Cognitive performance and basic symptoms in first-degree relatives of schizophrenic patients

The aim of the present study was to examine cognitive performance and basic symptoms (BS) in the relatives of schizophrenic patients. The experimental sample comprised 24 first-degree relatives of patients. Each relative was matched to one control. Cognitive tests were: Continuous Performance Test (CPT), N-Back Working Memory Test (N-BACK), Negative Priming Test (NPT), and Span of Apprehension Test (SPAN). The Basic Symptoms Questionnaire (FBF) was used to measure subjective disturbances. The relatives showed only slightly worse cognitive performance than the controls, especially in the tasks with greater cognitive processing load. The relatives also revealed more BS than the controls in the domain of thought, attention, memory, language, and visual representation. Only CPT performance was hardly associated with BS. The negative correlation between FBF and CPT was strongly evident in the relatives with poorer processing capacity. This finding suggests that the BS are associated with sustained attention performance. Future research is needed to clarify whether BS are related to other cognitive domains.     

Handedness and schizotypy in non-psychotic relatives of patients with schizophrenia

Existing studies have found the relationship between handedness and schizotypy to be inconsistent, and had limited generalisability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study participants consisted of non-psychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right-handed siblings of schizophrenia patients displayed more positive schizotypal features than their right-handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right-handedness was associated with positive schizotypy in non-psychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralisation underlying non-right-handedness may be also a contributing factor to positive schizotypy.     

Independence of positive and negative symptoms in a population of schizophrenic patients

Numerous recent studies have divided schizophrenic patients into subgroups based on a predominance of positive or negative symptoms. These works often assume that these symptoms are distributed discontinuously or inversely. In the present work, we sought relationships between positive and negative schizophrenic symptoms in a medication-free inpatient population of schizophrenic patients (N = 61). Measures of positive and negative symptoms were derived from clinical ratings using the Brief Psychiatric Rating Scale. No correlations were found between positive and negative symptoms in the entire group, or in subgroups defined by duration of illness or diagnostic subtype. Furthermore, no correlations were found between positive or negative symptoms and age, age at onset of illness, or duration of illness. These data suggest that positive and negative symptoms vary independently among patients; knowledge about the level of positive symptoms provides no predictive information about negative symptoms. In addition, the distribution of patients showed that a large percentage have a mixture of positive and negative symptoms. Accordingly, methodologies that form restrictive subgroups of patients with exclusively positive or negative symptoms may have little generalizability to schizophrenic populations. The results suggest that schizophrenic patients should not be routinely subtyped as predominantly positive or negative.     

Handedness and schizotypy in non-psychotic relatives of patients with schizophrenia

Existing studies have found the relationship between handedness and schizotypy to be inconsistent, and had limited generalisability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study participants consisted of non-psychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right-handed siblings of schizophrenia patients displayed more positive schizotypal features than their right-handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right-handedness was associated with positive schizotypy in non-psychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralisation underlying non-right-handedness may be also a contributing factor to positive schizotypy.     

Educating relatives of schizophrenic patients

Summary An education programme given to relatives of schizophrenic patients in the context of other social interventions is described. The findings show that although relatives remember relatively little one month after receiving the education, it is an important intervention. Several reasons are suggested, one of which is that education is a somewhat neutral but engaging beginning to the therapeutic relationship. At the later nine months follow up several positive changes in relatives' attitude were shown.     

Effect of anticholinergic medication on positive and negative symptoms in medication-free schizophrenic patients

It is generally assumed that anticholinergic drugs have no effects on schizophrenic symptomatology. A few studies, however, indicate that anticholinergic agents aggravate psychotic symptoms and antagonize therapeutic effects of neuroleptics in schizophrenic patients; more recently, some investigators have observed that these agents appear to benefit negative symptoms. In an effort to resolve this issue, we studied the effects of 2 days of treatment with biperiden on positive and negative symptoms in 15 medication-free schizophrenic patients. Positive symptoms increased significantly, while there was a trend toward a decrease in negative symptoms. The implications of these findings for the role of the cholinergic system in schizophrenia are discussed.     

