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Schizophrenia Subdivided by the Family History of Affective Disorder: A Comparison of Symptomatology and Course of Illness

Schizophrenia Subdivided by the Family History of Affective Disorder: A Comparison of... Abstract • Schizophrenics meeting DSM-III criteria were divided, based on family history of affective disorder in first-degree relatives, into three groups: N-schizophrenics, no relative with affective disorder; U-schizophrenics, a relative with unipolar affective disorder; and B-schizophrenics, a relative with dipolar affective disorder. Although N- and U-schizophrenics displayed similar symptoms during the prodromal, actively psychotic, and remitted stages of their illness, U-schizophrenics were significantly more likely to have a depressive syndrome develop during the follow-up period. Compared with N-schizophrenics, B-schizophrenics were more depressed during the prodrome, were more elated and catatonic when actively psychotic, had fewer residual symptoms when remitted, and were much more likely to have a manic syndrome develop during the follow-up period. Even when DSM-III criteria are met, hesitation is indicated in diagnosing schizophrenia in patients with a first-degree relative with bipolar illness. References 1. Kraepelin E: Dementia Praecox and Paraphrenia . Barclay RM (trans). New York, Krieger Publishing Co, 1919. 2. Kraepelin E: Manic-Depressive Insanity and Paranoia , Barclay RM (trans). New York, Arno Press Inc, 1921. 3. Serbski V: On the question of dementia praecox . J Ment Pathol 1902;2:175-182. 4. Kendell RE, Gourlay J: The clinical distinction between affective psychoses and schizophrenia . Br J Psychiatry 1970;117:261-266. 5. Ollerenshaw DP: The classification of the functional psychoses . Br J Psychiatry 1973;122:517-530.Crossref 6. Pope HG, Lipinski JF: Diagnosis in schizophrenia and manic-depressive illness: A reassessment of the specificity of'schizophrenic' symptoms in the light of current research . Arch Gen Psychiatry 1978;35:811-828.Crossref 7. Weinberg I, Lobstein J: Inheritance in schizophrenia . Acta Psychiatr Neurol Scand 1943;18:93-140.Crossref 8. Sjogren T: Genetic-statistical and psychiatric investigations of a westSwedish population . Acta Psychiatr Scand Suppl 1948;52:1-102. 9. Tsuang MT, Winokur G, Crowe RR: Morbidity risks of schizophrenia and affective disorders among first-degree relatives of patients with schizophrenia, mania, depression and surgical conditions . Br J Psychiatry 1980;137:497-504.Crossref 10. Loranger AW: Genetic independence of manic-depression and schizophrenia . Acta Psychiatr Scand 1981;63:444-452.Crossref 11. Kety SS, Rosenthal D, Wender PH, et al: Mental illness in the biological and adoptive families of adopted individuals who have become schizophrenic: A preliminary report based on psychiatric interview , in Fieve R, Rosenthal D, Brill H (eds): Genetic Research in Psychiatry . Baltimore, Johns Hopkins Press, 1975, pp 147-165. 12. Kendler KS, Gruenberg AM, Strauss JS: An independent analysis of the Copenhagen sample of the Danish adoption study of schizophrenia: IV. The relationship between major depressive disorder and schizophrenia . Arch Gen Psychiatry 1982;39:639-642.Crossref 13. Stenstedt A: A study in manic-depressive psychosis: Clinical, social and genetic investigations . Acta Psychiatr Scand Suppl 1952;79:1-111. 14. Reed SC, Hartley C, Anderson VE, et al: The Psychoses: Family Studies . Philadelphia, WB Saunders Co, 1973. 15. Smeraldi E, Negri F, Melica AM: A genetic study of affective disorders . Acta Psychiatr Scand 1977;56:382-398.Crossref 16. Perris C: A study of bipolar and unipolar recurrent depressive psychoses: I. Genetic investigations . Acta Psychiatr Scand Suppl 1966; 194:15-44.Crossref 17. Slater E: Psychotic and Neurotic Illnesses in Twins. London, Her Majesty's Stationery Office, 1953. 