Association of family history of schizophrenia and history of obstetric complications at birth: relationship with age at onset and psychopathology dimensions in a Nigerian cohort.

BACKGROUND: The nature of the association between obstetric complications (OCs) at birth and the genetic aetiology of schizophrenia remains unclear, as some authors suggest that it is an independent risk factor while others support either interactionism or an epiphenomenon perspective. OBJECTIVE: To examine the association of family history of schizophrenia (FHS) with history of OCs, with a view to assessing whether this relationship moderates clinical phenotypes such as symptom dimensions and age at onset of illness. METHODS: This study examined OCs among schizophrenia probands using the Obstetric Complications Scale. An inquiry into family history was performed using the Family history method. Psychopathological symptom dimensions were assessed using standard scales. Data were analyzed to examine the interaction of FHS and history of OCs with age at onset and symptom dimensions, using ANCOVA. RESULTS: FHS was significantly associated with the disorganized symptoms dimension (p=0.03). History of OCs was significantly associated with earlier age at onset (p=0.007). However, in ANCOVA, the effect of the interaction between FHS and history of OCs was not significant for age at onset and symptom dimensions (P = 0.059). CONCLUSION: FHS was significantly associated with disorganization syndrome, and OCs was significantly associated with age at onset.

Psychosis in a Patient with Davidoff-Dyke-Masson Syndrome.

OBJECTIVES: To report the finding of psychosis in a patient with Davidoff-Dyke-Masson Syndrome. METHOD: Case report. CONCLUSIONS: Right-sided hemiatrophy may be an addition to the list of neuro-developmental and structural cerebral anomalies associated with psychotic disorders including schizophrenia.

Total agenesis of the corpus callosum in a patient with childhood-onset schizophrenia.

The hypothesis that schizophrenia involves aberrant inter-hemispheric communication has a long pedigree, however its precise role remains unclear. We therefore report the case of a total agenesis of the corpus callosum in a 21-year-old man with childhood-onset schizophrenia. The presence of schizophrenia with very early onset on absence of corpus callosum offers an opportunity to examine neurodevelopmental model and theories regarding to interhemispheric communication in the pathogenesis of psychosis.

Autistic children who become schizophrenic.

Infantile autism and schizophrenia have been regarded as unrelated and distinct disorders. There is, however, some evidence in the literature that supports a relationship between the two disorders in that there may be a subgroup of autistic children in whom schizophrenia develops. The diagnostic criteria used in the literature to describe infantile autism and schizophrenia in childhood has not been uniform. The three cases in this report, diagnosed on the basis of current criteria and detailed clinical descriptions, clearly point to an initial diagnosis of infantile autism followed by the development of schizophrenia.

Blind ratings of mother-infant interaction in home movies of prepsychotic and normal infants.

Home movies of infants later diagnosed as having early childhood psychoses were compared with movies of normal control infants. A scale of attachment indicators measured mother-infant dyadic avoidance and reciprocity in the first 6 months of the infant's life. Three judges blind to diagnosis saw a general trend to dampened interaction for prepsychotic infants and their mothers. Prepsychotic and normal infants were not significantly different in touching and eye gaze behaviors, whereas mothers of prepsychotic infants exhibited less adequate eye gaze and touching than mothers of normal infants.

Childhood-onset schizophrenia and obstetric complications: a case--control study.

Obstetric complications (OCs) may be a risk factor for developing schizophrenia. In a recent study of a meta-analysis, the odds ratio for the development of the disorder in adulthood associated with OCs has been reported to be about 2.0 (i.e., a two-fold increase in risk). However, little attention has been paid to the involvement of OCs in risk of the development of childhood-onset schizophrenia. Therefore, the authors examined the relationship between OCs and childhood-onset schizophrenia. Thirty-three children, aged 8-13 years (average 12.4 years), meeting the DSM-III-R criteria for schizophrenia, were compared with controls (children with anxiety disorder) matched for sex and age. Childhood-onset schizophrenics showed significantly greater scores in all of the three measures of OCs according to Parnas et al.'s scale compared with controls. Moreover, those individuals exposed to OCs were 3.5 times as likely to develop schizophrenia as were those without OCs. The risk association between OCs and the disorder was far greater for male than for female schizophrenics. Our results, together with those in previous studies showing the association between OCs and adult-onset schizophrenia, suggest that childhood- and adult-onset schizophrenia may, at least in part, share a common neuropathogenesis.

Schizophrenia in children: a review of European research.

European literature on childhood schizophrenia is divergent and vast. The topic itself is controversial and complex. The article reviews selected European literature on childhood schizophrenia and presents the most important trends of research from the literature. Extensive work has been devoted in tracing and defining the boundaries of childhood schizophrenia from infantile psychosis, autism, organic psychoses, and borderline states, and of mapping out the condition. The factor of development as an important variable when studying diagnostic criteria and the course of the condition was singled out by many researchers. The evidence from the research on etiological factors was also reviewed, and most authors seem to agree on a nature-nurture interaction model. The different treatment modalities and approaches are also presented and discussed. Finally, a proposal is made for comparative studies to be carried out that will cover course and followup.

