O. El-Saadi

Paternal and maternal age as risk factors for psychosis: findings from Denmark, Sweden and Australia

BACKGROUND While the association between increased maternal age and congenital disorders has long been recognized, the offspring of older fathers are also at increased risk of congenital disorders related to DNA errors during spermatogenesis. Recent studies have drawn attention to an association between increased paternal age and increased risk of schizophrenia. The aim of the current study was to examine both paternal and maternal age as risk factors for the broader category of psychosis. METHOD We used data from three sources examining psychosis: a population-based cohort study (Denmark), and two case-control studies (Sweden and Australia). RESULTS When controlling for the effect of maternal age, increased paternal age was significantly associated with increased risk of psychosis in the Danish and Swedish studies. The Australian study found no association between adjusted paternal age and risk of psychosis. When controlling for the effect of paternal age, younger maternal age was associated with an increased risk of psychoses in the Danish study alone. CONCLUSIONS The offspring of older fathers are at increased risk of developing psychosis. The role of paternally derived mutations and/or psychosocial factors associated with older paternal age warrants further research.

Directional and fluctuating asymmetry in finger and a-b ridge counts in psychosis: a case-control study.

BackgroundSeveral studies have reported alterations in finger and a-b ridge counts, and their derived measures of asymmetry, in schizophrenia compared to controls. Because ridges are fully formed by the end of the second trimester, they may provide clues to disturbed early development. The aim of this study was to assess these measures in a sample of patients with psychosis and normal controls.MethodsIndividuals with psychosis (n = 240), and normal controls (n = 228) were drawn from a catchment-area case-control study. Differences in finger and a-b ridge count and Fluctuating Asymmetry were assessed in three group comparisons (non-affective psychosis versus controls; affective psychosis versus controls; non-affective psychosis versus affective psychosis). The analyses were performed separately for males and females.ResultsThere were no significant group differences for finger nor a-b ridge counts. While there were no group difference for Directional Asymmetry, for Fluctuating Asymmetry measures men with non-affective psychosis had significantly higher fluctuating asymmetry of the index finger ridge count (a) when compared to controls (FA-correlation score, p = 0.02), and (b) when compared to affective psychosis (adjusted FA-difference score, p = 0.04).ConclusionOverall, measures of finger and a-b ridge counts, and their derived measures of directional and fluctuating asymmetry were not prominent features of psychosis in this sample. While directional asymmetry in cerebral morphology is reduced in schizophrenia, this is not reflected in dermatoglyphic variables.

Urban birth and migrant status as risk factors for psychosis: an Australian case-control study.

Background Urban birth and migrant status have been identified as risk factors for psychosis in North American and European studies. The aim of this study was to explore these variables in an Australian case-control study. Method Country of birth of subjects and their parents, and place of birth of Australian-born subjects, were examined in individuals with psychosis drawn from a prevalence study (n = 310) and well controls recruited from the same catchment area (n = 303). Results Migrant status was associated with a significantly decreased odds of having a psychotic disorder. For those born in Australia, neither migrant status of parents nor urban birth was associated with having a psychotic disorder. Conclusions The lack of effect for urban birth and second-generation migrant status may help generate candidate environmental risk factors that operate in Europe but not in Australia.

A systematic review of the incidence of schizophrenia: The distribution of rate items and the influence of methodology, urbanicity, sex and migrant status

