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Age at Onset, Sex, and Familial Psychiatric Morbidity in Schizophrenia

Camberwell Collaborative Psychosis Study

Published online by Cambridge University Press:  02 January 2018

Pak Chung Sham ,
Peter Jones ,
Ailsa Russell ,
Karyna Gilvarry ,
Paul Bebbington ,
Shôn Lewis ,
Brian Toone  and
Robin Murray
Pak Chung Sham*
Affiliation:
Departments of Psychological Medicine and Biostatistics
Peter Jones
Affiliation:
Department of Psychological Medicine
Ailsa Russell
Affiliation:
Genetics Section
Karyna Gilvarry
Affiliation:
Genetics Section
Paul Bebbington
Affiliation:
MRC Social and Community Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
Shôn Lewis
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London W6 8RP
Brian Toone
Affiliation:
King's College and Maudsley Hospitals, Denmark Hill, London SE5 9RS
Robin Murray
Affiliation:
Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
*
Dr P. C. Sham, Institute of Psychiatry
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Abstract

Background

Although a genetic component in schizophrenia is well established, it is likely that the contribution of genetic factors is not constant for all cases. Several recent studies have found that the relatives of female or early onset schizophrenic patients have an increased risk of schizophrenia, compared to relatives of male or late onset cases. These hypotheses are tested in the current study.

Method

A family study design was employed; the probands were 195 patients with functional psychosis admitted to three south London hospitals, diagnosed using Research Diagnostic Criteria (RDC), and assessed using the Present State Examination (PSE). Information on their relatives was obtained by personal interview of the mother of the proband, and from medical records. Psychiatric diagnoses were made using Family History – Research Diagnostic Criteria (FH-RDC), blind to proband information.

Results

There was a tendency for homotypia in the form of psychosis within families. The lifetime risk of schizophrenia in the first degree relatives of schizophrenic probands, and the risk of bipolar disorder in the first degree relatives of bipolar probands, were 5–10 times higher than reported population risks. Relatives of female and early onset (<22 years) schizophrenic probands had higher risk of schizophrenia than relatives of male and late onset schizophrenic probands. However, this effect was compensated in part by an excess of non-schizophrenic psychoses in the relatives of male probands.

Conclusions

These results suggest a high familial, possibly genetic, loading in female and early onset schizophrenia, but do not resolve the question of heterogeneity within schizophrenia.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 4 , October 1994 , pp. 466 - 473
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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