RESUMEN
OBJECTIVE: The authors examined videotaped behaviors of children who developed schizophrenia as adults and of comparison subjects to disclose possible social and neuromotor deficits foreshadowing later development of schizophrenia. METHOD: In 1972, a sample of 265 11-13-year-old Danish children were filmed under standardized conditions while they were eating lunch. The examination was part of a larger study investigating early signs of schizophrenia spectrum disorders. Many of the subjects had a parent with schizophrenia, leaving them at high risk for developing a schizophrenia spectrum disorder. In 1991, adult psychiatric outcome data were obtained for 91.3% (N=242). This study systematically analyzed the videotapes to determine whether the children who developed schizophrenia as adults evidenced greater social and/or neuromotor deficits than children who did not develop a psychiatric disorder and children who developed other psychiatric disorders. RESULTS: The findings from this study suggest that the brief videotaped footage of children eating lunch was able to discriminate between the individuals who later developed schizophrenia and those who did not. Specifically, the preschizophrenia children evidenced differences on measures of sociability and general neuromotor functioning (among boys) from the children who developed other psychiatric disorders and the children who did not develop a psychiatric disorder. CONCLUSIONS: Social and neuromotor deficits specific to children who develop schizophrenia in adulthood provide further support for a neurodevelopmental hypothesis of schizophrenia.
Asunto(s)
Hijo de Padres Discapacitados , Discapacidades del Desarrollo/diagnóstico , Trastornos Psicomotores/diagnóstico , Esquizofrenia/epidemiología , Trastorno de la Conducta Social/diagnóstico , Grabación de Cinta de Video , Adolescente , Adulto , Factores de Edad , Niño , Comorbilidad , Dinamarca/epidemiología , Discapacidades del Desarrollo/epidemiología , Discapacidades del Desarrollo/psicología , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Estudios Prospectivos , Trastornos Psicomotores/epidemiología , Factores de Riesgo , Ajuste Social , Trastorno de la Conducta Social/epidemiología , Trastorno de la Conducta Social/psicologíaRESUMEN
OBJECTIVE: The Danish Longitudinal Study of Alcoholism utilized a prospective, high-risk research paradigm to identify putative markers of adult male alcoholism from a comprehensive database that began with the birth of the subject and extended over three decades. This article focuses on measures antedating abusive drinking that predicted lifetime alcohol abuse/dependence at age 30 years. METHOD: The original 330 subjects of this study were drawn from a large Danish birth cohort (N = 9,125) born between 1959 and 1961. The sample included 223 sons of treated alcoholic fathers (high-risk group) and 107 matched sons whose biological fathers had no record of treatment for alcoholism (low-risk group). This sample has been thoroughly investigated with a variety of methods representing multiple domains that included perinatal records, pediatric records, school records, teacher ratings, school physician records and a series of structured interviews and psychometric tests at ages 19-20 and 30 years. The present analysis focuses on the degree to which premorbid differences between the high- and low-risk groups later predicted lifetime drinking problems at age 30 (n = 241). RESULTS: As expected lifetime alcohol abuse/dependence by age 30 was reported significantly more often in the high-risk group. Of the 394 premorbid variables tested, 68 were found to distinguish the high- from the low-risk group before any subjects had developed a drinking problem. Of these 68 variables, 28 (41%) were also associated with DSM-III-R alcohol abuse/dependence at age 30. These 28 putative markers were reduced to 12 that were entered into a multiple regression analysis to search for the most powerful unique predictors of alcoholism. Four of the 28 putative markers were independently associated with problem drinking at age 30: low birth weight, number of life crises in childhood, ratings of childhood unhappiness and antisocial personality disorder. The regression model accounted for 46% of the drinking outcome variance. A father's alcoholism by itself no longer independently contributed to the prediction of his son's drinking and with one exception, did not systematically interact with the putative markers to facilitate the prediction of alcohol dependence at age 30. CONCLUSIONS: Risk itself. which significantly predicted problem drinking at age 30, was not uniquely associated with the development of alcoholism in adulthood. These findings, rather, provide broad support for the biopsychosocial model of alcoholism, especially for those models that emphasize the cumulative influence over time of internal and external variables in biologically vulnerable individuals.
Asunto(s)
Alcoholismo/epidemiología , Alcoholismo/psicología , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Análisis de Varianza , Dinamarca/epidemiología , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Pruebas Neuropsicológicas/estadística & datos numéricos , Valor Predictivo de las Pruebas , Estudios Prospectivos , Análisis de Regresión , Factores de Riesgo , Factores SocioeconómicosRESUMEN
A large body of research suggests a relationship between maternal influenza and the development of schizophrenia in the adult offspring. Some researchers, however, have questioned this association. A study by Crow and Done (1992) asserts that prenatal exposure to influenza does not cause schizophrenia. The methodology employed by Crow and Done may account for their null findings. Crow and colleagues assessed influenza by asking mothers at the time of birth to recall influenza infections experienced during pregnancy. Such retrospective recall may bias reporting. We assessed influenza symptoms during pregnancy in a group of 136 mothers at the twenty-fifth week of pregnancy, and again one or two days after birth. We compared accounts of influenza at the twenty-fifth week to recollection of influenza after birth. Results suggest that mothers tend to under-report infections when recalling infections after birth. Retrospective assessment of influenza symptoms at birth may be an inaccurate method of assessing influenza during pregnancy.
