Early Deviant Behavior Research Articles

Early deviant behaviour as a dimension trait and endophenotype in schizophrenia

BackgroundIn psychiatry, there is still a lack of objective biological diagnostic measurements. It is important to investigate measurements or symptom dimensions that can inform diagnostic assessments and allow for a more personalised approach to patients.AimTo discuss how early deviant behaviour (EDB) may be seen as a possible continuous symptom dimension trait and endophenotype in schizophrenia.MethodsConducting a commentary review by highlighting some important findings from available literature.ResultsFindings regarding EDB in schizophrenia in a South African genetic sample point towards EDB as a progressive subtype of schizophrenia, with very early onset of illness (even prior to the psychotic symptomatology) and a genetic form of illness.ConclusionValuable information can be gained by enquiring into EDB and viewing it as a continuous symptom dimension trait and endophenotype during the psychiatric diagnostic interview.

Cannabinoid dependence: psychological issues in a biopsychosocial approach research – a working paper

Introduction: The consumption of psychoactive substances in Portugal has been decreasing in the last decade. However, the latest report from the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) indicates that 5.1% of the Portuguese population has frequent cannabis use. The effect of psychosocial development in childhood and adolescence, or their life history, is considered to be a particularly important element in the genetic variation of the endocannabinoid system [1]. There are several techniques and instruments that can be used in the evaluation of drug addiction, namely: interview, self-registration, psychometric instruments and biological tests [2]. Although this study has a genetic and psychosocial approach, we will only present the psychological component of the research. Materials and methods: Objective data, such as consumption changes, age, initiation substance, routes of administration used, substances consumed, relapse circumstances, previous attempts to quit, and drug-related health problems allow access to the standard of consumption, as well as data on the subject’s feelings, circumstances and thoughts before and after consumption. To assess drug use we opted for the development of a small questionnaire focused on the above mentioned issues and aimed. Due to the association with psychopathology we use the Brief Symptoms Inventory (BSI). All ethical principles have been taken due to the sensitive nature of the data involved. Results: The large majority of studies on cannabinoid consumption suggest that hereditary influences that may be at the basis of predisposition towards substance use are attenuated in the presence of adequate parental monitoring/supervision [1,3]. Although this is still an investigation in curses, with no final results, there is a tendency for those evaluated to show a history of initiation of adolescents’ consumption with cannabis, followed by harder drugs. There is also a lack of parental control and supervision, apparently capable of correcting patterns of early deviant behavior. The psychopathology not yet have significant results due to sample size. Discussion and conclusions: As a working paper which derives from the application of a research pre-test, the results obtained only seek to understand the adequacy of the methodology to be used in the pilot study that will be started soon. This research is a pioneer, since it analyzes in parallel, possible genetic and psychosocial impacts on the consumption of psychoactive substances, contrary to what appears in most of the literature of reference.