Background: A single-blind, multicentre RCT compared the class of new (non-clozapine) atypical drugs with clozapine in patients in the NHS whose medication was being changed because of poor clinical response to two or more antipsychoticdrugs.Methods: The primary outcome was the Quality of Life Scale. Secondary clinical outcomes included symptoms (PANSS), side effects and participant satisfaction. Economic outcomes were costs of health and social care and a utility measure. A total of 136 (98% of the planned sample) participants were randomised. Followup at 52 weeks, blind to treatment allocation, was complete in 87%.Results: The intent to treat comparison of new atypicals compared with clozapine in people with more narrowly defined treatment resistance showed an advantage for commencing clozapine in quality of life (QLS) at trend level ( p = 0.08) and insymptoms (PANSS), that was statistically significant ( p = 0.01), at 1 year. Clozapine showed approximately a 4-point advantage (not statistically significant) on QLS score at 52 weeks, against the predicted 10 points, and approximately a 5-point advantage on PANSS total score. Clozapine showed a trend towards having less total extrapyramidal side effects ( p = 0.1). Participants reported at 12 weeks that their mental health was significantly better with clozapine than with new atypicals ( p < 0.05). Net costs of care varied widely, with a mean of �33,588 in the clozapine group and �28,122 in the new atypical group, not a statistically significant difference. Of these costs, 4.0% and 3.3%, respectively, were dueto antipsychotic drug costs.Background/objective: Despite the high comorbidity of substance misuse and schizophrenia, few large scale British studies have looked at symptom profile and outcome in this population. The aim of this study was to use data on substance use among subjects with schizophrenia collected in a randomised controlled trial, validated for the purpose of this study, to see if there are differences between substance users and non users on a variety of outcome measures. Method: 1. A sample of subjects in the CUtLASS study were interviewed using the SCID to determine whether SCID-diagnosed substance misuse disorders corresponded to substance misuse categories generated in the CUtLASS study from casenote review. 2. Substance users were compared with non users on a variety of outcome measures. Results: 1. Two CUtLASS categories, no substance use and major substance use, could be validated against SCID diagnoses; the third category, minor use, could not be validated. 2. Substance misusers were more likely to be young men. There were no significant differences between users and non users for positive and negative symptoms, quality of life, number of previous hospitalisations, extrapyramidal side effects or medication compliance. Drug users were younger at age of first treatment than non users. Alcohol users had more depressive symptoms than non users. Substance users had more negative attitudes towards prescribed medication, although this effect disappeared when age and gender were controlled for. Non compliance was associated with more severe psychopathology, and a worse quality of life. Conclusion: Substance misuse did not seem to confer the adverse outcomes that previous studies suggest.Background/objective: There is accumulating evidence for an important role for vitamin D in brain function, including our recent observations that animals deprived of vitamin D in utero had brains that were altered in shape at birth, with increased cell proliferation and reduced levels of NGF and GDNF. In the current study we examined the hypothesis that vitamin D deficiency during two separate developmental periods alters adult behaviour. Methods: Rats were conceived and born to mothers receiving a vitamin D-deficient diet and housed without UV light. At birth, the litters were reduced to three males and three females and half the mothers were placed under normal vitamin D conditions whilst half remained under vitamin D deplete conditions. At weaning, all animals were fed the normal diet. Mothers, and all animals at weaning, were rendered normocalcaemic with calcium supplemented water (2 mM). Control animals were born to mothers fed a normal diet but subject to similar litter size and calcium supplementation. At 10 weeks, all animals were subject to the holeboard test, elevated plus maze test, social interaction, prepulse inhibition of the acoustic startle response and a forced swim test. Results: Early vitamin D deficiency selectively enhanced locomotion in the holeboard test and increased activity in the elevated plus maze. Thus, early vitamin D deficiency appeared to induce quite specific behavioural deficits in adulthood, without inducing severe learning or motor abnormalities. Conclusion: These observations are consistent with an increase in dopaminergic tone, a finding previously reported in vitamin D depleted animals.Background/objective: There is accumulating evidence for an important role for vitamin D in brain function, including our recent observations that animals deprived of vitamin D in utero had brains that were altered in shape at birth, with increased cell proliferation and reduced levels of NGF and GDNF. In the current study we examined the hypothesis that vitamin D deficiency during two separate developmental periods alters adult behaviour. Methods: Rats were conceived and born to mothers receiving a vitamin D-deficient diet and housed without UV light. At birth, the litters were reduced to three males and three females and half the mothers were placed under normal vitamin D conditions whilst half remained under vitamin D deplete conditions. At weaning, all animals were fed the normal diet. Mothers, and all animals at weaning, were rendered normocalcaemic with calcium supplemented water (2 mM). Control animals were born to mothers fed a normal diet but subject to similar litter size and calcium supplementation. At 10 weeks, all animals were subject to the holeboard test, elevated plus maze test, social interaction, prepulse inhibition of the acoustic startle response and a forced swim test. Results: