Am J Psychiatry 1993; 150:435-442
Copyright © 1993 by American Psychiatric Association
Schizophrenia-related and affective personality disorder traits in relatives of probands with schizophrenia and personality disorders
JM Silverman, LJ Siever, TB Horvath, EF Coccaro, H Klar, M Davidson, L Pinkham, SH Apter, RC Mohs and KL Davis
Psychiatry Service, Bronx VA Medical Center, NY 10468.
OBJECTIVE: The possible heterogeneity of the schizophrenia-related
personality disorder traits associated with DSM-III criteria for
schizotypal personality disorder was investigated using the family history
method. A familial relationship to schizophrenia was hypothesized for
schizophrenia-related personality disorder traits without coexisting
affective personality disorder traits, pure schizophrenia-related
personality disorder traits. Alternatively, a familial relationship with
borderline personality disorder was hypothesized for schizophrenia-related
personality disorder traits with comorbid affective personality disorder
traits. METHOD: Criteria for schizophrenia-related and affective
personality disorder traits were used to assess the 588 nonpsychotic
first-degree relatives of 55 chronic schizophrenic probands and 67 probands
with personality disorders. The probands with one or more DSM-III
personality disorders were categorized as having schizotypal personality
disorder without borderline personality disorder (pure schizotypal
personality disorder), borderline personality disorder without schizotypal
personality disorder (pure borderline personality disorder), both
disorders, or neither. RESULTS: The morbid risk of all cases of
schizophrenia-related personality disorder traits was higher in relatives
of probands with schizophrenia and pure schizotypal personality disorder
than in relatives of probands with neither schizotypal nor borderline
personality disorder; however, it differed only slightly from that observed
in the relatives of probands with both schizotypal and borderline
personality disorders and pure borderline personality disorder. In
contrast, the risk of pure schizophrenia- related personality disorder
traits was higher in relatives of probands with schizophrenia and pure
schizotypal personality disorder, while the risk of coexisting
schizophrenia-related and affective personality disorder traits was lower
in both of these groups than among the relatives of probands with both
schizotypal and borderline personality disorders and pure borderline
personality disorder. CONCLUSIONS: These results offer preliminary
indications that schizotypal personality disorder features present without
comorbid affective personality disorder traits may more specifically
characterize the personality characteristics familially related to
schizophrenia. Furthermore, they indicate that schizotypal personality
disorder features as currently defined are found in relatives of patients
other than those with schizophrenia or schizotypal personality disorder.