Infantile autism and childhood schizophrenia: review of the issues from the sociocultural point of view.

After presenting an historical overview of the development of the concept of childhood psychosis, this paper discusses the various etiologies which have been offered to explain severe disturbances of childhood. Reference is made to the nature/nurture polemic. In spite of the general belief that the etiology is biologically determined, particularly in infantile autism, the actual evidence tends to be meagre. Furthermore, the literature includes a number of studies which have been found to be methodically weak and which seem to disclaim the intellectual and socioeconomic superiority of the parents of autistic children, contrary to Kanner's original finding that such superiority exists. The link between social class and autism, according to Cantwell's review, does not appear to fit a purely biological causation of autism. This remains an awkward finding which still demands an explanation. The contention of this paper is that contradictory findings could be explained, as stated by Kanner, by the 'inordinate' use of the label 'autism' to include various types of children's severe disorders, even brain-damaged children. Furthermore this review emphasizes the fact that a total neglect of sociocultural variables in the study of such children has led to confounding results. A careful reading of the literature and correspondence with numerous psychiatrists around the world have led the author to believe that infantile autism is more prevalent in highly technological countries where there is extensive geographical and economic mobility coupled with the nuclearization of the family. This paper offers supportive evidence for this speculation.

Birth seasonality in developmentally disabled children.

26 children with diagnoses of autism and 22 children with diagnoses of childhood schizophrenia or a variant thereof were compared on the variable of winter birth. Analyses showed that autistic children had a higher proportion of winter births than schizophrenic children. These findings are related to other research linking winter birth to negative-syndrome adult schizophrenia.

[Genetic classification of clinical forms of childhood schizophrenia]. / Geneticheskaia sistematika klinicheskikh form detskoi shizofrenii.

In an analysis of 225 families of probands with different forms of the course of children's schizophrenia, a hypothesis on the degree of their genetical similarity (or dissimilarity) was tested. Malignant and slow progredient form of children schizophrenia showed major genetical similarity (correlation coefficient 1.0) with the recurrent schizophrenia occupying a separate position having no common genetical predisposition factors with nuclear forms of schizophrenia. Paroxysmal progredient schizophrenia displayed a distinct genetical relation to any other form (genetical correlation coefficient ranging in 0.5-0.7).

[Characteristics of the development of juvenile schizophrenia in view of the late catamnesis]. / Nekotorye osobennosti razvitiia iunosheskoi shizofrenii v svete otdalennogo katamneza.

By means of a clinico-follow-up method the author studied 751 schizophrenic patients with the onset of the disease in adolescence and a catamnesis more than 10 years. It was established that in 96.5% of the cases the diagnostic evaluation made in inpatient conditions was correct. A comparison of the assessment of forms in the development of schizophrenia during the first examination and during follow-up study demonstrated that in most of the cases the first determination of the form of the development on the initial stages of the disease in adolescence was justified, but the frequency of correct initial assessment of the forms of development was different in various clinical states. Despite the formed opinion concerning the prevalent unfavourable outcome of schizophrenia with the onset in adolescence, on the remote stages there was a high percentage of patients under outpatient observation (80.7%), and those working at an ordinary production (40%). In many cases (49.6%) there was a frequent alleviation of the process activity on remote stages and formation of remission.

[Neuropsychological disintegration in the early ontogenesis of children from a group at high-risk of developing endogenous mental diseases]. / Nervno-psikhicheskaia dezintegratsiia v rannem ontogeneze detei iz gruppy vysokogo riska po éndogennym psikhicheskim zabolevaniiam.

The article is devoted to the topical questions of the study of the progeny born to patients with endogenic mental diseases, the search for psychopathological, neurological and other precursors of schizophrenia and the appearance of initial psychic disturbances associated with endogenic diseases in young children. A prospective study on the neuropsychic development of children from a high risk group has made it possible to identify specific deviations in the formation of mental and motor functions, as well as in the formation of behavioural reactions, contacts, and speech. Following specific disontogenesis some children developed psychopathological phenomena which may be considered as an onset of mental diseases at the given age. Further follow-up of this group of children will make it possible to differentiate symptoms of the disease from developmental deviations. At the present stage of the investigation it is difficult to answer the question whether the detected neuropsychic disintegration in the first years of life is only an indicator of subsequent schizophrenia.

[Correlations between endogenous and exogenous factors in the development of childhood schizophrenia]. / Sootnoshenie éndogennykh i ékzogennykh faktorov v formoobrazovanii detskoi shizofrenii.

The authors have examined 225 probands with childhood schizophrenia aged 4-14 yrs and their 519 first-degree relatives; 14.8% of the relatives (13.6% parents and 21.8% sibs) suffered from schizophrenia. An attempt is made to define the contribution of the genetic and environmental factors to the development of different clinical forms of childhood schizophrenia. The age when the disease manifests appears to depend on environmental factors. In all forms of schizophrenia (excluding slow progressive schizophrenia) the progressive development of the disease is associated with the impacts of exogenous factors. In the development of slow progressive schizophrenia the genetic factors play an important role.

