The functional psychoses in Afro-Caribbeans

Article Abstract:

There has been a high rate of schizophrenia within the Afro-Caribbean population of the UK. To determine whether this rise reflects diagnostic or recording errors or a true incidence rate, 54 Afro-Caribbean and 49 white British patients - consecutively admitted to a psychiatric hospital in London for psychosis - were studied. The study group consisted of 46 men and 57 women aged 15 to 69 years; the average age was 39 years. All patients were interviewed with the Present State Examination (PSE) within 24 hours of admission to the hospital and diagnosed according to World Health Organization diagnostic criteria and the 1980 Diagnostic and Statistical Manual of Mental Disorders. Analysis of the data revealed that the Afro-Caribbean patients were not clinically distinguishable from white British patients. A comparison of PSE individual symptoms of patients diagnosed with schizophrenia did not reveal any significant differences between ethnic groups. Afro-Caribbeans tended to experience more neutral and hostile auditory hallucinations than other groups. Otherwise, profiles between groups were similar. Ethnic groups were also fairly similar in terms of length of hospital stay, number of psychiatric admissions, responses to antipsychotic medications, and degree of recovery after follow-up. The average age at the onset of schizophrenia was earlier in the Afro-Caribbean group (28.3 years) than among white British patients (41 years). These findings do not indicate that there are any features specific to the Afro-Caribbean group, and do not explain the current high admission rates for schizophrenia in that community. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Social aspects, United Kingdom, Demographic aspects, Africans in United Kingdom, Africans, West Indians

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Langfeldt's schizophreniform psychoses fifty years later

Article Abstract:

Since the development of the diagnostic category 'schizophrenia' by Bleuler in 1911, there have been various attempts to determine whether any signs of the disorder can be associated with a good outcome. In 1939, Langfeldt used the term 'schizophreniform' to identify a subgroup of patients who exhibited schizophrenia-like symptoms, but who tended to have a better outcome than so-called 'true schizophrenics.' Over 50 years later, Langfeldt's classification, admittedly cast in outdated terms, has been reevaluated. A team of four psychiatrists developed case summaries for the original 100 cases classed by Langfeldt as 'schizophrenia(?)' to ascertain the validity of the schizophreniform label. Langfeldt himself eventually diagnosed 45 of the group with true schizophrenia, a percentage slightly higher than the more recent assessment allocated to that diagnosis. Of the remaining 55 individuals originally considered to have a schizophreniform disorder, modern psychiatry would more likely diagnose the majority with various affective (mood) disturbances, neuroses, or adjustment disorders, conditions that are all likely to have a better outcome than schizophrenia. Nevertheless, the clinical picture presented by the schizophreniform patients did not resemble schizophrenia. It is concluded that there is no solid basis for maintaining a distinct category of schizophreniform psychoses. The question of appropriate criteria for 'good-outcome' schizophrenia still remains unanswered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Identification and classification, Terminology, Psychiatry, Schizoaffective disorders, Schizoaffective disorder

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The functional psychoses - are oncogenes involved in their pathogenesis? some speculations

Article Abstract:

Oncogenes are genes that are thought to play a role in the development of some cancers. Much research has been done with viruses that cause cancerous tumors in an effort to improve preventative measures and treatment methods. The relevance of oncogenes to psychiatric illness has not yet been considered. However, given the vulnerability of the central nervous system and the possibility that viruses sometimes play a role in psychiatric illness, this area deserves investigation. Two strategies might be applied to address this question. First, a genetic search could be done in pedigrees (or generations) of families to identify oncogenes. If found, the link between the oncogenes and family history of psychoses could be explored. At least one study has found such a link in the Amish, but several attempts to replicate these results in other pedigrees have failed. The second method would involve utilization of the variety of available genetic tests for links between oncogenes and neurotransmitters, which are known to play a role in psychoses. While the hypothesis that oncogenes play a role in psychoses remains largely untested, it is a theory worthy of exploration. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Complications and side effects, Mental illness, Mental disorders, Oncogenes, Psychoses, Psychotic disorders, editorial

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