Clinical characteristics and risk factors for Kraepelinian subtype of schizophrenia: replication of previous findings and relation to summer birth

Bralet, Marie-Cécile; Loas, Gwenolé; Yon, Valérie; Maréchal, Virginie

doi:10.1016/s0165-1781(02)00148-8

Cited by 16 publications

(14 citation statements)

References 30 publications

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“…It has long been suggested that there may be a subgroup of patients with schizophrenia, who show a progressively deteriorating course conforming to the Kraepelin’s views, termed “Kraepelinian”. The Kraepelinian patients are characterized by severe dysfunctions in self-care [144, 145], disturbance in premorbid sociosexual functioning [146], more severe negative symptoms and formal though disorder [147], lower association with affective symptoms [148], extensive family history of schizophrenia spectrum disorders [145], resistance to antipsychotic treatments [144], early age of onset [149]. Decline in overall cognitive functions in those patients seems in fact greater than that which can be attributed to normal aging and it doesn’t seem to be attributable to a co-morbid neurodegenerative disease [150].…”

Section: Coursementioning

confidence: 99%

Schizophrenia: from Epidemiology to Rehabilitation

Mura¹,

Петретто²,

Bhat³

et al. 2012

CPEMH

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Purpose/Objective:We discuss recent evidences about schizophrenia (frequency, onset, course, risk factors and genetics) and their influences to some epidemiological myths about schizophrenia diffuse between psychiatric and psychopathology clinicians. The scope is to evaluate if the new acquisitions may change the rehabilitation approaches to schizophrenia modifying the balance about the neurodevelopmental hypothesis of schizophrenia accepting that the cognitive deficits are produced by errors during the normal development of the brain (neurodevelopmental hypothesis) that remains stable in the course of illness and the neurodegenerative hypothesis according of which they derived from a degenerative process that goes on inexorably.Research Method/Design:A review of the literature about epidemiology of schizophrenia has been performed and the contributions of some of these evidence to neurodevelopmental hypothesis and to rehabilitation has been described.Results:It cannot be definitively concluded for or against the neurodevelopmental or degenerative hypothesis, but efforts in understanding basis of schizophrenia must go on. Until now, rehabilitation programs are based on the vulnerability-stress model: supposing an early deficit that go on stable during the life under favorable circumstances. So, rehabilitation approaches (as neuro-cognitive approaches, social skill training, cognitive-emotional training) are focused on the individual and micro-group coping skills, aiming to help people with schizophrenia to cope with environmental stress factors.Conclusions/Implications:Coping of cognitive deficits in schizophrenia may represents the starting-point for further research on schizophrenia, cohort studies and randomized trials are necessary to defined the range of effectiveness and the outcome of the treatments.

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Section: Coursementioning

confidence: 99%

Schizophrenia: from Epidemiology to Rehabilitation

Mura¹,

Петретто²,

Bhat³

et al. 2012

CPEMH

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“…The renewal of interest in Kraepelin's dementia praecox since the 1990's has led researchers to attempt delineating a 'Kraepelinian' subtype of schizophrenia, in terms of negative or disorganized symptoms, poor outcome, neuropsychological deficits, and risk factors. [54][55][56] However, as indicated in Table 1, Kraepelin's original typology allowed for much greater heterogeneity in the clinical manifestations of dementia praecox than it is currently assumed.…”

Section: Putative Schizophrenia Subtypes Based On Clinical Featuresmentioning

confidence: 99%

Subtyping schizophrenia: implications for genetic research

2006

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Phenotypic variability and likely extensive genetic heterogeneity have been confounding the search for the causes of schizophrenia since the inception of the diagnostic category. The inconsistent results of genetic linkage and association studies using the diagnostic category as the sole schizophrenia phenotype suggest that the current broad concept of schizophrenia does not demarcate a homogeneous disease entity. Approaches involving subtyping and stratification by covariates to reduce heterogeneity have been successful in the genetic study of other complex disorders, but rarely applied in schizophrenia research. This article reviews past and present attempts at delineating schizophrenia subtypes based on clinical features, statistically derived measures, putative genetic indicators, and intermediate phenotypes, highlighting the potential utility of multidomain neurocognitive endophenotypes.

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“…Longitudinal outcome and severity of the illness have not been eschewed by this classificatory attention, leading to narrower, partially overlapping (Nakaya and Ohmori, 2006) categories of deficit/nondeficit and "Kraepelinian" schizophrenia (Roy et al, 2001). The latter, very poor outcome "Kraepelinian" subtype is defined by a complete existential dependence on others for maintaining basic necessities of life and thus may represent the majority of chronically institutionalized patients with schizophrenia (Keefe et al, 1987(Keefe et al, , 1988Bralet et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

“…In comparison to schizophrenia patients with more favorable outcomes, the course of the pooroutcome schizophrenia is characterized by severe dysfunctions in self-care (Keefe et al, 1996), limitations in premorbid sociosexual functioning (Keefe et al, 1989(Keefe et al, , 1990), more severe negative symptoms and formal thought disorder (Stephens, 1978;Keefe et al, 1989), poorer response to antipsychotic treatment , lower association with affective symptomatology (Kilzieh et al, 2003;Rieckmann et al, 2005), excessive summertime clustering of birthdates (Bralet et al, 2002), and more extensive family history of schizophrenia spectrum disorders (Keefe et al, 1992). Some of these poor-outcome characteristics are in turn interrelated, e.g.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive assessment of gray and white matter volumes and their relationship to outcome and severity in schizophrenia

et al. 2007

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Preliminary data suggest an association of posterior cortical gray matter reduction with poor outcome in schizophrenia. We made a systematic MRI assessment of regional gray and white matter volumes, parcellated into 40 Brodmann's areas, in 104 patients with schizophrenia (51 with good outcomes, 53 with poor outcomes) and 41 normal comparison subjects, and investigated correlations of regional morphometry with outcome and severity of the illness. Schizophrenia patients displayed differential reductions in frontal and to a lesser degree temporal gray matter volumes in both hemispheres, most pronounced in the frontal pole and lateral temporal cortex. White matter volumes in schizophrenia patients were bilaterally increased, primarily in the frontal, parietal, and isolated temporal regions, with volume reductions confined to anterior cingulate gyrus. In patients with schizophrenia as a group, higher illness severity was associated with reduced temporal gray matter volumes and expanded frontal white matter volumes in both hemispheres. In comparison to good-outcome group, patients with poor outcomes had lower temporal, occipital, and to a lesser degree parietal gray matter volumes in both hemispheres and temporal, parietal, occipital, and posterior cingulate white matter volumes in the right hemisphere. While gray matter deficits in the granular cortex were observed in all schizophrenia patients, agranular cortical deficits in the left hemisphere were peculiar to patients with poor outcomes. These results provide support for frontotemporal gray matter reduction and frontoparietal white matter expansion in schizophrenia. Poor outcome is associated with more posterior distribution (posteriorization) of both gray and white matter changes, and with preferential impairment in the unimodal visual and paralimbic cortical regions.

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Clinical characteristics and risk factors for Kraepelinian subtype of schizophrenia: replication of previous findings and relation to summer birth

Cited by 16 publications

References 30 publications

Schizophrenia: from Epidemiology to Rehabilitation

Schizophrenia: from Epidemiology to Rehabilitation

Subtyping schizophrenia: implications for genetic research

A comprehensive assessment of gray and white matter volumes and their relationship to outcome and severity in schizophrenia

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