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PubMed1996

Penetrance of schizophrenia-related disorders in multiplex families after correction for ascertainment.

Penetrance of schizophrenia and related disorders was calculated in 27 multiplex pedigrees ascertained by a consistent set of screening and selection criteria. The rationale for the study was that single major locus linkage models are frequently used on a pragmatic basis to analyze data for schizophrenia which is most likely to have a polygenic mechanism. Penetrance estimates assuming Mendelian inheritance represent maximum values and thus can provide guidance for construction of appropriate linkage models. Four diagnostic models were considered: narrow (schizophrenia and chronic schizoaffective disorder), intermediate (including other non-affective psychoses), broad (including schizotypal and paranoid personality disorders), and broad + suspected (including suspected schizophrenia spectrum disorders). Penetrance was calculated in the youngest affected adult sibship, under both dominant and recessive inheritance assumptions, either without correction, or with a correction that excluded individuals necessary to meet pedigree selection criteria. Without correction, penetrance values ranged from 0.70 to 0.90 assuming dominant and 1.0 to > 1.0 assuming recessive inheritance. After correction, the ranges were 0.30-0.51 for dominant and 0.47-0.59 for recessive models. The corrected values are likely to be overestimates given that the penetrance of any one locus in a multilocus model must be lower. It is suggested that lod score analyses of schizophrenia should attempt to derive information primarily from affected diagnoses, because information derived from unaffecteds under high penetrance models is likely to be spurious.

Adult↗
PubMed1983

Personality types of alcoholics on objective inventories. A review.

The personality profiles of alcoholics as derived from four objective inventories--the Minnesota Multiphasic Personality Inventory, the Sixteen Personality Factor Questionnaire, the Personality Research Form and the Differential Personality Inventory--are reviewed. An overall consistency of results is seen which interfaces with known clinical entities from other areas of mental health research.

Adjustment Disorders↗
PubMed1978

[Results of long-term catamnesis of neurotic and psychopathic states and assessment of the prognosis].

The results of long-term follow-up studies indicate the existence of significant differences in the outcome of neurotic and psychopathic states. The most unfavorable outcome was seen in patients with asthenic and unstable psychopathy. A classification of a "good" and "poor" outcome of the disease by means of a computer permitted to distinguish the most significant anamnestic and clinical signs indicating a possible unfavorable prognosis. In the most unfavorable variant of the disease (21% of 124 psychopathic patients) in asthenic, unstable, excitative and hysterical psychopathy there were states with prevalently neurotic and psychopathic symptomatology, nonspecific for any of the above-mentioned forms of psychopathy.

Adjustment Disorders↗
PubMed1990

Treatment outlines for paranoid, schizotypal and schizoid personality disorders. The Quality Assurance Project.

Treatment outlines for paranoid, schizotypal and schizoid personality disorders were developed by having nominated experts consider their own views in the light of the treatment literature and the responses of practising psychiatrists. In the detailed recommendations it is clear that while patients with all three disorders often present for treatment in a crisis and often see no issue other than the resolution of the crisis, patients with schizoid personality disorder can use long-term psychotherapy to develop and change to the extent of no longer being handicapped.

Adult↗
PubMed1985

[Comparative study of abnormal self-consciousness in mental disorders].

The state of awareness was studied over time in 449 patients with various forms of mental diseases: borderline, endogenic and organic psychoses, delirium tremens and chronic alcoholism. The clinical and psychopathological examinations of patients were supplemented with a number of new and modified methods of research into awareness whose description is given in the paper. It is established that the study into the pathology of awareness expands considerably the clinical examination of patients and contributes to the development of the optimal therapeutic and restorative measures.

Alcohol Withdrawal Delirium↗
PubMed2002

The neurotic versus delusional subtype of taijin-kyofu-sho: their DSM diagnoses.

The main purpose of the present study was to investigate the diagnostic concepts of taijin-kyofu-sho (TKS) and social phobia, by comparing the clinical diagnosis of TKS and the operational diagnosis of Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; DSM-III-R). Three evaluators conducted semistructured interview for DSM-III-R (SCID axis I and II, the Japanese version) to 88 outpatients who visited Jikei University Daisan Hospital, Japan, over a period of 1 year, requesting Morita therapy. The patients were also independently diagnosed by three psychiatrists to identify TKS. A total of 65.8% of 38 cases of TKS were diagnosed as social phobia. Among the neurotic TKS cases, the percentage was high at 81.5%, while among the delusional TKS cases it was 27.3%. A total of 42.1% of the TKS cases were diagnosed as mood disorder; 60.5% of the TKS cases presented some axis II disorders, among which avoidant personality disorder was the most prevalent (31.6%). There was no significant difference between the neurotic and delusional subtypes of TKS, regarding comorbidity with axis I diagnoses. As for axis II diagnoses, delusional TKS patients had a higher rate of comorbidity with paranoid personality disorder, although they demonstrated very similar trends in comorbidity with all other personality disorders. In the diagnostic system of DSM-III-R, it is highly likely that the neurotic and delusional subtypes of TKS will be seen to correspond to different diagnostic categories.

Adult↗
PubMed1986

[Psychogenic pathologic personality development in advanced age].

