Showing papers by "Robin M. Murray published in 1991"

The neurodevelopmental basis of sex differences in schizophrenia.

Abstract: Male schizophrenics tend to manifest a severe form of the disease, characterized by early onset, poor pre-morbid adjustment, 'typical' and 'negative' symptoms, and poor outcome; they are more likely than their female counterparts to have a history of preor peri-natal complications, and to exhibit structural brain abnormalities. The most plausible explanation for these differences is that more male than female schizophrenics have a form of disease due to neurodevelopmental anomaly. This hypothesis also accounts for the excess of males in strictly defined schizophrenic cohorts, and in those who present before 30 years of age. In contrast, many later-onset females diagnosed 'schizophrenic' have more in common, aetiologically, with affective psychosis than schizophrenia. Thus, much of the contemporary confusion about schizophrenia results from the conflation of two separate disorders, one commonest in young males and the other in older females.

The incidence of operationally defined schizophrenia in Camberwell, 1965-84.

Abstract: We established first-contact rates of schizophrenia in the defined area of Camberwell between 1965 and 1984. The rate of schizophrenia, whether defined by ICD, RDC, or DSM-III criteria, rose over the period under study. This finding is at odds with reports of an overall decline in first-admission rates for schizophrenia in England, over the same period. The discrepancy was largely accounted for by the influx into Camberwell of individuals of Afro-Caribbean origin, who showed rates of schizophrenia between four and eight times that of their Caucasian counterparts.

The genetics of schizophrenia is the genetics of neurodevelopment.

Abstract: Genes are now accepted as being important in the aetiology of schizophrenia (Gottesman & Shields, 1982; McGuffin et al, 1987), and over the past decade the emphasis in genetic research has shifted away from genetic epidemiology to searching the chromosomal DNA for the genes themselves. Despite this increasing technical sophistication, the application of linkage analysis to families multiply affected by schizophrenia has been accompanied by the familiar controversy over the exact borders of the adult clinical phenotype (Sherrington et al, 1988; St Clair et al, 1989). Indeed, the preoccupation of researchers with the vagaries of the clinical definition has resulted in repeated attempts to use genetic studies to determine the relative validity of different operational definitions of schizophrenia (McGuffin et al, 1984; Farmer et al, 1987). To us, such studies beg the question of how precisely genes are involved in the aetiology of schizophrenia; after all, genes code for proteins, not for auditory hallucinations in the third person.

Pre-morbid adjustment and personality in psychosis. Effects of sex and diagnosis.

Abstract: Pre-morbid schizoid and schizotypal traits and social adjustment were assessed blind to diagnosis by interviewing the mothers of 73 consecutively admitted patients with DSM-III schizophrenia or affective psychosis. Analysis of factors associated with pre-morbid deficits showed a highly significant interaction of diagnosis with sex, such that schizophrenic men showed much greater pre-morbid impairment than either schizophrenic women or men with affective disorder. Poor pre-morbid adjustment predicted an early age at first admission. The results can be explained by a neurodevelopmental disorder in some schizophrenic males.

Schizophrenia and Afro-Caribbeans : a case-control study

Abstract: A case-control study was performed using 90% of all first-contact patients with a clinical diagnosis of schizophrenia residing in the London borough of Camberwell between 1965 and 1984. Cases and controls were obtained from the Camberwell psychiatric case register. Controls were those presenting with first episodes of non-psychotic disorders, matched for age, sex and period. The risk of schizophrenia was greater in those of Afro-Caribbean ethnicity, irrespective of age, gender or place of birth. This risk increased over the study period. The results cannot be explained by changes in the age, gender or ethnic structure of the local population. Effects of misdiagnosis or change in diagnostic practice were reduced by using uniform operational criteria. Possible explanations include maternal exposure to unfamiliar infective agents, a differential fall in the age at onset of illness, or worsening social adversity.

The New Genetics of Mental Illness

Abstract: The cell, molecular biology and the new genetics, S.Whatley and M.Owen genetic models of madness, P.McGuffin the uses and abuses of linkage analysis in neuro-psychiatric disorder, F.Clerget-Darpoux the formal problems of linkage, J.Edwards schizophrenia - how far can we go in defining the phenotype, A.Farmer et al schizophrenia - classical approaches with new twists and provocative results, I.Gottesman and A.Bertelsen genetic linkage studies of schizophrenia, H.Gurling et al aberrant neurodevelopment as the expression of the schizophrenia genotype, P.Jones and R.Murray the familial aggregation of affective disorders - relation to symptom severity and social provocation, P.Bebbington et al life events and depressive symptoms - a twin study perspective, K.Kendler et al genetic markers and affective disorders, P.McGuffin and M.Sargeant the genetics of vulnerability to alcoholism, S.Hodgkinson et al genes and the aetiology of eating disorders, J.Treasure and A.Holland growing together and growing apart - the non-genetic forces on children in the same family, R.Goodman autism as a genetic disorder, M.Rutter learning disability and psychiatric/behavioural disorders - a genetic perspective, A.Holland the genetics of the common forms of dementia, A.Wright the molecular basis of Alzheimer's dimentia, J.Hardy prediction and prevention in Huntingdon's Disease, M.Morris and P.Harper.

