OBJECTIVE: Most investigators presume that schizophrenia and affective
disorder are separate diseases. Others have proposed alternatives to this
Kraepelinian view. These alternatives were addressed by preliminary
analyses of data from a family study of psychopathology. METHOD: The
authors identified 1,895 first-degree relatives of 166 patients with
DSM-III schizophrenia, 71 patients with affective disorder, and 85 medical
comparison probands; 949 relatives were blindly diagnosed. RESULTS: The
risks for schizophrenia and affective disorder (unipolar melancholia and
bipolar disorder combined) were significantly higher in the relatives of
the schizophrenic probands and the relatives of the probands with affective
disorder than in the relatives of the comparison probands. The morbid risk
for nonmelancholic depressions was not significantly higher. Among the
relatives of the schizophrenic probands, the risk for affective disorder
was highest among the relatives of the patients with "core" schizophrenia,
who were younger at illness onset, had chronic illness, had severe
emotional blunting, and showed few affective features. CONCLUSIONS: Despite
limitations, these preliminary analyses, consistent with other studies,
suggest some familial relationship between schizophrenia and severe forms
of affective disorder.Abstract Teaser