Morbidity risk of psychiatric disorders among the first degree relatives of schizophrenia patients in Taiwan.
This study aimed to assess the boundaries of the schizophrenia spectrum and whether inclusion of such phenotypes increases power for linkage analysis of schizophrenia. Participants were 234 first degree relatives (FDRs) of 94 schizophrenia probands in Northern Taiwan who completed a direct interview using the Diagnostic Interview for Genetic Studies (DIGS). Based on best estimate diagnosis, the morbidity risk in the relatives for schizophrenia was 2.5 percent (Weinberg's shorter method) or 3.9 percent (Kaplan-Meier estimate). Depending on the stringency of diagnosis, lifetime prevalence was 2.6 percent to 4.7 percent for schizotypal personality disorder, 3.4 percent to 8.6 percent for paranoid personality disorder, and 1.3 percent to 3.4 percent for schizoid personality disorder. These figures are significantly higher than the corresponding figures in the general population. However, none of the recurrence risk ratio for any spectrum that included both schizophrenia and a personality disorder (3.0 to 5.9) was greater than that of schizophrenia alone (9.3 to 14.4). Thus, including schizophrenia-related personality disorders in the spectrum did not increase power for linkage analysis of schizophrenia. (+info)
Importance of object relations theories for development of capacity for mature love.
We discuss Klein's, Winnicott's, and Mahler's object relational theories relevant for creating and maintaining the mature love relationship. The concept of love refers to the basic human relationship. The capacity for adult love involves the attainment of the relation towards the object as whole, satisfying the emotional needs of the self, including simultaneous tolerance of the specific needs of the object. It also involves the optimum resolution of anxiety related to schizo-paranoid and depressive positions and phases of separation and individuation. Primitive defense mechanisms, such as splitting, are replaced by more mature defense mechanisms, and primitive idealization is replaced by more mature idealization. The fusion with the object is reversible and helps in creating the experience of closeness with the partner, while the possibility of separation provides the possibility of recognizing and respecting the differences. Obstacles in the development of object relationships from pre-object to object phase, from symbiotic to separation and individuation phase can impair the capacity to love. (+info)
Reduction of caudate nucleus volumes in neuroleptic-naive female subjects with schizotypal personality disorder.
BACKGROUND: The caudate nucleus might contribute to the psychopathological and cognitive deficits observed in schizotypal personality disorder (SPD), a schizophrenia spectrum disorder. Here we focused on female patients, because this group is underrepresented in studies of SPD and schizophrenia, and we might learn more about the caudate and clinical and cognitive impairments that are unique to female patients diagnosed with SPD. METHODS: Magnetic resonance imaging scans, obtained on a 1.5-T magnet with 1.5-mm contiguous slices, were used to measure the caudate in 32 neuroleptic-naive women with SPD and in 29 female normal comparison subjects. Subjects were group-matched for age, parental socioeconomic status, and intelligence quotient. RESULTS: We found significantly reduced left and right caudate relative volume (8.3%, 7.7%) in female SPD subjects compared with normal comparison subjects. In female SPD subjects, we found significant correlations between smaller total caudate relative volume and worse performance on the Wisconsin Card Sorting test (nonperseverative errors) and on the California Verbal Learning Test (verbal memory and learning), and significant correlations between smaller total caudate relative volume and both positive and negative symptoms on the Structured Interview for Schizotypy. CONCLUSIONS: These findings demonstrate that, for female SPD subjects, smaller caudate volume is associated with poorer cognitive performance and more schizotypal symptomatology. (+info)
Hypertrophic discoid lupus erythematosus.
Hypertrophic discoid lupus erythematosus is a distinct form of chronic cutaneous (discoid) lupus, which is characterized by hyperkeratotic plaques that typically are observed over the face, arms, and upper trunk. We present the case of a 43-year-old man with verrucous plaques that were distributed symmetrically over the face, who initially was treated with oral antibiotics and topical glucocorticoids for acne vulgaris. A biopsy specimen confirmed the diagnosis of hypertrophic discoid lupus erythematosus. The clinical and histopathologic features of this clinical variant are reviewed. (+info)
Relationship between personality disorder dimensions and verbal memory functioning in a community population.
A controlled study of Tourette syndrome. IV. Obsessions, compulsions, and schizoid behaviors.
To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical impression that some TS patients have paranoid ideations, often feel that people are out to get them, and hear voices. (+info)
Yq deletion with short stature, abnormal male development, and schizoid character disorder.
A 33-year-old male with short stature, abnormal male sexual differentiation, aspermia, and schizoid character disorder is described, who had a Y chromosome with a deleted long arm. The correlation of the symptoms, including the psychotic abnormality, with the cytogenetic finding is discussed. (+info)
A family study of schizotypal disorder.
Direct, blind interviews were used to study the risk for and prevalence of DSM-III-R Axis I and II disorders in 93 first-degree relatives of outpatients with schizotypal personality disorder (SPD) and outpatients with other personality disorders. Risks for SPD (at a slightly loosened diagnostic threshold) and schizoid personality disorder were significantly higher in the families of probands with SPD. Schizophrenia was present only among relatives of probands with SPD, accounting for a morbid risk of 4.1 percent. Neither familial risks for mood and anxiety disorders nor the prevalence of other Axis II disorders significantly differed in the two groups of relatives. It is suggested that SPD is a familial disorder representing a phenotypic expression of liability to schizophrenia. (+info)