a poor or favorable mental health according to the total K10 score cutoff, and analyzed factors predicting the present mental health condition. Multivariate logistic regression analyses demonstrated that age, physical health, and parental histories of alcohol-related problems were significantly associated with the present mental health condition in both genders. However, jobs, present family relationships, history of attending the Danshu-kai meeting, and duration of abstinence were also significantly associated, but only in males. In conclusion, it is important to cooperate with self help groups such as Danshu-kai to highlight the association between alcohol-related problems and suicide. Furthermore, early intervention for individuals with alcohol-related problems before there is progression of any medical and/or psychosocial damage may prevent future suicides among alcoholics.     

Suicide risk in relation to socioeconomic,demographic, psychiatric,and familial factors: a national register-based study of all suicides in Denmark, 1981-1997

OBJECTIVE: Suicide risk was addressed in relation to the joint effect of factors regarding family structure, socioeconomics, demographics, mental illness, and family history of suicide and mental illness, as well as gender differences in risk factors. METHOD: Data were drawn from four national Danish longitudinal registers. Subjects were all 21,169 persons who committed suicide in 1981-1997 and 423,128 live comparison subjects matched for age, gender, and calendar time of suicide by using a nested case-control design. The effect of risk factors was estimated through conditional logistic regression. The interaction of gender with the risk factors was examined by using the log likelihood ratio test. The population attributable risk was calculated. RESULTS: Of the risk factors examined in the study, a history of hospitalization for psychiatric disorder was associated with the highest odds ratio and the highest attributable risk for suicide. Cohabiting or single marital status, unemployment, low income, retirement, disability, sickness-related absence from work, and a family history of suicide and/or psychiatric disorders were also significant risk factors for suicide. Moreover, these factors had different effects in male and female subjects. A psychiatric disorder was more likely to increase suicide risk in female than in male subjects. Being single was associated with higher suicide risk in male subjects, and having a young child with lower suicide risk in female subjects. Unemployment and low income had stronger effects on suicide in male subjects. Living in an urban area was associated with higher suicide risk in female subjects and a lower risk in male subjects. A family history of suicide raised suicide risk slightly more in female than in male subjects. CONCLUSIONS: Suicide risk is strongly associated with mental illness, unemployment, low income, marital status, and family history of suicide. The effect of most risk factors differs significantly by gender.     

Behavioral disinhibition induced by tryptophan depletion in nonalcoholic young men with multigenerational family histories of paternal alcoholism.

OBJECTIVE: A deficit in serotonergic neurotransmission has been linked to impulsive behavior, as well as to disorders characterized by disinhibition. The present study tested the hypothesis that young men at high risk for alcoholism demonstrate greater behavioral disinhibition after acute dietary depletion of tryptophan, the amino acid precursor of serotonin. METHOD: A double-blind, placebo-comparison, between-subjects study design was used. Nonalcoholic young men with a multigenerational paternal family history of alcoholism (N = 13) or with no family history of alcoholism (N = 15) in two previous generations were administered mixtures of tryptophan-deficient amino acid to achieve plasma tryptophan depletion. Comparison subjects with a multigenerational paternal family history of alcoholism (N = 1) and comparison subjects with no family history of alcoholism (N = 18) were given a balanced mixture. Five hours after this, all were tested on a modified Taylor task and a go/ no-go task measuring aggressive response and disinhibition, respectively. RESULTS: Plasma tryptophan levels were reduced by 89% in both groups. Tryptophan depletion had no effect on aggressive response. In contrast, tryptophan-depleted individuals with a family history of alcoholism made more commission errors (responses to stimuli associated with punishment or loss of reward) than did tryptophan-depleted individuals with no family history of alcoholism and those receiving the balanced (comparison) mixture of amino acid in either group. CONCLUSIONS: Low serotonin levels may be implicated in the high disinhibition or impulsivity observed in some individuals with a genetic vulnerability to alcohol abuse or dependence.     

Impact of family history of alcoholism on glutamine/glutamate ratio in anterior cingulate cortex in substance-naïve adolescents

Neuroimaging studies of individuals with family histories of alcoholism provide evidence suggesting neurobiological risk factors for alcoholism. Youth family history positive (FH+) for alcoholism exhibit increased impulsivity compared to family history negative (FH−) peers in conjunction with altered functional activation in prefrontal cortex, including anterior cingulate cortex (ACC). This study examined glutamate (Glu) and glutamine (Gln), amino acids vital to protein synthesis, cellular metabolism and neurotransmission, acquired from ACC and parieto-occipital cortex (POC) using magnetic resonance spectroscopy (MRS) at 4T. Participants were 28 adolescents (13 male, 12–14 yrs) and 31 emerging adults (16 male, 18–25 yrs), stratified into FH− and FH+ groups. Significantly higher ACC Gln/Glu was observed in emerging adults versus adolescents in FH− but not FH+ groups. In FH− adolescents, higher impulsivity was significantly associated with higher ACC Gln/Glu. In FH+ emerging adults, higher impulsivity was negatively associated with ACC Gln/Glu. No differences or associations were observed for POC. These findings provide preliminary evidence that family history of alcoholism is associated with a neurochemical profile that may influence normative age differences in glutamatergic metabolites and their association with impulse control, which together could confer greater genetic risk of addiction later in life.     