Early vitamin D deficiency selectively enhanced locomotion in the holeboard test and increased activity in the elevated plus maze. Thus, early vitamin D deficiency appeared to induce quite specific behavioural deficits in adulthood, without inducing severe learning or motor abnormalities. Conclusion: These observations are consistent with an increase in dopaminergic tone, a finding previously reported in vitamin D depleted animals.Background: The subjective experience of patients with schizophrenia, receiving antipsychotic medication has been a neglected research area.Methods: In a randomised controlled trial comparing the impact of new atypical antipsychotic drugs versus clozapine, 67 out of 136 patients with schizophrenia were randomised to receive clozapine. Baseline and 12 week assessments included the PANSS, DAI, and the Kemp Compliance scale.Results: The greater percentage improvement in total PANSS scores in patients randomised to clozapine was statistically significant when compared to the atypical group at 12 weeks (p < 0.05). Patients? subjective rating of their mental health improvement since commencing clozapine treatment correlated significantly with actual percentage improvement in PANSS scores from baseline to week 12 (p < 0.01). Significant correlations were also observed between the patients? subjective rating of their mental health improvement and both DAI score and theg12 PANSS insight item (p < 0.05). In a regression analysis, DAI score at week 12 explained 26% of the variance in patients? subjective rating of mental health improvement with clozapine. Percentage PANSS improvement explained a further 8% of the variance.Conclusion: Patients in an RCT of clozapine versus atypicals were able to subjectively rate their own improved mental health status, validated by objective improvement on the PANSS. This was predicted by drug attitude as measured by the DAI. Subjective reports are a useful and valid outcome measure in drug treatment trials.Background: Conceptually quality of life is a broad term and consists of a sense of well-being, life satisfaction and access to resources and opportunities.Methods: A subjective quality of life measure, the Lancashire quality of life scale(Oliver, 1991) was compared with an objective measure, the Heinrichs quality of life scale (Heinrichs et al,1884) in 75 subjects entering a randomised controlled trial comparing conventional and new atypical antipsychotics and clozapine.Results: A significant correlation was found between the two scales (r = 0.386 p < 0.01). Determinants of subjective and objective quality of life were explored using multiple regression analyses. The main determinants of subjective quality of life were depression measured on the Calgary Scale, insight(Birchwood Scale) and nonneurological side-effects, which together explained 44% of the variance p < 0.01. Depression was responsible for 34% of this variance. In contrast, the main determinant of objective QLS were PANSS negative score and PANSS total score. These two together explained 51% of the variance with PANSS negative accounting for most 46% of this p < 0.01.Conclusion: The choice of subjective or objective quality of life measures is likely to reflect different dimensions of outcome,reflecting the underlying psychopathology of schizophrenia as opposed to measuring a discrete construct. A value judgement must therefore be made as to which of these measures best encapsulates what is meant by quality of life in schizophrenic illnesses.Edited by Glen Van Brummelen The purpose of this department is to give sufficient information about the subject matter of each publication to enable users to decide whether to read it. It is our intention to cover all books, articles, and other materials in the field. Books for abstracting and eventual review should be sent to this department. Materials should be sent to Glen Van Brummelen, Bennington College, Bennington, VT 05201, U.S.A. (E-mail: gvanbrum@bennington.edu) Readers are invited to send reprints, autoabstracts, corrections, additions, and notices of publications that have been overlooked. Be sure to include complete bibliographic information, as well as transliteration and translation for non-European languages. We need volunteers willing to cover one or more journals for this department. In order to facilitate reference and indexing, entries are given abstract numbers which appear at the end following the symbol #. A triple numbering system is used: the first number indicates the volume, the second the issue number, and the third the sequential number within that issue. For example, the abstracts for Volume 20, Number 1, are numbered: 20.1.1, 20.1.2, 20.1.3, etc. For reviews and abstracts published in Volumes 1 through 13 there are an author index in Volume 13, Number 4, and a subject index in Volume 14, Number 1. The initials in parentheses at the end of an entry indicate the abstractor. In this issue there are abstracts by Francine Abeles (Kean, NJ), Peter Bernhard (Erlangen, Germany), Herbert Kasube (Peoria, IL), Gary S. Stoudt (Indiana, PA), Kevin VanderMeulen (Hamilton, Canada), David Wallace (Glasgow, UK), and Glen Van Brummelen. Abgrall, Philippe. La Géométrie de l’Astrolabe au Xe Siècle, Arabic Sciences and Philosophy 10(1) (2000), 7–77. An analysis of treatises of al-Saganı̄, al-Qūhı̄, and Ibn Sahl dealing with the projection of the sphere on a plane applied to the construction of the astrolabe. See the review by Emilia Calvo in Mathematical Reviews 2001d:01005. (GSS) #28.4.1 Abraham, George. See #28.4.58. Abramovich, Y. A.; and Veksler, A. I. G. Ya. Lozanovsky: His Contributions to the Theory of Banach Lattices, in Henryk Hudzik and Leszek Skrzypczak, eds., Function Spaces, New York: Dekker, 2000, pp. 5–21. This description of Lozanovsky’s main results in the theory of Banach lattices also contains reflections on his personality and mathematical legacy, as well as a supplement to the papers listed in his obituary. (GVB) #28.4.2 Almgren, Frederick J., Jr. Selected Works of Frederick J. Almgren, Jr., edited by Jean E. Taylor, Providence, RI: American Mathematical Society, 1999, xlvi+586 pp.,

