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PubMed1997

Factor structure of symptoms in functional psychoses.

Global ratings from the Scale for the Assessment of Positive Symptoms and Scale for the Assessment of Negative Symptoms were subjected to principal-component analysis (PCA) in 80 schizophrenia patients, 76 patients with schizophreniform disorder, 80 patients with schizoaffective and mood disorders, and 78 patients with delusional, brief reactive, and atypical psychoses. The resulting factors were correlated with depressive, manic, and catatonic syndromes, and subjected to a multivariate analysis of variance across DSM-III-R diagnoses. PCAs revealed that psychosis, disorganization, and negative factors were also present in each of the nonschizophrenic groups. The disorganization factor tended to be related to the manic syndrome, and the negative factor to depressive and catatonic syndromes. Overall, the three factors had little diagnostic relevance in functional psychoses, although the negative factor was relatively more characteristic of schizophrenia. The data suggest that positive, negative, and disorganization factors are not specific to schizophrenia; this is consistent with a dimensional view of psychopathology in functional psychoses.

Adult↗
PubMed2001

Tryptophan hydroxylase gene and major psychoses.

Disturbances of the serotoninergic neurotransmitter system have been implicated in the pathogenesis of mood disorders. The tryptophan hydroxylase (TPH) gene, which codes for the rate-limiting enzyme of serotonin biosynthesis, has been recently reported to be associated with bipolar disorder. In this study, we investigated TPH A218C gene variants in a sample of subjects affected by major psychoses. One thousand four hundred and twenty-four inpatients affected by bipolar (n=627), major depressive (n=511), schizophrenic (n=210), delusional (n=48) disorder and psychotic disorder not otherwise specified (n=27) (DSM-IV) were included; all patients and 380 controls were typed for the TPH variants using PCR techniques. A sub-sample of 963 patients was assessed using the Operational Criteria for Psychotic Illness (OPCRIT). TPH variants were not associated with major psychoses, but a trend was observed toward an excess of TPH*A/A in bipolar disorder. The analysis of symptomatology factors did not show any significant difference either; however, a trend was observed for males with the TPH*A genotype to have lower depressive symptoms compared with TPH*C subjects. Possible stratification factors such as current age and age of onset did not affect the observed results. TPH A218C variants are not, therefore, a major liability factor for the symptoms of major psychoses to have in the present sample. TPH*A containing variants may be a protective factor for depressive symptoms among male subjects with mood disorders or for a subtype of mood disorders characterized by a mainly manic form of symptomatology.

Adult↗
PubMed1997

Variants in neurotrophic factor genes and schizophrenic psychoses: no associations in a Spanish population.

Possible associations between schizophrenic psychoses, a ciliary neurotrophic factor (CNTF) null mutation and a neurotrophin in 3 (NT3) bi-allele polymorphism were investigated in a Spanish population. The sample consisted of 107 patients suffering from schizophrenic psychoses and 100 healthy volunteers. There was no statistical difference in the frequencies of the mutant CNTF allele in the index and control groups (0.125 vs. 0.121). The frequency of the rare NT3 allele (Glu) was very low and similar in both groups (0.005). Previous findings supporting the involvement of these genetic markers in the pathogenesis of schizophrenic psychoses were thus not confirmed. In light of neurodevelopmental hypotheses of schizophrenia, however, genes coding for neurotrophic factors remain interesting susceptibility loci in schizophrenia research. Subsequent studies should not focus exclusively on genetic alterations but also take into account secondary changes of the neurotrophic factor system at the mRNA and protein levels. Further, the current unsatisfying operationalized classification of the heterogeneous syndrome 'schizophrenia' remains a crucial problem that could be partially resolved by introducing more differentiated diagnoses defined on the basis of neurobiological criteria.

Ciliary Neurotrophic Factor↗
PubMed2001

Anticipation, imprinting, trinucleotide repeat expansions and psychoses.

