Increased Morbid Risk for Schizophrenia Related Disorders in Relatives of Schizotypal Personality Disordered Patients

Siever, Larry J.; Silverman, Jeremy M.; Horvath, Thomas; Klar, Howard; Coccaro, Emil F.; Keefe, Richard S.E.; Pinkham, Lynne; Rinaldi, Paul; Mohs, Richard C.; Davis, Kenneth L.

doi:10.1001/archpsyc.1990.01810190034005

Cited by 138 publications

(60 citation statements)

References 40 publications

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“…While SPD and schizophrenia patients appear to show some common temporal lobe abnormalities, SPD patients do not appear to show volumetric decreases in frontal cortex to the same extent as schizophrenia Siever et al 1990;Siever and Davis 2004;Siever et al 2002;Suzuki et al 2005). Reductions in frontal volume are associated with the deficit-like symptoms of SPD, implying that patients with smaller frontal lobe volume are more likely to display traits such as asociality (Diwadkar et al 2006;Raine et al 1992;Siever et al 1993).…”

Section: Introductionmentioning

confidence: 93%

Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients

Hazlett

Buchsbaum

Haznedar

et al. 2008

Schizophrenia Research

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104

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Magnetic resonance (MR) imaging studies have revealed fronto-temporal cortical gray matter volume reductions in schizophrenia. However, whether age-and sex-matched unmedicated schizotypal personality disorder (SPD) patients share some or all of the structural brain-imaging characteristics of schizophrenia patients has not been studied. We examined cortical gray/white matter volumes in a large sample of unmedicated schizophrenia-spectrum patients (n=79 SPD, n=57 schizophrenia) and 148 healthy controls. MR images were reoriented to standard position parallel to the anterior-posterior commissure line, segmented into gray and white matter tissue types, and assigned to Brodmann areas (BAs) using a postmortem-histological atlas. Group differences in regional volume of gray and white matter in the BAs was examined with MANOVA. Schizophrenia patients had reduced gray matter volume widely across the cortex but more marked in frontal and temporal lobes. SPD patients had reductions in the same regions but only about half that observed in schizophrenia and sparing in key regions including BA10. In schizophrenia, greater frontotemporal volume loss was associated with greater negative symptom severity and in SPD, greater interpersonal and cognitive impairment. Overall, our findings suggest that increased prefrontal volume in BA10 and sparing of volume loss in temporal cortex (BAs 22 and 20) may be a protective factor in SPD which reduces vulnerability to psychosis.

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Section: Introductionmentioning

confidence: 93%

Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients

Hazlett

Buchsbaum

Haznedar

et al. 2008

Schizophrenia Research

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104

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“…Thus, by studying SPD, we avoid the twin confounds on the caudate of the potential effects of chronic hospitalization and of the use of neuroleptic medications (Chakos et al 1994;Gur et al 1998;Keshavan et al 1998). Furthermore, genetic studies support the idea that SPD is genetically related to schizophrenia (i.e., is in the schizophrenia spectrum) (Kendler et al 1993a;Siever et al 1990Siever et al , 1993. Specifically, prior studies suggest a greater prevalence of SPD in the relatives of schizophrenic patients than in comparison groups (Kendler 1985;Kendler et al 1993b;Kety et al 1994).…”

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confidence: 91%

Reduction of Caudate Nucleus Volumes in Neuroleptic-Naïve Female Subjects with Schizotypal Personality Disorder

Koo

Levitt

McCarley

et al. 2006

Biological Psychiatry

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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.

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“…Because individuals with this disorder are not considered psychotic, they have generally not been prescribed medications. Nonetheless, persons with SPD and those with schizophrenia have a similar genetic predisposition, as suggested by multiple family studies 24,[27][28][29][30][31] reporting that 6-7% of individuals diagnosed with schizophrenia have a first-degree relative with SPD. Similarly, first-degree relatives of persons with SPD have a 6.9% chance of developing schizophrenia.…”

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confidence: 99%

The Brain in Schizotypal Personality Disorder: A Review of Structural MRI and CT Findings

Dickey¹

2002

Harvard Review of Psychiatry

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Studies of schizotypal personality disorder (SPD) are important because the condition is genetically related to schizophrenia and because data accumulating to confirm its biological underpinnings are challenging some traditional views about the nature of personality disorders. This review of 17 structural imaging studies in SPD indicates that individuals with this disorder show brain abnormalities in the superior temporal gyrus, parahippocampus, temporal horn region of the lateral ventricles, corpus callosum, thalamus, and septum pellucidum, as well as in total cerebrospinal fluid volume, similar to those seen in persons with schizophrenia. Differences between SPD and schizophrenia include lack of abnormalities in the medial temporal lobes and lateral ventricles in SPD. Whether the normal volume, and possibly normal functioning, of the medial temporal lobes in individuals with SPD may help to suppress psychosis in this disorder remains an intriguing but still unresolved question. Such speculation must be tempered due to a paucity of studies, and additional work is needed to confirm these preliminary findings. The imaging findings do suggest, however, that SPD probably represents a milder form of disease along the schizophrenia continuum. With further clarification of the neuroanatomy of SPD, researchers may be able to identify which neuroanatomical abnormalities are associated with the frank psychosis seen in schizophrenia.Although schizophrenia was once considered the "graveyard of neuropathologists," 1 recent neuroimaging techniques have radically changed this view. Early studies using computerized tomography (CT) were pivotal in demonstrating ventricular abnormalities in the disorder but did not provide the resolution required to document alterations in regions with unclear boundaries such as the amygdala and various thalamic nuclei. With the advent of magnetic resonance imaging (MRI), these latter brain regions of interest have been evaluated in schizophrenia and found to be abnormal. In recent comprehensive reviews 2, 3 of MRIdocumented morphological brain abnormalities in schizophrenia, most brain regions studied showed neuroanatomical alteration compared with the same regions in healthy controls. Nonetheless, a convergence of findings suggested that the major locus for brain abnormalities was the temporal lobe; fewer studies reported abnormalities in the lateral ventricles, prefrontal cortex, inferior parietal cortex, basal ganglia, thalamus, corpus callosum, or septum pellucidum.2 , 3 Note that, although many regions are involved in schizophrenia, they do not appear to be equally affected, and the temporal lobe regions are the most severely altered. NIH Public Access Author ManuscriptHarv Rev Psychiatry. Author manuscript; available in PMC 2010 April 13. In many cases, however, these MRI findings are difficult to interpret, given the possible confounding effects of the chronicity of the psychotic illness and the medications used to treat it. Although the definition of a personality disorder4 req...

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Increased Morbid Risk for Schizophrenia Related Disorders in Relatives of Schizotypal Personality Disordered Patients

Cited by 138 publications

References 40 publications

Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients

Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients

Reduction of Caudate Nucleus Volumes in Neuroleptic-Naïve Female Subjects with Schizotypal Personality Disorder

The Brain in Schizotypal Personality Disorder: A Review of Structural MRI and CT Findings

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