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Biomedical subjects

E Kringlen

Publications and source records attributed to E Kringlen.

At least 37 records · Page 2Linked to original sources

Family interaction: parental representation in schizophrenic patients.

12 monozygotic (MZ) and 19 same-sexed dizygotic (DZ) twin pairs discordant for DSM-III-R schizophrenia completed the Parental Bonding Instrument (PBI). The schizophrenic twins described their parents as less caring and being more overprotective compared to their non-schizophrenic co-twins. These results were independent of age, sex and zygosity. Difference in paternal overprotection was the most important variable discriminating between the schizophrenic probands and their co-twins. Three different hypotheses regarding these findings are discussed.

Adult↗

[Lobotomy at the Gaustad hospital].

The case records of 300 patients who were lobotomized, and 19 patients who had stereotaxic brain surgery during the period 1941-72 at Gaustad Hospital have been studied. The investigation shows that the practice of lobotomy was quite widespread. During the 1950s, lobotomy was carried out on broader indications than normally thought to be the case. Relatives were usually asked for their consent, but the information they received was often questionable. Many of the operations were fatal, particularly in the initial years, and this result can be traced to one specific surgeon.

Adult↗

[What can we learn from the lobotomy period?].

In 1991 the Ministry of Health and Social Affairs appointed a Commission of Inquiry, precipitated by a heated public debate on lobotomy. A group of four psychiatrists studied the case records of 300 patients lobotomized at Gaustad Hospital. The main review by the medical group focused on the high mortality rate during the 1940s. Also, surgery was done on broader indications than officially recommended, and the information given to the next of kin was often questionable. Since the obligation of the psychiatric profession also involves involuntary treatment, particular caution should be exercised in administering new methods. It is important to ensure control and critique by society. Ethical considerations should be integrated into quality control.

History, 20th Century↗

Parental representation in twins discordant for schizophrenia.

Parental representation was assessed with the Parental Bonding Instrument (PBI) in 12 monozygotic (MZ) and 19 dizygotic (DZ) same-sexed twin pairs discordant for DSM-III-R schizophrenia. The schizophrenic twins reported less care and more overprotection from both parents than the non-schizophrenic co-twins. Multiple regression analysis disclosed that the results were independent of sex and age. Furthermore, the analysis demonstrated that whether the twins were monozygotic or dizygotic had no impact on the results. A stepwise discriminant analysis showed that difference in perceived paternal protection was the most important variable distinguishing between schizophrenic probands and their non-schizophrenic co-twins.

Adult↗

A twin study of DSM-III-R anxiety disorders.

The prevalence of anxiety disorders was studied in a sample of 20 monozygotic (MZ) and 29 dizygotic (DZ) co-twins of anxiety disorder probands. A comparison group of co-twins of 12 MZ and 20 DZ twin probands with other non-psychotic mental disorders was also studied. All subjects were personally interviewed with the Structured Clinical Interview for DSM-III-R Axis I (SCID-I). Panic disorder was significantly more prevalent in co-twins of panic probands. Generalized anxiety disorder (GAD) was more prevalent in co-twins of GAD probands with a history of mood disorder (NS). Post-traumatic stress disorder was significantly more prevalent in co-twins of anxiety probands and was more prevalent in MZ than in DZ co-twins. The prevalences of social and simple phobia were equal in co-twins of anxiety and comparison probands. For both panic disorder and generalized anxiety disorder the MZ:DZ concordance ratio was more than 2:1. The results support the hypothesis of a genetic contribution in the etiology of panic disorder, generalized anxiety disorder and post-traumatic stress disorder. The hypothesis that simple and social phobia are mainly caused by environmental experiences was also supported.

Adult↗

Genes and environment in mental illness. Perspectives and ideas for future research.

Methodological questions in heredity-environment studies are discussed with special emphasis on schizophrenia and severe affective disorder. Mental disorder is a matter of behavioral and experimental manifestations, caused by complex interactions of genes and environment operating over a lifespan. It is therefore necessary to combine different research strategies in order to advance this field. However, progress in research is hampered by problems in classification and definition of phenotype. Accordingly, family, adoption and twin studies have a lot to contribute before molecular genetic research might be carried out.

Environment↗

"True" schizotypal personality disorder: a study of co-twins and relatives of schizophrenic probands.

OBJECTIVE: The aim of the study was to investigate the type and nature of personality disorders among biological relatives of schizophrenic probands. METHOD: A total of 176 nonschizophrenic co-twins and other first-degree relatives of schizophrenic probands were compared to 101 co-twins and first-degree relatives of probands with major depression. RESULTS: Schizotypal personality disorders were more common and histrionic personality disorders less common among the biological relatives of schizophrenic probands than among relatives of probands with major depression. A further exploration of the schizotypal criteria revealed that the so-called "negative" criteria such as odd speech, inappropriate affect, and odd behavior, as well as excessive social anxiety, were significantly more common among the relatives of schizophrenic probands. The latter criterion seems particularly important. The so-called "positive" schizotypal criteria were partly, although not statistically significantly, more common among the relatives of probands with major depression. There were only minor differences in frequencies of the negative criteria between monozygotic co-twins, dizygotic co-twins, and other first-degree relatives of schizophrenic probands. CONCLUSIONS: The present study suggests that DSM-III-R schizotypal disorder is defined by a set of criteria that partly describe a "true" schizophrenia-related personality disorder and partly features that are not specific for relatives of schizophrenic probands. Furthermore, the genetic relationship between schizophrenia and "true" schizotypal personality disorder seems weak. Excessive social anxiety may be a marker of a possible genetic link between the disorders.

Adult↗

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.

Adult↗

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.

Adolescent↗

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.

Adolescent↗

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.

Adult↗

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.

Adult↗

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.

Diseases in Twins↗