Eye tracking dysfunction in families with multiple cases of schizophrenia

There is increasing evidence that the genetic predisposition for schizophrenia in families affects more individuals than those fulfilling the criteria for schizophrenia. This finding is supposed to be one of the major problems in molecular genetic schizophrenia research, especially when linkage studies are employed. Eye-tracking dysfunction (ETD), which is conceived as a possible phenotypic marker for genetic liability to schizophrenia, may offer considerable advantages. However, there is only little information from families with multiple occurrence of schizophrenia. It is still unclear whether in these families ETD aggregates with diagnoses from the schizophrenia spectrum. This first report from an ongoing study presents the results of 48 individuals from 6 multiplex families. Smooth-pursuit eye movements were recorded by infrared reflectometry and assessed by quantitative measurement techniques. Along with the high degree of psychiatric morbidity in these families, in 56.3% of the individuals ETD was assessed. Reduced mean pursuit gain was present in 39.6%. The distribution of eye-tracking dysfunction resembles the distribution of schizophrenia-related psychiatry morbidity.     

Autoimmune model of schizophrenia with special reference to antibrain antibodies

Antibrain antibody titers were determined by hemagglutination technique in sera and cerebrospinal fluid of 54 schizophrenic patients and 27 nonschizophrenic controls. Antibrain antibodies were detected in sera and CSF of 26 (48.1%) schizophrenics but in none of the controls. They were significantly more often present in those schizophrenics who had a past history (p less than 0.01) and family history (p less than 0.01) of schizophrenia. They had no significant relationship with the subtype and the duration of schizophrenia. The possible genetic and immunological implications of these findings are discussed.     

Is eye tracking dysfunction specific to schizophrenia?

Based on eye tracking studies in psychiatric patients, normal controls, and first-degree relatives of patients, Holzman, Proctor, and Levy et al. (1974) state that eye tracking dysfunction (ETD) is specific to schizophrenia and may be a genetic marker of that disorder. A review of numerous subsequent studies, however, suggests that ETD is not specific to schizophrenia, but is restricted to functional psychosis. Evidence that ETD is a genetic marker of functional psychosis is, as yet, inconclusive.     

Long-term clinical outcome of schizophrenia with special reference to gender differences

A sample of 94 first-admitted schizophrenics and 47 patients with schizophreniform disorder (DSM-III) was personally re-examined after a mean of 10 years (by Retterstöl), and 110 of the patients after a mean of 31 years (by the author). Nearly half of the patients were admitted in 1946-1948 (long-term) and the remaining in 1958-1961 (short-term). Average outcome was significantly more favourable for short-term than for long-term patients. Single marital status and no, minimal or mild psychosocial stressor at onset (Axis IV) predicted poor long-term outcome. At 10-year follow-up there was no difference between men and women in clinical outcome. No substantial change was revealed in men at last follow-up, whereas on average women had clearly deteriorated.     

Late-onset schizophrenia: an overview

Onset of schizophrenia after the age of 40 has been a controversial topic. We reviewed more than 30 publications (mainly from Europe) on this subject. Many of the studies had methodological shortcomings, including problems in precisely dating the onset of schizophrenia. Nonetheless, it appears that a certain proportion of patients present for the first time with diagnosable schizophrenia after age 40. Late-onset schizophrenia is characterized by paranoid symptomatology, a high female:male ratio, an elevated prevalence of hearing loss and ocular pathology, schizoid or paranoid traits in premorbid personality, a tendency toward chronicity, and symptomatic improvement with neuroleptics. Family studies suggest that the prevalence of schizophrenia in relatives of late-onset schizophrenic probands is higher than that in the general population, but lower than that in relatives of earlier-onset schizophrenic probands. We believe that late-onset schizophrenia is a valid entity (or group of entities). Studies of the course, biological associations, neuropsychological performance, and pharmacological characterization of late-onset schizophrenia are warranted.     

Quantitative characterization of eye tracking dysfunction in schizophrenia

The purpose of this study was to characterize the nature of the processes that are involved in eye tracking dysfunction (ETD). We identified a combination of quantitative measures that best distinguished qualitatively normal eye tracking from qualitatively abnormal eye tracking, using discriminant analysis. Discriminant scores distinguished schizophrenics with ETD from both schizophrenics with normal eye tracking and normal controls, but did not distinguish schizophrenics with normal eye tracking from normal controls, underscoring the heterogeneity of schizophrenic patients with respect to eye tracking. The results of the discriminant analysis indicated that ETD is a multivariate process involving a primary impairment in the smooth pursuit system characterized by increased catch-up saccades and reduced gain, and, secondarily, disinhibition of intrusive saccades, especially square-wave jerks. Quantitative characterization of ETD makes it possible to consider eye tracking as a quantitative trait in genetic investigations of a multidimensional phenotype.     

Antipsychotics in the treatment of schizophrenia: an overview

Schizophrenia is characterized by positive, negative, cognitive, disorganization, and mood symptoms. Antipsychotics are the mainstay in the pharmacologic treatment of schizophrenia. Findings concerning efficacy for positive symptoms and disorganization suggest no consistent differences among available antipsychotics, with the exception of clozapine's superior efficacy for treatment-resistant schizophrenia. Efficacy for negative, depressive, and cognitive symptoms appears to be determined by (1) the extent to which reduction in positive symptoms brings about improvement in these other domains and (2) the extent to which extrapyramidal side effects (EPS) and anticholinergic effects (of the antipsychotic and of agents used to treat EPS) exacerbate them. Thus, the ability of antipsychotics to produce a potent antipsychotic effect without EPS and need for concomitant anticholinergic therapy yields multiple therapeutic benefits. In contrast to their broadly similar efficacy, antipsychotics differ markedly in their propensity to cause various adverse effects. Although second-generation antipsychotics (SGAs) have generally been believed to be associated with a lower risk of EPS but a higher risk of metabolic adverse effects than first-generation agents (FGAs), the substantial variation in these and other side effects among agents within both classes indicates that it is not clinically useful to make a categorical distinction between FGAs and SGAs. Choice of antipsychotic medication should be based on individual preference, prior treatment response and side effect experience, medical history and risk factors, and adherence history, with side effect profile a major determinant of antipsychotic choice.