Psychiatric Disorders In First-degree Relatives Research Articles

Risks and familial coaggregation of death by suicide, accidental death and major psychiatric disorders in first-degree relatives of individuals who died by suicide.

Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear. To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders. Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders. A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02-5.29) or accident (RR = 1.62, 95% CI 1.43-1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40-1.66), bipolar disorder (RR = 1.99, 95% CI 1.83-2.16), MDD (RR = 1.98, 95% CI 1.89-2.08) or ADHD (RR = 1.34, 95% CI 1.24-1.44). Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.

Early-Life and Family Risk Factors for Tic Disorder Persistence into Adulthood.

Many children with tic disorders outgrow their tics, but little is known about the proportion of individuals who will continue to require specialist services in adulthood and which variables are associated with tic persistence. The aims were to estimate the proportion of individuals first diagnosed with tic disorders in childhood who continued to receive tic disorder diagnoses after age 18 years and to identify risk factors for persistence. In this Swedish nationwide cohort study including 3761 individuals diagnosed with tic disorders in childhood, we calculated the proportion of individuals whose diagnoses persisted into adulthood. Minimally adjusted logistic regression models examined the associations between sociodemographic, clinical, and family variables and tic disorder persistence. A multivariable model was then fitted, including only variables that were statistically significant in the minimally adjusted models. Seven hundred and fifty-four (20%) children with tic disorders received a diagnosis of a chronic tic disorder in adulthood. Psychiatric comorbidity in childhood (particularly attention-deficit hyperactivity disorder, obsessive-compulsive disorder, pervasive developmental disorders, and anxiety disorders) and psychiatric disorders in first-degree relatives (particularly tic and anxiety disorders) were the strongest risk factors for persistence. We did not observe statistically significant associations with socioeconomic variables, perinatal complications, comorbid autoimmune diseases, or family history of autoimmune diseases. All statistically significant variables combined explained approximately 10% of the variance in tic disorder persistence (P < 0.0001). Childhood psychiatric comorbidities and family history of psychiatric disorders were the strongest risk factors associated with tic disorder persistence into adulthood. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Associations of a family history of lupus with the risks of lupus and major psychiatric disorders in first-degree relatives.

Genetic factors link psychiatric disorders, particularly major depressive disorder (MDD), bipolar disorder, and obsessive-compulsive disorder (OCD), with systemic lupus erythematosus (SLE). Additionally, maternal SLE is a risk factor for long-term developmental problems, particularly learning disabilities, attention disorders, autism spectrum disorder (ASD) and speech disorders, in children. We aimed to determine whether first-degree relatives (FDRs) of patients with SLE have increased risks of SLE and major psychiatric disorders. Using the Taiwan National Health Insurance Research Database, we recruited 40 462 FDRs of patients with SLE as well as 161 848 matched controls. The risks of major psychiatric disorders, including schizophrenia, bipolar disorder, OCD, MDD, ASD and attention-deficit/hyperactivity disorder (ADHD), were assessed. The FDRs of patients with SLE had higher risks of SLE (reported as the adjusted relative risk and 95% confidence interval: 14.54; 12.19-17.34), MDD (1.23; 1.12-1.34), ADHD (1.60; 1.55-1.65), OCD (1.41; 1.14-1.74) and bipolar disorder (1.18; 1.01-1.38) compared with controls. Specifically, male FDRs of patients with SLE had higher risks of SLE and bipolar disorder, whereas female FDRs of patients with SLE had higher risks of MDD and OCD. Differences in the familial relationship (i.e. parents, children, siblings and twins) were consistently associated with higher risks of these disorders compared with controls. The FDRs of patients with SLE had higher risks of SLE, MDD, ADHD, OCD and bipolar disorder than the controls.

Using big data of genetics, health claims, and brain imaging to challenge the categorical classification in mental illness.