1. Since 1991, approximately 20 trinucleotide repeat expansion type neurodegenerative disorders have been reported. They are clinically characterized by anticipation, i.e., worsening severity or earlier age at onset with each succeeding generation for an inherited disease, and imprinting, i.e., a process whereby specific genes are differentially marked during parental gametogenesis, resulting in the differential expression of these genes in the embryo and adult. 2. The phenomenon of anticipation in psychoses has been pointed out since the 19th century; however, it was ignored because no one knew the genetic mechanism underlying this type of inheritance pattern at the time, and because of several possible biases. 3. The discovery of trinucleotide repeat expansion diseases has reawakened interest in the phenomenon of anticipation in psychiatric diseases. Anticipation has been confirmed in schizophrenia, mood disorders, and anxiety disorders in much more sophisticated manners, although still not perfectly. 4. Molecular approaches as well as clinical ones have been taken to reveal the involvement of trinucleotide repeat expansion mechanism in psychoses by means of direct analyses of candidate genes, RED and DIRECT. Most efforts have been made for CAG type trinucleotide repeats. So far, direct analyses have failed to reveal pathogenic gene(s). There were several positive RED data at first, however, nowadays there seems to be a tendency of much more negative results. The DIRECT results did not support trinucleotide repeat expansions mechanism in psychoses either. One plausable explanation for the 'false positive' result is the presence of CAG trinucleotide repeats which are highly polymorphic but not associated with an obvious abnormal phenotype. Screening for trinucleotide repeats other than ones of the CAG type remained to be performed.

Anticipation, Genetic↗
PubMed2001

Brain-derived neurotrophic factor and neurotrophin 3 in schizophrenic psychoses.

Disturbed neural development has been postulated as a crucial factor in the pathophysiology of schizophrenic psychoses. The neurobiochemical basis for such changes of cytoarchitecture and changed neural plasticity could involve an alteration in the regulation of neurotrophic factors. In order to test this hypothesis, BDNF and NT-3 levels in post-mortem brain tissue from schizophrenic patients were determined by ELISA. There was a significant increase in BDNF concentrations in cortical areas and a significant decrease of this neurotrophin in hippocampus of patients when compared with controls. NT-3 concentrations of frontal and parietal cortical areas were significantly lower in patients than in controls. These findings lend further evidence to the neurotrophin hypothesis of schizophrenic psychoses which proposes that alterations in expression of neurotrophic factors could be responsible for neural maldevelopment and disturbed neural plasticity, thus being an important event in the etiopathogenesis of schizophrenic psychoses.

Aged↗
PubMed2004

Social adversity contributes to high morbidity in psychoses in immigrants--a national cohort study in two generations of Swedish residents.

BACKGROUND: Recent reports have indicated that immigrants have an elevated risk of schizophrenia as well as an increasing tendency for social exclusion. The aim of this study was to compare rates of schizophrenia and other psychoses in immigrants and their children of different ethnic groups with the majority population in Sweden in relation to social adversity. METHOD: The study population consists of a national cohort of 1.47 million adults (born 1929-1965) and 1.16 million children and youth (born 1968-1979) in family households from the national census of 1985. Multivariate Cox regression analyses was used to study hospital discharge data during 1991-2000 in relation to socio-economic household indicators from 1985 and 1990 (single adult household, adults having received social welfare, parental unemployment, urban residency, housing and socio-economic status). RESULTS: First as well as second generation immigrants had higher age and sex adjusted risk ratios for schizophrenia as well as for other psychoses (RRs 1.4-3.1 and 1.0-2.0 respectively) compared with the Swedish majority population. These risk ratios decreased considerably after adjusting for socio-economic indicators, for all groups, but particularly for the non-European immigrants. However, an elevated risk still remained in the Finnish and Eastern and Southern European study groups. CONCLUSIONS: A higher risk of schizophrenia and psychoses was found in two generations of immigrants of diverse ethnicity. The results indicate that social adversity contributes to the higher risk.

Adolescent↗
PubMed2000

Heterogeneity of cycloid psychoses: a latent class analysis.

BACKGROUND: Three hypotheses have been proposed in regard to the origin of cycloid psychoses: (1) they are an independent nosological entity; (2) they are atypical cases of affective disorders; and (3) they are a heterogeneous group of disorders. This study examined the heterogeneity hypothesis by attempting to delineate distinct affective and non-affective subgroups. METHODS: In 60 cases drawn from a classic study of cycloid psychoses by Perris (1974), latent class analysis was used to delineate subgroups. RESULTS: Two classes were identified in the analysis: one characterized by the convergence of affective symptoms and family history of affective disorders and the other by the relative paucity of such features. CONCLUSIONS: Cycloid psychoses are composed of at least two subgroups, distinguishable on the basis of symptoms and family history.