A study of 51 patients with psychogenic abnormalities developed in old age has shown that the development of such disorders is a comparatively frequent outcome of neuroses and reactive psychoses with the onset in the presenile period and only as an exception takes place in patients with the onset of psychogenic disturbances in old age. Depressive development has proved most typical for advanced age. Such manifestations as chronic subdepression, diffuse hypochondria, egocentrism and rent orientations are universal for all clinical variants of senile pathological development of personality. According to a regression analysis the development of psychogenic disturbances in the second half of life is facilitated by the objective significance and persistence of traumatic situations, a low professional level of patients and a number of other socio-psychological and biological characteristics of the person.

Age Factors↗
PubMed1996

Frontal lobe dementia presenting as personality disorder.

The early differential diagnosis of frontal lobe dementia is particularly difficult because changes of personality or behaviour overwhelm intellectual and cognitive impairments. We report the case of a patient presenting with paranoid personality disorder who refused to collaborate in neuropsychological testing. Initial functional imaging showed frontal hypometabolism that served as an early marker of frontal lobe dysfunction.

Brain↗
PubMed1985

Hearing and premorbid personality in paranoid states.

The author studied the hearing and premorbid personality of 79 patients whose illnesses began before they were 60 years old. Hearing was assessed by pure-tone audiometry and premorbid personality by interviewing relatives. Thirty-two patients had paranoid states, 32 matched patients had recurrent unipolar depression, and 15 patients had schizophrenia. Three paranoid patients and two depressed patients met DSM-III criteria for premorbid paranoid personality. There was no consistent difference in hearing loss between paranoid and depressed patients or between paranoid patients and a population control group. The author concludes that premorbid paranoid personality and hearing loss are not associated with paranoid states in middle age.

Audiometry, Pure-Tone↗
PubMed1998

Spontaneous dyskinesia in subjects with schizophrenia spectrum personality.

OBJECTIVE: The study of spontaneous dyskinesia in schizophrenia is confounded by the widespread use of neuroleptics. The authors hypothesized that spontaneous dyskinesia would be present in subjects with schizophrenia spectrum personality (schizoid, paranoid, or schizotypal). They also tested the hypothesis that dyskinetic-like movements would increase after repeated dextroamphetamine challenge to the dopaminergic system. METHOD: Dyskinetic-like movements were assessed in 34 spectrum subjects and 22 normal subjects; nine subjects from each group were administered both placebo and repeated dextroamphetamine challenges. RESULTS: Spectrum subjects had more dyskinetic-like movements than normal subjects. Spontaneous dyskinesia was present in 12% of the spectrum subjects but was not seen in the normal subjects. Subjects with schizotypal personality had more dyskinetic-like movements than subjects with schizoid personality or normal subjects. Dyskinesia was present in 24% of the schizotypal subjects but not in the other groups. Dyskinetic movement scores correlated with positive symptom scores. With repeated amphetamine challenge, normal subjects showed a pattern of behavioral sensitization (an increase in dyskinetic-like movements), but spectrum subjects showed an abnormal response (fewer dyskinetic-like movements). CONCLUSIONS: Dyskinesia and dyskinetic-like movements are more common in subjects with schizophrenia spectrum personality (primarily schizotypal) than in normal subjects and are related to positive symptoms. A failure of normal behavioral sensitization mechanisms after dextroamphetamine challenge is seen in subjects with schizophrenia spectrum personality.

Comorbidity↗
PubMed1987

Relationship of HLA to schizophrenia in 10 nuclear families.

We tested the hypothesis of linkage of HLA (human leukocyte antigens) and schizophrenia in 10 nuclear families that were ascertained on the basis of at least two siblings affected with chronic schizophrenia (SCH), as defined by Research Diagnostic Criteria, with or without superimposed affective disorder. All available parents and siblings were interviewed and typed for HLA antigens at the A, B, C, and Dr loci. Lod scores for linkage between HLA and a putative SCH-locus were calculated using the program LIPED, assuming several possible models for the mode of transmission of the SCH locus. Linkage was also tested with DSM-III schizotypal and paranoid personality disorders considered as part of the illness phenotype. The lod score analysis indicated that for most models of inheritance of schizophrenia, close linkage to HLA could be excluded. The results did not change if individuals with "spectrum" disorders were considered affected. We also tested for linkage using the affected sib-pair method which does not require any assumptions about the mode of transmission of the illness. The results of this analysis also indicated that linkage to HLA was very unlikely. If our results are considered together with other published studies, a susceptibility locus for schizophrenia or "schizophrenia spectrum" is not likely to be in the HLA region of chromosome 6.

Chromosome Mapping↗
PubMed1983

Psychiatric syndromes in Huntington's disease.

Thirty patients with Huntington's disease, a genetically transmitted neuropsychiatric disorder that can be diagnosed reliably, were evaluated systematically for psychopathology, followed for extended periods, and treated with psychopharmacological medications when necessary. DSM-III criteria were used for establishing syndromic diagnoses. Twenty-four individuals demonstrated substantial behavioral abnormalities, including affective and schizophrenic syndromes, changes of personality, and disorders that could not be classified adequately. Pharmacotherapy was modestly beneficial in some cases. Consideration of the array of behavioral disturbances encountered in this pathogenetically unified disorder suggests that a dimensional approach to symptom classification might prove more useful heuristically than present typological methods.

Adult↗