Disorders In Relatives Of Patients Research Articles

Post-traumatic stress disorder in parents of schizophrenic patients at the Arrazi Psychiatric Hospital in Salé following familial violence

IntroductionParents whose adult child has a serious mental illness are at risk of serious violence from their child. One of the reasons for the high risk of PTSD is violence in the home [1,2]. The high risk of PTSD in parents of patients with schizophrenia is an issue of great concern because parents are likely to fear repeated violence and, therefore, to object to patients being discharged from hospital.Objectives To assess the existence of post-traumatic stress disorder in relatives of patients with schizophrenia treated at the Arrazi University Psychiatric Hospital in Salé following familial violence.MethodsThis was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria, questions about domestic violence and an “IES-R” post-traumatic stress symptom assessment questionnaire to investigate the existence of post-traumatic stress disorder in relatives of patients with schizophrenia followed up at Arrazi University Psychiatric Hospital in Salé following familial violence.ResultsThe response of 72 relatives of schizophrenic patients was collected. About 70% of the participants were mothers. The average age of the participants was 58. All lived with children who had been treated for schizophrenia for more than 18 years (57% of participants). Around 20% of these children were in hospital at the time of completing this questionnaire. About 80% of the children with schizophrenia spent all their time at home, and about 89% of the participants had already been victims of violence from their sick children. 90% had been sworn at and insulted, the majority blamed themselves for the illness, about 56% had already been kicked or punched, and 36% had already received death threats and 12% serious injuries/. For all items, parents with a high IES-R score had significantly more experiences of violence than parents with a low IES-R score. The percentage of parents with a high IES-R score was 45%.Conclusions The experience of severe violence and hospitalisation of a patient was related to a high risk of post-traumatic stress disorder in parents. These two factors can be considered as traumatic events arising from crisis situations and can have harmful consequences for parents and their schizophrenic children, who are sometimes rejected. There seems to be a need to create crisis intervention programmes that offer a multidisciplinary approach capable of rapidly detecting the exacerbation of a serious mental illness and providing rapid and intensive treatment as quickly as possible. Finally, the provision of support, education or treatment for parents during their child’s hospitalisation is essential.Disclosure of InterestNone Declared

Post traumatic stress disorder in relatives of patients admitted to an intensive care unit

Post traumatic stress disorder in relatives of patients admitted to an intensive care unit

Familial Aggregation of Panic Disturbances in Parkinson's Disease

Familial Aggregation of Panic Disturbances in Parkinson's Disease

An investigation into the genetic relationship between bipolar affective disorder and (idiopathic) epilepsy in a sub-saharan African population

Background: Bipolar affective disorders and epilepsy have been linked by investigations concerning their phenomenology, neuro-biology and pharmacotherapy. One large Epidemiological study revealed that bipolar symptoms occurred in 12% of communitybased epilepsy patients, a rate of about seven times higher than normal controls. Little is known however, if these observations are epiphenomena of an underlying genetic substrate, the establishment of which is an important step in the understanding of these disorders, such that we can predict, prevent and effectively manage them. Objective: To determine if there is a probable genetic relationship between bipolar affective disorder and epilepsy. Method: A case control study assessing the prevalence of epilepsy among the first degree relatives of patients with bipolar affective disorder and the prevalence of bipolar disorder among first degree relatives of patients with epilepsy compared to normal controls. Results: A total of 150 patients attending the outpatient clinic between March and July 2006 were recruited for the study (40 bipolar, 60 epileptics and 50 health controls). It revealed a significantly high prevalence of epilepsy among the first degree relatives of 2 bipolar patients compared with healthy controls; 15.2% vs. 2.0% (˜ = 46.08, p<0.001). There was similarly high and significant prevalence of bipolar affective disorder in first degree relatives of patients with epilepsy compared with normal control; 14.5% vs. 2.1% 2 (˜ = 31.2, p<0.001). Conclusion: The biological links already noted by earlier studies between bipolar disorders and epilepsy seem to be strengthened by this findings of familial predisposition. This may be a prelude to other similar or more advanced studies to establish definite genetic link between these two important disorders.