Acute Disease↗
PubMed2001

A factor model of the functional psychoses and the relationship of factors to clinical variables and brain morphology.

BACKGROUND: Despite more than 100 years of study, there remains no definitive diagnostic validation of the functional psychoses. Factor analysis suggests the presence of three or more psychopathological syndromes in functional psychoses as a whole. The relationship between these factors and cerebral anatomy has been investigated in schizophrenia only. This study aimed to address the relationship of symptom factors to clinically important variables and cerebral anatomy in a sample of psychotic patients with a spread of diagnoses. METHODS: In a sample of patients with functional psychoses, symptom data was obtained on four consecutive admissions using the OPCRIT symptom checklist. OPCRIT data was used to generate operational diagnoses in accordance with pre-set criteria and a principle components analysis was performed on symptom data. Factor loadings were compared between each admission to examine factor stability over time. Factor scores at first admission were also correlated with clinical variables obtained from patients' case notes. From the sample of 204 patients, 64 subjects were recruited and underwent an MRI scan of the brain. Regional anatomical volumes were compared with diagnosis and factor loadings at first admission. RESULTS: A principal components analysis gave a four-factor solution of 'manic', 'depressive', 'disorganization' and 'reality distortion' factors at each admission. Factors showed a high degree of stability over the four admissions studied. The factors were significantly associated with several clinical variables. Three of the four factors were associated with a specific pattern of cerebral anatomy. CONCLUSIONS: This study suggests that factors may correspond to relatively specific disease processes underlying functional psychotic illness. We propose that the use of symptom factors may facilitate the investigation of the underlying mechanisms of psychotic illness.

Activities of Daily Living↗
PubMed2005

A linkage study between the GABAA beta2 and GABAA gamma2 subunit genes and major psychoses.

BACKGROUND: Alterations of the gamma-aminobutyric acid (GABA) system have been implicated in the pathophysiology of major psychoses. OBJECTIVE: Restriction fragment length polymorphisms associated with the human gamma-aminobutyric acid type A (GABAA) beta2 and GABAA gamma2 subunit genes on chromosome 5q32-q35 were tested to determine whether they confer susceptibility to major psychoses. METHODS: Thirty-two schizophrenic families and 25 bipolar families were tested for linkage. RESULTS: Nonparametric linkage (NPL) analysis performed by GENEHUNTER showed no significant NPL scores for both genes in schizophrenia (GABAA beta2: NPL narrow= -0.450; NPL broad= -0.808; GABAA gamma2: NPL narrow=0.177; NPL broad= -0.051) or bipolar disorder (GABAA beta2: NPL narrow=0.834; NPL broad=0.783; GABAA gamma2: NPL narrow= -0.159; NPL broad=0.070). CONCLUSION: Linkage analysis does not support the hypothesis that variants within the GABAA beta2 and GABAA gamma2 genes are significantly linked to major psychoses in a Portuguese population.

Bipolar Disorder↗
PubMed2001

Season of birth in schizophrenia and affective psychoses in Western Australia 1916-61.

OBJECTIVE: This study examines seasonality birth effects in schizophrenia and affective psychoses in the southern hemisphere, given possible confounding of age-incidence effects with winter birth peaks in northern hemisphere data. METHOD: Distributions of births by season, quarter and month for individuals born in Western Australia 1916-61 with a diagnosis of schizophrenia (N=2284), affective psychoses (N=3236), and neurotic depression (N=4869) on the statewide mental health register were compared with distributions for the general population. RESULTS: We found no association between season of birth and schizophrenia, affective psychoses or neurotic depression. For schizophrenia, the pattern of risks by quarter reflects northern hemisphere trends. Results by month are difficult to interpret due to large fluctuations in the data. While age-incidence effects had no impact on the distribution of risk, we found an artefactual increase in January births due to routine imputation of missing birth dates. CONCLUSION: Adjusting for artefacts in the data produced a pattern analogous to northern hemisphere trends.