S189. CARVING A MORE SPECIFIC SUBTYPE OF SCHIZOPHRENIA FOR GENETIC STUDIES: SPORADIC SCHIZOAFFECTIVE BIPOLAR TYPE

BackgroundSchizophrenia is a heterogeneous group of disorders. The familial-sporadic distinction has been considered under a range of genetic models. Research supports a strong association of de novo copy mutations with sporadic schizophrenia. The aim of the study was to determine a more homogenous phenotype for genetic research via comparison of various clinical and socio-demographic variables in familial and sporadic schizophrenia.MethodsA cross-sectional observational design was used. This study included 384 participants with schizophrenia/schizoaffective disorder from an Afrikaner founder population in South Africa that previously participated in genetic research. A comprehensive data capturing sheet was completed from a pre-existing database that contains information obtained from the Diagnostic Interview for Genetic Studies, chronological clinical summary reports and additional sources of information. The study protocol was approved by the Research Ethics Committee from the Faculty of Health Sciences at the University of Pretoria. Logit models were fitted using the backward elimination procedure to investigate relationships where the dependent variable was binary. Odds ratio estimates were calculated for independent variables that were significant in the model. The Kruskal-Wallis test was conducted to compare the means of groups. For cases where there were significant differences a post-hoc test with a Bonferroni correction was done to determine which groups differ significantly.ResultsThere were 214 familial and 170 sporadic subjects. 279 had a diagnosis of schizophrenia, 66 schizoaffective, bipolar type and 39 schizoaffective disorder, depressive type. 242 were male and 142 female. The age at onset of the primary psychiatric diagnosis, season of birth, co-morbid diagnoses, symptomatology, suicidality history and marital status weren’t significantly different when considering the combined schizophrenia/schizoaffective disorder group and its relationship to familiality. Early deviant behaviour was however decreased in the sporadic group. These findings were replicated when analysing schizophrenia independently from schizoaffective disorder. The sporadic schizoaffective disorder, bipolar type did however have a significantly lower age at onset (mean 20.18 versus 25.07 years), 8.8 times more hallucinations, 6.6 times more odd behaviour before the age of 10 and were 2.8 times more likely to be single. The bipolar type also had 2.9 times more suicide attempts as opposed to ideation. This finding wasn’t statistically significant. The sporadic schizoaffective group overall was 2.2 times more likely to abuse substances. The depressive type didn’t differ significantly with regards to age at onset, season of birth, co-morbidities, early deviant behaviour, symptomatology, suicidality or marital status.DiscussionThe combined schizophrenia/schizoaffective group didn’t differ significantly, nor did schizophrenia and schizoaffective disorder depressive type when analysed independently. The sporadic schizoaffective bipolar type differed significantly on multiple important variables that suggest a poorer prognosis and increased disease severity. The sporadic schizoaffective bipolar type forms a more homogenous group, with genetic studies hinting at relatively specific genetic risk factors. Studies elucidating the genetic architecture of this group could prove invaluable in clarifying the aetiology of schizophrenia.

Advancing paternal age at birth is associated with poorer social functioning earlier and later in life of schizophrenia patients in a founder population

Consistent associations have been found between advanced paternal age and an increased risk of psychiatric disorders, such as schizophrenia, in their offspring. This increase appears to be linear as paternal age increases. The present study investigates the relationship between early deviant behaviour in the first 10 years of life of patients as well as longer term functional outcome and paternal age in sporadic Afrikaner founder population cases of schizophrenia. This might improve our understanding of Paternal Age-Related Schizophrenia (PARS). Follow-up psychiatric diagnoses were confirmed by the Diagnostic Interview for Genetic Studies (DIGS). An early deviant childhood behaviour semi-structured questionnaire and the Specific Level of Functioning Assessment (SLOF) were completed. From the logistic regression models fitted, a significant negative relationship was found between paternal age at birth and social dysfunction as early deviant behaviour. Additionally, regression analysis revealed a significant negative relationship between paternal age at birth and the SLOF for interpersonal relationships later in life. Early social dysfunction may represent a phenotypic trait for PARS. Further research is required to understand the relationship between early social dysfunction and deficits in interpersonal relationships later in life.

Manajemen Parenting untuk Remaja

Teenagers are in the growing age that moves dynamically to seek and establish identity / identities. If this phase is one in the care of the risk, it would be borne by the teens themselves, families, communities and countries.The risks occurring in any ages of teen parenting among others is one of the associations having an impact on early marriage, deviant behavior and drop-out. To reduce the risks that occur in adolescents, it needs management in teen parenting, given the importance of the role of youth as the regeneration of the family and the nation are very high asset value, and the management of parenting adolescents needs to be built with a variety of strategies.Keywords: Manajemen, Parenting, Remaja dan Geografi Tubuh.

