Children at high risk for schizophrenia: parent and offspring perceptions of family relationships.
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Adolescent↗
Biomedical subjects
J Parnas
Publications and source records attributed to J Parnas.
The Copenhagen High-Risk Project, 1962-86.
Since 1962 we have followed a sample of 207 children at high risk for schizophrenia as well as 104 control children. For these individuals, the following factors and their interaction are related to an increased risk for schizophrenic breakdown: (1) greater schizophrenia family backgrounds, (2) perinatal trauma, and (3) unstable parenting and public institutional child care. The perinatal difficulties are positively related to adult periventricular atrophy. Results of a subsequent study tentatively suggest that part of the neurological deviance in schizophrenia may be produced by disruption occurring in the second trimester of fetal development.
Adolescent↗
A matched-paired comparison of treated versus untreated schizophrenia spectrum cases. A high-risk population study.
As a part of the American-Danish prospective study of children of schizophrenic mothers, psychiatrically hospitalised and untreated cases of schizophrenia spectrum conditions, i.e. borderline schizophrenia, schizoid and paranoid personality disorders, were compared on a number of characteristics. This exploratory analysis revealed that the groups were similar to each other on childhood conditions, sociodemographic variables, premorbid IQ and levels of schizophrenia-related psychopathology. The hospitalised group, however, exhibited higher levels of concomitant psychopathology, such as substance abuse, affective symptoms and psychopathic tendencies. It is suggested that the clinical population may not be representative of the diagnostic category in question owing to co-existence of confounding symptomatology (Berkson's fallacy).
Adolescent↗
The Copenhagen high-risk project. The diagnosis of maternal schizophrenia and its relation to offspring diagnosis.
The Copenhagen longitudinal high-risk study of offspring of 129 schizophrenic mothers commenced in 1962. At that time, the mothers were diagnosed according to contemporary Danish criteria. We have re-examined all of the hospital records of these mothers: 108 (84%) fulfil present-day DSM-III criteria for schizophrenia and 95 (74%) were diagnosed as paranoid schizophrenic according to ICD-8 criteria. In a follow-up at mean age 24, the offspring of the paranoid schizophrenic mothers were themselves found to be less frequently schizophrenic (5%) than were the offspring of non-paranoid schizophrenic mothers (29%).
Adult↗
Continuity of formal thought disorder from childhood to adulthood in a high-risk sample.
Within a longitudinal prospective study of children of schizophrenic mothers, premorbid, childhood levels of formal thought disorder correlated positively with measures of formal thought disorder obtained in adulthood. It is therefore concluded that schizophrenic symptomatology develops by gradual accretion and that schizophrenia is not a sudden, unexpected disease. Orthogonal factor analysis of formal thought disorder measures obtained in adulthood revealed two factors: one reflecting vague and drifting thinking, and the second relating to the richness of speech.
Adolescent↗
Risk factors in the development of schizophrenia: contributions from a study of children of schizophrenic mothers.
The development of and the results from a prospective longitudinal study of children of schizophrenic mothers are presented. The presented studies have been guided by a diathesis-stress model of psychopathology and data analyses relied on the paradigm that schizophrenics and schizotypes share genetic liability to schizophrenia, but that the former, in addition, suffer from environmental insult. This paradigm, hypothetically formulated by Paul Meehl (21) proved especially fruitful in the etiological inferences made in this study. The results indicate that schizophrenia is, to some degree, genetically transmitted and that schizotypes share this genetic vulnerability with schizophrenics. Schizophrenia may be conceptualized as an environmentally complicated schizotypal personality disorder. Deleterious environmental influences identified in this study are obstetric complications probably resulting in central brain atrophy as measured by the CT-scans. In addition, future schizophrenics experienced disrupted childhood conditions as measured here by the amount of institutional rearing during the first five years of life. Fathers of the high risk children were more frequently mentally disturbed than fathers of the low risk children. The presence of a schizophrenia spectrum disorder in the father significantly increased a risk for such disorder in the high risk offspring. Continuity of psychopathological deviance in the form of subtle formal thought disorder and defective emotional contact was demonstrated for the schizophrenics and schizotypes from childhood into adulthood. This suggests that such symptoms are central to schizophrenic psychopathology and that schizophrenia is a development and not a disease which affects people without forewarning.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Institutional rearing and diagnostic outcome in children of schizophrenic mothers. A prospective high-risk study.
Within a prospective, longitudinal study of offspring of schizophrenic mothers (so-called high-risk children), diagnostic outcome (schizophrenia, "schizotypal" personality disorder, other diagnoses, and no mental illness) was predicted by the mother's age at first hospitalization and by institutionalization during the first five years of life. Institutionalization was unrelated to adult psychopathology in a low-risk control group. These results are interpreted as supporting a diathesis-stress model of schizophrenic origin.
Adolescent↗
Mates of schizophrenic mothers. A study of assortative mating from the American-Danish high risk project.
Both mates of schizophrenic mothers and a control group consisting of mates of non-schizophrenic mothers were diagnostically examined. The former were more frequently psychiatrically deviant than their controls, both with respect to a life-time syndrome diagnosis and a personality diagnosis. Mating between a schizophrenic mother and a father who suffered from schizophrenia spectrum disorder significantly increased the offspring's risk of developing a schizophrenia spectrum disorder himself. Assortative mating was negatively correlated with age of onset of maternal schizophrenia. It is proposed that defective emotional rapport or sub-psychotic features constitute the phenotypic traits by which assortative mating operates in schizophrenia.