Prevalence of psychotic and non-psychotic disorders in relatives of patients with a first episode psychosis

Background Family members of individuals with schizophrenia suffer from elevated rates of schizophrenia-spectrum disorders (SSD) and other forms of psychopathology. However, few studies have examined familial psychopathology in probands with a first episode of psychosis (FEP). We systematically evaluated family history in patients experiencing an affective or non-affective FEP. Methods The Family Interview for Genetic Studies was used to obtain diagnostic information on all first- and second-degree relatives of probands admitted to a specialized FEP program. Probands were 94 previously untreated patients suffering from a first-episode of affective or schizophrenia spectrum psychosis, aged 14 to 30. The interview ascertained diagnoses of psychotic disorders, affective disorders, substance-use disorders (SUD), and schizophrenia-related personality disorders. Results One in five probands (19.1%) had a history of psychosis among their first-degree relatives, while 34.0% had any relative with psychosis. Fewer probands had a family history of SSD (7.4% with a first-degree history and 18.1% with a history among any relatives). Over half (53.2%) of probands had a first-degree relative with Major Depressive Disorder, and 38.3% had a first-degree relative with a SUD. Overall, 69.9% of probands had a first-degree relative with a mental disorder. The proportion of probands with a family history of any of these diagnoses did not vary by proband diagnosis (affective or SS Psychosis), though probands with co-morbid SUD were more likely to have a family history of substance abuse. Conclusions Diverse psychopathology is commonly present in families of FEP patients and may imply a generalized vulnerability to psychiatric disorders to be greater in such families compared to specific vulnerability to SS or affective psychosis. These findings may also have implications for provision of care for the probands.

Etiology of musician’s dystonia

To test the hypothesis that there is familial aggregation of dystonia and other movement disorders in relatives of patients with musician's dystonia (MD) and to identify possible environmental triggers. The families of 28 index patients with MD (14 with a reported positive family history of focal task-specific dystonia [FTSD] and 14 with no known family history [FH-]) underwent a standardized telephone screening interview using a modified version of the Beth Israel Dystonia Screen. Videotaped neurologic examinations were performed on all participants who screened positive and consensus diagnoses established. All patients were investigated for DYT1 dystonia and suitable families were tested for linkage to DYT7. All family members were administered questionnaires covering potential triggers of FTSD. A diagnosis of dystonia was established in all 28 index patients and in 19/97 examined relatives (MD: n = 8, other FTSD: n = 9, other dystonias: n = 2), 5 of whom were members of FH- families. In 27 of the 47 affected individuals, additional forms of dystonia were seen; other movement disorders were observed in 23 patients. In total, 18 families were multiplex families with two to four affected members. Autosomal dominant inheritance was compatible in at least 12 families. The GAG deletion in DYT1 was absent in all patients. Linkage to DYT7 could be excluded in 1 of the 11 informative families. With respect to potential environmental triggers, there was no significant difference between patients with MD/FTSD compared to unaffected family members. Our results suggest a genetic contribution to musician's dystonia with phenotypic variability including focal task-specific dystonia.

Increased Risk of Depressive and Anxiety Disorders in Relatives of Patients With Parkinson Disease

Relatives of patients with Parkinson disease (PD) have an increased risk of PD and other neurologic disorders; however, their risk of psychiatric disorders remains uncertain. To study the risk of depressive disorders and anxiety disorders among first-degree relatives of patients with PD compared with first-degree relatives of controls. In a population-based, historical cohort study, we included 1000 first-degree relatives of 162 patients with PD and 850 first-degree relatives of 147 controls. Both patients with PD and controls were representative of the population of Olmsted County, Minnesota. Documentation of psychiatric disorders was obtained for each relative separately through a combination of telephone interviews with the relatives (or their proxies) and review of their medical records from a records-linkage system (family study method). Psychiatric disorders were defined using clinical criteria from the DSM-IV or routine diagnoses. We found an increased risk of several psychiatric disorders in first-degree relatives of patients with PD compared with first-degree relatives of controls (hazard ratio [HR], 1.54; 95% confidence interval [CI], 1.21-1.95; P <.001). In particular, we found an increased risk of depressive disorders (HR, 1.45; 95% CI, 1.11-1.89; P = .006) and anxiety disorders (HR, 1.55; 95% CI, 1.05-2.28; P = .03). The results were consistent in analyses that adjusted for type of interview, excluded relatives who developed parkinsonism, or excluded relatives who developed both a depressive disorder and an anxiety disorder. These findings suggest that depressive disorders and anxiety disorders may share familial susceptibility factors with PD.

