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Biomedical subjects

E F Torrey

Publications and source records attributed to E F Torrey.

At least 109 records · Page 6Linked to original sources
PubMed1990

Neuropsychological assessment of monozygotic twins discordant for schizophrenia.

A comparison of monozygotic twins discordant for schizophrenia controls for genetic variance and reduces variance due to environmental circumstances, thus serving to highlight differences due to phenotypic-related variables. In this study, we assessed 16 such twin pairs on a wide range of neuropsychological tests. The affected twins tended to perform worse than their unaffected counterparts on most of the tests. Deficits were especially severe on tests of vigilance, memory, and concept formation, suggesting that dysfunction is greatest in the frontotemporal cortex. While manifest symptoms were not highly associated with neuropsychological scores, global level of functioning was. To address the issue of genetic liability, we also compared the sample of discordant unaffected twins with a sample of seven pairs of normal monozygotic twins. No significant differences between the groups were found for any neuropsychological test. In fact, the results suggest that neuropsychological dysfunction is a consistent feature of schizophrenia and that it is related primarily to the clinical disease process and not to genetic or nonspecific environmental factors.

Adult↗
PubMed1990

The seasonality of schizophrenic births: a reply to Marc S. Lewis.

Lewis contends that the previously demonstrated finding of seasonality of schizophrenic births is a statistical artifact due to the age-incidence effect. If Lewis is correct, then (1) January should have the highest schizophrenic birthrate, (2) December should have the lowest schizophrenic birthrate, (3) the Southern Hemisphere should show the same pattern as the Northern Hemisphere, and (4) the age-incidence effect should be more marked in younger age cohorts. None of these findings have been borne out by studies to date. It is concluded that the seasonality of schizophrenic birthrates is a replicable finding, and should be considered one of the more intriguing clues to the etiology of this disease.

Adult↗
PubMed1990

Geographical distribution of insanity in America: evidence for an urban factor.

The geographic distribution of insanity and schizophrenia in the United States is examined for 9 separate years between 1880 and 1963. A concentration of these conditions in Northeastern and Pacific Coast States was remarkably consistent over the 83 years. States with a high prevalence rate had approximately three times more insanity and schizophrenia than those with a low prevalence rate. There is a direct regional correlation of insanity/schizophrenia with urbanization, which is consistent with previous studies. There is also a direct regional correlation of schizophrenia with socioeconomic status, which contradicts previous studies carried out in large cities in which the schizophrenic rates were inversely correlated with socioeconomic status. The apparent discrepancy can be explained by postulating that the direct regional correlations are due to correlations of urbanization and socioeconomic status (cities have higher mean incomes than rural areas) whereas, within a particular city, schizophrenia is more prevalent among lower socioeconomic groups because of drift and other factors. Social, stress and crowding, genetic, and biological factors are discussed as possible explanations for the urban factor associated with insanity/schizophrenia.

Cross-Sectional Studies↗
PubMed1990

Morphometry of the corpus callosum in monozygotic twins discordant for schizophrenia: a magnetic resonance imaging study.

The corpus callosum (CC) has been the focus of several morphometric studies of patients with schizophrenia, but the results of these studies have been contradictory. In an attempt to improve the reliability of morphometric measurements of the corpus callosum, a computerised image analysis system was used to measure the shape, area, thickness and length of the CC on magnetic resonance imaging (MRI) in 12 pairs of monozygotic twins discordant for schizophrenia (SC). No differences in CC area (anterior, middle, posterior thirds and total), length or vertical thickness of the CC body (at three levels) were demonstrated by t test comparisons of the affected SC and unaffected twins. Statistical analysis of a Fourier expansion series suggested differences in shape between normal and SC cotwins in the second harmonic of the anterior and middle segments and effects of gender on posterior CC shape. These results fail to replicate previous findings of altered length, thickness and area in the schizophrenic CC, but implicate disease-related shape differences in the anterior and middle segment of the corpus callosum and gender-related differences in splenium shape. The disease-related shape distortion suggest ventriculomegaly rather than an intrinsic abnormality of the corpus callosum.

