The search for genetic linkage in schizophrenia.
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Biomedical subjects
Publications and source records attributed to D C Watt.
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Two hundred and eighty-two schizophrenics discharged from St John's Hospital, Stone, were followed-up. The reliability of the diagnosis was measured by the extent of agreement among the hospital clinicians. The number of readmissions and the time spent in hospital were ascertained and correlated with the sex, civil state and age at first admission of the subjects. It was found that a higher proportion of males than of females was readmitted; that the proportion of single persons among male schizophrenics is higher than among comparable age groups in the general population; that single males are more frequently admitted than single females; that the peak age of first admission for males is 10 years earlier than for females and that men whose age at first admission is below the median are more frequently readmitted than those whose age at first admission is above it. Women are more frequently married than men at the onset of schizophrenia, giving rise to the suggestion that marriage has a protective effect in schizophrenia. This hypothesis was not supported by our findings. The bearing of these findings on the course, genetics and marital handicap of schizophrenia is discussed.
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Evidence from a controlled, comparative trial indicates that oral pimozide is clinically at least as effective as depot injections of fluphenazine decanoate in the continuation therapy of a group of schizophrenic patients discharged from hospital. The administration of pimozide was associated with fewer unwanted effects. The implications of the findings are discussed.
A blind social assessment at home carried out twice during a year's follow-up of 41 patients on continuation therapy, 21 randomly allocated to pimozide tablets and 20 to fluphenazine decanoate injections. Patients on pimozide were significantly more favourably rated on aspects of sociability, use of leisure, warmth of personal relationships, household tasks and child-rearing. The mode of production of this result is discussed.
The hypothesis that schizophrenia is caused by the release of prostaglandin E into the hypothalamus and may sometimes be accompanied by an elevation of temperature was examined by a clinical trial of the prostaglandin E suppressant N-acetyl-p-amino-phenol (paracetamol, acetaminophen). Ten acute schizophrenic patients were included in a double-blind, crossover trial of paracetamol and a placebo, in which each treatment was given for a week. Regular 4-hourly temperatures were recorded in all these cases and in 5 non-schizophrenic patients for comparison. The findings provided no evidence that paracetamol mitigated the symptoms of schizophrenia. The temperatures of the schizophrenics were not elevated more than those of the controls, but the number of cases used was probably too small for this finding to be conclusive.
A survey of more than 6000 school children in 1961 established norms for symptomatology and behavior at ages 5-15. A follow-up to 1968 identified all children from the survey attending a child guidance clinic or appearing in court within that time. Those thus identified contained a significantly high proportion of boys who were reported as having more than 3 deviant items (i.e. occurring in approximately 10% of subjects in 1961). Specific health and behavioural items were found to have been reported in 1961 in proportions which were significantly different for children later appearing in child guidance clinic from those appearing in court. The amount of concern expressed by their parents over psychological and behavioural items distinguished court from clinic boys, while the concern shown by parents over items of physical health showed little difference in these 2 groups.
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