Negative symptoms of familial schizophrenia breed true in unstable (vs. stable) cerebral-ventricle pedigrees

A pattern of negative symptoms associated with a high rate of ongoing brain and ventricular instability has been described in a cohort of schizophreni a spectrum probands (patients with schizophrenia, schizoaffective disorder depressed and bipolar, and psychosis NOS) (Garver, D.L., Nair, T.R., Christ ensen, J.D., Holcomb, J., Ramberg, J., Kingsbury, S., 1999. Differential pa tterns of premorbid functioning, symptoms and neuroleptic response in stabl e and unstable ventricular-volume schizophrenia. Neuropsychopharmacology 20 , in press). The present study contrasts the prevalence of negative symptom s in first- and second-degree relatives of probands with unstable ventricle volume (UnsVV) and stable ventricle volume (SVV). One hundred and sixteen first- and second-degree relatives of 10 probands were interviewed using th e SANS, the 'Characterization of Course: "Pattern of Symptoms"' [from Compr ehensive Assessment of Symptoms and History (CASH)I, SCID and SCID-II by in terviewers blind to the status of the proband. Thirty-five of the 116 famil y members met DSM-IV criteria for schizophrenia, SA depressed, 'Cluster A' of the SCID-II (paranoid, schizotypal, schizoid personality disorder), psyc hosis NOS, or psychotic affective disorder. These 35 family members were de fined as falling within a 'schizophrenia spectrum' as described by Farmer, A.E., McGuffin, P., Gottesman, I.I., 1987. Arch. Gen. Psychiatry 44, 634-64 1, but with the addition of DSM-TV affective psychosis. On that basis, the 35 members were considered 'affected family members' (AFMs). The remaining 81 family members were considered unaffected. The 'predominant symptoms of illness' (during the past 2-3 years) for 25 of the 35 AFMs could be charact erized according to the 'Patterns of Symptoms' derived from the CASH. Twent y-five of the 35 AFMs were found to maintain a predominant symptom pattern during the course of illness, which could be characterized according to the 'Pattern of Symptoms' as 'predominantly positive' or 'predominantly negati ve'. Three of the probands had UnsVV; seven had SW. Of the 35 AFMs, II were related to the UnsW probands, and 24 were relatives of the SW probands. Th e nine rated AFMs of the UnsW probands showed a trend toward higher SANS sc ores (7.3 +/- 5.1) (mean +/- s.d.) than the 20 rated AFMs of SW probands (4 .3 +/- 5.1) (p = 0.08) at the time of the interview. Eighty-three per cent (eight of 10) of rated affected pedigree members of the pedigrees delineate d by probands with UnsW probands had a predominantly negative symptom cours e of illness, and 96% (23 of 24) of rated affected pedigree members of the pedigrees with SW probands had a predominantly positive symptom course of i llness during the preceding 2-3 years (p=0.002). None of the 12 rated affec ted pedigree members within pedigrees having UnsW probands were married at the time of the interview; 45% (14 of 31) of affected pedigree members havi ng SW probands were married (p = 0.004). A psychiatric disorder, characteri zed by unstable cerebral ventricles and predominant negative symptoms (incl uding avoidance/failure of marital relationships) appears symptomatically t o breed true in pedigrees containing schizophrenia-like illnesses. (C) 1999 Elsevier Science B.V. AU rights reserved.