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.     

An analysis of the clinical features of familial schizophrenia

Clinical features of familial schizophrenia were examined in 169 siblings from 80 families. Factor analysis of symptoms produced a negative symptom factor (affective flattening and negative thought disorder), a disorganization factor (inappropriate affect and positive thought disorder) and a reality distortion factor (delusions and hallucinations). The negative symptom factor correlated positively with duration of illness and poor outcome. The disorganization factor correlated positively with poor outcome and early age at onset. The only clear correlation between these factors and affective symptoms was a negative one between the negative symptom factor and mania. There were no significant gender differences in age at onset, factor scores or outcome. The implication of these findings in relation to recent research in the areas of psychopathology and epidemiology are discussed.     

Clusters in a cohort of untreated schizophrenia: prognostic importance, atypical cases and the familial versus sporadic distinction.

In search of features of prognostic importance, a cohort of patients admitted to a mental hospital in 1925 was investigated by means of multivariate clustering techniques. Using K-means cluster analysis or Q-factor analysis, a group containing cases with unfavourable prognosis was isolated. Other groups derived were prognostically heterogeneous. One group of patients, in early phases similar to good prognosis schizoaffective psychoses, could be distinguished and characterized by non-symptom items. There was initial periodicity and onset was acute. They were, on average, younger than the other subjects and there was no personality deviation or emotional disturbance before onset of disease. A family history of mental illness was rare. Two of the factors were positively and negatively characterized by items covering familial history of mental illness, thus seemingly confirming the familial vs sporadic distinction in the subclassification of schizophrenia. Though the clinical pictures were distinctively different at the time when the ratings underlying the analysis were made, approximately the same proportion of cases in the two groups had independently been diagnosed as paranoid schizophrenia--also taking the course of illness into account. It could furthermore be shown that the population at risk--siblings and children of subjects--as well as the observed number of years at risk in these groups were significantly smaller in the sporadic group than in the familial group. This was a combined effect of a lower fertility in subjects and parents in the sporadic group and a higher rate of drop out due to mortality and other reasons among siblings of these subjects. The same tendency was indicated when subjects with and without family history irrespective of factor belongingness were compared. It cannot be concluded that the familial vs sporadic distinction is without relevance in the research on schizophrenia, but its essence may easily be obscured, if the population at risk is not taken into account.     

Genetic and clinical correlates of season of birth of schizophrenics

Abstract The genetic and clinical characteristics of 55 patients with schizophrenia and 138 control patients (with major psychiatric disorders), were studied in relation to the season of birth. The morbid risk (MR) of schizophrenia was significantly higher among relatives of the schizophrenic probands born in Spring than among those of the psychiatric controls born in the same season. The MR of schizophrenia was also significantly higher among relatives of schizophrenic probands born in Winter or Spring (6.9%) than in those of schizophrenic probands born in Summer or Autumn (0%). Among the schizophrenic cases, Winter births were marginally related to the paranoid subtype, whereas other clinical variables showed no clear relationship with the season of birth.     

家族性与散发性精神分裂症对照研究

为探讨家族性与散发性精神分裂症患者的临床特征差异，对３２例家族性和７５例散发性精神分裂症患者进行了临床对照研究。结果显示：家族性与散发性精神分裂症患者的临床特征相比，在发病年龄、出生季节，病前适应能力，病程，阴性症状及意志缺乏，以及即期疗效等方面均有显著性差异。提示家族史与精神分裂症的一些临床特征有密切的关系，家族史作为精神分裂症的一个分类原则是适合的。     

家族性与散发性难治性精神分裂症的对照研究

目的 探讨家族性与散发性难治性分裂症患者的临床特点。方法 在533例住院分裂症患者中有113例符合难治性分裂症的标准，其中根据有无精神病家族史分为家族性分裂症组(研究组)和散发性分裂症组(对照组)，对研究组与对照组的临床资料进行比较。结果 研究组与对照组相比，在首次发病年龄上差异有显著性意义；而在性别、病前性格、文化程度、有无诱因、起病形式、治疗前病程、总病程、病程特点、住院次数、服药依从性、社会支持、家庭经济水平、症状特点及诊断分型等方面差异均无显著性意义。结论 首次发病年龄对于分裂症遗传学研究具有重要意义。     

Seasonality of birth in subtypes of chronic schizophrenia

ABSTRACT– Several reports in the literature suggest that schizophrenic patients are disproportionately born during the colder months compared to the general population. In this study, we report differences in the seasonality of birth between the subtypes of chronic schizophrenia, particularly when gender is considered. Cold months’ births (December to March) are most likely in nonparanoid females and paranoid males. Possible reasons for these differences are discussed in light of genetic and environmental factors in schizophrenia.     

