Reducing the "revolving door" phenomenon.
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Biomedical subjects
Publications and source records attributed to A Calzeroni.
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Although the excess of schizophrenic births in the winter and early spring has been replicated and some non-conclusive work supports the same seasonal birth trend in patients with major affective disorders, the aetiopathogenetic foundations of this phenomenon remain uncertain. The primary role of perinatal seasonal factors that predispose to the development of schizophrenia via induction of brain damage has been invoked, as has a tendency for patients to conceive during the spring and early summer. In order to test these two hypotheses, cerebral ventricular size and cortical atrophy in 206 schizophrenics and 107 patients with major affective disorders were assessed by CT and analysed in relation to month of birth. Compared with schizophrenics born during the remainder of the year, those born between December and April, particularly in cases lacking a family history of schizophrenia, showed increased chances for ventricular enlargement, but not for cortical atrophy. No association between season of birth and central or cortical atrophy was found for patients with major affective disorders. This suggests that the brain-damaging effect played by perinatal seasonal factors has both a disease and an anatomical specificity.
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The celibacy and fertility rates of 186 patients with major affective disorders were analysed as a function of the presence or absence of histories of mood congruent delusions or suicidal behaviour in the depressive phases of the disease. Both delusional and suicidal histories were irrelevant to celibacy rates. On the contrary, delusional depressives had a reduced incidence of cases with 2 or more children and suicide attempters had both a lower frequency of high-fertility cases and a smaller mean number of children than nonattempters. The differences were apparently not attributable to the length of the fertile period of life spent in illness.
The degree of cortical atrophy as revealed by computed tomographic scans was assessed in 124 patients meeting the DSM III criteria for schizophrenia and in 45 age- and sex-matched healthy controls. 21 patients, i.e., 33% of the entire sample, showed moderate to severe atrophy. The presence of atrophy was not associated with such variables as patients' age, age at onset and duration of illness, diagnostic subtype of schizophrenia, family history of schizophrenia in first degree relatives, history of suicidal behavior, I.Q., employment status, clinical outcome on neuroleptic treatment and HLA antigens distribution. The only variables found to be associated with atrophy were: male sex and cerebral ventricular enlargement. The significance of the CT finding of cortical atrophy in schizophrenia is discussed in the light of these results.