Age at Onset in Subtypes of Schizophrenic Disorders

Beratis, Stavroula; Gabriel, Joanna; Hoidas, Stavros

doi:10.1093/schbul/20.2.287

Cited by 76 publications

(37 citation statements)

References 31 publications

(36 reference statements)

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“…Women have been found to experience more paranoid symptoms (Beratis et al, 1994) and to be more likely to appear depressed than men (Morgan et al, 2008). The presence of affective symptoms is linked to more favourable outcomes (Lewine, 2004).…”

Section: Development Of Schizophrenia In Womenmentioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

641

672

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Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods:The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RANZCP GuidelinesGalletly et al. 411 Australian & New Zealand Journal of Psychiatry, 50(5)Results: The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. Conclusions:This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.

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Section: Development Of Schizophrenia In Womenmentioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

641

672

View full text Add to dashboard Cite

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“…15 Siblings who are past this critical age might therefore no longer be at high risk for schizophrenia, which might reduce the likelihood of finding grey matter abnormalities in this group. Second, the risk for schizophrenia increases as genetic load increases.…”

Section: J Psychiatry Neurosci 2015;40(3)mentioning

confidence: 99%

Grey matter, an endophenotype for schizophrenia? A voxel-based morphometry study in siblings of patients with schizophrenia

Velde

Gromann

Swart

et al. 2015

jpn

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IntroductionThe liability for schizophrenia is heritable, 1 with siblings of patients with schizophrenia being at increased risk (about a 10-fold increase) for the disorder.2 Structural brain abnormalities in patients with schizophrenia have been consistently reported. For example, patients show reduced grey matter in the frontal, temporal and thalamic regions (see the meta-analyses by Fornito and colleagues 3 and Haijma and colleagues 4 ). Previous studies have suggested that part of these grey matter abnormalities might not be related to the illness state, but rather to the genetic risk, and have proposed these abnormalities to be an endophenotype for schizophrenia. [5][6][7] Consistent with this proposal, 4 recent meta-analyses reported grey matter reductions in relatives of patients compared with controls. [8][9][10][11] Although the aims of these meta-analyses differed, all of them compared individuals at genetic high risk with controls. However, the results of these meta-analyses differed substantially, and the thresholds applied were rather low (p < 0.05, p < 0.005 and p < 0.001, uncorrected). Two meta-analyses showed grey matter reductions in relatives compared with controls in the lentiform nucleus 9,11 and medial prefrontal cortex, 9 whereas another meta-analysis reported higher levels of grey matter in the medial prefrontal cortex in siblings.11 Furthermore, reductions in the parahippompal gyrus and anterior cingulate have been reported, 8 while others reported reductions in the amygdala and hippocampus.10 Besides these contradictory reports, the 3 largest voxel-based morphometry (VBM) studies in siblings 12-14 did not report any significant differences in whole brain grey matter between siblings and controls.In a recent review, several hypotheses were proposed to explain these differences. 5 The first explanation was that many studies included participants who were already past the critical ages for schizophrenia developing. The onset of Background: Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophrenia given a number of reports of grey matter abnormalities in relatives of patients with schizophrenia. However, previous studies on grey matter abnormalities in relatives have produced inconsistent results. The aim of the present study was to examine grey matter differences between controls and siblings of patients with schizophrenia and to examine whether the age, genetic loading or subclinical psychotic symptoms of selected individuals could explain the previously reported inconsistencies. Methods: We compared the grey matter volume and grey matter concentration of healthy siblings of patients with schizophrenia and healthy controls matched for age, sex and education using voxel-based morphometry (VBM). Furthermore, we selected subsamples based on age (< 30 yr), genetic loading and subclinical psychotic symptoms to examine whether this would lead to different results. Results: We included 89 siblings and 69 controls in our study. The results showed that sibl...

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“…To what extent DDC might influence these specific parameters should be scrutinized in future studies of suitable patient samples. Moreover, several studies have reported that the early onset in males was particularly evident in paranoid schizophrenia, [22][23][24] and paranoid symptoms have been specifically related to increased dopaminergic activity on the basis of amphetamine-induced psychosis. 25,26 It has been shown that amphetamine causes a reduction in DDC mRNA and 2-PE production.…”

Section: ‫ء‬mentioning

confidence: 99%

Dopa decarboxylase genotypes may influence age at onset of schizophrenia

Børglum¹,

Hampson

Kjeldsen³

et al. 2001

Mol Psychiatry

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Several lines of evidence implicate dopa decarboxylase (DDC) with schizophrenia. By analysis of two putative functional DDC variants in 173 schizophrenic patients and 204 controls we tested the hypotheses that DDC is involved in: (1) predisposition to schizophrenia; and (2) modulation of age at disease onset. No association was observed with schizophrenia as a whole, whereas an association between DDC genotypes and age at disease onset was suggested in males (P = 0.03). This association was most pronounced in relation to genotypes of haplotypes comprising both variants, suggesting an additive model where one variant mediates early and the other late onset. Accordingly, the haplotypebased genotypes could be assigned into three groups by their possible relative effect on age at onset: an 'early', 'neutral' and 'late' group. Dividing the male schizophrenics into four groups with increasing age at onset, the 'early' genotypes were seen to decrease in frequency from 51.5% to 16.7% while the 'late' genotypes increased from 12.1% to 33.3% (P = 0.02). The difference in mean age at onset between male patients with 'early' genotypes vs patients with 'late' genotypes was close to 5 years (95% CI: 0.7-8.8). Thus, DDC may possibly act as a modulator of age at onset in male schizophrenics. Molecular Psychiatry (2001) 6, 712-717.

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Age at Onset in Subtypes of Schizophrenic Disorders

Cited by 76 publications

References 31 publications

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Grey matter, an endophenotype for schizophrenia? A voxel-based morphometry study in siblings of patients with schizophrenia

Dopa decarboxylase genotypes may influence age at onset of schizophrenia

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