Minor Physical Anomalies and Schizophrenia Spectrum Disorders: A Prospective Investigation

Schiffman, Jason; Ekstrøm, Morten; LaBrie, Joseph W.; Schulsinger, Fini; Sørensen, Holger J.; Mednick, Sarnoff A.

doi:10.1176/appi.ajp.159.2.238

Cited by 71 publications

(40 citation statements)

References 17 publications

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“…There is evidence to suggest that minor physical anomalies can, in fact, discriminate between at-risk individuals and help predict outcome. In a prospective study of 81 children between the ages of 11 and 13 who had a parent diagnosed with schizophrenia, 31% of those with 3 or more minor physical anomalies subsequently developed a schizophrenia spectrum disorder, compared to only 12% of those with 0-2 physical anomalies (Schiffman et al, 2002). This is equivalent to a test sensitivity of 71% and specificity of 58%.…”

Section: Discussionmentioning

confidence: 99%

Reduced posterior nasal cavity volume: A gender-specific neurodevelopmental abnormality in schizophrenia

Turetsky

Glass

Abbazia

et al. 2007

Schizophrenia Research

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Objective-We previously reported that men with schizophrenia had reduced volumes of the posterior nasal cavity bilaterally. Since the nasal cavities develop in conjunction with both the palate and ventral forebrain, this could represent a simple marker of embryological dysmorphogenesis contributing to schizophrenia. The current study expands on this finding by examining a larger sample of both male and female patients and unaffected 1 st -degree relatives, to determine the gender distribution of this abnormality and the extent to which it may be genetically mediated.Method-A measurement of nasal volume and geometry was acquired by acoustic rhinometry for 85 schizophrenia patients, 25 unaffected first-degree relatives of schizophrenia probands and 66 healthy comparison subjects.Results-Male patients had smaller posterior nasal volumes than both male control subjects and male relatives. However, female patients did not differ from either female controls or female family members. Unaffected first-degree relatives did not differ from same-sex control subjects. These findings persisted after covarying for height and smoking history, and were unrelated to clinical symptomatology or antipsychotic medication usage.Conclusion-Posterior nasal cavity volume decrement appears to be a specific developmental craniofacial abnormality that may reflect an early disruption in embryological development in males with schizophrenia. Although further study is needed, this may be a marker of a "second hit" that distinguishes genetically vulnerable men who go on to develop the illness from those who do not.

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Section: Discussionmentioning

confidence: 99%

Reduced posterior nasal cavity volume: A gender-specific neurodevelopmental abnormality in schizophrenia

Turetsky

Glass

Abbazia

et al. 2007

Schizophrenia Research

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“…Noncompliance as a clinical problem is multidetermined including psychopathology, medication-related factors, available social support, substance abuse comorbidity, and the quality of the therapeutic alliance [59]. Noncompliance is also caused by the fact that schizophrenic patients are a heterogeneous group with different longterm courses [68][69][70][71][72][73]. Another important reason is that on the one hand, the effects of neuroleptic treatment often improve illness symptoms, but on the other hand, the side effects of neuroleptics, especially the EPS, often simultaneously decrease the quality of patients' lives [11,36].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with preexistent cerebral damage (e.g. brain damage, comorbid alcoholism and patients pretreated with high neuroleptic doses over a longer period of time) are more likely to develop EPS and dyskinesia [73,76,77]. This is why we consider that these patients have a greater benefit from risperidone or other atypical neuroleptics.…”

Section: Discussionmentioning

confidence: 99%

Flupenthixol versus Risperidone: Subjective Quality of Life as an Important Factor for Compliance in Chronic Schizophrenic Patients

et al. 2003

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Objective: The primary aim of this paper was to compare the effects of flupenthixol and risperidone on subjective quality of life and attitude towards medication in chronic schizophrenic patients with mainly negative symptoms. In a spectrum ranging from its typical end ‘haloperidol’ to its atypical end ‘clozapine’, flupenthixol has typical and atypical characteristics. Methods: The effects of flupenthixol versus risperidone were investigated in a multicenter, double-blind trial, whereas subjective quality of life was assessed by means of the EuroQuol-Visual Analogue Scale and the patient satisfaction questionnaire. The attitude towards medication was assessed by means of the Drug Attitude Inventory-30 (DAI-30). Results: Mean daily dose of study medication was 6.6 (SD 2.9) mg/day flupenthixol and 3.6 (SD 1.2) mg/day risperidone. Both groups showed a significant improvement regarding subjective quality of life and positive attitude towards medication. Especially the categories ‘control of their thoughts’, concentration and ‘feeling better in general’ ameliorated in both groups. In the flupenthixol group, the ‘ability to cope with stress’, ‘feel more relaxed’ and the ‘ability to achieve something’ improved significantly more than in the risperidone group. Conclusions: (1) The spectrum of schizophrenia can be treated effectively with different neuroleptic treatments. (2) Flupenthixol especially improves the ability to cope with stress, the ability to achieve something and feeling more relaxed. (3) Subjective quality of life significantly increased with no difference between the groups.

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“…We have described the design of the study, the subject characteristics, and the premorbid and follow-up diagnoses in greater detail elsewhere (14).…”

Section: Methodsmentioning

confidence: 99%

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia: A Prospective Investigation

Schiffman

Walker²,

Ekstrøm³

et al. 2004

AJP

146

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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. The majority of individuals with schizophrenia manifest the illness in the second or third decade of life (1), yet subclinical signs of neuropathology are already evident during adolescence (2) and possibly as early as birth and infancy (3-5). Although some research suggests that the early signs of schizophrenia are nonspecific and that no one sign predicts schizophrenia uniquely and effectively (6), other studies indicate that both social and neuromotor abnormalities in childhood are reliable developmental precursors of the disorder.Social deficits exhibited before the onset of schizophrenia suggest that interpersonal difficulties precede recognizable psychotic symptoms. A unique study by Walker and colleagues (7) evaluated childhood home movies of schizophrenia patients and comparison subjects. The authors reported that girls who later developed schizophrenia showed fewer expressions of joy than did same-sex comparison subjects from infancy through adolescence; preschizophrenia boys showed nonsignificantly more negative expressions in preadolescence and early adolescence.Longitudinal study of "high-risk" individuals (those having at least one parent with schizophrenia) provides an alternative opportunity to view the developmental course of schizophrenia. Several investigations have followed high-risk subjects through the age of risk, providing information regarding premorbid functioning and adult diagnostic outcome. In an inve...

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Minor Physical Anomalies and Schizophrenia Spectrum Disorders: A Prospective Investigation

Cited by 71 publications

References 17 publications

Reduced posterior nasal cavity volume: A gender-specific neurodevelopmental abnormality in schizophrenia

Reduced posterior nasal cavity volume: A gender-specific neurodevelopmental abnormality in schizophrenia

Flupenthixol versus Risperidone: Subjective Quality of Life as an Important Factor for Compliance in Chronic Schizophrenic Patients

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia: A Prospective Investigation

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