Poster #120 PARALLEL INCREASES IN [H]MUSCIMOL AND [H]FLUMAZENIL BINDING IN THE DORSOLATERAL PREFRONTAL CORTEX IN SCHIZOPHRENIA ARE LINKED TO GABAA RECEPTOR A4 AND G2S MRNA SUBUNIT LEVELS RESPECTIVELY

Early non-psychotic deviance occurs in some, but not all, pre-schizophrenic patients and has been linked to the later course of the disorder, suggesting its relationship with the schizophrenia syndrome. However, early deviance has rarely been explored as an endophenotypic marker in large samples of schizophrenic patients. We characterized the early childhood behavior and syndrome history of 205 adults with DSM-IV schizophrenia. Sixty percent of our sample had poor socialization, extreme fears/chronic sadness, and/or attention impairment/learning disabilities beginning before age 10. The remaining 40% were without behavioral difficulties until the onset of schizophrenia. Logistic regression analyses suggested that the risk of syndrome onset before age 17 was 2.5 times more likely among patients with poor socialization beginning before age 10. Schizoaffective disorder was 3.75 times greater among patients with extreme fears/chronic sadness in childhood, and schizophrenic patients with early attention impairment/learning disabilities were 2 times more likely to have a 1°, 2° or 3° relative with schizophrenia. We concluded that early deviant behavior indicated a distinct subgroup of patients, and was linked to syndrome characteristics specifically relevant to genetic studies, in particular age at onset and family history of schizophrenia. Since early syndrome onset has been associated with specific genetic anomalies in other complex neuropathologic disorders, it may prove valuable to regard these early deviant behaviors as an indicator of early syndrome onset for future genetic studies of schizophrenia.

Velocardiofacial syndrome - a syndrome with many faces

Velocardiofacial Syndrome (VCFS) can present with many different features. In this paper we review some of these features: working memory deficits, dysmorphic features, co-morbid obsessive compulsive disorder (OCD), early deviant behaviour, functional impairment, and early age of onset of schizophrenia. Some uncommon features found in the five patients studied are discussed. Genetic counselling in these patients and what the future holds in terms of treatment are mentioned. Patients with VCFS can have covert symptoms that can easily be overlooked. For this reason, guidelines to the detection of the abnormalities in these patients are given. The patients whose cases are reviewed are five patients who were diagnosed with VCFS during an ongoing genetic project on the study of schizophrenia in the Afrikaner founder population.

Clinical Characteristics of an Afrikaner Founder Population Recruited for a Schizophrenia Genetic Study

The clinical characteristics of an Afrikaner founder population sample recruited for a schizophrenia genetic study are described. Comparisons on several clinical characteristics between this sample and a U.S. sample of schizophrenia patients show that generalization of findings in a founder population to the population at large is applicable. The assessment of the frequency of the 22q11 deletion in Afrikaner schizophrenia patients is approximately 2%, similar to findings in a U.S. sample. Results of analysis of early non-psychotic deviant behavior in subjects under the age of 10 years in the Afrikaner population broadly replicated findings in a U.S. sample. Approximately half of male schizophrenia patients and a quarter of female patients in the Afrikaner schizophrenia database used or abused cannabis. Male users of cannabis with severe early deviant behavior had the lowest mean age of criteria onset, namely 18.4 years. These findings confirm previous findings, indicating that early deviance is linked to later outcome of disease. The clinical characteristics and premorbid variables in 12 childhood-onset Afrikaner schizophrenia patients thus far recruited in this study compare favorably with what is known about childhood-onset schizophrenia in a U.S. sample. The prevalence of co-morbid OCD/OCS in this Afrikaner schizophrenia founder sample was 13.2% which is in keeping with that of co-morbid OCD in schizophrenia, estimated at 12.2% by the U.S. National Institute of Mental Health. These findings confirm that the clinical characteristics of a schizophrenia sample drawn from the Afrikaner founder population can be generalized to the schizophrenia population at large when compared to findings reported in the literature.