18. Lewis N, Piotrowski Z: Clinical diagnosis of manic-depressive psychosis , in Hoch PM, Zubin J (eds): Depression . New York, Grune & Stratton Inc, 1954. 19. Ziskind E, Somerfeld E, Jens R: Can schizophrenia change to affective psychosis? Am J Psychiatry 1971;128:331-335. 20. Sheldrick C, Jablensky A, Sartorious N, et al: Schizophrenia succeeded by affective illness: Catamnestic study and statistical enquiry . Psychol Med 1977;7:619-624.Crossref 21. Tsuang MT, Woolson RF, Winokur G, et al: Stability of psychiatric diagnosis: Schizophrenia and affective disorders followed up over a 30- to 40-year period . Arch Gen Psychiatry 1981;38:535-539.Crossref 22. Horgan D: Change of diagnosis to manic-depressive illness . Psychol Med 1981;11:517-523.Crossref 23. Hays P: Taxonomic map of the schizophrenia, with special reference to the puerperal psychosis . Br Med J 1978;2:755-757.Crossref 24. Curran D, Partridge M, Storey P: Psychological Medicine . New York, Churchill Livingstone, 1976. 25. Stern MJ, Pillsbury JA, Sonnenberg SM: Postpsychotic depression in schizophrenics . Compr Psychiatry 1972;13:519-598.Crossref 26. McGlashan TH, Carpenter WT: Postpsychotic depression in schizophrenia . Arch Gen Psychiatry 1976;33:231-239.Crossref 27. Hays P: Electroencephalographic variants and genetic predisposition to schizophrenia . J Neurol Neurosurg Psychiatry 1977;40:753-755.Crossref 28. Kendler KS, Hays P: Paranoid psychosis (delusional disorder) and schizophrenia: A family history study . Arch Gen Psychiatry 1981;38:547-551.Crossref 29. Kendler KS, Hays P: Schizophrenia with premorbid inferiority feelings: A distinct subgroup? Arch Gen Psychiatry 1982;39:643-647.Crossref 30. Kendler KS, Hays P: Familial and sporadic schizophrenia: A symptomatic, prognostic and electroencephalographic comparison . Am J Psychiatry 1982;139:1557-1562. 31. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 32. Cammilli G, Hopkins KD: Applicability of chi-square to 2 × 2 contingency tables with small expected cell frequencies . Psychol Bull 1978;85:163-167.Crossref 33. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co, 1956, pp 116-127. 34. Ballenger JC, Reus VI, Post RM: The 'atypical' clinical picture of adolescent mania . Am J Psychiatry 1982;139:602-606. 35. Taylor MA, Abrams R: Catatonia: Prevalence and importance in the manic phase of manic-depressive illness . Arch Gen Psychiatry 1977;34:1223-1225.Crossref 36. LeffJ: International variations in the diagnosis of psychiatric illness . Br J Psychiatry 1977;131:329-338.Crossref 37. Carlson GA, Goodwin FK: The stages of mania: A longitudinal analysis of the manic episode . Arch Gen Psychiatry 1973;28:221-228.Crossref 38. Galdi J, Rieder RO, Silber D, et al: Genetic factors in the response to neuroleptics in schizophrenia: A psychopharmacogenetic study . Psychol Med 1981;11:713-728.Crossref 39. Baron M, Gruen R, Asnis L, et al: Schizoaffective illness, schizophrenia and affective disorders: Morbidity risk and genetic transmission . Acta Psychiatr Scand 1982;65:253-262.Crossref 40. Fowler RC, Tsuang MT, Cadoret RJ, et al: A clinical and family comparison of paranoid and non-paranoid schizophrenics . Br J Psychiatry 1974;124:346-351.Crossref 41. Andreasen NC, Endicott J, Spitzer RL, et al: The family history method using diagnostic criteria: Reliability and validity . Arch Gen Psychiatry 1977;34:1229-1235.Crossref 42. Thompson WD, Orvaschel H, Prusoff BA, et al: An evaluation of the family history method for ascertaining psychiatric disorders . Arch Gen Psychiatry 1982;39:53-58.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Schizophrenia Subdivided by the Family History of Affective Disorder: A Comparison of Symptomatology and Course of Illness