Adult↗
PubMed2002

The meaning and form of occupational therapy as experienced by women with psychoses. A phenomenological study.

The meaning and form of occupational therapy as experienced by women with psychoses: a phenomenological study The aim of this study was to illuminate the experiences of occupational therapy interventions in individuals with psychoses. Repeated tape-recorded narrative interviews were conducted with six women participating in occupational therapy immediately after an intervention. The subsequent analyses followed a phenomenological approach. Key constituents integrated in two structures, are the main findings. The meaning of occupational therapy as expressed in the key constituents relief, self-knowledge, belief in the future, capability, resistance and satisfaction formed one structure. The form of occupational therapy as expressed in the key constituents time, environment, guidance, voluntariness and collaboration represented the other structure. These findings confirm and give empirical support to beliefs and assumptions expressed in occupational therapy literature. The results form a conceptual base for developing an evaluative assessment instrument for individuals with psychoses participating in occupational therapy.

Attitude to Health↗
PubMed2003

[CSF Filtration as Experimental Therapy in Therapyresistant Psychoses in Borna Disease Virus-Seropositive Patients]

According to previous investigations, mild Borna disease virus encephalitis may underlie a subgroup of affective or schizophrenic type psychoses. And virus-induced immune pathology may underlie even a larger subgroup of psychoses. We treated BDV seropositive patients suffering from therapy resistant schizophrenic or affective spectrum psychoses by cerebrospinal fluid filtration (CSFF) in an experimental add-on treatment. CSFF was shown previously to be an effective immune modulatory treatment in autoimmune neurological disease, Guillain-Barré syndrome. CSFF appears to be an effective treatment in therapy resistant psychosis also, but only 4 patients were treated yet.

Journal Article↗
PubMed2005

[Theories on etiopathogenesis of psychoses in childhood and adolescence].

OBJECTIVE: A focused review of a selected part of research on phenomenology of psychoses in children and adolescents is provided. Especially the differences to psychoses in adults are examined. Hallucinations and delusions are illustrated in context to the stage of development. RESULTS: The symptoms of the childhood psychotic disorder differ qualitatively and quantitatively from the adult form. Interpretation of symptoms has always to be set in relationship to developmental age. Delusions and hallucinations are referred to the stages of development according to Piaget. A possible explanation for the fact that symptoms vary strongly according to developmental age is provided. DISCUSSION: The insight for the development of psychotic symptoms from the background of child developmental stages will be increased. But many questions about the specific clinical picture of childhood psychoses still remain to be answered.

Adolescent↗
PubMed1985

[Psychogenic psychoses. A review of the clinical picture, genesis, prognosis and therapy].

The concept of psychogenic psychosis has always been regarded with scepticism, since it seems to harbour a contradiction in itself: Psychogenic mental disturbances are amenable to a rational approach, that is to say, they are understandable, whereas psychoses are incomprehensible mental disease patterns in respect of their content and course. Nevertheless, psychogenic psychoses have been described fairly often ever since scientific psychiatry came into being; in fact, they are being diagnosed quite frequently in some countries. For the purpose of helping to clarify these theoretical and practical difficulties, the article explains the history of the concept, the clinical patterns of manifestation, and the course of psychogenic psychoses, as well as the concept of their origin. An attempt is made to reconcile the immanent contradictions, and to demonstrate that this is actually a fruitful extension of the scope of the theoretical fundamentals of psychiatry.

Adjustment Disorders↗
PubMed1988

Derangement of one-carbon metabolism in episodic schizoaffective psychoses.

