Grandsons of alcoholics. A test of sex-linked transmission of alcohol abuse.

To test the hypothesis of a sex-linked factor influencing the occurrence of alcoholism and alcohol abuse, alcoholism or abuse rates were compared for 136 sons of the sons vs 134 sons of the daughters of 75 alcoholics. No substantial difference between the groups of grandsons was found in frequency of officially registered alcoholism or alcohol abuse, or both, which suggests no sex-linked factor is involved. The total sample was also used to calculate the risk of such registration for the grandson; the rate of registration by the grandsons' fifth decade of life was 43%, approximately three times that of the general male population, and even higher than the equivalent rate in brothers of alcoholics. This result is incompatible with an assumption of a recessive gene being involved in the occurrence of alcoholism, though it fits with the assumption of a dominant gene.

Swedish high-risk study: sample characteristics at age 6.

High-risk offspring of women with a history of nonorganic psychosis and control offspring of women with no history of psychosis were studied from the mother's pregnancy through 2 years of age and followed up at 6 years of age. The mothers tended to be older and have somewhat higher parity than did Swedish mothers in general. Sample attrition during the 6-year longitudinal period was significantly higher in the high-risk than the control sample, and selective in both groups. A limited set of early-life variables, investigated prospectively, was selected for studying the antecedents of mental disturbance in the offspring at 6 years. In the high-risk group, disturbance in the offspring was related to maternal anxiety during pregnancy, negative maternal attitude toward pregnancy, and maternal psychotic condition during the period from 6 months to 2 years post-partum, and tended to be related to low social class, male child, active maternal-mental disturbance during pregnancy, prolonged labor and low Apgar score at delivery, neonatal neurological abnormality, and anxious attachment to the mother at 1 year of age. None of these relationships (except low social class) appeared in the control group, and no significant antecedents of mental disturbance in control offspring were found among the limited set of variables studied in these analyses.

Development of a screening method for probable somatizing syndromes.

"Somatizing syndromes" is proposed to describe all conditions in which patients present with somatic complaints but without signs of organic disease. Fifty consecutive G.P. patients were given a Swedish version of the 52-item Illness Behaviour Questionnaire (IBQ) to test whether this questionnaire identifies those with signs of somatizing syndromes. The patients were also independently categorized by the G.P. into seven clinical groups reflecting the presence or absence of somatic disease, social/psychological problems and various combinations thereof. The test-retest reliability of the IBQ expressed as Pearson's r was 0.89. Patients presenting with concern over non-existing somatic disease and apparently unaware of any related psychological problem had significantly higher mean IBQ scores than did other patients. The IBQ was thus found to be a satisfactory instrument for primary identification of patients with probable somatizing syndromes.

Etiological relevance of comparisons of high-risk and low-risk groups.

The prospective study of groups at high risk for pathology is viewed as an increasingly important strategy in research on the etiology and possible prevention of a wide range of disorders. Yet, relatively little attention has been paid to proper and improper etiological interpretations of results based on studies of such groups. The comparison of groups at high risk and low risk for pathology, prior to the development of relevant disturbances in the subjects, cannot provide evidence that a given factor or a characteristic of the groups does or does not contribute to the etiology of the disturbances which will develop in the subjects. For the data to become etiologically relevant, they must be studied as possible antecedents to disturbances identified by following up the subjects. On the other hand, comparisons of high-risk versus low-risk groups are most appropriately interpreted as reflecting the characteristics, correlates and/or consequences of the risk criterion, and such comparisons may thus contribute to better understanding of the true meaning and ramifications of the risk criterion. Considerable caution must be exercised both by high-risk researchers and by observers of high-risk studies in interpreting the significance of results of these studies.

Length of interbirth intervals in female psychiatric patients and controls.

Length of 121 interbirth intervals for 77 multiparous female psychiatric patients was contrasted with the length of 605 interbirth intervals for 385 matched population-control women to test a clinical observation that female psychiatric patients often have long intervals between consecutive reproductions. No significant difference was found between all patients versus all controls or between any patient diagnostic group versus controls in studying the length of only those intervals including or subsequent to the first psychiatric hospitalization. Intervals during which this hospitalization occurred were significantly longer for all patients combined, for schizophrenic-like-psychotics, and for psychopaths, each as compared with its parity-matched control group. The clinical observation was not generally supported by the current data.

Pregnant women with nonorganic psychosis: life situation and experience of pregnancy.