The incidence and prevalence of schizophrenia: Preliminary results from a systematic review

105. This book contains a collection of the most significant “short” papers and expository and survey articles written by Frederick J. Almgren, Jr. See the review by Giandomenico Orlandi in Mathematical Reviews 2001f:01053. (HEK) #28.4.3 Amunategui, Godofredo Iommi. See #28.4.87. Andreozzi, Luciano. Vito Volterra as Scientific Organizer and the Origins of Mathematical Biology in Italy [in Italian], Nuncius 15(1) (2000), 79–109. Discusses Volterra’s organizational role in oceanographic studies from 1910 to 1925. (GVB) #28.4.4 Aouad, Maroun. See #28.4.61. Apostol, Tom M. A Centennial History of the Prime Number Theorem, in R. P. Bambah, V. C. Dumir, and R. J. Hans-Gill, eds., Number Theory, Basel: Birkhäuser, 2000, pp. 1–14. A survey article on the prime number 315 0315-0860/01

The incidence of schizophrenia: A systematic review

35.00 C

Paternal age as a risk factor for psychosis and schizophrenia: Findings from Denmark, Sweden and Australia

While it has been reported that individuals with psychosis are at increased or decreased risk of various physical disorders such as cancer and rheumatoid arthritis, there has been less research on the co-segregation of physical disorders within the first-degree relatives of those with psychosis compared to relatives of well controls. The aim of this study was to examine these issues in an epidemiologically informed catchment-area based case-control study. Patients with psychosis were drawn from a prevalence study undertaken as part of the Australian National Mental Health Survey. In addition, we recruited well controls who resided in the same catchment area. For each subject, we drew pedigrees and used a structured checklist to assess the presence of selected psychiatric disorders, and selected disorders such as multiple sclerosis, epilepsy, spina bifida, thyroid disorders, diabetes, asthma and eczema. Data based on pedigrees from 293 individuals with psychosis and 292 well controls was available. As expected, the odds of havingschizophrenia and affective disorders were significantly increased in the families of cases versus controls. The odds of havingeczema were significantly reduced in the relatives of those with psychosis. All other disorders occurred with equal frequency in cases versus control pedigrees. Current theories of eczema suggest that an absence of early life exposure to antigens and infectious agents may fail to prime the na¨ive immune system, and leave the person at increased risk of eczema. The results of this study suggest that genetic andror environmental factors that facilitate psychosis may protect against eczema. The Stanley Foundation supported this project.The offspringof older fathers have an increased risk of various disorders that may be due to the accumulation of DNA mutations during spermatogenesis. Previous studies have suggested increased paternal age may be a risk factor for schizophrenia. The aim of the current study was to examine paternal age as a risk factor for schizophrenia andror psychosis. We used data from three sources: a population-based cohort studyŽDenmark., and two case-control studiesŽSweden and Australia.. In the Danish and Australian studies, we examined both psychosis and schizophrenia. In the Swedish study we examined psychosis only. After controllingfor the effect of maternal age, increased paternal age was significantly associated with increased risk of both psychosis and schizophrenia in the Danish study and of psychosis in the Swedish study. The Australian study found no association between paternal age and risk of psychosis or schizophrenia. In all three studies the relationship between paternal age and risk of disorder in the offspring was AUB-shaped. In addition to an increased risk for the offspringof older father Ž)35 years., there was a non-significant increase for the offspringof fathers aged less than 20 years. The possible role of paternally derived DNA mutations andror other psychosocial factors associated with older paternal age warrants further research. The ‘U’-shaped relationship suggests that factors other than DNA mutations may warrant consideration in this research. The Stanley Foundation supported this project.Recent studies have shown that individuals with schizophrenia who are born in summer have an increased odds of have deficit syndrome versus nondeficit syndrome. This study extends this work to examiningthis issue in patients from the Southern Hemisphere. Data which included OPCRITrSCAN items and demographic information was obtained for Australian-born cases from the Australian National Mental Health Survey. Followingpreviously published methods, cases were assigned to the deficit group Žns153.or non-deficit groupŽns228.. A logistic regression analysis was used to ascertain whether beingborn in summer ŽDecember, January, February.in the Southern Hemisphere altered the odds of havingdeficit syndrome. There was no association between summer birth and odds of havingdeficit