1.172 Increased risk of depressive and anxiety disorders in relatives of patients with Parkinson's disease

Context: Relatives of patients with Parkinson disease (PD) have an increased risk of PD and other neurologic disorders;however,theirriskofpsychiatricdisordersremains uncertain. Objective:Tostudytheriskofdepressivedisordersand anxiety disorders among first-degree relatives of patients with PD compared with first-degree relatives of controls. Design, Setting, and Participants: In a populationbased, historical cohort study, we included 1000 firstdegree relatives of 162 patients with PD and 850 firstdegree relatives of 147 controls. Both patients with PD andcontrolswererepresentativeofthepopulationofOlmsted County, Minnesota. Main Outcome Measures: Documentation of psy

Alcohol use disorders in relatives of patients with panic disorder

Alcohol use disorders in relatives of patients with panic disorder

Alcohol use disorders in relatives of patients with panic disorder

Objective The aim of this study was to use data from a family study of anxiety disorders to examine the familial association between alcohol use disorders and panic disorder (PD), controlling for alcohol use disorders in the proband. Method Data from a family study of anxiety disorders were used to compare rates of alcohol use disorders in the relatives of 3 proband groups (PD with lifetime alcohol use disorders, PD without lifetime alcohol use disorders, and not-ill controls). Results There was a significantly higher rate (12%) of alcohol use disorders among the relatives of PD probands compared with relatives of controls (5%), even in the absence of alcohol use disorders in the proband and after adjusting for differences in sociodemographic characteristics and lifetime drug use disorders ( χ 2 = 5.4; df = 1; P = .02). Anxiety symptoms were more frequent among the male relatives of panic probands who received an alcohol diagnosis, compared with those who did not have alcohol use disorders (10/25 vs 22/111; χ 2 = 4.6; df = 1; P = .03). A similar pattern was found in women (8/11 vs 63/156; χ 2 = 4.4; df = 1; P = .036). Conclusions These findings suggest a familial association between PD and alcohol use disorders. Future studies with more refined alcohol diagnoses are needed to replicate and investigate the mechanism of this association.

Prevalence of autoimmune disorders in relatives of patients with celiac disease.

Celiac disease (CD) is frequently associated with an autoimmune disorder (AD). The aim of the study was to establish if an AD is more frequent than expected in relatives of CD patients and, in particular, if it is related to the presence of silent unrecognised CD. We also evaluated the prevalence of ADs in CD patients and compared it with that in a control series. A structured questionnaire was used to evaluate the prevalence of ADs in 125 (51 males and 74 females with a mean age of 8.9 years) children with CD (group A), 125 (67 males and 58 females with a mean age of 8.1 years) matched "healthy" children (group B), all 1352 first- and second-degree relatives of the 125 children with CD (group C), all 1238 first- and second-degree relatives of the control group B of "healthy" children (group D), and all 205 first- and second-degree relatives of 20 children with AD (group E). We also used the antiendomysium antibody assay to screen 354 of the 373 first-degree relatives of group C. An AD was present in 9 of the 125 (7.2%) children with CD (group A), in 1 of the 125 (0.8%) healthy children (group B), in 67 of the 1352 (4.9%) relatives of CD patients (group C), in 14 of the 1238 (1.1%) relatives of healthy children (group D), and in 7 of the 205 (3.4%) of relatives of patients with AD (group E). Clinically silent CD was found in 20 of the 354 first-degree relatives of CD patients (5.6%), and the risk of silent CD was significantly higher, reaching 25% (4/16) in the subgroup of relatives also affected by another AD. Relatives of CD patients had an increased prevalence of AD compared to control groups, and relatives of CD patients with ADs, have a risk as high as 25% of being silent celiacs: they should thus be screened for CD.

