Sex concordance for schizophrenia in families

The relationship between bipolar disorder and alcoholism: a controlled family study.

SYNOPSISBipolar disorder and alcoholism are familial disorders. The familial–genetic relationship between both is controversial and has received insufficient study. This study explores whether bipolar disorder and alcoholism share familial risk factors, and whether the co-occurrence of lifetime diagnosis of bipolar disorder and alcoholism is familial. We report on first-degree relatives of 146 consecutively admitted patients with either bipolar disorder or/and alcoholism; relatives of the patients (in total 728 relatives directly interviewed) were compared with first-degree relatives of 109 general population probands (320 relatives directly interviewed). Overlap between the familial compon…

Relation of schizophrenia and panic disorder: Evidence from a controlled family study

The intention of this controlled family study was to evaluate reasons for comorbidity of schizophrenia and panic disorder. Observed rates of psychiatric disorders in first-degree relatives of patients and of controls were compared with rates predicted by possible hypotheses explaining comorbidity. The sample consisted of 59 patients with schizophrenia (including seven with schizophreniform disorder), 54 patients with panic disorder (with or without agoraphobia), 29 comorbid patients with lifetime diagnoses of panic disorder and schizophrenia (or schizophreniform disorder, 2 patients) and 109 controls, and their 1068 first-degree relatives. Information from clinical performance, clinical and…

Schizoaffective disorder and affective disorders with mood-incongruent psychotic features: keep separate or combine? Evidence from a family study.

Objective This study investigated whether the distinction between schizoaffective disorder and affective disorders with mood-incongruent psychotic features as described in DSM-III-R is reflected by aggregation of schizophrenia in the families of probands with the former disorder and aggregation of affective disorders mainly among the relatives of probands with the latter type of disorders. Method The probands were 118 inpatients with definite lifetime diagnoses of DSM-III-R schizoaffective disorder or a major mood disorder with incongruent psychotic features according to structured clinical interviews. Diagnostic information on 475 of the probands' first-degree relatives was gathered throug…

Amygdala-hippocampal atrophy and memory performance in dementia of Alzheimer type.

The aim of the present study was to examine the involvement of brain structures, especially the amygdala-hippocampal complex, in dementia of Alzheimer type (DAT), and to assess the relation of amygdala-hippocampal atrophy with memory dysfunction. 14 patients with DAT and 10 healthy age-matched controls were examined with different neuropsychologic tests including the UCLA-Auditory Verbal Learning Test. MRI was performed with a conventional 1.5-tesla scanner. Atrophy was found in many brain structures of demented subjects in comparison with healthy age-matched controls. The volumes of amygdala-hippocampal complexes and of the temporal lobes of demented subjects were more reduced than the tot…

The impact of gender and age at onset on the familial aggregation of schizophrenia.

Some recent family studies have shown that the familial risk for schizophrenia is higher in female than in male schizophrenics. It is debated whether the risks for the other disorders, such as schizotypal personality disorder or affective disorders in families of schizophrenics are similarly influenced by the proband's gender. Also, the reason for the effect of proband's gender on the recurrence risk for schizophrenia has not been clarified. This family study (159 probands, 589 first degree relatives) confirms that schizophrenia, but also schizophrenia spectrum disorders were more frequent in families of female compared with male schizophrenics. Neither age at onset in probands nor the inte…

The risk of minor depression in families of probands with major depression: sex differences and familiality.

Currently it is not clear whether minor forms of unipolar depression not matching the criteria of “major depression” should be considered as a separate diagnostic category. A controlled family study examined the familial aggregation of minor depression among probands with unipolar major depression. In the families of these probands the relative risk for minor depression was elevated by a similar magnitude to the risk for major depression. Threrefore, the diagnostic category “minor depression” would not increase diagnostic sensitivity at the expense of diagnostic specificity as far as familiality is the criterion. In agreement with recent epidemiological studies, minor depression did not rev…

The impact of sex, age at onset and birth complications on the risk of schizophrenia in a family study sample

PROTON MAGNETIC RESONANCE SPECTROSCOPY IN DEMENTIA OF ALZHEIMER TYPE

Reduced N-acetyl aspartate (NAA) and increased myo-inositol (MI) levels have been reported in patients with dementia of Alzheimer type (DAT) in comparison with controls. We wished to assess the validity of these findings and to evaluate possible correlations of metabolite proportions with cognitive dysfunction in DAT. Twelve patients with DAT and 10 healthy age-matched controls were included. The severity of dementia was assessed using different scales including the Mini-Mental State Examination. MRS was performed with a conventional 1.5 Tesla scanner in a single voxel in the centrum semi-ovale (TE = 30 ms or TE = 136 ms; TR = 1500 ms). The evaluation of MRS results was limited by low inter…

The distinction of bipolar II disorder from bipolar I and recurrent unipolar depression: results of a controlled family study.