versus non-deficit schizophrenia ŽOdds Ratios0.75, 95% CI 0.49–1.16.. Based on our previous work showingthat the size of the winterrspringbirth excess in schizophrenia is reduced in the Southern Hemisphere, we speculate that factors that influence the association between summer birth and non-deficit syndrome may also vary across geography andror latitude. The Stanley Foundation supported this project.We have previously found an association between variations in schizophrenia birth rates and varyinglevels of perinatal sunshine duration. This study examines whether such an association can also be found for Ža. affective psychosis, and Žb. broadly defined nonaffective psychoses. Data for individuals born between 1931 and 1970 in Australia with ICD9 Other PsychosisŽ295–299.were obtained from the Queensland Mental Health Statistical System. ‘Affective psychosis’ included affective psychosis, schizo-affective psychosis, and depressive and excitative non-organic psychoses. ‘Non-affective psychosis’ included chizophrenia, paranoid disorders and other non-organic psychoses. Those receiving both affective and non-affective psychotic diagnoses were excluded. Rates per 10,000 live monthly general population births were calculated. For each month, we assessed the agreementŽusing the kappa statistic. between trends in Ža. birth rates and Žb. long-term trends in seasonally adjusted perinatal sunshine duration. The analyses were performed separately for males and females. There were 6265 with non-affective psychosis ŽMs3964 rate 66r10,000; Fs2299 44r10,000. and 2858 with affective psychosisŽMs1392 24r10,000; Fs1466 28r10,000.. There were no significant associations between Ža. affective psychosis birth rates for either males or females and Žb. sunshine duration. There was a significant association between nonaffective psychosis birth rates for males only and Žb. sunshine duration Žkappas0.15 p-0.001.. This suggests that, as a risk factor, the effect of reduced perinatal sunshine is specifically associated with males who develop non-affective psychosis. The Stanley Foundation supported this project.We tested the hypothesis that patients with schizophrenia are more prone to impairment in planning and problem-solving as compared with normal controls and patients with traumatic brain injury (TBI) by administering the Tower of Hanoi (TOH) task. A total of one hundred and fifty-three participants (51 in each group) were recruited. The performance of the patient groups was markedly worse than normal controls in terms of profile score, number of rule-breaking behaviour, and mean execution time. Two-way 3 (group) x 6 (complexity) ANOVAs indicated that significant main effects of group and complexity were observed in the number of moves, planning time to initiate the first move and subsequent execution time. The general performance of TOH in the schizophrenia group was very similar to that of the TBI group. Subsequent comparison of sub-groups of frontal and posterior lobe damage indicated the pattern of performance in schizophrenia patients lie between them. Taken together, these findings suggest that neither focal frontal nor temporal lobe damage is a sufficient explanation for the problem-solving deficits in patients with schizophrenia.Dermatoglyphic measures are of interest to schizophrenia research because they serve as persistent markers of deviant development in foetal life. Several studies have reported alterations in A–B ridge counts, total finger ridge counts and measures related to asymmetry in schizophrenia. The aim of this study was to assess these measures in an Australian catchment area, case-control study. Individuals with psychosisŽns246.were drawn from a catchment-area prevalence study, and well controlsŽns229. were recruited from the same area. Finger and palm prints were taken usingan inkless technique and all dermatoglyphic measures were assessed by a trained rater blind to case status. The dermatoglyphic measures Žfinger ridge count, A–B ridge count, and their derived asymmetry measures. were divided into quartiles based on the distribution of these variables in controls. The main analysis Žlogistic regression controlled for age and sex.examined all psychotic disorders, with planned subgroup analyses comparing controls with Ž1. nonaffective psychosis Žschizophrenia, delusional disorder, schizophreniform psychosis, atypical psychosis.andŽ2. affective psychosis Ždepression with psychosis, bipolar disorder, schizoaffective psychosis.. There were no statistically significant alterations in the odds of havinga psychotic disorder for any of the dermatoglyphic measures. The results did not change when we examined affective and nonaffective psychosis separately. The dermatoglyphic features that distinguish schizophreniar psychosis in other studies were not identified in this Australian study. Regional variations in these findings may provide clues to differential ethnicrgenetic and environmental factors that are associated with schizophrenia. The Stanley Foundation supported this project.

