Rorschach Developmental Level in the offspring of patients with schizophrenia and manic-depressive illness

The Developmental Level (DL) score was assessed from Rorschach inkblot tests of 305 children. Children were either the offspring of one schizophrenic, one manic-depressive, one physically ill, or of two normal parents. Socioeconomic status, age, and intelligence were treated as covariates. Children of one schizophrenic parent had lower DL scores than children in the other three groups.     

Catamnestic surveys on somato-psychosocial development in childhood and adolescence of patients with unipolar depressive and bipolar manic-depressive psychoses

The somatic and psychosocial development of 80 subjects with manifest affective-phasic psychoses is studied retrospectively and compared with that of an identically sized control group consisting of neuropsychiatrically healthy subjects. Statistically significant differences were found particularly in the answers to questions dealing with social situation and social adaptability. Achievement at school and vocational qualifications were lower among the parents of the patients than among those of the healthy subjects. Characteristic features of the patients' childhood and adolescence were transient depression, often for no apparent cause, and maladaption, and vocational wishes were fulfilled less often than among the controls. The patients experienced greater difficulty in settling in to a new group due to their contact difficulties.     

Enhanced encoding of nonverbal cues in bipolar illness in males

Twenty-five affectively bipolar males were found to possess an enhanced ability to encode nonverbal cues when compared to matched controls. This ability was present during both manic and euthymic phases.     

Error monitoring dysfunction across the illness course of schizophrenia

Response monitoring abnormalities have been reported in chronic schizophrenia patients, but it is unknown whether they predate the onset of psychosis, are present in early stages of illness, or are late-developing abnormalities associated with illness progression. Response-synchronized event-related potentials (ERP) recorded during a picture-word matching task yielded error-related negativity (ERN), correct-response negativity (CRN), and error positivity (Pe) from 84 schizophrenia patients (SZ), 48 clinical high risk patients (CHR), and their age-matched healthy controls (HC; n = 110 and 88, respectively). A sub-sample of 35 early illness schizophrenia patients (ESZ) was compared to 93 age-matched HC and the CHR patients (after statistically removing the effects of normal aging). Relative to HC, 1) SZ, ESZ, and CHR had smaller ERNs, and 2) SZ and ESZ had larger CRNs and smaller Pes. Within the SZ, longer illness duration was associated with larger CRNs but was unrelated to ERN or Pe. CHR and ESZ did not differ on ERN or CRN, although Pe was smaller in ESZ than CHR. These results indicate that while ERN, CRN, and Pe abnormalities are present early in the illness, only the ERN abnormality is evident prior to psychosis onset, and only the CRN abnormality appears to worsen progressively over the illness course. Brain regions subserving response monitoring may be compromised early in the illness and possibly during its clinical prodrome.     

Temporal discounting of rewards in patients with bipolar disorder and schizophrenia

Patients with bipolar disorder (BD) and schizophrenia (SZ) often show decision-making deficits in everyday circumstances. A failure to appropriately weigh immediate versus future consequences of choices may contribute to these deficits. We used the delay discounting task in individuals with BD or SZ to investigate their temporal decision making. Twenty-two individuals with BD, 21 individuals with SZ, and 30 healthy individuals completed the delay discounting task along with neuropsychological measures of working memory and cognitive function. Both BD and SZ groups discounted delayed rewards more steeply than did the healthy group even after controlling for current substance use, age, gender, and employment. Hierarchical multiple regression analyses showed that discounting rate was associated with both diagnostic group and working memory or intelligence scores. In each group, working memory or intelligence scores negatively correlated with discounting rate. The results suggest that (a) both BD and SZ groups value smaller, immediate rewards more than larger, delayed rewards compared with the healthy group and (b) working memory or intelligence is related to temporal decision making in individuals with BD or SZ as well as in healthy individuals.     

The contemporary face of bipolar illness: complex diagnostic and therapeutic challenges

Manic depression, or bipolar disorder, is a multifaceted illness with an inevitably complex treatment. The current article summarizes the current status of our knowledge and practice concerning its diagnosis and treatment. While the prototypic clinical picture concerns the "classic" bipolar disorder, today mixed episodes with incomplete recovery and significant psychosocial impairment are more frequent. The clinical picture of these mixed episodes is variable, eludes contemporary classification systems, and possibly includes a constellation of mental syndromes currently classified elsewhere. Treatment includes the careful combination of lithium, antiepileptics, atypical antipsychotics, and antidepressants, but not all of the agents in these broad categories are effective for the treatment of bipolar disorder.     

Psychoanalytic and biological approaches to mental illness: schizophrenia.