P300 and alcohol consumption in normals and individuals at risk for alcoholism. A preliminary report

Pairs of college student subjects (36 male, 36 female) were matched on age, sex, and personal drinking history. One pair member had a parent who met the DSM III criteria of alcoholism, while the other pair member had no close alcoholic relative. The P300 event-related brain potential (ERP) was obtained from each subject with auditory stimuli in an "oddball" paradigm. Target stimuli occurred randomly on 20% of the trials in a frequency discrimination task, a relatively easy intensity discrimination task, and a more difficult intensity discrimination task. Subjects indicated when the target items occurred by moving their index finger. No significant overall effects were obtained for family history for either P300 latency or amplitude. P300 latency increased and amplitude decreased with increases in the reported amount of alcohol consumption in all subjects only for the difficult intensity task but were statistically significant only for individuals with a negative family history for alcoholism.     

Clinical characteristics of familial versus sporadic alcoholism in a sample of male and female patients.

Presence of a family history of alcoholism may predict clinical characteristics in affected subjects, such as an earlier age at onset. More frequent and severe social maladjustment and somatic complications are also regularly cited for familial alcoholism, although subject to many other confusing factors. We analysed the clinical specificities of 79 alcohol-dependent inpatients according to the absence versus presence of family history of alcoholism. Patients were evaluated for lifetime psychiatric morbidity with the Diagnostic Interview for Genetic Studies (DIGS), for somatic complications with a systematic screening list, and first-degree relatives (N = 428) were assessed with the Family Inventory Schedule and Criteria (FISC). Age at onset and social complications were predicting familial versus sporadic alcoholism, even when considering censored data and/or interaction between variables. But differences became non-significant when excluding patients with antisocial personality. If age at onset effectively appears to be the most informative characteristic for predicting familial versus sporadic alcoholism, it seems that it may be necessary in future studies to systematically take into account antisocial personality diagnosis, because of a probable contamination.     

Tridimensional Personality Questionnaire scores of sons of alcoholic and nonalcoholic fathers

The authors studied 33 men whose fathers had severe alcohol-related problems and 33 subjects with no family history of alcoholism. The former supplied information about the course of their fathers' alcohol problems; all 66 men answered questions about their own drinking and drug use and completed the Tridimensional Personality Questionnaire. There were no significant relationships between any of the 18 questionnaire scores and a subject's quantity/frequency of drinking or his family history of alcoholism. There was only one significant correlation between the alcoholic fathers' type 2 characteristics, according to the type 1/type 2 theory, and the sons' questionnaire scores. The relevance of these findings to the theory is discussed.     

Heterogeneity in the inheritance of alcoholism. A study of male and female twins

Genetic influence on risk for alcoholism was examined in a US treatment sample of 50 monozygotic (MZ) and 64 dizygotic (DZ) male and 31 MZ and 24 DZ female same-sex twin pairs. For the DSM-III composite diagnosis of Alcohol Abuse and/or Dependence, statistically significant MZ/DZ differences in concordance were found with male, but not female, twins. For specific diagnoses, MZ/DZ differences were found in male subjects for both Alcohol Abuse and Alcohol Dependence, while MZ/DZ differences in female subjects were found only for Alcohol Dependence. The male MZ/DZ concordance difference for composite diagnosis but not for Alcohol Dependence could be accounted for statistically by differences in age of onset between MZ and DZ probands. As with alcohol, differences in MZ/DZ concordance were found for DSM-III composite diagnoses of Other Substance Abuse and/or Dependence with male, but not female, twins. Using Epidemiological Catchment Area data to estimate the population base rates of both alcohol and other substance use disorders allowed for heritability analyses that showed genetic factors to have only a modest influence on overall risk in both sexes (heritability estimates of approximately 0.35 for male subjects and 0.24 for female subjects). However, evidence for heterogeneity in the pattern of inheritance was also found, suggesting forms of alcoholism that may be moderately to highly heritable.     

The social complications of chronic alcohol abuse: relative influence of family history and severity of alcohol dependence

Alcoholics with a family history of the disease are said to present more severe consequences than alcoholics without such a history. This study examined the frequency distribution of severe alcohol dependence and police arrests for public drunkenness across samples of alcoholics with (n = 77) and without (n = 37) a family history of alcoholism. Both the percentage of subjects presenting severe dependence and the history of police arrests were greater in the positive family history group, but these differences did not reach conventional levels of statistical significance. However, results of logistic regression analyses demonstrate that male sex, younger age and, above all, severity of alcohol dependence, are better correlates of the occurrence of police arrests than is the subject's family history of alcoholism. The picture presented by this sample of outpatient alcoholics appears to qualify some currently held assumptions of the influence of family history on the phenomenology of alcoholism.     