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American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1983.01790080033004
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Abstract

Abstract • Schizophrenics meeting DSM-III criteria were divided, based on family history of affective disorder in first-degree relatives, into three groups: N-schizophrenics, no relative with affective disorder; U-schizophrenics, a relative with unipolar affective disorder; and B-schizophrenics, a relative with dipolar affective disorder. Although N- and U-schizophrenics displayed similar symptoms during the prodromal, actively psychotic, and remitted stages of their illness, U-schizophrenics were significantly more likely to have a depressive syndrome develop during the follow-up period. Compared with N-schizophrenics, B-schizophrenics were more depressed during the prodrome, were more elated and catatonic when actively psychotic, had fewer residual symptoms when remitted, and were much more likely to have a manic syndrome develop during the follow-up period. Even when DSM-III criteria are met, hesitation is indicated in diagnosing schizophrenia in patients with a first-degree relative with bipolar illness. References 1. Kraepelin E: Dementia Praecox and Paraphrenia . Barclay RM (trans). New York, Krieger Publishing Co, 1919. 2. Kraepelin E: Manic-Depressive Insanity and Paranoia , Barclay RM (trans). New York, Arno Press Inc, 1921. 3. Serbski V: On the question of dementia praecox . J Ment Pathol 1902;2:175-182. 4. Kendell RE, Gourlay J: The clinical distinction between affective psychoses and schizophrenia . Br J Psychiatry 1970;117:261-266. 5. Ollerenshaw DP: The classification of the functional psychoses . Br J Psychiatry 1973;122:517-530.Crossref 6. Pope HG, Lipinski JF: Diagnosis in schizophrenia and manic-depressive illness: A reassessment of the specificity of'schizophrenic' symptoms in the light of current research . Arch Gen Psychiatry 1978;35:811-828.Crossref 7. Weinberg I, Lobstein J: Inheritance in schizophrenia . Acta Psychiatr Neurol Scand 1943;18:93-140.Crossref 8. Sjogren T: Genetic-statistical and psychiatric investigations of a westSwedish population . Acta Psychiatr Scand Suppl 1948;52:1-102. 9. Tsuang MT, Winokur G, Crowe RR: Morbidity risks of schizophrenia and affective disorders among first-degree relatives of patients with schizophrenia, mania, depression and surgical conditions . Br J Psychiatry 1980;137:497-504.Crossref 10. Loranger AW: Genetic independence of manic-depression and schizophrenia . Acta Psychiatr Scand 1981;63:444-452.Crossref 11. Kety SS, Rosenthal D, Wender PH, et al: Mental illness in the biological and adoptive families of adopted individuals who have become schizophrenic: A preliminary report based on psychiatric interview , in Fieve R, Rosenthal D, Brill H (eds): Genetic Research in Psychiatry . Baltimore, Johns Hopkins Press, 1975, pp 147-165. 12. Kendler KS, Gruenberg AM, Strauss JS: An independent analysis of the Copenhagen sample of the Danish adoption study of schizophrenia: IV. The relationship between major depressive disorder and schizophrenia . Arch Gen Psychiatry 1982;39:639-642.Crossref 13. Stenstedt A: A study in manic-depressive psychosis: Clinical, social and genetic investigations . Acta Psychiatr Scand Suppl 1952;79:1-111. 14. Reed SC, Hartley C, Anderson VE, et al: The Psychoses: Family Studies . Philadelphia, WB Saunders Co, 1973. 15. Smeraldi E, Negri F, Melica AM: A genetic study of affective disorders . Acta Psychiatr Scand 1977;56:382-398.Crossref 16. Perris C: A study of bipolar and unipolar recurrent depressive psychoses: I. Genetic investigations . Acta Psychiatr Scand Suppl 1966; 194:15-44.Crossref 17. Slater E: Psychotic and Neurotic Illnesses in Twins. London, Her Majesty's Stationery Office, 1953. 