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The Continuum of Psychosis and its Implication for the Structure of the Gene

Published online by Cambridge University Press:  29 January 2018

T. J. Crow
T. J. Crow*
Affiliation:
Head of Division of Psychiatry, Clinical Research Centre, Northwick Park Hospital, Watford Road, Harrow, Middlesex HAI 3UJ
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Extract

Three observations challenge Kraepelin's binary view of the functional psychoses: a bimodal distribution of the clinical features of manic-depressive illness and schizophrenia has not been demonstrated; affective illness appears to predispose to schizophrenia in later generations; and “schizoaffective’ illnesses cannot be separated in family studies from either of the prototypical psychoses. The alternative concept is that psychosis is a continuum extending from unipolar, through bipolar affective illness and schizoaffective psychosis, to typical schizophrenia, with increasing degrees of defect. According to this concept the genes predisposing to psychosis have a degree of stability that ensures that the form of the psychosis tends to remain the same within families, but there is also the possibility of change, implying that the genetic mechanisms themselves are variable. It is proposed that quantal changes in the “virogene’ are due to replications within the genome (e.g. the generation of tandem repeats of the element or a component of it); that such replications occur at a critical stage (e.g. gametogenesis, fertilisation, very early embryogenesis) in the course of reproduction; and that the “season of birth effect’ reflects the operation of the mechanism responsible for these replications.

Type
Papers
Information
The British Journal of Psychiatry , Volume 149 , Issue 4 , October 1986 , pp. 419 - 429
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (DSM-III). Washington DC: APA.Google Scholar
Andreasen, N. C. & Powers, P. S. (1975) Creativity and psychosis. Archives of General Psychiatry, 32, 70–73.CrossRefGoogle ScholarPubMed
Angst, J., Felder, W. & Lohmeyer, B. (1979) Schizo-affective disorders. I. Results of a genetic investigation. Journal of Affective Disorders, 1, 139–153.CrossRefGoogle Scholar
Annett, M. (1978). A Single Gene Explanation of Right and Left Handedness and Brainedness. Coventry: Lanchester Polytechnic.Google Scholar
Annett, M. (1985) Left, Right, Hand and Brain: The Right Shift Theory. London: Eribaum.Google Scholar
Baron, M., Gruen, R., Asnis, L. & Kane, J. (1982) Schizo-affective illness, schizophrenia and affective disorders. Acta Psychiatrica Scandinavica, 65, 253–262.Google Scholar
Beck, A. T.(1972) Depression: Causes and Treatment. University of Pennsylvania, Philadelphia.Google Scholar
Biederman, J., Lerner, Y. & Belmaker, R. H. (1979) Combination of lithium carbonate and haloperidol in schizo-affective disorder. Archives of General Psychiatry, 36, 327–333.Google Scholar
Bland, R. C. & Orn, H. (1980) Schizophrenia: Schneider's first rank symptoms and outcome. British Journal of Psychiatry, 137, 63–68.CrossRefGoogle ScholarPubMed
Brockington, I. F., Kendell, R. E. & Wainwright, S. (1980) Depressed patients with schizophrenia or paranoid symptoms. Psychological Medicine, 10, 665–675.CrossRefGoogle ScholarPubMed
Brown, R., Colter, N., Corsellis, J. A. N., Crow, T. J., Frith, C. D., Jagoe, R., Johnstone, E. C. & Marsh, L. (1986) Post-mortem evidence of structural brain changes in schizophrenia. Archives of General Psychiatry, 43, 36–42.CrossRefGoogle Scholar
Cammer, L. (1970) Schizophrenic children of manic-depressive parents. Diseases of the Nervous System, 31, 177–180.Google ScholarPubMed
