Ronald O. Rieder

Neuropsychological deterioration and CT scan findings in chronic schizophrenia.

Structural abnormalities of the brain, particularly ventricular enlargement and prominence of cortical sulci, have been documented reliably in CT scan investigations of chronic schizophrenic patients. Although the clinical significance of these findings is still obscure, neuropsychological (NP) deficits have emerged as relatively robust correlates of the structural anomalies. Unfortunately, it remains unknown whether the previous findings of NP impairment in association with CT scan abnormalities reflect poor premorbid abilities or deterioration from previously higher levels. This study involved administration of an extensive NP battery and CT scans in a chronic schizophrenic sample. In addition to global and specific scales of NP functions, indices of premorbid ability and deterioration were also employed. The results are consistent with the hypothesis that CT scan findings are associated more with deterioration of functioning than with global measures of NP dysfunction or poor premorbid ability. Conversely, the findings suggest that in patients with normal scans, NP morbidity may be a consequence of failure in the acquisition of a normal cognitive repertoire.

THE OFFSPRING OF SCHIZOPHRENIC PARENTS: A REVIEW

This paper reviews the literature on the offspring of schizophrenic parents. Older papers are compared with more recent data that have been gathered as part of studies investigating the etiology of schizophrenia. Rather than discussing the implications these new studies have for the causation of schizophrenia, this paper focuses upon their clinical findings. These studies have shown: a) there is a wide spectrum of psychopathology found among the adult offspring of schizophrenics, ranging from schizoid disorders through schizophrenia to psychopathy, as Kallmann first described; b) that the incidence of this spectrum of psychopathology among these offspring is high, ranging from 25 to 45 per cent; and c) that the offspring of schizophrenics, as children, also show a considerable incidence of social and psychological maladjustment, estimated around 20 per cent, again with two prominent types: a withdrawn, schizoid type; and a hyperactive, asocial, delinquent type. As opposed to older reports, these children do differ from the offspring of control.

Schizophrenic symptoms and deterioration. Relation to computed tomographic findings.

Thirty-two patients with a research diagnosis of chronic schizophrenia were studied using structured clinical scales for premorbid adjustment, clinical symptomatology, and social deterioration. By computed axial tomography (CAT), ventricle-brain ratio (VBR) and cortical atrophy were assessed. The relation between the clinical variables and CAT findings was assessed using linear correlation. CAT-based subgroups were compared using univariate analysis of variance. Previous findings of ventricular enlargement and cortical atrophy in some schizophrenics were replicated. Premorbid asociality and social deterioration were found to have a modest, positive relation with CAT findings but formal thought disorder had a negative relation to ventricle size. There was no relation between the negative symptoms and CAT measures. Within the CAT-positive group the presence of cortical atrophy appeared to be associated with a more severe illness compared with those with ventricular enlargment but the sample sizes were too small to obtain any significant differences.