Resemblance of psychotic symptoms and syndromes in affected sibling pairs from the Irish Study of High-Density Schizophrenia Families: evidence for possible etiologic heterogeneity

doi:10.1176/ajp.154.2.191

Cited by 112 publications

(14 citation statements)

References 57 publications

(44 reference statements)

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“…Three other studies not reporting an affective dimension chose to focus on nonaffective symptoms in their analyses [17,37,39]. Of the studies reporting affective dimensions, all but 7 found separate manic and depressive dimensions [31,33,38,41–43,45]. McGrath et al [31] included limited coverage of affective symptoms, which resulted in a single inclusive affective dimension.…”

Section: Resultsmentioning

confidence: 99%

“…All but one study agreed on a class reminiscent of Kraepelin’s description of dementia praecox , although the nomenclature of this empirically derived class varied among studies: classic schizophrenia [44,63,64]; Kraepelinian schizophrenia [46]; prominent delusions, flat affect, thought disorder [45]; and mixed psychotic [47]. This class was characterized by poor outcome and high levels of positive and negative symptoms, whereas varying levels of disorganization and affective symptoms were observed among studies.…”

Section: Resultsmentioning

confidence: 99%

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Categorical vs dimensional classifications of psychotic disorders

Potuzak

Ravichandran

Lewandowski

et al. 2012

Comprehensive Psychiatry

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Objective Both categorical and dimensional methods appear relevant to classifying psychotic disorders; however, there is no clear consensus on the most appropriate categories and dimensions or on the best approach for constructing nosologic criteria that integrate these 2 methods. This review examines the evidence on specific dimensions and categories that would best characterize psychoses. Method Entries in the MEDLINE database between 1980 and 2011 were searched for studies of the dimensional and/or categorical structure of psychosis. Studies were included if samples represented a spectrum of psychotic disorders and dimensions/categories were empirically derived using principal components analysis, factor analysis, or latent class analysis. Results Most dimensional studies observed 4 or 5 dimensions within psychosis, with positive, negative, disorganization, and affective symptom domains most frequently reported. Substance abuse, anxiety, early onset/developmental, insight, cognition, hostility, and behavioral/social disturbance dimensions appeared in some studies. Categorical studies suggested 3 to 7 major classes within psychosis, including a class similar to Kraepelin’s dementia praecox and one or more classes with significant mood components. Only 2 studies compared the relative fit of empirically derived dimensions and categories within the same data set, and each had significant limitations. Conclusion There is relatively consistent evidence on appropriate categories and dimensions for characterizing psychoses. However, the lack of studies directly comparing or combining these approaches provides insufficient evidence for definitive conclusions about their relative merits and integration. The authors provide specific recommendations for designing future studies to identify valid dimensions and/or categories of the psychoses and investigate hybrid approaches to model the structure of the underlying illnesses.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Categorical vs dimensional classifications of psychotic disorders

Potuzak

Ravichandran

Lewandowski

et al. 2012

Comprehensive Psychiatry

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show abstract

“…Affective symptoms are common in schizophrenia, and factor analytic studies consistently identify affective dimension among other symptom factors of schizophrenia [65,66]. It has been demonstrated that affective symptoms show high heritability in schizophrenia [67], and some studies indicate genetic factors influencing the risk of affective symptoms among patients with schizophrenia [38,39,68,69,70]. Additionally, in a recent review, authors claim that schizophrenia is primed for an increased expression of affective symptoms, mainly through the activation of immune-inflammatory pathways [71].…”

Section: Discussionmentioning

confidence: 99%

CTLA4 and CD28 Gene Polymorphisms with Respect to Affective Symptom Domain in Schizophrenia

