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Am J Psychiatry 1997; 154:191-198
Copyright © 1997 by American Psychiatric Association
Resemblance of psychotic symptoms and syndromes in affected sibling pairs from the Irish Study of High-Density Schizophrenia Families: evidence for possible etiologic heterogeneity
KS Kendler, L Karkowski-Shuman, FA O'Neill, RE Straub, CJ MacLean and D Walsh
Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond 23298-0126, USA. kendler@gems.vcu.edu
OBJECTIVE: The authors sought to determine whether the clinical
manifestations of schizophrenia and other psychotic disorders are
correlated in affected sibling pairs. METHOD: They examined, in 256 sibling
pairs concordant for DSM-III-R schizophrenia and 457 sibling pairs
concordant for all nonaffective psychoses ascertained in the Irish Study of
High-Density Schizophrenia Families, similarity for 1) symptoms, course,
and outcome; 2) symptom factors; and 3) syndromes, defined by latent class
analysis. RESULTS: Global course and outcome, as well as all major symptoms
except hallucinations, were modestly but significantly correlated in
sibling pairs concordant for schizophrenia. Three symptom factors-negative
symptoms, positive symptoms, and affective symptoms-were all significantly
correlated in concordant sib pairs. Latent class analysis suggested five
schizophrenic syndromes. Class membership was significantly correlated in
concordant sibling pairs. Similar results were found for sibling pairs
concordant for nonaffective psychoses. CONCLUSIONS: The clinical
manifestations of the schizophrenic syndrome (both narrowly and broadly
defined) are moderately influenced by familial factors. From a
familial/genetic perspective, schizophrenia as currently defined may be
etiologically heterogeneous.
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