A chart review study of late-onset and early-onset schizophrenia

Article Abstract:

Symptoms of schizophrenia include delusions, hallucinations, and thought disorders. In late-onset schizophrenia, initial symptoms occur any time after the age of 45. Most early-onset schizophrenia starts between age 20 and 40. Risk factors for this disorder include genetic predisposition (family history), sensory impairment, and social isolation. The medical records were reviewed of three groups of psychiatric inpatients in an East Baltimore clinic, namely young early-onset schizophrenics, elderly early-onset schizophrenics and late-onset schizophrenics. Approximately 80 percent of the subjects were women, possibly suggesting that male patients were less likely to seek treatment. Fifty percent of the late-onset patients were living alone at onset of illness, compared to none in the other elderly group. Thought disorder and loss of affect, or feeling, were less prevalent in the late-onset group. Occurrence of these symptoms decreased with increasing age of onset. The two older groups more frequently experienced hallucinations than the younger group. The late-onset group experienced more types of hallucinations than the early-onset groups. Both older groups had more delusions, but the late-onset group again had more. Visual and hearing impairments were more common in the late-onset elderly group than the other elderly group. A diagnosis of schizoid premorbid personality was assigned to 63 percent of the late-onset group, 50 percent of the elderly early-onset group, and almost 28 percent of the younger group. Almost half of the late-onset group responded with complete remission to antipsychotic drug therapy, and approximately 25 percent responded either partially or not at all. Thought disorder and schizoid premorbid personality criteria were noted to predict poor response to treatment with antipsychotic drugs, and family and gender had no effect on treatment outcome. These results confirm a relationship between social isolation and late-onset schizophrenia, but whether it is a symptom or cause is not clear. There is a trend in the United States to ignore the same symptoms in an older patient which would be sufficient for a diagnosis of schizophrenia in a young person. These results show more similarities in onset groups and accent optimistic expectations for therapy.

Research, Demographic aspects, Schizophrenics

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Association between family history of affective disorder and the depressive syndrome of Alzheimer's disease

Article Abstract:

A family history study was performed to investigate the relationship between Alzheimer's disease with depression and a family history of affective disorder. Depression often accompanies Alzheimer's disease, but it is not known if this is merely a response to the dementia or if it is a part of a major affective disorder. Affective disorders and dementia can coexist; depression may be the result of dementia, or cognitive disturbances may result from depression. Forty-one patients who were diagnosed with probable Alzheimer's disease and who experienced one episode of depression were assessed, along with 71 Alzheimer's patients who were not depressed. The 41 depressed patients met the criteria in the Diagnostic and Statistical Manual of Mental Disorders, third edition, (DSM-III) for major a depressive episode, and had no history of depression. For each of these patients, two first-degree relatives were interviewed and assessed for symptoms of depression, also using the DSM-III criteria. Data were analyzed and an association was found between the Alzheimer's patients with depression and a higher incidence of depression in first- and second-degree relatives. About half of the patients with depression had one or more relative with major depression, compared with only 11 percent of the Alzheimer's disease patients without depression. These results suggest that there is a genetic relationship between a family history of depression and the depression which may occur in Alzheimer's disease. Further investigation of this feature in Alzheimer's disease may provide a useful model for studying aspects of depression and its progression. (Consumer Summary produced by Reliance Medical Information, Inc.)

Depression, Mental, Depression (Mood disorder), Genetic aspects, Alzheimer's disease, Affective disorders, Mood disorders

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Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia

Article Abstract:

Previous studies have revealed changes in the temporal lobe of the brain in schizophrenic patients over time. In addition, studies have indicated that hallucinations can be produced by electrical stimulation of the superior temporal gyrus, located in the temporal lobe of the brain. Auditory hallucinations are a common, but unexplained, symptom of schizophrenia. A study of the brains of 15 schizophrenic patients was undertaken using magnetic resonance imaging (an advanced imaging technique) to measure temporal lobe size and overall brain size. These results were compared with those of 15 normal control subjects. It was hypothesized that the volume of certain brain structures would be less than average in the schizophrenic patients. The results revealed structural abnormalities in the schizophrenics; the superior temporal gyrus and the left amygdala were smaller in these patients. These areas of the brain were also smaller than expected compared with the overall temporal lobe size and brain size of the individual. When the severity of hallucination in the patients was assessed, a correlation was found with the shrinkage of the left superior temporal gyrus. These results are also consistent with previous studies finding physiological abnormalities in the brains of schizophrenics. Additional studies are needed to understand the specific relationships among these anatomic findings, neurophysiologic changes, and patient symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Physiological aspects, Temporal lobes, Auditory hallucinations

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