Biomedical subjects
E Kringlen
Publications and source records attributed to E Kringlen.
Birthweight and obstetric complications in schizophrenic twins.
Birthweight and obstetric complications were registered retrospectively in 24 monozygotic (MZ) twin pairs. Sixteen pairs were discordant and 8 pairs were concordant for DSM-III-R schizophrenia. There was no significant intrapair difference in birthweight between the 2 groups of MZ twins. Prematurity was more often observed in the discordant pairs, but neither differences in prematurity nor differences in obstetric complications between the concordant and discordant twins reached significance. No difference in respect of family history of schizophrenia between the 2 groups of MZ twins was found. In the discordant pairs, no significant difference between the schizophrenic twin and the nonschizophrenic co-twin was observed regarding birth order, birthweight or physical condition at birth.
Adoption studies in functional psychosis.
The scientific rationale of the adoptive methods in genetic studies has been discussed. Three strategies have been employed in psychiatric research. In the adoptee's study method, one examines the adopted away offspring of biological parents, known to be affected by the disorder. A higher prevalence of the disorder among adoptees born to affected biological parents indicates that genetic factors are important. In the adoptee's relatives method, one starts with adoptees known to be disturbed, and then continues by investigating their biological and adoptive families. Comparisons of prevalence rates between relatives of the biological and the rearing index and control families permits one to estimate the influence of the genetic factors. A third method is cross-fostering, which is rarely employed. Children of normals who are "cross-fostered" to adoptive parents who later became ill, are studied. Adoption studies in the field of schizophrenia and manic depressive illness are more specifically discussed. Taken all together, the family, twin and adoption studies support the genetic etiology in schizophrenia and manic depressive illness, although it must be admitted that we need replications to arrive at firm conclusions in the last group of disorder.
High interrater reliability for the Structured Clinical Interview for DSM-III-R Axis I (SCID-I).
The interrater reliability of the Structured Clinical Interview for DSM-III-R (SCID) was studied. Fifty-four audiotaped SCID interviews were rated independently by 3 raters. The highest interrater agreements were observed for schizophrenia (0.94), major depressive disorder (0.93), dysthymia (0.88), generalized anxiety disorder (0.95), panic disorder (0.88), alcohol use disorder (0.96) and other psychoactive substance use disorder (0.85). The remaining diagnoses of mood and anxiety disorders obtained acceptable interrater agreement (0.70-0.80), with an exception for obsessive-compulsive disorder (0.40). The poorest agreement was obtained for somatoform disorders ( -0.03). Lack of hierarchy in DSM-III-R allows for multiple Axis I diagnoses. Interrater reliability for multiple diagnoses was tested. Agreement was generally good for combinations of 2 diagnoses, and poorer when 3 diagnoses were combined. Our findings confirm that SCID yields highly reliable diagnoses. SCID is recommended for research on mental disorders.
Subtypes of schizophrenia--evidence from a twin-family study.
In a combined twin-family study, the concordance for subtype of schizophrenia was investigated. The sample included 31 monozygotic (MZ) and 28 dizygotic (DZ) twin probands fulfilling the criteria of DSM-III-R schizophrenia. Their co-twins and first-degree relatives were personally interviewed and diagnosed in accordance with DSM-III-R. Any twin or relative diagnosed as schizophrenic was subclassified as either paranoid or nonparanoid. Schizophrenia was more often observed in co-twins of MZ probands with nonparanoid schizophrenia than in MZ probands with paranoid schizophrenia, indicating a stronger genetic influence in nonparanoid schizophrenia. Fifteen MZ pairs were concordant for schizophrenia, and 13 of these pairs were also concordant for subtype. Such a relationship was not observed in the first-degree relatives with schizophrenia. Our results indicate a complex etiology of subtypes in schizophrenia, and to some extent the etiology of subtypes may differ from the etiology of schizophrenia.
Twin concordance for DSM-III-R schizophrenia.
The monozygotic (MZ)/dizygotic (DZ) concordance rates for schizophrenia and the relationship between schizophrenia and schizophrenic spectrum disorders were studied in a sample of 31 MZ and 28 DZ schizophrenic probands and their co-twins. All subjects were personally interviewed with structured diagnostic instruments and classified according to DSM-III-R criteria. The concordance rates of 48% for MZ twins and 4% for DZ twins indicate a genetic transmission of DSM-III-R schizophrenia. In addition to the schizophrenic co-twins, 3 MZ co-twins had a noneffective psychotic disorder, thus supporting the hypothesis that genes are involved in the development of Axis I schizophrenic spectrum disorders. Schizotypal and paranoid personality disorders were observed in both MZ and DZ co-twins. These disorders may be familially related to schizophrenia, but a genetic relationship was not confirmed for the Axis II spectrum disorders. A substantial number of MZ co-twins of schizophrenic probands had no mental disorder.
Mental disorders in first-degree relatives of schizophrenics.
A total 215 first-degree relatives of 88 twin probands with schizophrenia, mood disorders and nonaffective psychoses were studied. The twins' parents and siblings were personally interviewed with structured diagnostic instruments and diagnosed in accordance with DSM-III-R criteria. The first-degree relatives were interviewed by interviewers who were blind to the twins' diagnoses. Schizophrenia and schizotypal personality disorder were significantly more frequent in first-degree relatives of schizophrenic twins. Respectively, anxiety and mood disorders were significantly more prevalent among the parents and siblings of probands with mood disorders. Schizophrenic spectrum disorders were significantly more common in the families of schizophrenic probands compared with relatives of mood disorder probands, thus confirming a relationship between schizophrenia and schizophrenic spectrum disorders. However, we cannot, based on our study, specify whether this relationship is caused by genetic or environmental factors.
[Contact with patients with psychogenic somatic diseases].
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[Diagnosis of suicidal tendencies].
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[Gene technology and mental disorders].
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[A critical view on biological psychiatry].
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[The need for psychiatric research].
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[Exposure therapy of phobic and compulsive disorders].
Several methods have been used to treat anxiety disorder. In phobic conditions and in obsessive compulsive disorders, exposure therapy is most effective. In exposure therapy, the relevant evoking stimuli are presented repeatedly to the patient. This method does not suit all patients, however. For favourable results, certain exclusion criteria must be observed. In addition, the treatment procedure must be followed systematically.
Offspring of monozygotic twins discordant for schizophrenia.
We studied the incidence of psychopathologic disorder in offspring of monozygotic twins discordant for schizophrenia. The original material was based on a complete national sample of twins who were hospitalized for functional psychosis in Norway. A comparison of adult offspring of schizophrenic monozygotic twins with offspring of their nonpsychotic cotwins showed that although there are more schizophrenic and schizophreniclike cases in the first group, an observation that may be ascribed to environmental factors, the difference is not statistically significant.
[Mental health system (6). Psychiatry--therapy and "police activities". Interview by Eivind Berggrav].
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A single dominant gene can account for eye tracking dysfunctions and schizophrenia in offspring of discordant twins.
Eye movement dysfunctions (EMDs), detectable during smooth pursuit, occur in a majority of schizophrenics and in 45% of their first-degree relatives. Previous data suggest that they represent a biologic marker for schizophrenia. To determine the mode of transmission of the schizophrenia-EMD complex, the eye movements of offspring of monozygotic and dizygotic twins were recorded. One group of twins was discordant for schizophrenia; the other group for manic depression or reactive psychosis. The data suggest that EMDs and at least some schizophrenias can be considered expressions of a single underlying trait that is transmitted by an autosomal dominant gene.