Adult↗
PubMed1990

Economic barriers to widespread implementation of model programs for the seriously mentally ill.

Although deinstitutionalization has been linked with an increase in the number of mentally ill people who are homeless or in jails, several demonstration programs started during the past 30 years have shown that community-based services for the seriously mentally ill can be both humane and cost-effective. Four such programs, none of which has been widely implemented or has significantly influenced service delivery systems, are described. The author contends that the chaotic and illogical funding system for mental health services is primarily responsible for failure of the widespread implementation of demonstrably effective programs. The economic disincentives of the present system include lack of coordination of services at the state and local level and federal policies that favor hospitalization, restrict payment for outpatient and rehabilitation services, and discourage mentally ill persons from working. The author suggests that public services for the mentally ill are unlikely to improve significantly until such disincentives are addressed.

Aftercare↗
PubMed1988

Stalking the schizovirus.

The possibility that some cases of schizophrenia are caused by a chronic infectious process of the central nervous system is being explored. This hypothesis was popular in the early years of the 19th century and has been revived as certain properties of viruses have become better understood (e.g., neurotropism, latency, and ability to alter cell enzymes without affecting cell structure). Schizophrenia could theoretically be caused by infections occurring either in utero or at any time up to the age of onset. Research on a possible viral etiology of some cases of schizophrenia is being carried out using both indirect measures (seasonality of schizophrenic births, prevalence studies, immunological abnormalities, antiviral effects of antipsychotic drugs, and studies of identical twins) as well as direct measures (neuropathology, transmission to laboratory animals, and detection of the viral genome, antigen, or antibody).

Brain↗
PubMed1987

Prevalence studies in schizophrenia.

Over 70 prevalence studies of schizophrenia published since 1948 are reviewed. Despite problems of method, the studies suggest that there may be significant differences in prevalence among different populations and that prevalence may change over time. Further research is needed on how much differences in diagnosis or the course of schizophrenia contribute to the variable prevalence rates. The paper suggests the following as areas for additional enquiry: a possible north-south gradient, special populations (e.g. American Hutterites, northern Swedes, western Irish, castes in India) and ongoing case registers in areas of suspected high and low prevalence.

Adult↗
PubMed1986

Continuous treatment teams in the care of the chronic mentally ill.

Since deinstitutionalization began, the model of service delivery for the chronic mentally ill has been characterized first by the mere availability of services and then by continuity of care as coordinated through the case manager system. However, there is increasing evidence that the continuity of care model has neglected an element crucial to its success--continuity of caregivers. Continuity of caregivers means that a single, continuous treatment team is responsible for patients in both inpatient and outpatient settings. The author discusses several programs that have successfully used continuous treatment teams, the theoretical considerations supporting use of the teams, and the problems be encountered after trying to implement such teams at a public psychiatric hospital in Washington, D.C.

Australia↗
PubMed1986

Management of chronic schizophrenic outpatients.

Mental health practitioners can effectively manage outpatient care of chronic schizophrenic patients by regulating antipsychotic and ancillary maintenance medications; providing supportive "psychotherapy"; advising on programs to fulfill basic needs such as housing, vocational rehabilitation, and a social network; engaging the patient's family along with the patient in a partnership to maximize functioning; and encouraging appropriate social interactions. When done skillfully, this outpatient practice can be among the most rewarding in psychiatry.

Antipsychotic Agents↗
PubMed1985

Serum interferon in patients with psychosis.

High titers of interferon were found in serum from 20 (24.4%) of 82 patients with psychosis and from only two (3.1%) of 64 control subjects. Interferon-positive patients were more likely than interferon-negative patients to have had a recent onset or exacerbation of their illness and to be on low-dose or no medication. No interferon was detected in the CSF of 65 patients or 20 control subjects. These findings suggest that there may be immunological abnormalities or viral infections in some patients with psychosis.

Adolescent↗