Gary A. Chase

The association of affective disorder with Huntington's disease in a case series and in families.

Major affective disorder clinically similar to the disorder found in conditions other than Huntingtons Disease (HD) was found in 41% of patients with HD in a consecutive case series ascertained through multiple sources in a defined geographical area. The association appears to be confined to certain families, and affective disorder may appear as long as 20 years before the onset of chorea and dementia. The association may represent genetic heterogeneity in HD.

Conduct disorder and affective disorder among the offspring of patients with Huntington's Disease

The rate of occurrence of conduct disorder and affective illness was studied for a sample of 112 offspring of 34 Huntingtons Disease (HD) patients. Psychiatric disorder in the offspring was assessed as a function of: (1) age of the parent at the onset of symptoms of HD; (2) family disorganization; and (3) psychiatric disorder in either parent. The findings indicated an increased frequency of conduct disorder in disrupted families, most especially in those where the HD parent had an early onset of symptoms and the non-HD parent showed psychiatric disorder. Affective disorder in the offspring was most strongly associated with the presence of similar symptoms in the HD parent. Affective disorder, but not conduct disorder, may be an early manifestation of the HD gene. The implication of these findings for genetic counselling is discussed.

Disability and psychiatric disorders in an urban community : measurement, prevalence and outcomes

BACKGROUND The purpose of this analysis was to examine: (1) the prevalence of psychiatric disorders among disabled people, using seven different measures of disability; (2) variation in disability between and within psychiatric diagnostic categories; and (3) relationship of diagnosis and disability to health service utilization. METHOD Data were drawn from Phase I and Phase II of the Eastern Baltimore Mental Health Survey, part of the Epidemiologic Catchment Area Program (ECA) conducted in 1980-1 to survey mental morbidity within the adult population. A total of 810 individuals received both a household interview and a standardized clinical psychiatric evaluation. Estimated prevalence rates were computed using appropriate survey sampling weights. RESULTS Prevalence of disability ranged from 2.5 to 19.5%, varying with specific disability measure. Among those classified as disabled by any of the measures examined, 56 to 92% had a psychiatric disorder and serious chronic medical conditions were present in the majority of these cases (54 to 78%). Disability was expressed differently among the various diagnostic groups. Diagnostic category and disability were significant independent predictors of medical service utilization and receipt of disability payments. CONCLUSIONS The majority of disabled adults living in the community have diagnosable psychiatric disorders, with the majority of these individuals suffering from significant chronic medical conditions as well, thus making co-morbidity the norm.

The ENCU scoring system: A strategy for solving a class of single-locus genetic counseling problems

A general rule is derived for calculating the conditional probability of a pedigree given that the consultand is a carrier. The method is designated the ENCU system. It is a generalization to accommodate all unilocal systems of inheritance with arbitrary penetrance operating independently in relatives of the ENSU system previously described (Murphy 1970a). The amount of information provided by the normal phenotypes of a person and his descendants is expressed in units of equivalent genotypically normal offspring (ENCUs). The method is applied to a typical genetic counseling problem, and it is shown that a considerable reduction in the quoted risk is obtained because the ENCU system takes into account the normal phenotypes of potential carriers of an incompletely penetrant gene.

Referral for medically unexplained somatic complaints: The role of histrionic traits

Abstract The judgment of physicians about histrionic traits in patients referred by them for psychiatric evaluation of medically unexplained somatic complaints was assessed. Such traits were attributed to many of the 100 patients studied, but, interestingly, the characterization of patients as histrionic did not entail the opinion that they were malingering, had factitious illnesses, or were misappropriating the benefits of the sick role. Histrionic traits as rated by referring physicians did not correlate with psychiatrists’ diagnoses of somatoform disorders, nor with the patients sex, age, or race.

A matrix method for calculating recurrence risks of unilocal disorders for genetic counselling.

A matrix method to calculate conditional likelihoods in a pedigree and use them to determine recurrence risks for unilocal disorders in genetic risks is presented in this paper. Different matrices are assigned to individual members of the pedigree and combined into matrix expressions. The method is explained for X-linked recessive conditions and autosomal dominant conditions with incomplete penetrance.