The so-called cycloid or degeneration psychoses form a subgroup of the vaguely defined schizoaffective psychotic disorders, or according to the DSM III criteria: "Psychotic Disorders Not Elswhere Classified" (295.40; 298.80; 295.70; 298.90). Recovery from these acute psychoses is always complete, though episodic recurrence is commonly observed. The clinical syndrome is characterized by a kaleidoscopic, polymorphous clinical picture, e.g. sudden mood swings, motility disturbances, states of pananxiety and ecstasy with visionary experiences, perfunctory delusional ideas and visual hallucinations. At the onset of the psychoses many patients experienced psychedelic phenomena. It was postulated that these patients suffered from an abnormality in one-carbon metabolism resulting in the formation of beta-carbolines which were held responsible for evoking the psychotic symptoms. Since serine is the principle donor for one-carbon units, serine was administered to nonsymptomatic patients. Two to three hours after the administration patients became psychotic again. Analysis of blood samples from these patients showed a decreased fasting plasma concentration of serine and an increased fasting plasma level of taurine. In addition a decreased formation of serine from glycine was found. These findings are in agreement with the postulated derangement of one-carbon metabolism. Moreover, the beta-carboline norharman was present in blood obtained during acute psychotic episodes and was not present in blood of nonsymptomatic patients nor in blood of healthy controls. No abnormal activities of enzymes were found in skin fibroblasts from these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Bipolar Disorder↗
PubMed1992

[The Leonhard classification of endogenous psychoses--initial biological findings and differential therapeutic considerations].

Current systems of classification of endogenous psychoses, the APA's Diagnostic and Statistical Manual and the International Classification of Diseases in particular, aim at a synthesis of Kraepelin's prognosis-orientated diagnostic scheme with the symptomatological approach as established by Eugen Bleuler and Kurt Schneider. The restriction to few diagnostic entities has remained unchanged to the present day and appeared at first to be confirmed and validated by modern pharmaco-psychiatry. Kraepelin's dichotomy has failed to make a major contribution to the etiologic clarification of endogenous psychoses. New diagnostic concepts beyond those currently applied in clinical psychiatry and biological psychiatric research must therefore be considered and should lead towards a more differentiated approach to psycho-pathological phenomena. Karl Leonhard's classification of endogenous psychoses which rests upon the pioneer work of Carl Wernicke and Karl Kleist is part of a tradition in psychopathology emphasizing the interface of biology and psychopathology. It might provide a basis for future empirical research in biological psychiatry and pharmacopsychiatry.

Humans↗
PubMed1977

Genetic and other factors in schizophrenic, manic-depressive, and schizo-affective psychoses.

The major psychoses have been investigated for genetic and environmental etiological factors for over two centuries. Recent emphasis has been placed on a genetic (diathesis) environmental stress model. For schizophrenia, manic-depressive, and schizo-affective psychoses, research evidence from psycho-biological studies, family, pedigree, twin, and adoptee studies has provided sufficient data from diagnostic and follow-up studies and new psychopharmacological research that for these three major psychoses a strong necessary but not sufficient basis for genetic causation exists. This review attempts to summarize existing data into a hypothesis that suggests that two separate gene pools of polygenic nature relate to the development of schizophrenia and manic-depressive illness and that schizo-affective illness may result from genetic transmission from each of these separate gene pools. The hypothetical model for each psychosis proposes that polygenetic inheritance affects different central nervous system neuroanatomical sites in the human which are in homeostasis as to catecholamine neurotransmitter regulation of the psyche. With sufficient environmental stress, an "imbalance" occurs in the neural integrative systems which produces phenotypically the three separate psychotic behavioral syndromes of schizophrenia, manic-depressive psychosis, and schizo-affective psychosis.

Adoption↗
PubMed1983

Risks of occurrence of psychoses in relation to the types of epilepsies and epileptic seizures.

The possible existence of the risks of occurrence of psychoses was examined in relation to the types of epilepsies and epileptic seizures. This study consisted of two investigations: 1) A study of 879 epileptic patients was conducted in which the incidence of psychoses in the different types of epilepsies was surveyed; the result was that the incidence in temporal lobe epilepsy was the highest, being relatively higher than that of other (non-temporal lobe) partial epilepsies but not significantly different from that of generalized epilepsies. 2) A comparative study was carried out on 96 patients with temporal lobe epilepsy in which 48 were psychotic and another 48 were non-psychotic which served as a control group. The differences of seizure symptomatology between the two groups were compared. The results were that the psychotic group was found to exhibit at a significantly higher rate generalized tonic-clonic convulsion and compound seizure manifestations in comparison with the non-psychotic group. The results appear to support the fact that generalizing mechanisms of temporal lobe epileptic manifestations are closely related to a physiopathogenic factor influencing psychoses.

Adolescent↗