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Am J Psychiatry 1995; 152:749-754
Copyright © 1995 by American Psychiatric Association
Evaluating the spectrum concept of schizophrenia in the Roscommon Family Study
KS Kendler, MC Neale and D Walsh
Department of Psychiatry, Medical College of Virginia, Richmond 23298- 0710, USA.
OBJECTIVE: The authors sought to evaluate whether the pattern of
schizophrenia and related disorders in probands and their relatives can be
explained by a single underlying continuum of liability to the
"schizophrenia spectrum." METHOD: In the epidemiologically based Roscommon
Family Study, the authors separately examined--in siblings, parents, and
relatives of index and comparison probands--the familial aggregation and
coaggregation of five hierarchically defined disorders: schizophrenia,
schizoaffective disorder, schizotypal/paranoid personality disorder, other
nonaffective psychoses, and psychotic affective illness. A multiple
threshold model was fitted to these contingency tables by maximum
likelihood. RESULTS: The multiple threshold model that constrained
resemblance to be the same in siblings and parents fit the data well and
estimated the correlation in liability to schizophrenia spectrum disorders
between probands and first-degree relatives at 0.36. Parents, however,
required higher levels of liability to manifest schizophrenia spectrum
disorders than siblings. While schizophrenia and psychotic affective
illness could be clearly assigned to the two extremes of the schizophrenia
spectrum, the proper ordering of schizoaffective disorder,
schizotypal/paranoid personality disorder, and other nonaffective psychoses
could not be unambiguously determined. CONCLUSIONS: These results are
consistent with the existence of a schizophrenia spectrum in which these
five disorders are manifestations, of varying severity, of the same
underlying vulnerability. This vulnerability is strongly transmitted within
families.
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