Biological psychiatrists tend to look upon the phenomena of mind and meaning, which are the data of psychoanalysis, as meaningless epiphenomena, and propose reductive explanations of complex mental states, whereas psychoanalysts tend to ignore the proliferation of neurobiological data indicating the importance of constitutional factors in mental illness. Interactive models which confuse biological causes and psychological consequences, or vice-versa, are theoretically unsound. A scientific model hierarchy is proposed, along with some principles for coexistence and collaboration between neurobiology and psychoanalysis. The problem is illustrated with schizophrenia, a condition whose probable biological underpinnings are now generally considered to remove it from the realm of psychoanalysis. Schizophrenia-vulnerable phenotypes consistent with organic findings and clinical observations are hypothesized, and some ideas about their development in the context of early object relations, leading to pathological forms of symbiosis, are elaborated. A neurobiological rationale for the psychoanalytic treatment of schizophrenia is presented, and special problems related to the biological and symbiotic substrate are examined.     

Historical origins of schizophrenia: two early madmen and their illness

Schizophrenia is a serious mental illness with a remarkably short recorded history. Unlike depression and mania, which are recognizable in ancient texts, schizophrenia-like disorder appeared rather suddenly in the psychiatric literature of the early nineteenth century. This could mean that the illness is a recent disease that was largely unknown in earlier times. But perhaps schizophrenia existed, embedded and disguised within more general concepts of madness and within the arcane languages and cultures of remote times. Both possibilities present major challenges to historical and psychiatric scholarship. These challenges are explored in this paper by presenting two "new" cases of schizophrenia, one from the eighteenth and one from the fourteenth century. The cases suggest that the illness may have existed as early as the medieval period. However, establishing the population prevalence of schizophrenia in earlier times--and therefore resolving the permanence-recency debate--may not be a feasible enterprise.     

Impact of a television film on attitudes toward mental illness

The possible impact of a prime time television film portraying a mentally ill killer was investigated. Groups of college students were shown the film with and without a film trailer reminding viewers that violence is not characteristic of mentally ill persons. A third group viewed a film not about mental illness. Postfilm responses to the Community Attitudes toward the Mentally Ill scale indicated that those who saw the target film expressed significantly less favorable attitudes toward mental illness and community care of mentally ill persons than did those who saw the control film, regardless of whether of not they received the trailer along with the target film. Results support concerns that media depictions add to mental illness stigma and also suggest that corrective information alone may be sufficient to counteract the stigmatizing impact of such audience-involving mass media portrayals.     

Performance of schizophrenia and bipolar patients on verbal and figural working memory tasks

Working memory (WM) was studied in 82 healthy volunteers, 43 schizophrenia patients, and 81 bipolar patients. Schizophrenia patients were impaired on verbal and figural WM tasks that possessed similar test discriminating power. Bipolar patients performed similarly to healthy volunteers. A mathematical model of WM performance revealed a primary role for reduced WM span in accounting for the impaired verbal WM of schizophrenia patients and a primary role for diminished attention in accounting for impaired figural WM. Although WM impairment in schizophrenia is due neither to the general effects of severe mental illness nor to the specific type of material studied, the microarchitecture of abnormal WM in schizophrenia may depend on the stimulus material presented.     

Individual differences in susceptibility to infection and illness following respiratory virus challenge

Abstract

The aim of the present research was to investigate whether susceptibility to experimentally-induced respiratory virus infections and illness is related to measures of personality, physiological state, performance efficiency, and subjective ratings of alertness and motivation obtained prior to virus challenge. Two studies, using different viruses, showed that volunteers who subsequently developed colds had higher temperatures prior to virus challenge than those who remained free from illness. Similarly, those who later had colds were worse than other volunteers on certain performance tests given in the pre-challenge period. The results also showed that task-related motivation was related to subsequent infection. Personality scores were poor predictors of infection and illness, the only exception being introversion, which, in one study, was related to the likelihood of developing a sub-clinical infection.     

Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder

Hellvin, T., Sundet, K.,Vaskinn, A., Simonsen, C.,Ueland, T., Andreassen, O.A. & Melle, I. (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology 51, 525–533. Studies of social functioning in severe mental disorders are disadvantaged by the multitude of different assessment instruments in use. The present study aims to establish reliability and validity of the Norwegian version of the Social Functioning Scale (SFS) and to examine social functioning in bipolar disorder (BD) compared to schizophrenia (SZ) and healthy controls (HC). SFS, a 76 item questionnaire divided into seven subscales measuring various aspects of daily life functioning, was administered to samples diagnosed with BD (n = 100) or SZ (n = 100) and to HC (n = 100), recruited from the ongoing Tematic Organized Psychosis (TOP) study. Reliability analyses prove adequate psychometric properties both for the composite full scale score (α: 0.81) as well as for the seven subscale scores (α: 0.60–0.88). Principal component analysis of the subscales confirms a one‐component structure, explaining 59% of the variance. Although significantly correlated with the Global Assessment of Functioning, our results indicate that the SFS measures different aspects of social functioning, is less influenced by demographic and clinical characteristics, but differentiates at the same time significantly BD from SZ. Thus, SFS adds valuable information as a supplement to standard clinician‐rated assessment tools of social functioning, suited both for research and clinical work.