We wished to determine the specificity of smooth-pursuit eye tracking dysfunction to schizophrenia and the prevalences of dysfunction among functionally psychotic and normal individuals. Therefore, we investigated pursuit tracking in a large sample of psychotic patients, normal subjects, and first-degree relatives (N = 482). Patients were recruited as part of an epidemiological study of first-episode psychosis that used a broadly based referral network to identify all cases in a major metropolitan area over a 2'/2-year period. Patients received diagnoses of schizophrenia, schizophreniform disorder, psychotic mood disorder, and paranoid or other psychotic disorder based on the third edition of the Diagnostic and Statistical Manual of 'Mental Disorders (American Psychiatric Association, 1980). The distribution of tracking performance was bimodal for the schizophrenic patients and their relatives, perhaps reflecting major gene action. Moreover, poor tracking ran in families. Pursuit tracking dysfunction was relatively specific to schizophrenic patients and their relatives and occurred infrequently in other psychotic patients and normal subjects.In many independent investigations an association between smooth-pursuit eye tracking impairment and schizophrenia has been documented (for recent reviews, see lacono, 1988). First-degree relatives of schizophrenic individuals, including their twins, are also likely to show oculomotor dysfunction (Holzman et al, 1988;Matthysse, Holzman, & Lange, 1986). Some have speculated that deviant pursuit oculomotion is a psychophysiological marker of genetic predisposition to schizophrenia, and a genetic model has been advanced to account for some family data (Holzman et al., 1988). Holzman et al. (1988) and Matthysse et al. (1986) have posited that almost all cases of schizophrenia can be accounted for by a latent trait governed by a dominant gene. The expression of the gene is hypothesized to be pleiotropic, with carriers manifesting schizophrenia, dysfunctional pursuit tracking, or both traits.

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The literature indicates that whether or not schizophrenic patients are reported to have significant lateral ventricular enlargement depends on control, and not schizophrenic-group values. This discrepancy does not result from differences in age, the ratio of males to females, the number of control subjects used in each study, or whether control groups are comprised of normal subjects or medical patients. However, medical-patient controls tend to have smaller ventricles than do normal individuals. Thus, we assessed lateral- and third-ventricle size and the degree of cortical atrophy in 30 normal volunteers, 30 medical patients, and 30 chronic schizophrenic patients. The use of a medical control group seemed to result in underestimates of ventricle and sulcal size in the normal population and, therefore, overestimates of these values in schizophrenic groups.

The present study describes the development and initial validation of a behavioral rating scale, the Riverview Psychiatric Inventory (RPI). The RPI is a 36-item scale that is scored into four subscales covering daily routine problems, psychological symptoms, social interaction problems, and aggressive behavior. Interrater reliability using 70 pairs of raters assessing 145 patients resulted in a reliability coefficient of .89. Internal consistency for the total score was high (alpha = .93) and each of the subscales showed alpha coefficients ranging from .76 to .87. Validity was evaluated on a sample of 359 adult psychiatric inpatients. The RPI total score significantly distinguished three groups of patients on hospital units designed to treat differing levels of psychiatric illness. The RPI is superior to other behavioral rating scales employed by mental health clinicians because it does not require lengthy training in administration and scoring. The scale is useful for routine assessments on a busy psychiatric unit.

To determine whether abnormalities in brain morphology are present at the onset of illness, patients with schizophrenia, schizophreniform and bipolar disorders, and major depression who were experiencing their first episodes of psychosis were compared with normal and medical control subjects. The schizophrenic patients had larger third ventricles but not larger lateral ventricles or cortical sulci than the normal subjects. The other psychotic patients did not differ from the normal group on these measures. A different pattern of results emerged when the medical patients were used for comparison, indicating that the choice of control group can influence the findings of computerized tomography studies.

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