[Mental disorders and the characteristics of development of young children (up to 3 years of age) with a high risk of schizophrenia]. / Psikhicheskie rasstroistva i osobennosti razvitiia detei rannego vozrasta (do 3 let) iz gruppy vysokogo riska po shizofrenii.

Prospective clinico-psychopathological investigation of 50 young children born to schizophrenic parents revealed that 83% of the children had a common feature: dissociation of mental development that could be termed as a "Schizotypal diathesis" (SD). SD has 3 major course patterns: (1), regredient; (2), stable; (3), progredient. Psychopathologic signs are characteristic for only the 3rd type of SD that is indicative of the schizophrenic character of this dysontogeny. The children with 3rd and 2nd (stable with spontaneous phases) type SD patterns seem to be most vulnerable.

[Pathomorphosis of schizophrenia in children and adolescents]. / O patomorfoze shizofrenii u detei i podrostkov.

In order to study the pathomorphosis of schizophrenia in children and adolescents the authors accomplished a comparative study of 2 groups of patients, first admitted to hospitals during 1948-1952 and in 1970-1972. It was established that during the past 20 years the clinical picture of schizophrenia had undergone significant changes, related mainly to the acuity of the debut, degree of progressivity of the process, as well as to the traits of the psychopathological picture of the disease.

[Problems of clinical prognosis in endogenous diseases with predominant affective disorders in childhood]. / Voprosy klinicheskogo prognozirovaniia pri éndogennykh zabolevaniiakh s preobladaiushchimi affektivnymi rasstroistvami v detskom vozraste.

Based on a ++clinico-statistical analysis of patients (n-159) with cyclothymia and schizophrenia with predominant affective symptomatology who fell ill in childhood and were followed up for 5 to 18 years the main tendencies of the disease course and different patterns of the personality dynamics were discovered, correlating with a number of the premorbid characteristics and the structure of the first attack. The mathematic treatment using the Boolean model enabled one to obtain a prognostic model which may form the basis for the expert system to objectively evaluate, specify and accelerate the process of individual forecasting in the endogenous affective syndromes in childhood. The author provides evidence for relativity of the alternative importance of the clinical signs whose genuine prognostic weight only becomes known in diverse combinations with the other signs.

[Comparative characteristics of somatic risk factors for the development of Tourette syndrome and slowly-progressing schizophrenia in childhood]. / Sravnitel'naia kharakteristika somaticheskikh faktorov riska dlia razvitiia sindroma Turetta i maloprogredientnoi shizofrenii detskogo vozrasta.

The contribution of the environmental risk-factors has been studied in 25 children with Tourette's syndrome and 25 children with sluggish schizophrenia. It has been established that the levels of the severity of the toxicosis in pregnancy, the presence of the nephropathy, neuroinfections of the first year of life were significantly higher in the Tourette's syndrome, than in schizophrenia. Those data are not in line with the speculations about one major dominance gene transmission for the Tourette's syndrome, because genetic contributions in it and in the child schizophrenia are equal. The environmental risk-factors may morbogenic role in the development of Tourette's syndrome.

[Neuropsychological study of memory in the complex clinical, psychological and neurophysiologic examination of children with schizophrenia]. / Neiropsikhologicheskoe issledovanie pamiati v kompleksnom kliniko-psikhologo-neirofiziologicheskom izuchenii bol'nykh shizofreniei detei.

Combined clinical, psychologic and neurophysiological investigation was conducted in children with slow-progredient schizophrenia: with dominant affective disorders and hypomaniac states (Group I, 14 patients), and with predominant neurosis-like and psychopathy-like pathology (Group II, 12 patients). The patients distinctly differed in not only the clinical course of the disease but also according to neuropsychological investigations of memory, pathopsychological and EEG studies. These data are reliably intercorrelated. A high incidence of visual mnestic, marked perception disorders, and frequent focal signs of lesion of parieto-occipital cortex with cortical irritation were all characteristics of the Group I. In Group II a high inhibitability of the traces characteristic of the diencephalic-brainstem dysfunction, predominant impairment of objective-substantional thinking and the symptoms of brainstem irritation were marked.

The family role in the aetiology of schizophrenia in Iran.

The family characteristics of 100 Schizophrenic patients were compared with the family characteristics of 100 subjects recognized as normal. It was confirmed that the family disruptions amond the schizophrenics was significantly more than in the non-psychiatric group. This study could not find a family which could be specifically called as schizophrenic family, but what was found was a general defective and conflictive parent-child communication, but not a specific type of communication. Based on such findings, it was concluded that it is such dysfunction in parent-child communication which negatively affects the child's identification process, specifically when the child is going through the formative years of life. The influence of inadequate family atmosphere was also discussed in relation with few studies and it was inferred that such inappropriate family conditions are among other precipitating factors in the etiology of schizophrenia, becasue the of predisposing factors are regarded as dependent on genetic constitution.