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.

A hipótese que a esquizofrenia envolve comunicação inter-hemisférica aberrante possui longa tradição, entretanto seu papel permanece incerto. Nós relatamos um caso de agenesia total do corpo caloso em um homem de 21 anos portador de esquizofrenia de início na infância. A associação de esquizofrenia de início precoce na ausência de corpo caloso oferece uma oportunidade para exame do modelo neurodesenvolvimental e de teorias que envolvem a comunicação interemisférica na patogênese da psicose.

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.

The association between obstetric complications and childhood-onset schizophrenia: a replication study.

BACKGROUND: Many previous studies have shown that individuals who develop schizophrenia in adult life are more likely than normal controls to have a history of obstetric complications (OCs) at birth. However, little attention has been paid to the involvement of OCs in the risk of developing childhood-onset schizophrenia (COS). In our earlier report, we found an association between OCs and the development of COS. In this study, we determined whether the association could be replicated in another, independent set of patients with COS. METHODS: OCs, birth weight and gestational age were retrospectively assessed in 35 children, aged between 14 and 15 years old (average 15.4 years), who met the DSM-III-R criteria for schizophrenia, and in age- and gender-matched controls (children with anxiety disorders). RESULTS: The COS patients showed significantly greater scores in all of the three measures of OCs according to the Parnas et al. scale compared to controls. Moreover, individuals exposed to OCs were about 3.2 times (odds ratio = 3.22; 95% confidence interval, 1.1-9.8) more likely to develop schizophrenia than those without a history of OCs. The mean birth weight was significantly lower in schizophrenics than in controls (P < 005). The frequency of prematurity signs with weight < 2500 g was significantly higher in schizophrenics than in controls (P < 0.05). CONCLUSION: Repeatedly reported association between OCs and adult-onset schizophrenia have also been demonstrated in patients with COS. This suggests that there may be a continuity between childhood- and adult-onset schizophrenia.

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.

Mental disorders in children and adolescents with sickle cell disease.

This study compares the rate of mental disorders in children and adolescents with sickle cell disease with the rate in a corresponding control population. Using the clinical interview, a diagnosis based on DSM-III-R criteria for the presence of 13 mental disorders common to childhood was considered in a sequential sample of 39 subjects with sickle cell disease and a convenience sample of 26 same-race control subjects. Thirty-one percent of the sickle cell group and 42% of the control group screened positive for one or more of the selected mental disorders. The difference was not significant. When subgroups of mental disorders were considered (anxiety disorders, depressive disorders, disruptive behavior disorders, psychotic disorders, and other selected disorders), the differences were still not significant. This study suggests that children and adolescents with sickle cell disease do not have a greater risk for clinically significant mental disorders than same-race outpatient clinic controls. This study supports other reports in the medical literature that suggest that children attending outpatient medical clinics are at a higher risk for mental disorder than is seen in epidemiologic studies of nonmedical populations.

[Depressive states at an early age]. / Depressivnye sostoianiia v rannem vozraste.

100 children of 1-3 years old were observed. In 50 of them depressive states developed in conditions of total deprivation--the situation of orphanhood. In other 50 children the depressions were caused by partial deprivation--upbringing by schizophrenic mother (children from group with high risk of schizophrenia). Three variations of depression were found in the first group: autonomic, somatizated, and regressive-apathetic. Depressions in the second group were presented either by infantile depression or by infantile distress-syndrome in frames of schizotypic diathesis.

The neurodevelopmental theory of schizophrenia: evidence concerning structure and neuropsychology.

Severe schizophrenics as a group show subtle abnormalities of cerebral structure. Cerebral ventricular enlargement is the best replicated finding, and this tends to be associated with impairment of neuropsychological performance. The idea that these abnormalities have a neurodevelopmental origin gains indirect support from the, admittedly less consistent, evidence of abnormalities of cerebral asymmetry and of neuronal migration in adult schizophrenics, as well as from the better established behavioural, psychomotor, and cognitive impairments reported in preschizophrenic children. However, the relationship between childhood and adult neuropsychological and brain structural findings has not been proven, and we don not know whether only some schizophrenia has a developmental origin, or whether patients differ only in the degree of developmental impairment that they show.

Psicoses desintegrativas / Desintegrative psychoses

As psicoses desintegrativas foram incluídas na CID-9, como sinônimo de síndrome de Hedler, e assim permaneceu na CID. Foram descritas como psicoses que apareceriam após cerca de 2 anos de desenvolvimento normal. Apresentariam uma regressäo em poucos meses, tornando-se, as crianças, retardadas, autistas, hiperativas, com padröes estereotipados de respiraçäo, estereotipias manuais e marcha atáxica. Essa síndrome, no entanto, pode ocorrer nas mais variadas condiçöes clínicas. Estudando atentamente as psicoses desintegrativas, iremos ver que elas se superpöem, perfeitamente, à síndrome psicorgânica de Eugen Bleutler, näo sendo clinicamente correto, pois, considerá-las apenas como psicoses infantis, pois podem ocorrer em indivíduos de qualquer faixa etária

[Motor disorders and their correction in children from a high-risk group for the development of schizophrenia at an early age]. / Dvigatel'nye narusheniia i ikh korrektsiia u detei iz gruppy vysokogo riska po razvitiiu shizofrenii v rannem vozraste.

A 7-year study of locomotor function in 103 children born in the families where one of the parents suffered from schizophrenia has found no locomotor abnormalities only in 20% cases. The rest of them had: disorders of the general locomotor activity, disorders of the static and locomotor development, symptoms of extrapyramidal and cerebral regulation dysfunctions, changes of the muscle tone, ataxia, pathologic locomotor phenomena, speech disorders. The severity of the above disturbances and their variability correlated with the child's general and mental development. Attempts of relevant locomotor correction including massage provided good results.

[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.

[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.

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.

[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.

[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).

[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.