Types of alcoholics, I. Evidence for an empirically derived typology based on indicators of vulnerability and severity.

An empirical clustering technique was applied to data obtained from 321 male and female alcoholics to identify homogeneous subtypes having discriminative and predictive validity. The clustering solution identified two "types" of alcoholics who differed consistently across 17 defining characteristics in the male and female samples. One group, designated type A alcoholics, is characterized by later onset, fewer childhood risk factors, less severe dependence, fewer alcohol-related problems, and less psychopathological dysfunction. The other group, termed type B alcoholics, is characterized by childhood risk factors, familial alcoholism, early onset of alcohol-related problems, greater severity of dependence, polydrug use, a more chronic treatment history (despite their younger age), greater psychopathological dysfunction, and more life stress. The two types also differed with respect to treatment outcome assessed prospectively at 12 and 36 months. The results are consistent with historical and contemporary typological theories that have postulated similar subgroups of alcoholics. The findings suggest that an empirically derived, multivariate typology of alcoholism has theoretical implications for explaining the heterogeneity among alcoholics and may provide a useful basis for predicting course and estimating treatment response.     

Prevalence and demographic correlates of alcohol-related problems in Japanese employees

Summary To examine the relationship of basic sociodemographic characteristics to alcohol-related problems in Japanese employees, a questionnaire survey was conducted of a total of 2,581 employees of a computer factory in a suburb of Tokyo. The questionnaires included items on gender, age, marital status, social class (i. e., education, family income and occupation), alcohol consumption, and the Kurihama Alcoholism Screening Test (KAST). Data from 1098 male and 265 female current drinkers aged 20 years or older were analyzed; 15% and 6% of the male and female subjects, respectively, were classified as having alcohol-related problems on the basis of the KAST score (13% and 4% of the entire study population, respectively). Multiple logistic regression analysis indicated that alcohol-related problems were more prevalent in the less educated, managers and those who had a high alcohol consumption. The results suggested that education and occupation are important factors related to alcoholrelated problems in Japanese employees.     

Endogenous breath acetaldehyde levels among alcoholic and non-alcoholic probands: effect of alcohol use and smoking

The effects of possible confounding factors on endogenous breath acetaldehyde levels were examined in alcoholic and non-alcoholic subjects. Demographic characteristics, family history for alcoholism, smoking and drinking history, and breath acetaldehyde levels were assessed. Differences in endogenous breath acetaldehyde levels could not be attributed to age, sex, or having a family history positive for alcoholism. Individuals who smoke or abuse alcohol had higher endogenous breath acetaldehyde levels than persons who did not.     

Differences in frontal lobe function between violent and nonviolent conduct disorder in male adolescents

Aims:  The objective of the present study was to investigate the differences in frontal lobe function between violent and nonviolent male adolescents with conduct disorder.
Methods:  A total of 309 male adolescents who had been admitted to the Nagoya Juvenile Classification Home participated. The participants were divided into two groups, a violent group composed of individuals who had committed violence against others, and a nonviolent group. The subjects were given the Wisconsin card sorting test (Keio version: KWCST) and the Iowa Gambling task. The presence of violent cases was analyzed in terms of age, family history (crime, drug abuse/dependence, alcohol-related disorder, and psychiatric treatment), experience of being abused by their parents or by the persons who were responsible for raising them, as well as categories achieved (CA) of KWCST (≤4, >4) and total selection of disadvantage cards of Iowa Gambling task (≥50, <50).
Results:  Multivariate logistic regression analyses indicated that a family history of drug abuse/dependence (odds ratio = 0.3, 95% confidence interval = 0.1–0.9) and a CA of the KWCST (odds ratio = 1.8, 95% confidence interval = 1.0–3.1) were significantly associated with violence.
Conclusions:  An impaired rate of CA of the KWCST was related to violence, whereas a family history of drug abuse/dependence was related to nonviolence in male adolescents with conduct disorder.     

Effects of gender and alcoholism on verbal and visual-spatial learning

Sex differences in cognitive abilities of chronic alcoholics were investigated using a paired-associates learning test with separate but similarly structured verbal and visual-spatial components. Four groups of 35 subjects each, equated for age and education, were tested: male and female alcoholics, and male and female community control subjects. As expected, sex differences were found on the component tasks: overall, nonalcoholic women performed significantly better than nonalcoholic men on the verbal measure, and nonalcoholic men performed better than nonalcoholic women on the visual-spatial measure. Nonalcoholic men had a larger discrepancy between component scores than nonalcoholic women, suggesting greater lateralization of cognitive functions; however, this difference did not reach significance. The effects of alcoholism were different for the sexes. Alcoholic women were not impaired on either the verbal or visual-spatial measure, but the alcoholic men demonstrated deficits in visual-spatial performance. In addition, they showed less difference between verbal and visual-spatial component scores than the other groups, suggesting that alcoholism attenuated the effects of hemispheric specialization for cognitive abilities normally found in men.