Clark, J. A. & Mallett, B. L. (1963) A follow-up study of schizophrenia and depression in young adults. British Journal of Psychiatry, 109, 491–499.CrossRefGoogle ScholarPubMed
Cloninger, C. R., Marttn, R. L., Guze, S. B. & Clayton, P. J. (1985) Diagnosis and prognosis in schizophrenia. Archives of General Psychiatry, 42, 15–25.Google Scholar
Croughan, J. L., Welner, A. & Roams, E. (1974) The group of schizo-affective and related psychoses-critique, record, follow-up and family studies. Archives of General Psychiatry, 31, 632–637.Google Scholar
Crow, T. J. (1984) A re-evaluation of the viral hypothesis: is psychosis the result of retroviral integration at a site close to the cerebral dominance gene? British Journal of Psychiatry, 145, 243–253.CrossRefGoogle Scholar
Crow, T. J. (1986) Left brain, retrotransposons and schizophrenia. British Medical Journal, 293, 3–4.CrossRefGoogle ScholarPubMed
Crow, T. J. & Cooper, S. J. (1986) The genetics of the unitary psychosis. Proceedings of the IVth World Congress of Biological Psychiatry. Amsterdam: Elsevier.Google Scholar
Dalen, P. (1975) Season of Birth: A Study of Schizophrenia and Other Mental Disorders. Amsterdam: North-Holland.Google Scholar
Davis, J. M. (1975) Overview: maintenance therapy in psychiatry. I. Schizophrenia. American Journal of Psychiatry, 132, 1237–1245.Google ScholarPubMed
Davis, J. M. (1976) Overview: maintenance therapy in psychiatry: II. Affective disorders. American Journal of Psychiatry, 133, 1–13.Google ScholarPubMed
Delva, N. J. & Letemendia, F. J. J. (1986) Lithium treatment in schizophrenia and schizo-affective disorders. In Contemporary Issues in Schizophrenia (eds Kerr, A. & Snaith, R. P.). Gaskeli, London.Google Scholar
Elsasser, G. (1952) Die Nachkommen Geisteskranker Eltempaare. Stuttgart: G. Thieme.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Flor-Henry, P. (1969) Psychosis and temporal lobe epilepsy: a controlled investigation. Epilepsia, 10, 363–395.CrossRefGoogle ScholarPubMed
Flor-Henry, P. (1983) Cerebral Basis of Psychopathology. Boston: J. Wright.Google Scholar
Galaburda, A. M., Sanides, F. & Geschwind, N. (1978) Human brain-cyto architectonic left right asymmetries in the temporal speech area. Archives of Neurology, 35, 812–817.CrossRefGoogle Scholar
Gershon, E. S. & Rieder, R. O. (1980) Are mania and schizophrenia genetically distinct? In Mania. An Evolving Concept (eds Belmaker, R. H. & van Praag, H. M.). New York: Spectrum.Google Scholar
Gershon, E. S., Hamovit, J., Guroff, J. J., Dibble, E., Leckmann, J. F., Sceery, W., Targum, S. D., Nürnberger, J. I., Goldin, L. R. & Bunney, W. E. (1982) A family study of schizo-affective, bipolar I, bipolar II, unipolar and normal control patients. Archives of General Psychiatry, 39, 1157–1167.Google Scholar
Griesinger, W. (1861) Die Pathologie und Therapie der Psychischen Krankheiten. Stuttgart: Krabbe.Google Scholar
Groves, C. P. & Humphrey, N. K. (1973) Asymmetry in gorilla skulls, evidence of lateralised brain function? Nature, 244, 53–54.CrossRefGoogle Scholar
Guislain, J. (1833) Traité des Phrenopathies. Brussels: Établissement Encyclographique.Google Scholar
Hare, E. H. & Walter, S. D. (1978) Seasonal variations in admission of psychiatric patients and its relation to seasonal variation in their birth. Journal of Epidemiology and Community Health, 32, 47–52.Google Scholar
Hickey, W. E. (1982) Selfish DNA: a sexually-transmitted nuclear parasite. Genetics, 101, 519–531.Google Scholar
Hollister, L. E., Overall, J. E., Shelton, J., Pennington, V., Kimbell, I. & Johnson, M. (1967) Drug therapy of depression: amitriptyline, perphenazine and their combination in different syndromes. Archives of General Psychiatry, 17, 486–493.CrossRefGoogle ScholarPubMed