Eighty-eight index women with a history of nonorganic psychosis and 104 demographically similar control women were interviewed during pregnancy after quickening concerning their experience of pregnancy and their current life situation. The index group, compared with controls, reported a significantly increased frequency of material-situational problems, interpersonal difficulties and a lack of support for the pregnancy among the spouse and the woman's parents, an initially unplanned and undesired pregnancy, a negative attitude toward the pregnancy after quickening, moderate-to-heavy smoking, nervousness and anxiety, panic about the delivery, and great concern about their own mental health in the near future. No significant difference between groups was found on frequency of typical pregnancy symptoms, the experienced effect of pregnancy on physical health or concerns about the child's health or mothering.

Birthrates of schizophrenics following relatively warm versus relatively cool summers.

Schizophrenics have consistently been found to be born with unusually high frequency in the early months of the calendar year. A previous study found significantly more schizophrenics to be born following warmer as contrasted with cooler summers, thus suggesting that summer temperature or a correlate of summer temperature may be an effective factor in the season of birth schizophrenia relationship. The current study re-tested the warmer vs. cooler summer finding, using both a local sample (N = 301) and a nationwide sample of Swedish schizophrenics (N = 13,440), each sample showing increased frequency of births in the early months of the year. In order to localize the possible effects of temperature to a more specific gestational period, the schizophrenics in each sample were further divided into sub-groups based upon which trimester of gestation likely occurred during the summer prior to the birth. The 71 years (1876-1946) during which the patients were born rank-ordered by mean summer temperature at representative geographical locations, and the rank-orders of years were divided into temperature quartiles. The rates of births for the total patient groups and the trimester sub-groups among both samples showed no positive linear or systematic relationship to temperature during the previous summer. Even the warmest among the 71 years were not followed by increased rates of births of schizophrenics. The results of the study did not corroborate the earlier finding.

Season of birth among siblings of schizophrenics. A test of the parental conception habits interpretation.

Many studies have shown schizophrenics to be born with unusual frequency in the period January-April, and one interpretation of this seasonality of birth is that the parents of schizophrenics have an unusually strong general tendency to conceive offspring who will be born in January-April. This parental conception habits interpretation may be tested by studying whether the siblings of schizophrenics are also born with increased frequency in January-April. The present study investigated the season of birth of 288 full siblings and 44 half-siblings in 91 families of male schizophrenics. Approximately 5% of the siblings were known to be schizophrenic; with the schizophrenic siblings excluded from the analyses, the full siblings showed a birth pattern much closer (nonsignificant) to that of the schizophrenics than to that of the general population. Half-siblings showed January-April birth rates at or below the population level. Although the mechanisms responsible for the current results still remain unclear, the study suggests that seasonality of births of schizophrenics may be related to the parents' conception habits as well as to an etiological or triggering effect on the development of schizophrenia in the offspring.

Women with nonorganic psychosis: factors associated with pregnancy's effect on mental health.

Pregnancy's effect on mental health during pregnancy was studied in relation to 17 variables representing the pregnant woman's demographic, social, material, physical and attitudinal characteristics, in an attempt to explain the highly varied effect of pregnancy on mental health which had been observed both among 88 index women with a history of nonorganic psychosis and among 104 demographically similar pregnant control women. Little explanation or predictability was found for the varied effect of pregnancy. Among index cases, only maternal age and the experienced effect of pregnancy on physical health were significantly related to its effect on mental health. In controls, the presence of material-situational problems and a negative/ambivalent initial reaction to pregnancy were each related to increased change in mental health, i.e. to both improvement and worsening in mental health associated with pregnancy.

Women with nonorganic psychosis: mental disturbance during pregnancy.

Rates of mental disturbance during pregnancy were studied in 88 index women with a history of nonorganic psychosis and 104 demographically similar control women. The sources of information were the woman's own report at interview during pregnancy, the interviewer's assessment and, for index cases, psychiatric record notations relevant to the pregnancy period. Highly significantly increased rates of active mental disturbance were identified for index women, as compared with controls, based both on the woman's own report and on the interviewer's assessment. Most disturbed were women with a history of Schizophrenia, Cycloid, Postpartum and Other Psychoses, and only those index women with a history of Affective Illness did not differ from controls. Only one third of the index cases were in contact with a psychiatrist during pregnancy, and high rates of active mental disturbance were identified at interview even in those index women without psychiatric contact.