Susceptibility to backward masking in schizophrenic patients with positive or negative symptoms

The authors used the backward masking paradigm to compare visual information processing in schizophrenic patients with predominantly positive or predominantly negative symptoms. The results indicate significantly slower information processing in patients with negative symptoms.     

Episodic memory in schizophrenic patients and their relatives

BACKGROUND: Memory dysfunction among healthy relatives of patients with schizophrenia suggests that genetic liability to the disorder can also be manifested as cognitive impairment. This study was designed to further elucidate the nature of the memory dysfunction being transmitted. METHOD: Memory function was assessed in 62 schizophrenic patients, 98 of their healthy relatives and 66 controls. Material-specific immediate/delayed recall and percentage retention were investigated using the Logical Memory and Visual Reproduction tests of the Wechsler Memory Scale (WMS). A third subtest of the WMS, the Associate Learning and a visual analogue of it, the Abstract Paired Associates, were used to measure verbal and visual learning. Current general intellectual function was assessed using a five-subtest short-form of the Wechsler Adult Intelligence scale-Revised (WAIS-R). RESULTS: Schizophrenic patients performed significantly worse than controls on nearly all measures. Their relatives also showed significant deficit on the immediate and delayed recall of the Logical Memory, immediate recall of the Visual Reproduction, and the Abstract Paired Associates tests. Logical memory was substantially more impaired than the other measures for both patients and relatives. The deficit in immediate recall of the Logical Memory remained significant even after excluding those relatives with an Axis I diagnosis and schizotypal personality disorder. These findings were despite the relatives having an equivalent level of general intellectual function to that of controls. CONCLUSION: Familial, presumed genetic, liability to schizophrenia may be expressed as dysfunction in verbal memory.     

Obsessive-compulsive symptoms and positive, negative, and depressive symptoms in patients with recent-onset schizophrenic disorders.

OBJECTIVES: To study the relation between obsessive-compulsive symptoms (OCS) and positive, negative, and depressive symptoms in patients with recent-onset schizophrenic disorders. METHODS: We undertook a prospective study of 113 consecutively hospitalized patients with recent-onset schizophrenia or related disorders diagnosed according to DSM-IV criteria. We compared 3 subgroups: one without comorbid OCS, one with OCS not fulfilling DSM-IV criteria for obsessive-compulsive disorder (OCD), and one with comorbid OCD diagnosed according to DSM-IV criteria. We assessed OCS severity at admission and 6 weeks thereafter with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The Positive and Negative Syndrome Scale (PANSS) and the Montgomery-Asberg Depression Rating Scale (MADRS) were independently administered. RESULTS: At admission, patients with schizophrenic disorders and OCD had higher mean MADRS scores than both other groups; patients with OCS not fulfilling DSM-IV criteria for OCD had lower mean PANSS negative subscale scores than both other groups. After 6 weeks, there were no significant between-group differences, and OCS severity remained constant. CONCLUSIONS: Acute patients with recent-onset schizophrenia and OCD have more severe depressive symptoms but do differ in negative symptoms, compared with patients without comorbid OCD. Mild OCS may be related to less severe negative symptoms. During regular inpatient treatment, OCS severity remains constant     

The structure of schizotypy: relationships between neurocognitive and personality disorder features in relatives of schizophrenic patients in the UCLA Family Study

Schizotypal personality features and certain neurocognitive deficits have been shown to aggregate in the relatives of schizophrenic patients, supporting the view that both are likely to reflect genetic contributions to liability to schizophrenia. Within the relatives of schizophrenic patients, however, the interrelationships between these potential indicators of liability to schizophrenia are not well known. Using data from the UCLA Family Study, we examine the interrelationships between personality disorder symptoms and neurocognitive functioning in nonpsychotic first-degree relatives of schizophrenic patients. Factor analyses indicate that several dimensions of schizotypy can be identified. A neurocognitive dysfunction dimension includes loadings from measures of sequential visual conceptual tracking, rapid perceptual encoding and search, and focused, sustained attention as well as the rating of odd and eccentric behavior from schizotypal personality disorder. Other aspects of schizotypal personality disorder form separate positive schizotypy and negative schizotypy dimensions. These analyses support the view that schizotypy is multidimensional in relatives of schizophrenic patients and indicate that neurocognitive deficits in perception and attention are associated with particular schizotypal personality features.     