The aim of the study was to differentiate bipolar II, bipolar I and recurrent unipolar depression by their familial load for affective disorders. Eighty bipolar, 108 unipolar, 80 control subjects and interviewed first-degree relatives were diagnosed according to Research Diagnostic Criteria using the Schedule for Affective Disorders and Schizophrenia – lifetime version. The morbid risks for bipolar I disorder were equivalent in relatives of bipolar I (3.6%) and bipolar II (3.5%) subjects and lower in relatives of unipolar subjects (1.0%). The morbid risks of relatives for bipolar II disorder distinguished bipolar II subjects (6.1%) from bipolar I subjects (1.8%), from unipolar depressives (…

IMPROVEMENT OF PICTURE RECALL BY REPETITION IN PATIENTS WITH DEMENTIA OF ALZHEIMER TYPE

The evidence for positive effects of repetition on recall performance in patients with dementia of Alzheimer type is equivocal. This may be due to the difference repetition conditions used. The aim of this study was therefore to evaluate the effects of different repetition modes on the improvement of recall performance in demented subjects. Twenty-four patients with Alzheimer type dementia and 24 control subjects with remitted depression were included in the study. Pictures were presented repeatedly using different presentation modes at a constant total presentation time. Free recall was tested repeatedly after different periods of delay (0-8 hours). Immediate and delayed list repetition si…

Vulnerabilität für Schizophrenie: Entwicklung einer Modellvorstellung anhand von Familienstudien

Vulnerabilitatsmodelle fur schizophrene und affektive Storungen gehen davon aus, das sowohl klinische Storungen als auch subklinische Varianten und Normabweichungen durch dieselben disponierenden Faktoren evoziert werden. Die Starke der Vulnerabilitat (Disposition) zu einer Storung bildet sich auf einer Dimension ab, die durch die additive Wirkung verschiedener Ursachenbedingungen determiniert wird; die verschiedenen Auspragungsstufen auf dieser Dimension drucken sich in unterschiedlichen, aber qualitativ ahnlichen Verhaltensmustern aus und zwar so, das mit steigender Vulnerabilitatsstarke auch die Devianz dieser Verhaltensformen zunimmt. Die maximale Auspragungsstufe dieser Vulnerabilitats…

Bipolar II disorders in six first-degree relatives

As proposed by Dunner et al (1976), the distinction of bipolar !! disorder from other effective disorders has been included in Research Diagnostic Criteria (RDC) (Spitzer et al 1978) but not in DSM-IiI-R or ICD 10 (APA 1987, WHO 1991). Family studies indicate that bipolar 1I disorder might represent a distinct diagnostic entity with a common genetic background (Gershon et al 1982; Dunner 1983; Endicott et al 1985; Andreasen et al 1987). Familial aggregation, diagnostic stability, and course of illness represent external validators for nosologic classifications (Kendler 1990). Therefore, pedigrees with multiple cases of diagnostically stable bipolar Ii disorder without cases of bipolar 1 dis…

Vasomotor reactivity in dementia of alzheimer type

The objective of this study was to examine the cerebral blood flow and the vasomotor function of CO2-responsive intracerebral vessels in Alzheimer's disease. Patients met DSM-III-R criteria for dementia of Alzheimer type and had neither symptoms nor signs of cardiovascular or cerebrovascular disease. Blood flow velocities in both middle cerebral arteries (MCA) were recorded using transcranial Doppler sonography during hypercapnia, normocapnia and hypocapnia. Several psychometric tests were performed. Patients' age, disease duration and severity of dementia did not correlate with vasomotor reactivity. Exploratory analysis revealed that mean flow velocities under hypercapnia correlated with s…

Personality traits in subjects at risk for unipolar major depression: A family study perspective

Particular patterns of personality (e.g., introversion, neuroticism, obsessionality) have been found to be associated with unipolar depression by a large number of investigators; recent prospective studies have stressed neuroticism as a premorbid risk factor for depression. This study examines whether similar patterns of personality are found in relatives of affective disorder patients and of controls. First-degree relatives of normal controls and of subjects with primary unipolar depression were studied using the Munich Personality Test. Relatives in remission from an episode of unipolar depression had clearly higher levels of neuroticism and rigidity and lower levels of extraversion than …

Transcranial Doppler sonography in dementia of Alzheimer type.

The intention of this study was to examine the relation of clinical variables and cognitive dysfunction to cerebrovascular blood flow in a sample of patients with Alzheimer''s disease without any sign or symptom of cardiovascular or cerebrovascular disease. The patients met DSM-III-R criteria for dementia of Alzheimer type. Blood flow velocities in the anterior, middle (MCA) and posterior cerebral arteries were recorded using transcranial Doppler sonography. Several psychometric tests including the Mini-Mental State Examination (MMSE) were performed. The patients’ age correlated significantly with the systolic flow velocity in the left MCA (r = –0.57) explaining 24% of the total variance; t…

Visual memory in Alzheimer patients: effects of practice, retention interval and severity of cognitive decline.