Role of family history and 5-HTTLPR polymorphism in female seasonal affective disorder patients with and without premenstrual dysphoric disorder

Seasonal affective disorder (SAD) and premenstrual dysphoric disorder (PMDD) share many clinical features, and have been associated with brain serotonin dysfunction. Females with SAD frequently fulfil the diagnostic criteria for PMDD. A polymorphism in the serotonin transporter promoter gene (5-HTTLPR) has been associated with SAD. We investigated the role of family history and 5-HTTLPR in female SAD patients with and without PMDD. Forty-four SAD females with, and 43 SAD females without PMDD, were genotyped for 5-HTTLPR. Family history of affective disorders in first degree relatives was assessed. An association between the presence of PMDD and family history ( P=0.0029) and 5-HTTLPR long/short allele-heterozygosity ( P=0.033) was found in females with SAD. PMDD and SAD may share genetic vulnerability factors, one candidate gene being 5-HTTLPR. The elevated rate of affective disorders in relatives of patients with SAD and PMDD suggests higher genetic vulnerability in this subgroup when compared to patients with SAD alone.

Relation of schizophrenia and panic disorder: evidence from a controlled family study.

The intention of this controlled family study was to evaluate reasons for comorbidity of schizophrenia and panic disorder. Observed rates of psychiatric disorders in first-degree relatives of patients and of controls were compared with rates predicted by possible hypotheses explaining comorbidity. The sample consisted of 59 patients with schizophrenia (including seven with schizophreniform disorder), 54 patients with panic disorder (with or without agoraphobia), 29 comorbid patients with lifetime diagnoses of panic disorder and schizophrenia (or schizophreniform disorder, 2 patients) and 109 controls, and their 1068 first-degree relatives. Information from clinical performance, clinical and structured interviews, and from family history was joined to establish DSM-III-R diagnoses in patients and relatives. As expected, schizophrenia and panic disorder were found to be familial. The hypothesis, that the familial load for primary panic disorders distinguished schizophrenics (4.3%) and controls (0.9%), could be verified (P < 0.01); the familial aggregation for primary panic disorders did not distinguish schizophrenics and subjects with panic disorder. However, the risk for schizophrenia was not enhanced in relatives of patients with panic disorder (0%) in comparison to controls (0.3%, P > 0.05). The observed familial aggregation pattern of psychiatric disorders in relatives of schizophrenics, panic patients, comorbid patients, and controls refers to an etiological relation of schizophrenia and panic disorder, or at least to a relationship of subgroups of these disorders.

Psychoactive substance use disorder in relatives of patients with anorexia nervosa

We assessed the lifetime prevalence and morbid risk of psychoactive substance use disorder (SUD; alcoholism and drug use disorder) in the first- and second-degree relatives, excluding children, of 34 female patients with anorexia nervosa (AN) and 34 age- and sex-matched controls who had no history of an eating disorder. Diagnoses of relatives were made blind to probands' diagnoses. The prevalence of SUD was 9% in both anorectic and control relatives, and the figures for morbid risk were 14% and 15%, respectively; these differences were nonsignificant. These results suggest that adolescent and adult women with AN do not possess many of the familial factors that predispose to the development of psychoactive SUD.

The risks of seizure disorders among relatives of patients with childhood onset epilepsy

The risk of seizure disorders in relatives of patients with childhood-onset epilepsy was evaluated by a cohort study of the other descendants of parents of probands with epilepsy. The probands comprised 196 cases of idiopathic epilepsy and 60 individuals with isolated idiopathic seizures diagnosed among residents of Rochester, Minnesota, from 1935 to 1974. The risk of epilepsy through age 20 among the siblings and children of probands was 4.1%, three times the rate in the general Rochester population. The risk of any type of seizure (including isolated seizures, febrile convulsions, or seizures due to an acute cerebral insult) through age 20 was 11% in siblings and 13.1% in children of probands. The risks of seizure disorders among the nieces and nephews of probands were not greater than the general population rates.

Primary affective disorder in relatives of patients with anorexia nervosa.

The authors examined the incidence of primary affective disorder (PAD) in relatives of 25 patients with anorexia nervosa and of 25 normal control subjects. Among the relatives of patients with anorexia nervosa, 22% (N = 43) had histories of PAD, while only 10% (N = 17) of the relatives of controls had such histories. Among the PAD relatives of anorectic probands, 34 had histories of unipolar depression and 9 of bipolar affective disorder. These findings provide further evidence of a possible relationship between anorexia nervosa and affective illness.