Neurocognitive correlates of schizotypy in first degree relatives of schizophrenia patients

We examined neurocognitive correlates of three dimensions of schizotypy in 63 healthy first degree relatives of schizophrenia patients. Neurocognitive measures of attention, verbal memory, and prefrontal functioning were combined with self-report and interview measures of schizotypy. State-psychopathology (anxiety and depression) was a strong predictor for positive schizotypy (PS) and negative schizotypy (NS). PS was slightly correlated to verbal long-term memory, therefore weakly supporting the hypothesis that temporal-limbic malfunctioning underlies PS. NS was not correlated to any prefrontal measure, and therefore no evidence was found for the hypothesis that prefrontal malfunctioning underlies NS. Disorganization schizotypy (DS) was strongly correlated to the false alarm variable of the Continuous Performance Test (CPT), probably supporting the hypothesis of orbitofrontal malfunctioning underlying DS. This correlational pattern of DS echoes closely two schizophrenia studies reporting a relationship between formal thought disorder and the false alarm CPT variable. This similarity, across schizophrenia and relatives samples, may be considered as evidence that false alarms on the CPT and (subtle) problems in goal directedness of thinking are indicators of a genetically determined vulnerability to schizophrenia.     

Bcl-2 associated with positive symptoms of schizophrenic patients in an acute phase

B cell lymphoma protein-2 (Bcl-2) may contribute to the pathophysiology of schizophrenia in the brain. The aim of this study was to investigate the serum levels of Bcl-2 in schizophrenic patients in an acute phase, and evaluate Bcl-2 level changes after antipsychotic treatment. We consecutively enrolled 41 schizophrenia patients in an acute phase; 28 were followed up with a 4-week antipsychotic treatment. Serum Bcl-2 levels were measured with assay kits. All patients were evaluated by examining the correlation between Bcl-2 levels and Positive and Negative Syndrome Scale (PANSS) scores, using Pearson correlation coefficients. In schizophrenic patients in an acute phase, positive PANSS subscores were significantly negatively correlated with Bcl-2 levels. In addition, we found Bcl-2 levels had a significantly negative correlation with PANSS total scores and positive subscores in male patients in an acute phase. Using the paired t-test, we found no significant changes in Bcl-2 levels in schizophrenia patients who had received the 4-week treatment with antipsychotic drugs (n=28). In conclusion, our results suggest that Bcl-2 might be an indicator of schizophrenia severity in the acute phase. In addition, Bcl-2 levels might be associated with positive symptoms in male patients with schizophrenia.     

Generality and specificity of emotion-recognition deficit in schizophrenic patients with positive and negative symptoms.

Schizophrenic patients with positive and negative symptoms, as well as non-patient control subjects, were asked to recognize emotional stimuli of happy, sad, and neutral facial expressions. Dependent measures were the percentage of correct responses, and the incorrect use of an emotion category owing to false recognition. Schizophrenic patients with negative symptoms exhibited a generalized emotion-recognition deficit, and their use of emotion categories during false recognition was random. Schizophrenic patients with positive symptoms showed a deficit in their recognition of 'sad' emotion and were 'positively biased' to the category 'happy' as reflected by its most frequent usage during false recognition.     

Effect of pimozide on positive and negative symptoms in schizophrenic patients: are negative symptoms state dependent?

In a double-blind, placebo-controlled trial of treatment with the neuroleptic pimozide, negative symptoms improved in schizophrenic patients who showed an antipsychotic response. Furthermore, there was a significant positive correlation between changes in positive and negative symptoms for the group as a whole, including both pimozide responders and nonresponders. In our patient sample, neuroleptic treatment did not exert a differential effect on the positive and negative symptoms of schizophrenia. It is conceivable that negative symptoms are state dependent and may become neuroleptic nonresponsive over time just as positive symptoms do in some chronic patients.     