Asunto(s)
Gripe Humana/epidemiología , Femenino , Humanos , Gripe Humana/microbiología , Embarazo , Complicaciones del Embarazo , Estudios Retrospectivos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: The authors prospectively assessed the relationship between minor physical anomalies identified in childhood and adult psychiatric outcome. METHOD: In 1972, minor physical anomalies were measured in a group of 265 Danish children ages 11-13. The examination was part of a larger study investigating early signs of schizophrenia spectrum disorders. Many of the subjects had a parent with schizophrenia, leaving them at high risk for developing a schizophrenia spectrum disorder. In 1991, adult psychiatric outcome data were obtained for 91.3% (N=242) of the original subjects, including 81 who were at high risk. RESULTS: Individuals with a high number of minor physical anomalies developed schizophrenia spectrum disorders significantly more often than they developed a no mental illness outcome. Further, individuals with a high number of minor physical anomalies tended to develop schizophrenia spectrum disorders more often than other psychopathology. Among individuals at genetic high risk, higher numbers of minor physical anomalies may interact with pre-existing vulnerabilities for schizophrenia to increase the likelihood of a schizophrenia spectrum disorder outcome. CONCLUSIONS: Minor physical anomalies may provide important clues to understanding schizophrenia spectrum disorders from a neurodevelopmental perspective. Minor physical anomalies appear to signal stressors relevant to schizophrenia spectrum development, especially in those at genetic risk for schizophrenia.
Asunto(s)
Anomalías Congénitas/genética , Esquizofrenia/genética , Adolescente , Adulto , Niño , Estudios de Cohortes , Comorbilidad , Anomalías Congénitas/diagnóstico , Anomalías Congénitas/epidemiología , Dinamarca/epidemiología , Diagnóstico Diferencial , Femenino , Predisposición Genética a la Enfermedad/genética , Humanos , Masculino , Riesgo , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiología , Trastorno de la Personalidad Esquizotípica/diagnóstico , Trastorno de la Personalidad Esquizotípica/epidemiología , Trastorno de la Personalidad Esquizotípica/genéticaRESUMEN
The current investigation examines perceived family relationships prior to the onset of psychopathology in a sample at high-risk for schizophrenia. Previous research suggests that environmental factors, such as family relationships, may contribute to later schizophrenia in high-risk individuals. This investigation extends work by Burman et al. [Burman B, Mednick SA, Machon RA, Parnas J, Schulsinger F. Children at high risk for schizophrenia: parent and offspring perceptions of family relationships. Journal of Abnormal Psychology 1987;96(4):364-6] by examining high-risk subjects from a longitudinal data set who had not yet decompensated to schizophrenia at the time of the Burman study. Findings suggest that having positive relationships with both the mother and father may be protective against schizophrenia among HR children.
Asunto(s)
Familia/psicología , Relaciones Padres-Hijo , Esquizofrenia/genética , Psicología del Esquizofrénico , Adolescente , Adulto , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Factores de RiesgoRESUMEN
Univariate prediction models of schizophrenia may be adequate for hypothesis testing but are narrowly focused and limited in predictive efficacy. Therefore, we used a multivariate design to maximize the prediction of schizophrenia from premorbid measures and to evaluate the relative importance of various predictors. Two hundred twelve Danish subjects with at least one parent diagnosed in the schizophrenia spectrum (high risk) and 99 matched subjects with no such parent (low risk) were assessed on 25 premorbid variables in seven domains (genetic risk, birth factors, autonomic responsiveness, cognitive functioning, rearing environment, personality, and school behavior) when the subjects averaged 15 years of age. Twenty-five years later, 33 subjects had received lifetime diagnoses of schizophrenia. Discriminant function analyses were used to discriminate schizophrenia outcomes from no mental illness and nonschizophrenia outcomes on the basis of premorbid measures. Regardless of the comparison group used, schizophrenia was predicted by the interaction of genetic risk with rearing environment, and disruptive school behavior. Within the high-risk group, two-thirds of schizophrenia outcomes were correctly predicted by these premorbid measures; three-quarters of those with no mental illness were also correctly predicted. Prediction was enhanced among those with two schizophrenia spectrum parents, lending support to a multiplicative gene x environment model. Implications for early identification/primary prevention efforts are discussed.