18. Lewis N, Piotrowski Z: Clinical diagnosis of manic-depressive psychosis , in Hoch PM, Zubin J (eds): Depression . New York, Grune & Stratton Inc, 1954. 19. Ziskind E, Somerfeld E, Jens R: Can schizophrenia change to affective psychosis? Am J Psychiatry 1971;128:331-335. 20. Sheldrick C, Jablensky A, Sartorious N, et al: Schizophrenia succeeded by affective illness: Catamnestic study and statistical enquiry . Psychol Med 1977;7:619-624.Crossref 21. Tsuang MT, Woolson RF, Winokur G, et al: Stability of psychiatric diagnosis: Schizophrenia and affective disorders followed up over a 30- to 40-year period . Arch Gen Psychiatry 1981;38:535-539.Crossref 22. Horgan D: Change of diagnosis to manic-depressive illness . Psychol Med 1981;11:517-523.Crossref 23. Hays P: Taxonomic map of the schizophrenia, with special reference to the puerperal psychosis . Br Med J 1978;2:755-757.Crossref 24. Curran D, Partridge M, Storey P: Psychological Medicine . New York, Churchill Livingstone, 1976. 25. Stern MJ, Pillsbury JA, Sonnenberg SM: Postpsychotic depression in schizophrenics . Compr Psychiatry 1972;13:519-598.Crossref 26. McGlashan TH, Carpenter WT: Postpsychotic depression in schizophrenia . Arch Gen Psychiatry 1976;33:231-239.Crossref 27. Hays P: Electroencephalographic variants and genetic predisposition to schizophrenia . J Neurol Neurosurg Psychiatry 1977;40:753-755.Crossref 28. Kendler KS, Hays P: Paranoid psychosis (delusional disorder) and schizophrenia: A family history study . Arch Gen Psychiatry 1981;38:547-551.Crossref 29. Kendler KS, Hays P: Schizophrenia with premorbid inferiority feelings: A distinct subgroup? Arch Gen Psychiatry 1982;39:643-647.Crossref 30. Kendler KS, Hays P: Familial and sporadic schizophrenia: A symptomatic, prognostic and electroencephalographic comparison . Am J Psychiatry 1982;139:1557-1562. 31. American Psychiatric Association, Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980. 32. Cammilli G, Hopkins KD: Applicability of chi-square to 2 × 2 contingency tables with small expected cell frequencies . Psychol Bull 1978;85:163-167.Crossref 33. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co, 1956, pp 116-127. 34. Ballenger JC, Reus VI, Post RM: The 'atypical' clinical picture of adolescent mania . Am J Psychiatry 1982;139:602-606. 35. Taylor MA, Abrams R: Catatonia: Prevalence and importance in the manic phase of manic-depressive illness . Arch Gen Psychiatry 1977;34:1223-1225.Crossref 36. LeffJ: International variations in the diagnosis of psychiatric illness . Br J Psychiatry 1977;131:329-338.Crossref 37. Carlson GA, Goodwin FK: The stages of mania: A longitudinal analysis of the manic episode . Arch Gen Psychiatry 1973;28:221-228.Crossref 38. Galdi J, Rieder RO, Silber D, et al: Genetic factors in the response to neuroleptics in schizophrenia: A psychopharmacogenetic study . Psychol Med 1981;11:713-728.Crossref 39. Baron M, Gruen R, Asnis L, et al: Schizoaffective illness, schizophrenia and affective disorders: Morbidity risk and genetic transmission . Acta Psychiatr Scand 1982;65:253-262.Crossref 40. Fowler RC, Tsuang MT, Cadoret RJ, et al: A clinical and family comparison of paranoid and non-paranoid schizophrenics . Br J Psychiatry 1974;124:346-351.Crossref 41. Andreasen NC, Endicott J, Spitzer RL, et al: The family history method using diagnostic criteria: Reliability and validity . Arch Gen Psychiatry 1977;34:1229-1235.Crossref 42. Thompson WD, Orvaschel H, Prusoff BA, et al: An evaluation of the family history method for ascertaining psychiatric disorders . Arch Gen Psychiatry 1982;39:53-58.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Sep 1, 1983

References