Psychiatric disorders in the families of patients with obsessive-compulsive disorder.

The rate of comorbid diagnoses in a group of 92 patients with obsessive-compulsive disorder (OCD) was examined, with particular attention being paid to mood disorders. The family history method was used to study the frequency of psychiatric disorders in the patients' families and to analyze the characteristics of the familial loading for OCD and mood disorders. A comorbid diagnosis of mood disorder occurred in 35.9% of the patients. The morbidity risk for OCD in the patients' families accounted for 3.4%; when 21 patients with an age of onset under 14 were examined, the morbidity risk in first degree relatives reached 8.8%. This tendency did not appear to be true for mood disorders.     

Psychiatric disorders in 36 families with Wolfram syndrome

OBJECTIVE: The purpose of this study was to test the hypothesis that heterozygous carriers of the gene for the Wolfram syndrome, who constitute about 1% of the population, are predisposed to significant psychiatric illness. The Wolfram syndrome is an autosomal recessive neurodegenerative syndrome in which 25% of the individuals who are homozygous for the condition have severe psychiatric symptoms that lead to suicide attempts or psychiatric hospitalizations. METHOD: The authors collected questionnaires, death certificates, and hospital records for blood relatives and their spouses in 36 families of individuals with the Wolfram syndrome and compared the proportion of blood relatives who had had psychiatric hospitalizations, had committed suicide, or had self-reported mental illness to the proportion of spouses with the same manifestations. RESULTS: The proportion of blood relatives who had had psychiatric hospitalizations, had committed suicide, or had self-reported mental illness significantly exceeded the proportion of spouses with the same manifestations. CONCLUSIONS: Since heterozygous carriers of the gene for the Wolfram syndrome are 50-fold more common among the blood relatives than among the spouses, the larger proportion among blood relatives is evidence that heterozygous carriers of the gene for the Wolfram syndrome are predisposed to significant psychiatric illness.     

Difference in reaction time between subjects with schizotypal and borderline personality disorders

Patients with schizophrenic spectrum disorders and affective disorders were compared on a reaction time procedure. The nonhospitalized schizotypal subjects performed similarly to the schizophrenic patients on the crossover measure. Mean reaction time discriminated between hospitalized and nonhospitalized patients rather than between types of pathology.     

Handedness and schizotypal features in healthy subjects.

BACKGROUND: An excess of mixed-handedness has been repeatedly reported in schizophrenia and schizotypy. Handedness is a measure of atypical cerebral lateralization, which is considered as a risk factor for schizophrenia. Several studies have attempted to identify correlations between handedness and dimensions of psychosis but the results obtained so far remain inconclusive. OBJECTIVE: To explore a possible link between mixed-handedness and the three classical dimensions of psychosis. As speech and language disorders may be associated with cerebral lateralization, we predicted a correlation between mixed-handedness and disorganized dimension. METHODS: We used the Schizotypal Personality Questionnaire (SPQ) and the Edinburgh Handedness Inventory (EHI) to study the correlation between mixed-handedness scores and positive, negative or disorganized dimensions in a sample of 62 healthy subjects. RESULTS: We found a negative correlation between mixed-handedness and the disorganized dimension of schizotypy, as individuals with prominent mixed-handedness showed more severe disorganization. CONCLUSION: We have identified a link between mixed-handedness and the disorganized dimension that may help to identify genetic vulnerability factors involved in psychosis.     

Psychiatric disorders in the biological and adoptive families of adopted individuals with affective disorders

To investigate the contribution of genetic and environmental factors in the etiology of mood disorders, a study was initiated to examine the frequency of psychiatric disorders in the biological and adoptive relatives of adult adoptees with mood disorders and in matched normal adoptees. Psychiatric evaluations of the relatives were made on the basis of independent blind diagnoses based on mental hospital and other official records. Analysis of the data showed an eightfold increase in unipolar depression among the biological relatives of the index cases and a 15-fold increase in suicide among the biological relatives of the index cases. These data demonstrate a significant genetic contribution to unipolar depression and suicide. They fail to disclose a significant contribution of family-associated transmission in the genesis of the mood disorders.     

Fluoxetine in the treatment of borderline and schizotypal personality disorders.