Does recurrent depression lead to a change in neuroticism

Abstract: The hypothesis that recurrent or chronic depressive illness produces a long-term change in neuroticism was examined in a sample (N = 34) from a consecutive series of 89 depressed patients admitted to the Maudsley Hospital in 1965/6. The Eysenck Personality Inventory (EPI) was administered at the time of the index illness both when the patients were depressed and on recovery, and then again at follow-up 18 years later. The change in the neuroticism (N) score over the 18-year-period was compared in good and poor outcome groups defined variously by a global rating of outcome, frequency of episodes, extent of subsequent hospitalization and the presence or absence of subsequent chronicity. The mean N score for the sample as a whole did not change significantly over the 18 years, and no differential change in the N score was observed between any of the good and poor outcome groups. Thus, the hypothesis was not supported.

Assessing schizophrenia in adults with mental retardation. A comparative study.

Abstract: Twenty-five patients with mild mental retardation were compared with 26 schizophrenic patients of normal intelligence. The patients with retardation had suffered an earlier onset and were less likely to have been married or employed. However, the clinical phenomena exhibited by the two groups, as elicited by a SADS-L interview, were very similar. Thus, standardised interviews and criteria for schizophrenia can be readily applied to those with an IQ between 50 and 70.

Fetal Brain Development and Later Schizophrenia

Abstract: Computed tomography and magnetic resonance imaging studies have shown cerebral ventricular enlargement and a decreased volume of temporal lobe structures in a proportion of schizophrenic patients Neuropathological investigations confirm these findings and also show diminished volume of the hippocampus and abnormal pre-alpha cell clusters in the parahippocampal gyrus Compared with controls, schizophrenic patients are more likely to have minor physical anomalies, to have a history of obstetric complications, and to have been born in the late winter Together the evidence regarding structural brain abnormalities and epidemiology suggests that a significant proportion of cases of schizophrenia have their origins in fetal or neonatal life The mechanisms involved in the aberrant neurodevelopment remain obscure but some impairment of neuronal migration is an appealing hypothesis

Do Different Subtypes of Hospitalized Depressives Have Different Long-term Outcomes?

Abstract: • In 1965 and 1966, a consecutive series of 89 patients admitted to the Maudsley Hospital, London, England, with depressive illness were interviewed, and various personality questionnaires were administered; 18 years later, they were followed up and reinterviewed. Then, on the basis of the index data alone and without knowledge of their eventual outcomes, they were subtyped according to the Research Diagnostic Criteria, DSM-III , Newcastle Index, and Present State Examination diagnostic criteria. Patients who met the various subtype criteria at index were compared with those who did not in respect to their long-term outcome. Subtyping had little prognostic utility except for three endogenous criteria that were all associated with poor outcome. In addition, DSM-III melancholia had an interactive effect with the personality measure neuroticism, so that those melancholic patients who at index had high neuroticism scores were very likely to have a poor outcome.

MRI in schizophrenia: basal ganglia and white matter T1 times.

Abstract: The T1 relaxation time of the basal ganglia (putamen, globus pallidus and head of caudate) and of the frontoparietal centrum semiovale was compared between 49 schizophrenic patients and 36 healthy controls. Previous reports of increased T1 time in the basal ganglia were not confirmed, and group differences were not detected within the white matter. Within patients T1 values could not be related to tardive dyskinesia or other clinical features. Normal variation seen in basal ganglia T1 times is described for the first time: lowest values occur in the globus pallidus and highest in the caudate, and values within the putamen increase rostrally.

Psychological deficit from excessive alcohol consumption: evidence from a co-twin control study

Abstract: Twenty-five pairs of monozygotic twins discordant for either the alcohol dependence syndrome or heavy drinking were studied to determine the adverse cognitive effects of alcohol. The twins and their co-twins were well-matched for premorbid history and personality but twins with high alcohol consumption performed significantly less well overall on cognitive testing than their co-twins. Impaired performance in parts of the following tests was found: visual spatial ability, visual spatial recognition, Mill Hill vocabulary, Bexley Maudsley category sorting, tactual performance. The number of years of problem drinking correlated with inferior scores on subtests of the tactual performance test. This study provides further evidence that alcohol abuse produces long-term cognitive sequelae which may not be grossly evident in clinical practice, and which may occur even at relatively low levels of intake.

Is schizophrenia disappearing?: Introductory remarks of the chief-editor

Abstract: The incidence of schizophrenia is regarded as being similar between different cultures and times. However, several studies, mostly based on first-admission rates, have suggested that the incidence has declined over the past 10-15 years. Data from England and Wales for 1952-86 have been examined: there has been a substantial decrease, beginning in the mid-1960s, in the incidence of schizophrenia.

Neurodevelopment and the Chronological Curiosities of Schizophrenia

Abstract: Several lines of evidence suggest that at least some cases of schizophrenia are a consequence of a structurally abnormal brain (Stevens, 1982). Although it is only now possible to study the cells of the brain and the genes controlling them, many of the most enduring findings in the field of schizophrenia research were established more than half a century ago and concern the timing of events. These findings include the excess of schizophrenics born in the late winter and spring (Tramer, 1929), the importance of the perinatal period in the development of psychopathology (Critchton-Browne, 1862), the association of early head trauma and psychosis (Tennent, 1937), and the earlier age of onset of schizophrenia in males (Bleuler, 1911 trans. 1950). Such findings have been widely replicated but for many years were not considered to be of fundamental importance to the understanding of schizophrenia. Instead, they were disregarded as mere chronological curiosities.