精神分裂症患者家属的情感表达

目的探讨中国精神分裂症患者家属情感表达的特点。方法对Ｃａｍｂｅｒｗｅｌ家庭会谈表（ＣＦＩ）中文版的信度和效度进行检验，并用其测定成都市７１例精神分裂症患者家属的情感表达。结果ＣＦＩ中文版具有较好的信度和效度，评定者间总体评定的一致率为９０％；情感表达５个变量之间结构效度检验，Ｐ＜０．０５或＜０．０１；精神分裂症患者家属高情感表达者占２８．２％，敌视的比例为１５．５％。结论中国文化背景下家属高情感表达者较少；家属对疾病的认识可能是影响精神分裂症患者家属情感表达的重要因素     

Obsessive-compulsive symptoms in clozapine-treated schizophrenic patients

The aim of the present study was to assess the occurrence of obsessive-compulsive symptoms (OCS) in schizophrenic patients treated with clozapine, and to examine the relationship between OCS and other clinical variables. The results support earlier findings which suggest that clozapine produces or unmasks OCS. In addition, the severity of OCS was not related to other dimensions of psychopathology, severity of illness, clinical improvement or dose and duration of clozapine treatment.     

Multiple dimensions of schizotypy in first degree biological relatives of schizophrenia patients

Considerable research has been devoted to identifying individuals predisposed to schizophrenia, with much of the effort devoted to identifying the personality characteristics of the biological relatives of schizophrenia patients. Although resource-consuming interviews have yielded promising results, investigators have long sought self-report measures that index genetic risk for schizophrenia. The Schizotypal Personality Questionnaire (SPQ) is a self-report measure that assesses the nine features of DSM-defined schizotypy. The SPQ, modified to include validity scales, was administered to 135 nonpsychotic first degree relatives of schizophrenia patients and 112 healthy controls. Principal components analysis (PCA) yielded three factors that correlated highly with previously reported factors (social-interpersonal, cognitive-perceptual, and disorganization). Social-interpersonal deficits were found to best differentiate relatives from controls. Contrary to the hypothesis that schizophrenia relatives are more defensive in responding to schizotypy questionnaires, relatives were significantly less defensive than controls. The results demonstrate that a multidimensional paper-and-pencil measure can characterize schizotypal features in schizophrenia relatives, which will be useful for the further delineation of the heritable schizophrenia spectrum phenotype.     

Relationship between positive and negative symptoms of schizophrenia and schizotypal symptoms in nonpsychotic relatives.

BACKGROUND: Continuous rather than categorical measures of psychopathology may provide greater statistical power to detect susceptibility loci for schizophrenia. However, it has not been established that the dimensions of schizophrenic symptomatology and personality traits in nonpsychotic individuals share etiological factors. We therefore sought to clarify the relationship between positive and negative symptoms of schizophrenic probands and dimensions of schizotypy in their first-degree relatives. METHODS: In the Roscommon Family Study, we examined the ability of positive and negative symptoms in probands to predict 7 factors of schizotypy in nonpsychotic relatives using regression analysis. These consisted of positive, negative, and avoidant symptoms; odd speech; suspicious behavior; social dysfunction; and symptoms of borderline personality disorder. We examined 3 proband groups: schizophrenia (n = 127); schizophrenia, simple schizophrenia, and schizoaffective disorder (n = 178); and all nonaffective psychoses (n = 216), and their nonpsychotic relatives (n = 309, 477, and 584, respectively). RESULTS: Positive symptoms in all nonaffective psychoses probands predicted positive schizotypy (beta = 0.1972, P =.0004), social dysfunction (beta = 0.0719, P =.0489), and borderline personality disorder symptoms (beta = 0.1327, P =.0084) in relatives, while negative symptoms predicted negative schizotypy (beta = 0.2069, P =.0002), odd speech (beta = 0.2592, P =.0001), suspicious behavior (beta = 0.2749, P =.0001), and social dysfunction (beta =.2398, P =.0002). Proband negative symptoms and borderline personality disorder symptoms in relatives in the schizophrenia, simple schizophrenia, and schizoaffective disorder group were inversely related (beta = -0.1185, P =.05). CONCLUSIONS: Positive and negative symptoms in schizophrenia predict corresponding schizotypal symptoms in relatives. This provides evidence that these schizophrenic symptom factors (1) are etiologically distinct from each other and (2) occur on an etiological continuum with their personality-based counterparts.