No association between the deficit syndrome in psychosis and summer birth in the Southern Hemisphere

There has been a debate on whether or not the incidence of schizophrenia varies across time and place. In order to optimise the evidence upon which this debate is based, we have undertaken a systematicsystematic review of the literature. In this paper we provide an overview of the methods of the review and a preliminary analysis of the studies identified to date. Electronic databases (Medline, Psychlnfo, Embase, LILAC) were systematically searched for articles published between January 1965 and December 2001. The search terms were: (schizo* OR psycho*)AND (incidence OR prevalence). References were also identified from review articles, reference list and by writing to authors. To date we have identified 137 papers drawn from 33 nations. 37 papers in language other than English await translation. The currently included papers have generated 1413 different items of rate information data. In order to analyze these data we have undertaken several sequential filters in order to identify (a) non-overlapping data, (b) birth cohort study versus noncohort studies, (c) overall and sex-specific rates, (d) diagnostic criteria, (e) age ranges, (f) epoch of study, and (g) data on migrant or other special interest groups. In addition, we will examine the impact of urbanicity of site, age and/or sex standardization, and quality score on the incidence rates. The various discrete incidence rates will be presented graphically and the impact of various filters on these rates will be inspected using meta-analytic techniques. The use of meta-analysis may help elucidate the epidemiological landscape with respect to the incidence of schizophrenia and aid in the generation of new hypothesis. Acknowledgements: The Stanley Medical Research Institute supported project

Decreased duration of perinatal sunshine is associated with higher scores on reality distortion symptoms