The Afrikaner and schizophrenia: A Genetic study

An overview is given on the genetics of schizophrenia in an Afrikaner founder population. This research has been done over a period of ten years. Founder populations hold tremendous promise for mapping genes for complex traits, as they offer less genetic and environmental heterogeneity and greater potential for genealogical research. Not all founder populations are equally valuable, however. The Afrikaner population meets several criteria that make it an ideal population for mapping complex traits. These include founding by a small number of initial founders that likely allowed for a relatively restricted set of mutations and a large current population size that allows identification of a sufficient number of cases. Since a large number of patients was traced to an original founder couple, the genealogical data of the research support the hypothesis that a substantial portion of the schizophrenia cases the researchers have identified will share the same or a small number of susceptibility alleles. Results further show that genetic variation at the 22q11 locus enhances the risk to develop schizophrenia. More than one gene in this region can independently or synergistically increase the risk of schizophrenia in non-deleted patients. In three independent samples, evidence was provided for a contribution of the PRODH/DGCR6 locus in 22q11 associated schizophrenia. One of these samples was from South Africa as part of an ongoing collection of schizophrenia patients of Afrikaner origin. An unusual pattern of PRODH2 gene variation that mimics the sequence of a linked pseudogene was uncovered. Several of the pseudo gene-like variants identified, resulted in missense changes at conserved residues and may prevent synthesis of a fully functional enzyme. The results have implications for understanding the genetic basis of the 22q11-associated psychiatric phenotype and provide further insight into the genomic instability of this region. It was shown in an independent sample of Afrikaner schizophrenia patients that the frequency of 22q11 deletion syndrome was 2%, as suggested in earlier studies. Early deviant behaviour before 10 years of age was the most important factor related to the onset of illness. Early deviant childhood behaviour was grouped into three clusters: social functioning impairment cluster, mood/anxiety cluster and cognitive impairment cluster. Some of these factors are important in male schizophrenia patients and maybe used as endophenotypic markers. The LRRTM1 gene is implicated in the paternal transmission of schizophrenia. This gene may be implicated in the development of specific forebrain structures. It influences neuronal differentiation and connections. Male users of cannabis suffering from schizophrenia; with prominent early deviant behaviour have the lowest age of onset of illness, namely 18.4 years. Approximately half of the male schizophrenia patients and a quarter of the female schizophrenia patients used or abused cannabis. These figures are high and make cannabis use/abuse an important part of the management strategy of these patients. It was stated that in male patients with a specific subtype of schizophrenia (where early deviant behaviour was present) the use of cannabis triggers an illness with earlier onset and a poor prognosis. The prevalence of obsessive-compulsive disorder and obsessive-compulsive symptoms in Afrikaner patients suffering from schizophrenia was 13.25%. This finding differs from those in another ethnic group in South Africa suggesting the possible role of genetic and cultural factors in the prevalence of co-morbid OCD/OCS in this patient population. The most common obsession reported was contamination followed by religious obsession. The most common compulsion was checking behaviour. Clinical characteristics of Afrikaner schizophrenia and schizo-affective disorder patients with and without co-morbid OCD/OCS are the same; both groups were associated with significant psychopathology and a poor prognosis.

Pathways to ecstasy use in young adults: Anxiety, depression or behavioural deviance?

Aims To investigate pathways to ecstasy use disorders from pre-birth to early adulthood with particular attention to the relationship between early depressive and anxiety symptoms and later ecstasy use disorders. Design Prospective, longitudinal, population-based study started in Brisbane, South East Queensland (Australia) in 1981. Participants were 2143 young adults, followed up from pre-birth to young adulthood. Measurements Ecstasy use disorders were assessed with the composite international diagnostic interview (CIDI-Auto). Maternal socio-economic position and mental health status were assessed at baseline (antenatal visit); maternal substance use was measured at the 5-year follow-up, adolescents’ behaviour at the 5- and 14-year follow-up and tobacco and alcohol use were assessed at the 14-year follow-up. Findings Eight syndrome scales of childhood behaviour were examined. After adjustment for important confounders, delinquent and aggressive behaviour in early adolescence remained significantly associated with ecstasy use disorders in early adulthood. The associations became statistically non-significant when adolescent tobacco and alcohol use were included in the model [OR = 1.50 (95%CI = 0.75, 3.01) for delinquency and OR = 1.69 (95%CI = 0.92, 3.12) for aggression]. Formal mediation tests were statistically significant ( p = 0.001 for delinquent behaviour and p = 0.05 for aggressive behaviour). Conclusions Our findings suggest a pathway from early deviant behaviour to ecstasy use disorders, possibly mediated through licit drug experimentation in early adolescence.

