Computerised tomography in schizophrenia: 15 years on

Article Abstract:

A review of the literature demonstrates that since its introduction 15 years ago, computerized tomography (CT) has been widely used to examine brain structure in schizophrenia. However, early studies comparing CT brain scans of schizophrenic patients with scans of non-schizophrenic individuals provided inconsistent data. Overall, CT differences between schizophrenic and non-schizophrenic populations were shown to be more quantitative than qualitative. More recent studies have also failed to demonstrate consistent and significant CT abnormalities among schizophrenic patients. The structures most commonly measured for comparative purposes are the lateral cerebral ventricles. Most studies have not demonstrated significant lateral ventricular enlargement in schizophrenic populations. Studies which examined differences (between schizophrenic and normal individuals) in other cerebral cortex fluid spaces have reported minor degrees of enlargement of the third ventricle and cortical sulci of schizophrenics. There seems to be more evidence that abnormal CT scans are related to atypical non-organic psychoses and affective (mood) disorders. For example, CT scans of patients with unusual syndromes such as Capgras syndrome (which entails the delusion that important people have been replaced by identical impostors) have demonstrated greatly enlarged ventricles. In sum, studies have failed to demonstrate a significant degree of difference between schizophrenic and normal CT brain scans, although various demographic features (such as age, sex, race and alcohol consumption), as well as the presence of affective disorder or cognitive defects, are emerging as factors which significantly affect the degree of abnormalities found. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Physiological aspects, CT imaging, CAT scans, Brain

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Pre-morbid adjustment and personality in psychosis: effect of sex and diagnosis

Article Abstract:

It is often found that schizophrenic adults exhibited deficits in thinking and feeling as children. Traits such as isolation, coldness, and eccentric behavior are common in such children, as are a degree of paranoia, rigid character, and unusual speech. The former traits are characteristic of the schizoid personality. While this relationship seems to exist, there is little data as to the nature and causality of the relationship. Mothers of 73 psychotic patients, 45 schizophrenics (mean age of 26.8 years) and 28 with depression with psychotic features or bipolar disorder (mean age of 30.1 years), were interviewed and assessment of their child's functioning prior to illness was made. Mothers of schizophrenics reported significantly more schizoid and schizotypal traits in their child's personality prior to illness than did mothers of children with affective disorders. Schizophrenic men, in particular, were reported to have exhibited more abnormal personality traits than schizophrenic women or patients with affective disorders. Social impairment later in childhood was associated with schizophrenia as well. Female schizophrenics and both male and female patients with affective disorders differed little overall in personality and socialization during childhood. The results suggest that there may be a subset of schizophrenia characterized by the deficits in childhood functioning studied here, and more commonly found in men. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Risk factors, Demographic aspects, Personality disorders, Psychoses, Psychotic disorders

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Can brain damage protect against schizophrenia? A case report of twins

Article Abstract:

Although the most firmly established risk factor for schizophrenia is having an affected relative, genetic factors are not thought to be wholly responsible for the disease, since the concordance rate (both twins developing the disorder) in monozygotic (MZ), or identical, twins is only about 50 percent. A case report is presented of a pair of MZ twins discordant for schizophrenia (one developed it and the other didn't). Magnetic resonance imaging (MRI) techniques did not reveal any abnormality in the schizophrenic twin. However, white matter damage, ventricular enlargement and lesions in the right brain of the nonschizophrenic twin, thought to have resulted from obstetric complications, were found. The nonschizophrenic twin had been born with a partial left paralysis and had developed complex seizures by age 14. The schizophrenic twin had a relatively normal medical history. Previous research has demonstrated that in discordant MZ twins, lateral ventricular enlargement and left hemisphere lesions are more common in the schizophrenic twin than in the well twin. This case does not fit well with previous cases, since the more severe brain damage was found in the nonschizophrenic MZ twin. The possibility exists that some patterns of early brain damage may reduce rather than increase the later risk of developing schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Genetic aspects, Magnetic resonance imaging

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