Adult↗
Cerebral ventricular size in the offspring of schizophrenic mothers. A preliminary study.
Within a prospective, longitudinal study of offspring of schizophrenic mothers, computed tomographic scan-derived measurements of ventricular size were evaluated for a subsample consisting of schizophrenics, borderline schizophrenics (DSM-III schizotypal), and mentally healthy individuals. Schizophrenics exhibited larger ventricular sizes and borderline schizophrenics smaller ventricular sizes than mentally healthy individuals. Ventricular size correlated with premorbidly obtained obstetric data. These results are interpreted as being consistent with the hypothesis that neurological insult may decompensate schizotypal individuals toward florid schizophrenia.
Adolescent↗
50 years in research of anthropozoonoses.
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History, Modern 1601-↗
[Psychiatry in the United States. Impressions from a study trip].
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Hospitals, Psychiatric↗
Behavioral precursors of schizophrenia spectrum. A prospective study.
In a prospective longitudinal study of children of severely schizophrenic mothers, premorbid behavioral data on individuals diagnosed as suffering from schizophrenia spectrum disorder were compared with the same data on individuals diagnosed as not suffering from any mental disorder. Future schizophrenia spectrum individuals were passive babies who exhibited short attention spans. In school, they experienced interpersonal difficulties and displayed disturbing behavior, reflecting poor affective control. From clinical assessments at a mean of 15 years of age, formal cognitive disturbance and defective emotional rapport emerged as premorbid characteristics of schizophrenia spectrum disorder. These results seem to indicate that signs of defective emotional contact and formal thought disorder are important for the psychopathology of schizophrenia. Furthermore, the premorbid similarity of borderline schizophrenia and schizophrenia suggests a basic relationship between these two disorders.
Adolescent↗
Controlled trials in epilepsy: a review.
A comprehensive review, evaluating 51 randomized double-blind controlled studies, covering different aspects of epileptology, is presented. Trials were grouped according to the investigated topic and for each group an attempt was made to derive an overall conclusion. The majority of studies investigated antiepileptic drug treatments. Other topics were: psychotropic effect of antiepileptic drugs, folic acid and vitamin D administration in epilepsy, and EEG investigations. A cross-sectional analysis of items such as designs, patient sampling principles, recording of effect parameters and side effects, concomitant treatments, and statistical evaluations demonstrated that cross-over designs, investigating fixed dosage schedules, were extensively used. Less than half of these studies included a washout period between treatments, complicating the interpretation of the obtained results. The vast majority of studies involved only chronic patients; and marked heterogeneity in patient selection with respect to age, seizure type, and mental status, and severity of epilepsy was observed. Classifications of seizures varied between the studies. The most prominent effect parameter was seizure frequency. The use of heterogeneous patient samples frequently necessitated equalization of widely different seizure types in order to perform statistical analyses. The mean duration of trials was 6 months, precluding evaluation of chronic toxicity. The majority of studies recorded side effects, but data collection was rather unsystematic and statistical evaluation was seldom applied. Most studies were add-on trials, and since concomitant treatment was frequently changed during the investigations, it was difficult to evaluate the influence of this variable. A correlation analysis across trials demonstrated, among other things, that the common assumption that short controlled trials provide too optimistic results, could not be substantiated. This survey provides no firm indication of which drug is more suitable for which seizure type.
Anticonvulsants↗
Chronic psychosis in epilepsy. A clinical investigation of 29 patients.
A clinical study comprising psychiatric, psychological and neurological examination of 29 patients suffering from long-term psychosis and severe epilepsy was performed. Only five patients fulfilled the diagnostic criteria of schizophrenia. They differed from the rest of the patients by being less organic and having infrequent laterality to the left of their epileptogenic focus. They were regarded as genuine schizophrenics, while the pathogenesis of the remaining sample was considered multifactorial, including both organic and psycho-social causes.
Adult↗
Epilepsy and psychosis.
In an attempt to survey the evidence of causal relationship between epilepsy and chronic psychosis the literature has been searched with respect to frequency of psychoses, psychopathological classifications and correlations between biological and behavioural variables. It is concluded that a unitary theory of aetiology in epileptic psychosis can not be maintained. The psychotic pictures seldom fulfill the Bleulerian concept of schizophrenia, and consequently the term schizophrenia-like should be avoided. With respect to future investigations a prospective research method is advocated.
Brain↗
Continuity of character neurosis from childhood to adulthood. A prospective longitudinal study.
In a prospective longitudinal study, stability of personality traits was examined between the age of 15 and the age of 25. Scales, derived from an Adjective Check List, intending to predict obsessive-compulsive character neurosis, anti-aggressive character neurosis and non-neurotic personality have been utilized. Temporal stability of the examined personality traits was demonstrated.
Adolescent↗
Perinatal complications and clinical outcome within the schizophrenia spectrum.
In a prospective study of offspring of schizophrenic mothers, perinatal complications reported in midwife protocols were analysed for those offspring who, as adults, were diagnosed as schizophrenic, borderline schizophrenic or as not suffering from mental illness. The schizophrenics were found to have had the most complicated births, and the borderlines, the least complicated births. This difference is interpreted in terms of a 'diathesis-stress' model. It is proposed that birth complications can decompensate borderline individuals towards schizophrenic breakdown.
Adolescent↗