Hunt, R. C. & Appel, K. E. (1936) Prognosis in the psychoses lying midway between schizophrenia and manic-depressive psychoses. American Journal of Psychiatry, 93, 313–339.Google Scholar
Jamison, K. R. (1986) Manic-depressive illness and accomplishment: creativity, leadership, and social class. In Manic-Depressive Illness (eds Goodwin, F. K. & Jamison, K R.). Oxford: Oxford University Press.Google Scholar
Johnstone, E. C., Crow, T. J., Frith, C. D., Husband, J. & Kreel, L. (1976) Cerebral ventricular size and cognitive impairment in chronic schizophrenia. The Lancet, ii, 924–926.Google Scholar
Kant, O. (1942) The incidence of psychoses and other mental abnormalities in the families of recovered and deteriorated schizophrenic patients. Psychiatric Quarterly, 16, 176–186.Google Scholar
Karlsson, J. (1974) Inheritance of Schizophrenia. Acta Psychiatrica Scandinavica, Suppl. 247.Google Scholar
Karlsson, J. (1978) Inheritance of Creative Intelligence. Chicago: Nelson-Hall.Google Scholar
Karlsson, J. (1984) Creative intelligence in relatives of mental patients. Hereditas, 100, 83–86.Google Scholar
Kasanin, J. (1933) The acute schizo-affective psychoses. American Journal of Psychiatry, 90, 97–126.Google Scholar
Kendell, R. E. & Gourlay, J. (1970) The clinical distinction between the affective psychoses and schizophrenia. British Journal of Psychiatry, 117, 261–266.Google Scholar
Kendell, R. E. & Brockington, I. F. (1980) The identification of disease entities and the relationship between schizophrenia and affective psychoses. British Journal of Psychiatry, 137, 324–331.Google Scholar
Kendler, K. S. & Tsuang, M. T. (1982) Identical twins concordant for the progression of affective illness to schizophrenia. British Journal of Psychiatry, 141, 563–566.Google Scholar
Kendler, K. S. & Hays, P. (1983) Schizophrenia subdivided by the family history of affective disorder. Archives of General Psychiatry, 40, 951–955.CrossRefGoogle ScholarPubMed
Kendler, K. S., Gruenberg, A. M. & Tsu ang, M. T. (1985) Psychiatric illness in the first degree relatives of schizophrenic and surgical control patients: a family study using DSM -III criteria. Archives of General Psychiatry, 42, 770–779.Google Scholar
Kraepelin, E. (1899) Psychiatrie (6th ed.) Leipzig: Barth.Google Scholar
Le May, M. & Geschwind, N. (1975) Hemispheric differences in the brains of great apes. Brain Behaviour and Evolution, 11, 48–52.Google Scholar
Llopis, B. (1954) La psicosis unica. Archivos de Neurobiologia. 17, 1–39.Google Scholar
Loranger, A. W. (1981) Genetic independence of manic-depression and schizophrenia. Acta Psychiatrica Scandinavica, 63, 444–452.CrossRefGoogle ScholarPubMed
McGuffin, P., Reveley, A. M. & Holland, A. (1982) Identical triplets: non-identical psychosis? British Journal of Psychiatry, 140, 1–6.CrossRefGoogle ScholarPubMed
Magnan, V. (1893) Leçons Clinique sur les Maladies Mentales. Paris: Battaile.Google Scholar
Myerson, A. (1925) The Inheritance of Mental Diseases. Baltimore: Williams and Wilkins.Google Scholar
Menninger, K., Ellenberger, H., Pruyser, P., & Mayman, M. (1958) The unitary concept of mental illness. Bulletin of the Menninger Clinic, 22, 4–12.Google Scholar
Morel, B. A. (1860) Traité des Maladies Mentales. Paris: Masson.Google Scholar
Neumann, H. (1859) Lehrbuch der Psychiatrie. Erlangen: F. Enke.Google Scholar
Noreik, K. & ODEGAARD, Ø. (1966) Psychoses in Norwegians with a background of higher education. British Journal of Psychiatry, 112, 43–55.CrossRefGoogle ScholarPubMed
Ødegaard, Ø. (1963) The psychiatric disease entities in the light of a genetic investigation. Acta Psychiatrica Neurologica Scandinavica, 39, 94–104.Google Scholar
Ødegaard, Ø. (1972) The multifactorial inheritance of predisposition to schizophrenia. In Genetic Factors in ““Schizophrenia” “ (ed. Kaplan, A. R.). Springfield: C. C. Thomas.Google Scholar