Twenty-two patients meeting the criteria for borderline or schizotypal personality disorder or both participated in a prospective, nonblind 12-week trial of fluoxetine. There were significant reductions in self-injury and in scores on the Hopkins Symptom Checklist regardless of diagnosis. The results suggest that controlled trials of fluoxetine and investigations of the serotonergic system in these disorders would be useful.     

Overlap between borderline and schizotypal personality disorders.

Borderline personality was split into two diagnostic categories in DSM-III: borderline personality disorder (BPD) and schizotypal personality disorder (SPD). There remains a great deal of diagnostic overlap between these two categories despite modifications in DSM-III-R. This report discusses four possible hypotheses for this overlap: (1) an independent, random association; (2) artifactual overlap due to imperfections in the criteria sets; (3) a synergistic association of the two personality disorders; and (4) a manifestation of dimensional psychopathology. Empirical evidence for each of the first three hypotheses is weak and contradictory. Recent biologic and treatment studies appear to most strongly support the use of dimensional models of "borderline" and "schizotypal" personality traits.     

Psychiatric disorders in the parents of autistic individuals.

Eighty-one parents of 42 autistic probands and 34 parents of 18 Down syndrome probands were examined using a semistructured, investigator-based version of the Schedule for Affective Disorders and Schizophrenia Lifetime Version to estimate the lifetime risk of psychiatric disorder. The lifetime prevalence rate of anxiety disorder was significantly greater in parents of autistic probands than in parents of Down syndrome probands. The lifetime prevalence rate of major depressive disorder, while not significantly different in cases and controls, may be high in the parents of autistic probands (27%) in comparison with populations rates.     

Age-of-onset in schizophrenia and schizotypal disorders. Clinical and genetic implications

Age-of-onset data were gathered on 93 chronic schizophrenic probands and 57 affected (mainly schizotypal) siblings. 55% of affected individuals were ill before age 20 and 14% had their onset before age 14. The risk period for schizophrenia and schizotypal personality disorders terminated at age 40. Age-of-onset did not distinguish paranoid from nonparanoid schizophrenics, or definite from probable schizotypal personalities. Schizophrenic and schizotypal subjects were similar in their age-of-onset patterns. Sex effect on age-of-onset was not present. A square-root normal distribution gave the best fit to the data. The implications of these findings for schizophrenia research were discussed.     

Psychiatric management of sleep disorders.

This chapter will focus on the office management of psychiatric patients with sleep disorders. Psychiatric aspects of insomnia, the parasomnias, circadian rhythm disorder and disorders of excessive sleepiness will be reviewed. The antidepressants, electroconvulsive therapy, amino acids and bright lights.     

Psychiatric disorders in two African villages.

Adults in two small Ugandan villages were interviewed, using a standard psychiatric examination and standard methods of case identification and diagnosis. Twenty percent had disorders just above threshold level, and a further 5% had more definite disorders. Most of these conditions were depressive, but hypomanic and anxiety states were also represented. A survey of women in southeast London found only half this frequency of disorders. Further studies are required to confirm these results.     

Psychiatric disorders in an Arctic community.

OBJECTIVE: To determine the rates of depression, anxiety, and alcohol abuse, using modern nosology, in a random sample of residents aged 14 to 85 years living in an Arctic community. METHOD: A cross-sectional 2-step survey of randomly selected households was undertaken, using a self-report questionnaire to screen for anxiety, depression, and alcohol abuse. The survey included the Hospital Anxiety and Depression Scale (HADS) and Ewing and Roose's 4-question alcohol screening instrument (the CAGE questionnaire). Cut-off scores for the HADS and CAGE were found by comparing HADS and CAGE scores with scores on the Structured Clinical Interview for the DSM-III-R (SCID) in a stratified subsample. RESULTS: Estimated rates of depression and anxiety were 26.5% and 19.0% respectively within the past week, and estimated rates of lifetime alcohol abuse were 30.5%. CONCLUSIONS: The estimated prevalence of psychiatric disorders in this Arctic community is higher than that indicated in previous findings on Native mental health.     