Frydecka

Beszłej²,

Pawlak³

et al. 2015

Neuropsychobiology

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Background: Accumulating evidence indicates that immune alterations in schizophrenia are due to genetic underpinnings. Here, we aimed at investigating whether polymorphisms in CTLA4 and CD28 genes, encoding molecules that regulate T-cell activity, influence schizophrenia symptomatology. Method: We recruited 120 schizophrenia patients and 380 healthy age- and sex-matched controls. We divided the patients into two groups: one with no co-occurrence between psychotic and affective symptoms and the second one with psychotic symptoms dominating in the clinical manifestation, although also with occasional affective disturbances in the course of illness. Results: Among the patients with co-occurring affective symptoms, there were significantly more CTLA4 c.49A>G[A] alleles (p = 0.018, odds ratio (OR) 2.03, 95% confidence interval (CI) 1.2-3.66) and more CTLA4 g.319C>T[T] alleles (p = 0.07, OR 1.93, 95% CI 0.94-4.13) in comparison to the second group. Additionally, we have shown that CD28 c.17 + 3T>C[C+] were more significantly overrepresented among patients with co-occurring psychotic and affective symptoms (p = 0.0003, OR 3.36, 95% CI 1.69-6.68) than in patients without co-occurence between these symptoms (p = 0.012, OR 1.88, 95% CI 1.15-3.10). Conclusion:CTLA4 and CD28 gene polymorphisms may not only act in immune deregulation observed in schizophrenia, but may also influence the course of the illness by modifying the susceptibility to the co-occurrence of psychotic and affective symptoms.

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“…For example symptom factors including positive, negative and affective symptoms 11 , thought withdrawal, thought insertion, thought broadcasting and delusions of control 12 and disorganization 13, 14, 15 have been found to be significantly correlated in sibling pairs (including twins) concordant for psychotic illness. Moreover, a meta-analysis of family-based studies of BPD demonstrated statistically significant familial aggregation for the psychosis phenotype 5 .…”

Section: Heritability Of Psychosismentioning

confidence: 99%

“…Negative symptoms are a particularly attractive phenotype for genetic investigation, as they tend to be more stable across the duration of illness, may present prior to the onset of illness, and are often unaffected by antipsychotic drug treatment 43 . Moreover, heritability studies of clinical symptomatology have indicated that affected relative pairs with schizophrenia may share similar severity of negative symptoms more often than expected by chance 11 , indicating a substantial genetic component. Data from several groups suggest that negative symptoms may be influenced by DTNBP1 genotype.…”

Section: Evidence Derived From Candidate Gene Studiesmentioning

confidence: 99%

Molecular Genetics of the Psychosis Phenotype

2012

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Objective Relative to recent successes in elucidating the genetic mechanisms associated with complex diseases including macular degeneration, Type II diabetes, heart disease and cancer, molecular genetic approaches to psychiatric illness have met with more limited success. While factors such as small allelic effects, allelic heterogeneity and variation in population sub-structure have received considerable attention in attempt to explain the paucity of significant results in psychiatric genetics, significantly less focus has been directed towards phenotypic factors. Method Data derived from molecular genetic studies of the psychosis phenotype in patients with a range of psychiatric illnesses are reviewed. Results Available data suggest that genes do not respect the boundaries of the current diagnostic system but may confer risk for symptom-based phenotypic variation that traverses those boundaries. Conclusions Molecular genetic studies offer convincing evidence for a relation between genetic variation and symptom-based phenotypic variation within psychiatric illness. These data may provide novel insights into the pathophysiology of schizophrenia and other related disorders. The exploration of relationships between genetic variation and symptom variation that traverses traditional diagnostic boundaries may ultimately lead to more refined classification systems that more closely reflect the genetic etiology of psychiatric illness.

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Resemblance of psychotic symptoms and syndromes in affected sibling pairs from the Irish Study of High-Density Schizophrenia Families: evidence for possible etiologic heterogeneity

Abstract: 1997; 154:191-198)

Cited by 112 publications

References 57 publications

Categorical vs dimensional classifications of psychotic disorders

Categorical vs dimensional classifications of psychotic disorders

<b><i>CTLA4</i></b> and <b><i>CD28</i></b> Gene Polymorphisms with Respect to Affective Symptom Domain in Schizophrenia

Molecular Genetics of the Psychosis Phenotype

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