While it has been reported that individuals with psychosis are at increased or decreased risk of various physical disorders such as cancer and rheumatoid arthritis, there has been less research on the co-segregation of physical disorders within the first-degree relatives of those with psychosis compared to relatives of well controls. The aim of this study was to examine these issues in an epidemiologically informed catchment-area based case-control study. Patients with psychosis were drawn from a prevalence study undertaken as part of the Australian National Mental Health Survey. In addition, we recruited well controls who resided in the same catchment area. For each subject, we drew pedigrees and used a structured checklist to assess the presence of selected psychiatric disorders, and selected disorders such as multiple sclerosis, epilepsy, spina bifida, thyroid disorders, diabetes, asthma and eczema. Data based on pedigrees from 293 individuals with psychosis and 292 well controls was available. As expected, the odds of havingschizophrenia and affective disorders were significantly increased in the families of cases versus controls. The odds of havingeczema were significantly reduced in the relatives of those with psychosis. All other disorders occurred with equal frequency in cases versus control pedigrees. Current theories of eczema suggest that an absence of early life exposure to antigens and infectious agents may fail to prime the na¨ive immune system, and leave the person at increased risk of eczema. The results of this study suggest that genetic andror environmental factors that facilitate psychosis may protect against eczema. The Stanley Foundation supported this project.The offspringof older fathers have an increased risk of various disorders that may be due to the accumulation of DNA mutations during spermatogenesis. Previous studies have suggested increased paternal age may be a risk factor for schizophrenia. The aim of the current study was to examine paternal age as a risk factor for schizophrenia andror psychosis. We used data from three sources: a population-based cohort studyŽDenmark., and two case-control studiesŽSweden and Australia.. In the Danish and Australian studies, we examined both psychosis and schizophrenia. In the Swedish study we examined psychosis only. After controllingfor the effect of maternal age, increased paternal age was significantly associated with increased risk of both psychosis and schizophrenia in the Danish study and of psychosis in the Swedish study. The Australian study found no association between paternal age and risk of psychosis or schizophrenia. In all three studies the relationship between paternal age and risk of disorder in the offspring was AUB-shaped. In addition to an increased risk for the offspringof older father Ž)35 years., there was a non-significant increase for the offspringof fathers aged less than 20 years. The possible role of paternally derived DNA mutations andror other psychosocial factors associated with older paternal age warrants further research. The ‘U’-shaped relationship suggests that factors other than DNA mutations may warrant consideration in this research. The Stanley Foundation supported this project.Recent studies have shown that individuals with schizophrenia who are born in summer have an increased odds of have deficit syndrome versus nondeficit syndrome. This study extends this work to examiningthis issue in patients from the Southern Hemisphere. Data which included OPCRITrSCAN items and demographic information was obtained for Australian-born cases from the Australian National Mental Health Survey. Followingpreviously published methods, cases were assigned to the deficit group Žns153.or non-deficit groupŽns228.. A logistic regression analysis was used to ascertain whether beingborn in summer ŽDecember, January, February.in the Southern Hemisphere altered the odds of havingdeficit syndrome. There was no association between summer birth and odds of havingdeficit versus non-deficit schizophrenia ŽOdds Ratios0.75, 95% CI 0.49–1.16.. Based on our previous work showingthat the size of the winterrspringbirth excess in schizophrenia is reduced in the Southern Hemisphere, we speculate that factors that influence the association between summer birth and non-deficit syndrome may also vary across geography andror latitude. The Stanley Foundation supported this project.We have previously found an association between variations in schizophrenia birth rates and varyinglevels of perinatal sunshine duration. This study examines whether such an association can also be found for Ža. affective psychosis, and Žb. broadly defined nonaffective psychoses. Data for individuals born between 1931 and 1970 in Australia with ICD9 Other PsychosisŽ295–299.were obtained from the Queensland Mental Health Statistical System. ‘Affective psychosis’ included affective psychosis, schizo-affective psychosis, and depressive and excitative non-organic psychoses. ‘Non-affective psychosis’ included chizophrenia, paranoid disorders and other non-organic psychoses. Those receiving both affective and non-affective psychotic diagnoses were excluded. Rates per 10,000 live monthly general population births were calculated. For each month, we assessed the agreementŽusing the kappa statistic. between trends in Ža. birth rates and Žb. long-term trends in seasonally adjusted perinatal sunshine duration. The analyses were performed separately for males and females. There were 6265 with non-affective psychosis ŽMs3964 rate 66r10,000; Fs2299 44r10,000. and 2858 with affective psychosisŽMs1392 24r10,000; Fs1466 28r10,000.. There were no significant associations between Ža. affective psychosis birth rates for either males or females and Žb. sunshine duration. There was a significant association between nonaffective psychosis birth rates for males only and Žb. sunshine duration Žkappas0.15 p-0.001.. This suggests that, as a risk factor, the effect of reduced perinatal sunshine is specifically associated with males who develop non-affective psychosis. The Stanley Foundation supported this project.We tested the hypothesis that patients with schizophrenia are more prone to impairment in planning and problem-solving as compared with normal controls and patients with traumatic brain injury (TBI) by administering the Tower of Hanoi (TOH) task. A total of one hundred and fifty-three participants (51 in each group) were recruited. The performance of the patient groups was markedly worse than normal controls in terms of profile score, number of rule-breaking behaviour, and mean execution time. Two-way 3 (group) x 6 (complexity) ANOVAs indicated that significant main effects of group and complexity were observed in the number of moves, planning time to initiate the first move and subsequent execution time. The general performance of TOH in the schizophrenia group was very similar to that of the TBI group. Subsequent comparison of sub-groups of frontal and posterior lobe damage indicated the pattern of performance in schizophrenia patients lie between them. Taken together, these findings suggest that neither focal frontal nor temporal lobe damage is a sufficient explanation for the problem-solving deficits in patients with schizophrenia.Dermatoglyphic measures are of interest to schizophrenia research because they serve as persistent markers of deviant development in foetal life. Several studies have reported alterations in A–B ridge counts, total finger ridge counts and measures related to asymmetry in schizophrenia. The aim of this study was to assess these measures in an Australian catchment area, case-control study. Individuals with psychosisŽns246.were drawn from a catchment-area prevalence study, and well controlsŽns229. were recruited from the same area. Finger and palm prints were taken usingan inkless technique and all dermatoglyphic measures were assessed by a trained rater blind to case status. The dermatoglyphic measures Žfinger ridge count, A–B ridge count, and their derived asymmetry measures. were divided into quartiles based on the distribution of these variables in controls. The main analysis Žlogistic regression controlled for age and sex.examined all psychotic disorders, with planned subgroup analyses comparing controls with Ž1. nonaffective psychosis Žschizophrenia, delusional disorder, schizophreniform psychosis, atypical psychosis.andŽ2. affective psychosis Ždepression with psychosis, bipolar disorder, schizoaffective psychosis.. There were no statistically significant alterations in the odds of havinga psychotic disorder for any of the dermatoglyphic measures. The results did not change when we examined affective and nonaffective psychosis separately. The dermatoglyphic features that distinguish schizophreniar psychosis in other studies were not identified in this Australian study. Regional variations in these findings may provide clues to differential ethnicrgenetic and environmental factors that are associated with schizophrenia. The Stanley Foundation supported this project.