Psychiatric disorders in relatives of subjects with Alzheimer's disease. No evidence for common genetic risk factors

Introduction The clustering of two or more disorders in the same family might indicate the presence of common genetic risk factors. The prevalence of various psychiatric disorders in relatives of Alzheimer's disease (AD) patients has rarely been investigated. Consequently, family study data were reinvestigated to assess, if there are indications for an overlap of genetic risk factors of AD and other psychiatric disorders. Method Family history information on 2964 living and deceased first-degree relatives of 146 AD patients, 168 patients with major depression (MD) and 136 control subjects were obtained by at least one informant. Of the living relatives, 49.2 % could also be interviewed. Best-estimate lifetime diagnoses were made on all available information. Lifetime prevalences of psychiatric disorders were compared in relatives of AD patients, of MD patients and of control subjects using chi² statistics. Cox proportional hazards regression analyses were additionally performed to control for the relative's age, gender and source of information (interview vs. family history information). Results Relatives of AD patients had no increased risk of other psychiatric disorder compared with relatives of the comparison groups. Conclusion AD is genetically distinct from other psychiatric disorders, i. e., schizophrenia, anxiety, obsessive-compulsive, somatoform disorders, alcoholism, substance abuse or dependency. Received: 23 May 2001 / Accepted: 23 April 2002     

Prospective memory deficits in subjects with schizophrenia spectrum disorders: a comparison study with schizophrenic subjects, psychometrically defined schizotypal subjects, and healthy controls

Memory impairment is one of the core deficits in schizophrenia. This study explored the memory profiles of schizophrenic and psychometrically defined schizotypal subjects. The study participants included 15 patients with schizophrenia, 41 schizotypal subjects, and 20 healthy controls. All of the participants completed verbal and visual memory, working memory, and prospective memory tasks. The results showed that patients with schizophrenia were impaired in all aspects of memory function, whereas the schizotypal subjects tended to show moderate to large impairment effect sizes in prospective memory. It is suggested that prospective memory be considered a potential endophenotype of schizophrenia.     

Vocational functioning in schizotypal and paranoid personality disorders

Impaired vocational functioning is a hallmark of schizophrenia, but limited research has evaluated the relationships between work and schizophrenia-spectrum personality disorders, including schizotypal (SPD) and paranoid personality disorder (PPD). This study compared employment history and job characteristics of 174 individuals drawn from the community or clinic, based on four personality disorder groups: SPD Only, PPD Only, SPD+PPD, and No SPD or PPD. Symptoms and cognitive functioning were also assessed. Both PPD and/or SPD were associated with lower rates of current employment, and a history of having worked at less cognitively complex jobs than people without these disorders. Participants with PPD were less likely to have a history of competitive work for one year, whereas those with SPD tended to have worked at jobs involving lower levels of social contact, compared with those without these disorders. When the effects of symptoms and cognitive functioning were statistically controlled, PPD remained a significant predictor of work history, and SPD remained a significant predictor of social contact on the job. The findings suggest that impaired vocational functioning is an important characteristic of SPD and PPD.     

Biological markers in schizotypal and borderline personality disorders

A preliminary but growing body of evidence supports the existence of biological substrates in personality disorders. Based on a review of the literature, the article deals with the major biological markers: genetic, cognitive, biochemical, electrophysiological and organic markers, of schizotypal and borderline personality disorders. In addition, the article compares these findings in these two types of pathological personality. In the field of genetics, we notice several indices in favour of a relationship between schizotypal personality disorder (SPD) and chronic schizophrenia. In contrast, in borderline personality disorder (BPD), indices were lacking for such a relationship between this disorder and one of the axis I diagnosis, or a clear genetic transmission. In the field of cognitive tests, we can note in both SPD and BPD, that the abnormalities which would be at the level of temporal and frontal lobes, may be implicated in the observable cognitive troubles in these two disorders. In the field of neurobiochemistry, the dopaminergic and serotonergic systems seem to be implicated in the etiology of SPD while several data point out the fact that several neurotransmitter systems (dopaminergic, serotonergic, noradrenergic and cholinergic) seem to be involved in the etiology of BPD. Finally, in the field of electrophysiology, we notice that some of these tests observed in SPD (smooth pursuit eye movements, evoked potentials, modification of the electrodermic response) seem reinforcing the relationship between SPD and schizophrenia while those observed in BPD seem reinforcing either a relationship between BPD and depression (sleep studies), or a relationship between BPD and schizophrenia (evoked potentials, smooth pursuit eye movements).