Morbidity risks of schizophrenia and affective disorders among first-degree relatives of patients with schizoaffective disorders

Article Abstract:

There is no consensus as to the clinical picture of patients diagnosed as having schizoaffective disorder. The term's first use in 1933 was for the purpose of labelling patients who had symptoms of both schizophrenia and affective (mood) disorders. Some have seen schizoaffective disorder as a subtype of schizophrenia, while others have categorized it as a subtype of affective disorder. Still others have seen it as an independent disorder. Records were reviewed for patients admitted to a psychiatric hospital over a 10-year period beginning in 1934. Records of 200 schizophrenics, 225 patients with affective disorder (depression), and 310 patients with atypical psychosis (alternating symptoms of affective disorder and schizophrenia) who were admitted to a psychiatric hospital between 1934 and 1944 were reviewed. Relatives of these patients were traced and contacted, or medical records were reviewed, for evidence of psychiatric disorders. The atypical psychosis group was further subtyped into three groups: one group resembled schizophrenics, one group resembled those with affective disorders, and one group resembled neither. The latter was labeled schizoaffective and 57 cases met the criteria. When the risk of psychiatric illness in family members of schizoaffective, schizophrenic, and affective disorder groups was evaluated, it was found that the relatives of schizoaffective patients had a 6.6 percent incidence of schizophrenia, which was similar to the risk for families of schizophrenics but much higher than the risk of schizophrenia seen in family members of affective patients (2.2 percent). The incidence of affective disorder in relatives of schizoaffective patients was 13 percent as compared with 18.1 percent of relatives of patients with affective disorders and 10 percent in families of schizophrenics. This shows that depending upon the dimension under study, schizoaffective patients and their relatives may appear to be more similar to schizophrenics or to those with affective disorders. This suggests that schizoaffective disorder, as defined in this study, is different from both affective disorder and schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mentally ill persons, Diagnosis, Mentally ill, Family, Affective disorders, Mood disorders

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Sex differences in the familial transmission of schizophrenia

Article Abstract:

This study tests the hypothesis that first-degree relatives of schizophrenic men (male probands) have a lower risk for schizophrenia or related disorders than relatives of female schizophrenic probands. Schizophrenic related disorders include schizophreniform (a schizophrenic-like disorder, but with shorter duration and better prognosis), schizoaffective disorder (a major depression or manic syndrome concurrent with psychotic symptoms), paranoid disorders, atypical psychosis, and schizotypal personality disorder (characterized by a pervasive pattern of deficits in interpersonal behavior, with peculiarities in thinking, appearance, and behavior). The study data came from longitudinal family cohort studies that began in 1970. Probands (171 men and 161 women) and 725 of their first-degree relatives (9 percent parents, 72 percent siblings, and 19 percent children) were diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, third edition. Probands were primarily young, white, middle- to lower-middle class schizophrenics in the early stages of the disorder. Statistical analysis revealed that male and female relatives of female probands had a significantly higher risk for schizophrenia than relatives of male probands. Relatives of female probands were at a higher risk for the more severe forms of the spectrum, while relatives of males were at a higher risk for the least severe form (schizotypal personality disorder). Overall findings seem to demonstrate that sex is an important factor in understanding the transmission of schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Genetic aspects

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Heterogeneity of schizophrenia: conceptual models and analytic strategies

Article Abstract:

Schizophrenia is thought by many to be a heterogeneous disorder. That is, they believe that there is a spectrum of subtypes of schizophrenia that have different symptoms and causes. The multifactorial polygenic (MFP) process model of schizophrenia suggests that there is no single cause of the illness, whereas the single major locus (SML) model says that there is a single gene that causes schizophrenia. Neither model is able to explain all the empirical findings. It has been suggested that comparing schizophrenics with controls on some measure is not as valuable a research tool as ordering phenomena associated with schizophrenia and drawing hypotheses about indicators that emerge from the data. There are several levels of indicators proposed: level I indicators include such factors as those found at birth, level II indicators include physiological abnormalities, and level III indicators include traditional signs and symptoms. The levels are causally related; lower-level indicators are likely to be causes of higher-level indicators. Patterns need to be examined across levels as well as within. While there are several theoretical models possible, the MFP model, which supports the presence of many factors that are relevant to the development of schizophrenia, is the most viable. These factors need to be analyzed and tested statistically, and causal agents must be investigated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Models, Diseases, Identification and classification, Etiology (Medicine)

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