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Does Familiality Predispose to both Emergence and Persistence of Psychosis?

A Follow-Up Study

Published online by Cambridge University Press:  02 January 2018

Hélène Verdoux ,
Jim Van Os ,
Pak C. Sham ,
Peter B. Jones ,
Karyna Gilvarry  and
Robin Murray
Hélène Verdoux
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London
Jim Van Os*
Affiliation:
University of Limburg, Maastricht
Pak C. Sham
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
Peter B. Jones
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
Karyna Gilvarry
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
Robin Murray
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
*
Dr Van Os, Department of Psychiatry, Section Social Psychiatry and Psychiatric Epidemiology, University of Limburg, PO Box 616, 6200 MD Maastricht, The Netherlands
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Abstract

Background

It has been suggested that in schizophrenia an association exists between family history of schizophrenia and poor outcome on the one hand, and family history of affective disorders and good outcome on the other.

Method

We tested for associations between four-year outcome and familial loading for psychotic disorders in a mixed sample of 150 consecutively admitted patients with functional psychosis (schizophrenia, psychotic affective disorders, other psychotic disorders) of recent onset. For each proband, a familial loading score for (i) broadly defined psychotic disorder, (ii) schizophrenia, and (iii) affective disorder was calculated using information on relatives obtained through the Family History Research Diagnostic Criteria method and direct interviews of relatives with the Schedule for Affective Disorders and Schizophrenia.

Results

In our sample of psychotic patients, familial loading for psychotic disorder predicted persistent negative symptoms over the follow-up period (OR 1.5; 95% CI 1–2.2), especially in schizophrenia, and was also associated with more time hospitalised (P > 0.05), and more social disability at follow-up (P < 0.05). Greater familial loading for schizophrenia predicted a greater likelihood of non-recovery (OR 2.2; 95% CI 1.1–4.4) and a greater likelihood to have had persistent negative symptoms over the follow-up period (OR 1.7; 95% CI 0.9–3.1). No association was found between outcome and familial loading for affective disorder.

Conclusions

We conclude that familial loading may be a continuous risk factor for some dimensions of clinical outcome in the functional psychoses. This suggests that there is a continuum of genetic liability not only to the emergence of psychotic illness, but also the subsequent chronicity of the disorder.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 5 , May 1996 , pp. 620 - 626
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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