The study was aimed at estimating the effect size of practice, retention interval and dementia severity on free recall performance in Alzheimer patients. Patients met DSM-III-R criteria for dementia of Alzheimer type. Different picture sets were presented on 4 days. The forgetting curves on different days were compared using ANOVA for repeated measurements. Practice had a minor, but significant negative effect on recall performance explaining 1% of the variance in recall performance. The retention interval varied between zero and 24 h explaining 23% of the total variance. Dementia severity explained 52% of the variance. For the development of memory improvement strategies in Alzheimer patie…

Continuity and discontinuity of affective disorders and schizophrenia. Results of a controlled family study.

Background: It is widely acknowledged that the genetic diatheses for schizophrenia and affective disorders are independent. However, there are increasing doubts about this classic view, and empirical evidence for a dichotomy of these two prototypes of functional psychoses is limited. A controlled family study of consecutive admissions was conducted to determine whether familial risks for schizophrenic (SCZ) and affective disorders were independent or overlapping. Methods: Index probands met Research Diagnostic Criteria for SCZ (n=146), schizoaffective (SA [n=115]), bipolar (BP [n=80]), or unipolar major depressive (UP [n=184])disorder. Comparison probands met Research Diagnostic Criteria fo…

Morbid risks for major disorders and frequencies of personality disorders among spouses of psychiatric inpatients and controls

Three hundred fifty-three psychiatric inpatients and their 192 living spouses and 98 control subjects and their 54 living spouses were examined and interviewed for affective, schizoaffective, schizophrenic (Research Diagnostic Criteria [RDC]), and personality disorders (DSM-III-R) using the Lifetime Version of the Schedule for Affective Disorders and Schizophrenia (SADS-L) and the Structured Clinical Interview for DSM-III-Personality Disorders (SCID). The morbid risks of spouses for unipolar depression were between .15 and .25, and those for other major disorders were below .03. The morbid risks of spouses of bipolar patients for unipolar depression exceeded those of other spouses by 50% wi…

Demenzscreening im klinischen Alltag

Dementia-screening in clinical routine requires short, sensitive and specific tools. A number of standardized instruments are available for this purpose. The present study analysed the relationship between size of three exemplary dementia-screening tests and their diagnostic accuracy. The Mini-Mental-State-Examination (MMSE), the Structured Interview for the Diagnosis of Dementia of the Alzheimer-type, Multiinfarct Dementia and Dementias of other Aetiologies according to ICD-10 and DSM-III-R (SIDAM) and the Alzheimer's Disease Assessment Scale (ADAS) were applied to 71 patients with dementia of the Alzheimer-type and 73 non-demented controls. A ROC-analysis revealed that neither SIDAM nor A…

The role of obstetric complications in schizophrenia.

The importance of obstetric complications in sporadic and familial psychoses was analyzed in 43 schizophrenic and 28 chronic schizoaffective patients. Patients and first-degree relatives were diagnosed using Research Diagnostic Criteria and the best-estimate procedure. Mothers of patients were interviewed for histories of pregnancy and obstetric complications in their offspring. Patients had more often suffered perinatal complications (42%) than their siblings (29%). The risk for obstetric complications and secondary cases of psychosis was enhanced in relatives of patients with a history of obstetric complications. Siblings with obstetric complications had a low incidence of psychoses; ther…

Effect of Repetition and Inspection Times on Picture Recall in Patients with Dementia of Alzheimer Type

The present study is part of a series of systematic studies intended to identify simple strategies of picture presentation to improve recall performance in demented subjects. The aims of this design were to examine the effects of elaboration by naming, 4-fold repetition and different inspection times on memory performance. 19 patients with senile dementia of Alzheimer type and 21 control subjects with remitted depression were included. Picture recall was examined using different presentation conditions on 5 consecutive days. The presentation conditions significantly influenced recall performance depending on the diagnosis and on the delay of recall. Naming of pictures did not improve later …

Selection bias during recruitment of elderly subjects from the general population for psychiatric interviews

The aim of the present study was to determine and assess a possible selection bias in an epidemiologic investigation in the elderly. A stratified sample of 1305 probands aged 60-99 years was initially contacted by mail and then by telephone to obtain their consent to participate in a psychiatric interview. A liberal recruitment procedure led to interview participation of only 291 subjects. The proportion of younger, male, and married subjects participating in the study was greater than that of elderly, female, and single or widowed subjects. Subjects without a psychiatric lifetime diagnosis were more cooperative than those with a psychiatric disorder. The latter finding demonstrates the nee…

Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer's disease

Eleven susceptibility loci for late-onset Alzheimer's disease (LOAD) were identified by previous studies; however, a large portion of the genetic risk for this disease remains unexplained. We conducted a large, two-stage meta-analysis of genome-wide association studies (GWAS) in individuals of European ancestry. In stage 1, we used genotyped and imputed data (7,055,881 SNPs) to perform meta-analysis on 4 previously published GWAS data sets consisting of 17,008 Alzheimer's disease cases and 37,154 controls. In stage 2, 11,632 SNPs were genotyped and tested for association in an independent set of 8,572 Alzheimer's disease cases and 11,312 controls. In addition to the APOE locu…