Cannabis and other variables affecting age at onset in a schizophrenia founder population

Objective: An ongoing collaborative study between the Human Neurogenetic Laboratory of Rockefeller University, New York and the Department of Psychiatry at the University of Pretoria, has been taking place since 1997, to map genes for schizophrenia. Aspects of cannabis use/abuse will be reported. Method: The Diagnostic Interview for Genetic Studies [DIGS] is used for all diagnosis. A narrative report is completed. From this database we determined: gender, diagnostic subtype, age of illness onset, early insults, early deviant behaviour, cannabis use/abuse and family history of schizophrenia. Results: From 341 subjects we found: 61% [n=209] males and 39% [n=132] females. In males, 75% [n=156] had schizophrenia and 25% [n=53] schizoaffective disorder[SADJ]. In females 74% [n=97] had schizophrenia and 26% [n=35] SAD . 35% of subjects, [n=118], 44% [n=91] males and 20% [n=27] female’s used/abused cannabis. The mean age at onset of illness for the males was 20.5 years. This is significantly earlier than that of males with no cannabis use/abuse group as well as for both these groups in females. The long-term course of illness was similar in both cannabis use/abuse and non-use/abuse groups. An analysis of variance was used to determine the contribution of different factors in determining the age of criteria onset. According to the results obtained, early deviant behaviour was the most important determining age of criteria onset. The group with the lowest mean age of criteria were male users of cannabis with severe early deviant behaviour [18,4 years]. Conclusion: Cannabis use/abuse is common amongst male schizophrenia subjects, and affects age at onset of illness. Early deviant behaviour in the first ten years of life in these subjects is more important in this regard, and may be seen as a possible endophenotypical marker.

High school drug use predicts job-related outcomes at age 29

The present study examines the relationship between hard drug use in high school and occupational and job quality outcomes measured at approximately age 29. We use two different methods aimed at ruling out the possibility of spurious correlations between high school drug use and occupational outcomes: (1) directly controlling for pre-high school characteristics that may affect both high school drug use and later occupational characteristics (e.g., educational orientation, early drug use and deviant behavior); and (2) matching high school users with a subset of nonusers that have very similar characteristics and then estimating the difference in labor market outcomes for these two groups (i.e., propensity score matching). Overall, the results suggest that adolescent drug use is linked with poorer occupational and job quality outcomes as much as 10 years after high school. Interestingly, which job-related outcomes are affected by early hard drug use varies by gender. Females who use hard drugs as adolescents end up in lower skill, lower status jobs while males who use hard drugs as adolescents are more likely to end up in jobs with fewer benefits (e.g., health, retirement).

Early non-psychotic deviant behaviour as an endophenotypic marker in bipolar disorder, schizo-affective disorder and schizophrenia

Objective: To determine and compare the incidence of early non-psychotic deviant behaviour (i.e. under the age of ten) in Afrikaner patients with bipolar disorder, schizo-affective disorder and schizophrenia. Methods: Patients with bipolar disorder, schizo-affective disorder and schizophrenia were interviewed using a structured questionnaire probing for early deviant childhood behaviour starting before the age of 10 years. Information from close family members was also obtained where possible. Seven areas of possible deviance were probed into: social dysfunction, unprovoked aggression, extreme anxiety, chronic sadness, extreme odd behaviours, attention impairment and learning difficulties. Demographic data included: age, marital status, gender, and years of formal education. The following clinical features were also recorded: age of onset of illness and suicide attempts. Results: A total of 74 patients diagnosed with bipolar disorder, 43 patients diagnosed with schizo-affective disorder and 80 patients diagnosed with schizophrenia were interviewed. Early deviant behaviour was statistically more prevalent in schizophrenia (65%) and schizo-affective disorder (60,5%), than in the bipolar group (21,6%). Deviant childhood behaviour was grouped into 3 clusters: social functioning impairment cluster (social isolation, aggression, extreme odd behavior), mood/anxiety cluster (extreme fears, chronic sadness) and a cognitive impairment cluster (attention impairment, learning disability). Bipolar patients showed significantly less social functioning and cognitive impairment compared to patients with schizo-affective disorder and schizophrenia. Conclusion: Our findings suggest that early deviant behaviour may be a possible endophenotypic marker in schizophrenia and schizoaffective disorder. Keywords: early non-psychotic deviant behaviour, endophenotype, bipolar disorder, schizo-affective disorder, schizophrenia South African Psychiatry Review Vol. 8(4) 2005: 153-159