The Maudsley family study I: Structural brain changes on magnetic resonance imaging in familial schizophrenia

1. 1. The authors investigated the prevalence of qualitatively rated structural brain abnormalities in schizophrenic probands and their first-degree relatives from families multiply affected with schizophrenia.

2. 2. Magnetic resonance imaging was used to evaluate brain morphology in 33 schizophrenic probands, 54 of their non-schizophrenic first-degree relatives (including 11 presumed obligate carriers) and 37 unrelated control subjects. Structural images were examined by a neuroradiologist who was blind to diagnostic and family status.

3. 3. 52% of the schizophrenic subjects were rated as showing abnormalities compared with 27% of presumed obligate carriers, 16% of their non-schizophrenic relatives and 11% of unrelated controls.

4. 4. Brain abnormalities were more frequent in schizophrenic subjects from multiplex families than in their first-degree relatives and controls. Abnormalities were also found in unaffected relatives particularly those who appear to be transmitting the disorder.

     

Neural disruption to theory of mind predicts daily social functioning in individuals at familial high-risk for schizophrenia

Theory-of-mind (ToM) ability is foundational for successful social relationships, and dependent on a neurocognitive system, which includes temporoparietal junction and medial prefrontal cortex. Schizophrenia is associated with ToM impairments, and initial studies demonstrate similar, though more subtle deficits, in unaffected first-degree relatives, indicating that ToM deficits are a potential biomarker for the disorder. Importantly, the social consequences of ToM deficits could create an additional vulnerability factor for individuals at familial high risk (FHR). However, behavioral studies of ToM are inconsistent and virtually nothing is known about the neural basis of ToM in FHR or the relationship between ToM and social functioning. Here, FHR and non-FHR control participants underwent functional MRI scanning while reasoning about a story character’s thoughts, emotions or physical appearance. Afterwards, participants completed a 28-day online ‘daily-diary’ questionnaire in which they reported daily social interactions and degree of ToM reasoning. FHR participants demonstrated less neural activity in bilateral temporoparietal junction when reasoning about thoughts and emotions. Moreover, across all participants, the degree of neural activity during ToM reasoning predicted several aspects of daily social behavior. Results suggest that vulnerability for schizophrenia is associated with neurocognitive deficits in ToM and the degree of deficit is related to day-to-day social functioning.     

Onset and progression of primary torsion dystonia in sporadic and familial cases

Four hundred and sixty records of patients with primary torsion dystonia (296 women and 164 men) were evaluated. The mean age at disease onset was 48.3 ± 17.7 years; 13 patients carried the DYT1 CAG deletion. The distribution of age at onset was represented by a bi-modal curve, with a nadir at 21 year separating early onset from late onset cases. In 15.9% of cases there was a positive family history of dystonia. Cranial, cervical or lower limb onset was more common amongst women (M:F ratios were 1:2.7, 1:1.9, and 1:3); by contrast, onset in the upper limb was more common in men (M:F ratio 2.2:1). As expected, disease progression was more pronounced in cases with early onset; it was reckoned that onset at or above 32 years was associated with a negligible likelihood to progress to a generalized form. The mean age at onset of familial cases was 44.8 ± 11.2 years, significantly lower than the mean age at onset of sporadic cases (53.5 ± 13.4 years). Familial cases were characterized by more sites involved throughout disease course. Familial cases had a higher tendency to progress to a segmental or generalized form than sporadic cases.     

Analysis of familial and sporadic restless legs syndrome in age of onset,gender, and severity features

Abstract Restless Legs Syndrome is characterized by the irresistible, often indescribable unpleasant urge to move the limbs while resting. It has an estimated prevalence of ~29.3 % in US private practice. Restless Legs Syndrome often has a familial component; whether the familial and non-familial forms differ in terms of clinical features has previously been investigated, with the only significant factor emerging as younger age at onset in familial cases. Our study further explores a possible underlying difference between familial and sporadic forms of RLS by comparing familial RLS with sporadic RLS in terms of demographic and clinical features including subject gender, age of onset, and severity measures based an the IRLSSG severity scale. Both gender and family history are significant predictors of onset age in an overall model and also significant when analyzed independently. Participants who reported more severe RLS symptoms were significantly younger in age and progressed more rapidly. Two variables from the IRLSSG severity scale were significantly associated with age of onset when tested independently: discomfort and the urge to move the limb for relief. Our analysis supports the prevailing hypothesis that RLS is divided into earlier onset disease with a clear genetic component and later onset disease wich unclear etiology, and that one or more endophenotypes might exist within the disorder which could further characterize these subjects for future genetic studies.     