Penrose, L. S. (1968) Critical survey of schizophrenia genetics. In Modern Perspectives in World Psychiatry (ed. Howells, J. G.). Edinburgh: Oliver and Boyd.Google Scholar
Pollock, H. M. & Malzberg, B. (1940) Hereditary and environmental factors in the causation of manic-depressive psychosis and dementia praecox. American Journal of Psychiatry, 96, 1227–1247.Google Scholar
Pope, H. G. & Lipinski, J. F. (1978) Diagnosis in schizophrenia and manic-depressive illness. A reassessment of the specificity of “schizophrenic” symptoms in the light of current research. Archives of General Psychiatry, 35, 811–828.Google Scholar
Powell, A., Thomson, N., Hall, D. J. & Wilson, L. (1973) Parent-child concordance with respect to sex and diagnosis in schizophrenia and manic-depressive psychosis. British Journal of Psychiatry, 123, 653–658.Google Scholar
Pulver, A. E., Stewart, W., Carpenter, W. T. & Childs, B. (1983) Risk factors in schizophrenia: season of birth in Maryland, U.S.A. British Journal of Psychiatry, 143, 389–396.Google Scholar
Reich, T., Cloninger, C. R., Suarez, B. & Rice, J. (1982) Genetics of the affective disorders. In Handbook of Psychiatry, 3. Psychoses of Uncertain Aetiology (eds Wing, J. K. & Wing, L.). Cambridge: Cambridge University Press.Google Scholar
Rennert, H. (1982) Zum Modell “Universalgenese der Psychosen”-Aspekte einer unkonventionellen Auffasung der psychische Krankheiten. Fortschritte der Neurologie und Psychiatrie, 50, 1–29.Google Scholar
Rosenthal, D. (1970) Genetic Theory and Abnormal Behaviour (p. 207). McGraw-Hill, New York.Google Scholar
Schneider, K. (1957) Primare and sekundare Symptome bei der Schizophrenie. Fortschritte der Neurologie und Psychiatrie, 25, 487–490.Google Scholar
Schulz, B. (1940) Kinder manische-depressiver und anderer affectiv psychotischer Elternpaare. Zeitschrift für die Gesamte Neurologie und Psychiatrie, 169, 311–412.Google Scholar
Sheldrick, C. (1975) The validity of the distinction between schizophrenia and manic-depressive psychosis. M Phil, thesis, University of London.Google Scholar
Sheldrick, C., Jablensky, A., Sartorius, N. & Shepherd, M. (1977) Schizophrenia succeeded by affective illness: catemnestic study and statistical enquiry. Psychological Medicine, 7, 619–624.Google Scholar
Slater, E. (1936) Inheritance of manic-depressive insanity. The Lancet, i, 429–431.Google Scholar
Slater, E. (1953) Psychotic and Neurotic Illness in Twins. Medical Research Council Special Report series no. 278. London, HMSO.Google Scholar
Stevens, B. C. (1969) Marriage and Fertility of Women Suffering from Schizophrenia or Affective Disorders. Maudsley Monograph no. 19. Oxford: Oxford University Press.Google Scholar
Tsuang, M. T. (1979) Schizo-affective disorder: dead or alive? Archives of General Psychiatry, 36, 633–634.Google Scholar
Tsuang, M. T., Dempsey, G. M., Dvoredsky, N. & Struss, A. (1977) A family history study of schizo-affective disorder. Biological Psychiatry, 12, 331–338.Google Scholar
Tsuang, M. T., Dempsey, G. M., Winokur, G., & Crowe, R. R. (1980) Morbidity risks of schizophrenia and affective disorders among first degree relatives of patients with schizophrenia, mania, depression and surgical conditions. British Journal of Psychiatry, 137, 497–504.Google Scholar
Watson, G. C., Kucala, T., Angulski, G. & Brunn, C. (1982) Season of birth and schizophrenia: a response to the Lewis and Griffin critique. Journal of Abnormal Psychology, 91, 120–125.Google Scholar
Yeni-Komshian, G. H. & Benson, D. A. (1976) Anatomical study of cerebral asymmetry in the temporal lobe of humans, chimpanzees and rhesus monkeys. Science, 192, 387–389.CrossRefGoogle ScholarPubMed
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