Multiple affected Afrikaner families in a schizophrenia genetic study: environmental risk factors in interaction with genotypes: original article

The authors report on six multiple affected Afrikaner families suffering from schizophrenia or schizoaffective disorders. These families form part of an ongoing study on genetics of schizophrenia. Three or more first degree relatives were affected in these families. In each family, the following will be reported on: a family tree, sociodemographic data, diagnostic features, substance abuse, early insults, early deviant behaviour, and longitudinal course of illness. Environmental risk factors in interaction with genotypes are discussed and it is emphasised that diseases will tend to cluster in families not because of a direct genetic effect, but because relatives are more vulnerable to the risk-increasing effect of a prevalent environmental risk factor. Progress in the study of environmental factors that interact with genes needs to go hand in hand with developments in molecular genetics. Key Words: Multiple affected founder families, Genetics, Schizophrenia, Environmental risk factors South African Psychiatry Review Vol.7(4) 2004: 10-14

13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004

13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004

Correlates of Early Substance Use and Crime Among Adolescents Entering Outpatient Substance Abuse Treatment

Although many studies have examined the relationship between early deviant behavior and subsequent life problems among adolescents drawn from the general population, such relationships have not been examined for youth attending substance abuse treatment. Based on in‐depth psychosocial assessments conducted with adolescents entering an outpatient substance abuse treatment program (N = 193), the current study examines individual characteristics, life circumstances, and other behavioral and psychological characteristics that are correlated with the age at which these youth initiated substance use and criminal activity. Early onset of substance use was associated with greater levels of family deviance and a variety of problems including school adjustment, drug use, criminal involvement, bullying and cruelty to people and animals, and involvement in risky sexual activities. In contrast, early onset of crime was related only to male gender, early onset of substance use, and cruelty to people. Findings suggest that treatment providers may need to consider the ages at which their adolescent clients initiated substance use given its association with illegal activity, other deviant behavior, and precocious and high‐risk sexual behaviors.

A comparison study of early non-psychotic deviant behavior in Afrikaner and US patients with schizophrenia or schizoaffective disorder

In a previous study early non-psychotic deviant behaviors in US adult schizophrenic patients recruited for a large-scale genetic study were examined ( Psychiatry Research, 101, 101). Early deviance characterized a distinct subgroup of patients at rates that were consistent with earlier reports. In addition, specific early non-psychotic deviant behaviors were meaningfully associated with later disease outcomes. In the present study, we examined the demographic, syndrome course, symptom and early deviant behavior history of 109 Afrikaner probands who met criteria for DSM schizophrenia or schizoaffective disorder, and compared them to 109 age- and gender-matched US probands. Consistent with past findings, 68% of Afrikaner probands, as compared to 67% of age- and gender-matched US probands, reported one or more forms of early non-psychotic deviance, including poor socialization, extreme fears/chronic sadness, and/or attention/learning impairment. The remaining 32 and 33% of probands, respectively, were without behavioral deviance until the onset of schizophrenia or schizoaffective disorder. The frequency and distribution of individual deviant behaviors were strikingly consistent between the samples. However, logistic regression analyses revealed different patterns of associations between the early deviant behaviors manifested and disease outcome. Afrikaner participants with early fears/chronic sadness were 3 times more likely to attempt suicide, while among US participants, this form of early deviance conferred 3.5 times more risk for later schizoaffective disorder, and 3 times greater likelihood of later sensory (tactile and/or olfactory) hallucinations. Afrikaner participants with attention/learning impairment were 2.5 times more likely to experience later auditory hallucinations, while US participants with these early difficulties were 3 times more likely to experience thought disorder. We concluded that early non-psychotic childhood deviance in this independently collected Afrikaner population distinguished a distinct subtype of patients and that the forms of early deviance manifested were meaningfully linked to later disease outcome. Possible reasons for the association pattern differences in these two populations are considered.