家族性与散发性分裂症患者暗示性的对比分析

目的 了解家族性与散发性分裂症患者在暗示性方面的差异。方法 以住院分裂症病人为研究对象，完全依照唐安平的暗示性测查方法，测查其暗示性，同时调查其可能的影响因素。结果 散发性分裂症患者在视觉暗示性和触觉暗示性方面明显高于高发家系分裂症患者，低发家系分裂症患者在视觉暗示性方面明显高于高发家系分裂症患者。家族史是被纳入逐步判别方程的一个重要变量。结论 各群组间暗示性的差异为家族性与散发性、高发家系与低发家系的不同源或者不同质提供了间接的佐证。     

Season of birth: comparison of patients with schizophrenia,affective disorders and alcoholism

The distribution of patients suffering from schizophrenia, affective disorders and alcoholism by months of their birth was studied, all patients having been reliably diagnosed using Research Diagnostic Criteria. Significant differences were found between the three groups. The winter-spring birth rate excess in schizophrenia was confirmed, a spring-summer birth rate excess in alcoholics was demonstrated. Different distributions are due to different reasons: for schizophrenic patients the harmful effects hypothesis and for alcoholics the procreational hypothesis seem to be appropriate explanations.     

Season of birth of schizophrenics in Mississippi, USA.

Prior reviews indicate that schizophrenics tend to be born in the winter, relative to non-psychiatric controls. This conclusion has been criticized, however, as the association between birth seasonality and schizophrenia may be the result of a statistical artifact, the age-incidence effect. To examine this possibility, we studied the birth seasonality of 2892 schizophrenics, controlling for the age-incidence effect. Both before and after instituting these controls, we found excesses for the months of December and March. We conclude that the age-incidence hypothesis does not provide any general explanation of the season-of-birth effect in schizophrenia.     

Does family history of schizophrenia influence age at onset of schizophrenia?

The relation between age at onset of schizophrenia diagnosed using DSM-III criteria and the presence or absence of this illness among first-degree relatives was investigated in 2417 patients. The mean age at onset among those with a family history of schizophrenia was slightly and nonsignificantly earlier than that of schizophrenic patients without a positive family history. The former developed their illness before the age of 25 years more frequently than did the latter.     

A case-control study of family history and cerebral cortical abnormalities in schizophrenia

The relationship between family history of psychosis and cortical sulcal widening on CT scans was investigated. Forty-two schizophrenic subjects with a positive family history were individually matched to 42 schizophrenics with no documented family history and 42 healthy controls. Abnormally wide sulci, as defined on the basis of the normal control data, were significantly more common in the family history negative group (9/42) than in the family history positive group (1/42) or the controls (2/36). No significant correlation was found between cerebral cortical ratings and ventricular size.     

Fine motor function and neuropsychological deficits in individuals at risk for schizophrenia

Deficits in fine motor function and neuropsychological performance have been described as risk factors for schizophrenia. In the Basel FEPSY study (Früherkennung von Psychosen; English: Early Detection of Psychosis) individuals at risk for psychosis were identified in a screening procedure (Riecher–Rössler et al. 2005). As a part of the multilevel assessment, 40 individuals at risk for psychosis and 42 healthy controls matched for age, sex and handedness were investigated with a fine motor function test battery and a neuropsychological test battery. Individuals at risk showed lower performances in all subtests of the fine motor function tests, predominantly in dexterity and velocity (wrist/fingers and arm/hand). In the neuropsychological test battery, individuals at risk performed less well compared to healthy controls regarding sustained attention, working memory and perseveration. The combined evaluation of the two test batteries (neuropsychological and fine motor function) separates the two groups into individuals at risk and healthy controls better than each test battery alone. A multilevel approach might therefore be a valuable contribution to detecting beginning schizophrenia.     

Interaction between genetic vulnerability and family environment: the Finnish adoptive family study of schizophrenia.

A nationwide Finnish sample of schizophrenics' offspring given up for adoption was compared blindly with matched controls, that is, adopted-away offspring of nonschizophrenic biologic parents. The adoptive families were investigated thoroughly by joint and individual interviews and psychologic tests. Biologic parents were also interviewed and tested. Among the 144 index and 178 control offspring, the percentage of both psychoses and other severe diagnoses (borderline syndrome and severe personality disorder) was significantly higher in the index adoptees than in the matched control adoptees. Of the 15 psychotic adoptees in the total sample to date, 13 are offspring of schizophrenics and 2 are control offspring. Both global clinical ratings and test data for the adoptive, rearing parents also correlate with the symptomatic status of the adoptees. A prospective, longitudinal study of adoptees at risk is being undertaken to explore the direction of effects between adoptees and adoptive parents.