The co-segregation of psychosis and selected physical disorders within families of patients with psychosis versus well controls

While it has been reported that individuals with psychosis are at increased or decreased risk of various physical disorders such as cancer and rheumatoid arthritis, there has been less research on the co-segregation of physical disorders within the first-degree relatives of those with psychosis compared to relatives of well controls. The aim of this study was to examine these issues in an epidemiologically informed catchment-area based case-control study. Patients with psychosis were drawn from a prevalence study undertaken as part of the Australian National Mental Health Survey. In addition, we recruited well controls who resided in the same catchment area. For each subject, we drew pedigrees and used a structured checklist to assess the presence of selected psychiatric disorders, and selected disorders such as multiple sclerosis, epilepsy, spina bifida, thyroid disorders, diabetes, asthma and eczema. Data based on pedigrees from 293 individuals with psychosis and 292 well controls was available. As expected, the odds of havingschizophrenia and affective disorders were significantly increased in the families of cases versus controls. The odds of havingeczema were significantly reduced in the relatives of those with psychosis. All other disorders occurred with equal frequency in cases versus control pedigrees. Current theories of eczema suggest that an absence of early life exposure to antigens and infectious agents may fail to prime the na¨ive immune system, and leave the person at increased risk of eczema. The results of this study suggest that genetic andror environmental factors that facilitate psychosis may protect against eczema. The Stanley Foundation supported this project.The offspringof older fathers have an increased risk of various disorders that may be due to the accumulation of DNA mutations during spermatogenesis. Previous studies have suggested increased paternal age may be a risk factor for schizophrenia. The aim of the current study was to examine paternal age as a risk factor for schizophrenia andror psychosis. We used data from three sources: a population-based cohort studyŽDenmark., and two case-control studiesŽSweden and Australia.. In the Danish and Australian studies, we examined both psychosis and schizophrenia. In the Swedish study we examined psychosis only. After controllingfor the effect of maternal age, increased paternal age was significantly associated with increased risk of both psychosis and schizophrenia in the Danish study and of psychosis in the Swedish study. The Australian study found no association between paternal age and risk of psychosis or schizophrenia. In all three studies the relationship between paternal age and risk of disorder in the offspring was AUB-shaped. In addition to an increased risk for the offspringof older father Ž)35 years., there was a non-significant increase for the offspringof fathers aged less than 20 years. The possible role of paternally derived DNA mutations andror other psychosocial factors associated with older paternal age warrants further research. The ‘U’-shaped relationship suggests that factors other than DNA mutations may warrant consideration in this research. The Stanley Foundation supported this project.Recent studies have shown that individuals with schizophrenia who are born in summer have an increased odds of have deficit syndrome versus nondeficit syndrome. This study extends this work to examiningthis issue in patients from the Southern Hemisphere. Data which included OPCRITrSCAN items and demographic information was obtained for Australian-born cases from the Australian National Mental Health Survey. Followingpreviously published methods, cases were assigned to the deficit group Žns153.or non-deficit groupŽns228.. A logistic regression analysis was used to ascertain whether beingborn in summer ŽDecember, January, February.in the Southern Hemisphere altered the odds of havingdeficit syndrome. There was no association between summer birth and odds of havingdeficit versus non-deficit schizophrenia ŽOdds Ratios0.75, 95% CI 0.49–1.16.. Based on our previous work showingthat the size of the winterrspringbirth excess in schizophrenia is reduced in the Southern Hemisphere, we speculate that factors that influence the association between summer birth and non-deficit syndrome may also vary across geography andror latitude. The Stanley Foundation supported this project.We have previously found an association between variations in schizophrenia birth rates and varyinglevels of perinatal sunshine duration. This study examines whether such an association can also be found for Ža. affective psychosis, and Žb. broadly defined nonaffective psychoses. Data for individuals born between 1931 and 1970 in Australia with ICD9 Other PsychosisŽ295–299.were obtained from the Queensland Mental Health Statistical System. ‘Affective psychosis’ included affective psychosis, schizo-affective psychosis, and depressive and excitative non-organic psychoses. ‘Non-affective psychosis’ included chizophrenia, paranoid disorders and other non-organic psychoses. Those receiving both affective and non-affective psychotic diagnoses were excluded. Rates per 10,000 live monthly general population births were calculated. For each month, we assessed the agreementŽusing the kappa statistic. between trends in Ža. birth rates and Žb. long-term trends in seasonally adjusted perinatal sunshine duration. The analyses were performed separately for males and females. There were 6265 with non-affective psychosis ŽMs3964 rate 66r10,000; Fs2299 44r10,000. and 2858 with affective psychosisŽMs1392 24r10,000; Fs1466 28r10,000.. There were no significant associations between Ža. affective psychosis birth rates for either males or females and Žb. sunshine duration. There was a significant association between nonaffective psychosis birth rates for males only and Žb. sunshine duration Žkappas0.15 p-0.001.. This suggests that, as a risk factor, the effect of reduced perinatal sunshine is specifically associated with males who develop non-affective psychosis. The Stanley Foundation supported this project.We tested the hypothesis that patients with schizophrenia are more prone to impairment in planning and problem-solving as compared with normal controls and patients with traumatic brain injury (TBI) by administering the Tower of Hanoi (TOH) task. A total of one hundred and fifty-three participants (51 in each group) were recruited. The performance of the patient groups was markedly worse than normal controls in terms of profile score, number of rule-breaking behaviour, and mean execution time. Two-way 3 (group) x 6 (complexity) ANOVAs indicated that significant main effects of group and complexity were observed in the number of moves, planning time to initiate the first move and subsequent execution time. The general performance of TOH in the schizophrenia group was very similar to that of the TBI group. Subsequent comparison of sub-groups of frontal and posterior lobe damage indicated the pattern of performance in schizophrenia patients lie between them. Taken together, these findings suggest that neither focal frontal nor temporal lobe damage is a sufficient explanation for the problem-solving deficits in patients with schizophrenia.Dermatoglyphic measures are of interest to schizophrenia research because they serve as persistent markers of deviant development in foetal life. Several studies have reported alterations in A–B ridge counts, total finger ridge counts and measures related to asymmetry in schizophrenia. The aim of this study was to assess these measures in an Australian catchment area, case-control study. Individuals with psychosisŽns246.were drawn from a catchment-area prevalence study, and well controlsŽns229. were recruited from the same area. Finger and palm prints were taken usingan inkless technique and all dermatoglyphic measures were assessed by a trained rater blind to case status. The dermatoglyphic measures Žfinger ridge count, A–B ridge count, and their derived asymmetry measures. were divided into quartiles based on the distribution of these variables in controls. The main analysis Žlogistic regression controlled for age and sex.examined all psychotic disorders, with planned subgroup analyses comparing controls with Ž1. nonaffective psychosis Žschizophrenia, delusional disorder, schizophreniform psychosis, atypical psychosis.andŽ2. affective psychosis Ždepression with psychosis, bipolar disorder, schizoaffective psychosis.. There were no statistically significant alterations in the odds of havinga psychotic disorder for any of the dermatoglyphic measures. The results did not change when we examined affective and nonaffective psychosis separately. The dermatoglyphic features that distinguish schizophreniar psychosis in other studies were not identified in this Australian study. Regional variations in these findings may provide clues to differential ethnicrgenetic and environmental factors that are associated with schizophrenia. The Stanley Foundation supported this project.