Predictors of late-onset smoking and cessation over 10 years.

To identify predictors of smoking onset and cessation between early (age 13 years) and late adolescence (age 18 years) and between late adolescence (age 18 years) and young adulthood (age 23 years). We employed logistic regression to predict smoking initiation and cessation for an ethnically diverse sample of 3056 adolescents recruited from 30 West Coast schools in 1985 and observed from age 13 to age 23 years. Fifty-six percent of the sample was female. Predictors tapping sociodemographic characteristics, environmental influences, attitudes and beliefs about smoking, bonds with school, and problem behavior were measured at age 13 years (older teenager models) and at age 18 years (young adult models). Robust predictors of both initiation and cessation across the two developmental periods included doing poorly in middle/high school and prior smoking behavior. Predictors common to three of the four models included being young for one's grade cohort and intending to smoke in the next 6 months. Early deviant behavior and drinking fostered initiation among older teenagers, but problem behavior as an older teenager did not predict young adult initiation. Smokers who had few or no high school friends who smoked and felt able to resist prosmoking pressures at age 18 years were more likely to quit by age 23 years. Being female predicted initiation by age 18 years; being African-American, Hispanic, or Asian inhibited it. The strong association of prior smoking behavior and intentions with later smoking status among both adolescents and young adults underscores the importance of starting smoking prevention early and continuing it through high school. Such programs might also consider the greater vulnerability of females, youth who are young for their grade cohort, and those who are doing poorly in school.

Early, non-psychotic deviant behavior in schizophrenia: a possible endophenotypic marker for genetic studies

Early non-psychotic deviance occurs in some, but not all, pre-schizophrenic patients and has been linked to the later course of the disorder, suggesting its relationship with the schizophrenia syndrome. However, early deviance has rarely been explored as an endophenotypic marker in large samples of schizophrenic patients. We characterized the early childhood behavior and syndrome history of 205 adults with DSM-IV schizophrenia. Sixty percent of our sample had poor socialization, extreme fears/chronic sadness, and/or attention impairment/learning disabilities beginning before age 10. The remaining 40% were without behavioral difficulties until the onset of schizophrenia. Logistic regression analyses suggested that the risk of syndrome onset before age 17 was 2.5 times more likely among patients with poor socialization beginning before age 10. Schizoaffective disorder was 3.75 times greater among patients with extreme fears/chronic sadness in childhood, and schizophrenic patients with early attention impairment/learning disabilities were 2 times more likely to have a 1°, 2° or 3° relative with schizophrenia. We concluded that early deviant behavior indicated a distinct subgroup of patients, and was linked to syndrome characteristics specifically relevant to genetic studies, in particular age at onset and family history of schizophrenia. Since early syndrome onset has been associated with specific genetic anomalies in other complex neuropathologic disorders, it may prove valuable to regard these early deviant behaviors as an indicator of early syndrome onset for future genetic studies of schizophrenia.

Factors in childhood and youth predicting alcohol dependence and abuse in Swedish women: findings from a general population study.

The aim was to assess risk factors during childhood and youth for alcohol dependence/abuse (ADA) in a population-based study of Swedish women. A total of 316 women were interviewed after stratified random sampling in the general population and a screening questionnaire. The interviews focused on social, psychological and behaviour characteristics as well as on early substance use patterns. Alcohol diagnoses were made according to DSM-III-R and CIDI-SAM. Experiences of sexual abuse before the age of 13 years, a history of psychological or psychiatric problems, early deviant behaviour and an episode of alcohol intoxication before the age of 15 years were significantly associated with ADA in a logistic model. General indicators of low social class were not associated with increased risk of ADA in a multivariate analysis. Sexual abuse in childhood was the strongest predictor of ADA. This association has potential public health importance, and should be addressed in future studies on women and alcohol.