Psychiatric disorders in first-degree relatives (FDRs) often differ from the index patient's diagnosis, suggesting that there is genetic contribution to psychiatric disorders in which related cases do not all map to the same diagnosis as the index case. Our aim is to look for psychiatric comorbidities across major mental illnesses using three approaches, genetics, clinical diagnosis, and brain imaging to address common associations and pathology among mental illnesses. Genome-wide association studies from the Psychiatric Genomics Consortium showed single gene polymorphisms are common across 5 major psychiatric disorders, including schizophrenia (SZ), bipolar disorder (BD), major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD). Clinically, results of Taiwan's nationwide population studies showed that other major psychiatric disorders were more likely to coaggregate in families with an index case of an individual with a psychiatric disorder, compared to control families. Finally, resting functional connectivity (FC) magnetic resonance imaging (MRI) and whole-brain connectomic analysis of SZ, BD I, BD II, MDD, and healthy controls revealed that the four groups of patients shared similar patterns of abnormal neural substrate in the brain that differed from controls. In conclusion, using big data from genetics, administrative health claims, and brain imaging, we identified concordance, indicating dimensional coherence of genetic heritability, clinical mutual associations, and common neurobiological substrates across major psychiatric disorders. These results will challenge the current diagnostic classification system and possibly move psychiatry beyond descriptive syndromes towards a nosology informed by disease cause.

Study Family History of Psychiatry Disorders in Schizophrenia Patients

Background: Schizophrenia is a chronic heterogeneous mental disorder that often has debilitating long-term outcomes. Our aim in this study is to survey history of psychiatric disorders in first-degree relatives of schizophrenia patients and its association with the disease clinical and demographic profile. Methods: In this retrospective study the hospital records of all schizophrenia patients that had been admitted in Ibn Sina Psychiatric Hospital from March 2018 to March 2019 were surveyed. Histories of any psychiatry disorders in the first-degree relatives of the schizophrenia patients were searched. The patients with positive family history were compared with those with negative family history in regard to age of onset, sex, negative symptoms, substance abuse and education level. Results: Of 250 files that were studied, 62 (24.2%) patients had family history of psychiatry disorders. Schizophrenia (10.8%), schizoaffective disorder (7.2%) and bipolar disorder (4.2%) were the most common psychiatry disorders in first-degree relatives of schizophrenia patients. Male sex, lower age at onset, substance abuse, negative symptoms, and lower education were more frequently observed in schizophrenia patients with positive family history. Conclusions: Our study demonstrated that family histories of schizophrenia, schizoaffective and bipolar disorder were higher in family history of schizophrenia patients than normal population. Furthermore, positive family history for psychiatric disorder is associated with worse prognosis in schizophrenia patients. J Neurol Res. 2020;10(6):231-234 doi: https://doi.org/10.14740/jnr631

Familial coaggregation of major psychiatric disorders in first-degree relatives of individuals with autism spectrum disorder: a nationwide population-based study.

Family coaggregation of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia have been presented in previous studies. The shared genetic and environmental factors among psychiatric disorders remain elusive. This nationwide population-based study examined familial coaggregation of major psychiatric disorders in first-degree relatives (FDRs) of individuals with ASD. Taiwan's National Health Insurance Research Database was used to identify 26 667 individuals with ASD and 67 998 FDRs of individuals with ASD. The cohort was matched in 1:4 ratio to 271 992 controls. The relative risks (RRs) and 95% confidence intervals (CI) of ADHD, ASD, BD, MDD and schizophrenia were assessed among FDRs of individuals with ASD and ASD with intellectual disability (ASD-ID). FDRs of individuals with ASD have higher RRs of major psychiatric disorders compared with controls: ASD 17.46 (CI 15.50-19.67), ADHD 3.94 (CI 3.72-4.17), schizophrenia 3.05 (CI 2.74-3.40), BD 2.22 (CI 1.98-2.48) and MDD 1.88 (CI 1.76-2.00). Higher RRs of schizophrenia (4.47, CI 3.95-5.06) and ASD (18.54, CI 16.18-21.23) were observed in FDRs of individuals with both ASD-ID, compared with ASD only. The risk for major psychiatric disorders was consistently elevated across all types of FDRs of individuals with ASD. FDRs of individuals with ASD-ID are at further higher risk for ASD and schizophrenia. Our results provide leads for future investigation of shared etiologic pathways of ASD, ID and major psychiatric disorders and highlight the importance of mental health care delivered to at-risk families for early diagnoses and interventions.

Coaggregation of Major Psychiatric Disorders in First-Degree Relatives of Individuals With Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Study.

Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable mental illness that is easily passed from one generation to the next. Studies have shown that first-degree relatives (FDRs; ie, parents, offspring, and siblings) of individuals with ADHD had a higher risk of also having ADHD. However, the familial coaggregation of ADHD with other major psychiatric disorders, specifically schizophrenia (ICD-9-CM code 295), bipolar disorder (ICD-9-CM cods 296 except codes 296.2, 296.3, 296.9, and 296.82), major depressive disorder (ICD-9-CM codes 296.2 and 296.3), and autism spectrum disorder (ASD; ICD-9-CM code 299), remains unclear. Among the entire Taiwanese population in 2010, there were 220,966 parents of children with ADHD (ICD-9-CM code 314), 174,460 siblings of children with ADHD, and 5,875 children of parents with ADHD. Matched control individuals who did not have FDRs with ADHD (1:4) were selected based on age, sex, and their relation to family members. FDRs (parents, offspring, siblings, and twins) of ADHD-diagnosed individuals had higher relative risks (95% CI) of major psychiatric disorders than the controls: 1.69 (1.60-1.79) for schizophrenia, 2.21 (2.10-2.32) for bipolar disorder, 2.08 (2.02-2.13) for major depressive disorder, 4.14 (3.90-4.39) for ASD, and 6.87 (6.73-7.01) for ADHD. These results show that ADHD coaggregated with other major psychiatric disorders, specifically schizophrenia, bipolar disorder, major depressive disorder, and ASD, within families. The results suggest that public health officials and psychiatrists should closely monitor and follow the mental health of FDRs of ADHD-diagnosed individuals, such as parents and siblings of children with ADHD.

Postpartum depression and affecting factors in primary care.

The aim of this study was to determine the frequency and affecting factors of postpartum depression (PPD) in Edirne city center. This cross-sectional study was conducted among 111 pregnant women in their third trimester in Family Health Centers in Edirne, Turkey. The participants filled out a questionnaire on sociodemographic factors developed by the researchers along with the Beck Depression Inventory for Primary Care (BDI-PC) before childbirth. Women with a probability of depression, determined with the BDI-PC, were excluded, and the remaining 100 participants were applied the Edinburgh postpartum depression scale (EPDS) in the first and second months after childbirth. The frequency of PPD was 14% (n = 14) in the first month and 17% (n = 17) in the second month of delivery. Thus, 24 different mothers out of 100 were determined to have PPD in the first two months after childbirth. The probability of PPD, measured with EPDS, was significantly higher among younger mothers, mothers with unemployed husbands, mothers with lower income, mothers with a health problem of the child, and mothers who do not breastfeed. There was no significant relationship between PPD and mother's education status, marriage age, the age of first labor, PPD after previous childbirth, psychiatric disorders in first-degree relatives, higher number of children, method of delivery, and unwanted pregnancies. PPD is an important community problem. Thus, it is useful to monitor the risky mothers in primary care and screen them with the practical EPDS in order to prevent the negative effects on the baby and the mother.

A clinical comparison of schizophrenia with and without pre-onset cannabis use disorder: a retrospective cohort study using categorical and dimensional approaches.

Background A high prevalence of cannabis use disorder has been reported in subjects suffering from schizophrenia, fuelling intense debate about whether schizophrenia with pre-onset cannabis use disorder may be a distinct entity with specific features or whether cannabis use disorder can precipitate schizophrenia in genetically vulnerable subjects.Methods We retrospectively assessed schizophrenia subjects with and without pre-onset cannabis use disorder on the basis of their clinical features, assessed categorically and dimensionally with the operational criteria checklist for psychotic illnesses (OCCPI). We also investigated whether the two groups could be differentiated on the basis of a history of psychiatric disorders in first-degree relatives. A principal component factor analysis of the OCCPI items was used to identify specific symptom dimensions. The relationships between symptom dimensions and cannabis status were analysed by point-biserial correlation analysis to control for sex and age at time of the assessment and illness duration.ResultsOne hundred and seventy-one subjects with a diagnosis of schizophrenia were included. Among them, forty-one patients (18.2 % of the sample) had a cannabis use disorder before or at the time of the onset of schizophrenia. We found similar results in symptoms patterns or family history between patients with and without pre-onset cannabis use disorder.ConclusionsOur results clearly argue against cannabis-associated schizophrenia being a relevant distinct clinical entity of schizophrenia with specific features.

Prevalence of Psychiatric Disorders in First-degree Relatives of Patients With Drug Dependence With and Without Comorbid Psychiatric Disorder Using the Family History Method (FH-RDC)

Aim: The aim of this study was to evaluate psychiatric morbidity risks in first-degree relatives of patients with drug dependence with and without comorbid psychiatric disorder. Methods: The case-control study was carried out in Nigeria. The Family History Method was used to evaluate psychiatric disorders in the first-degree relatives of the patients. Results: The family psychiatric morbidity risks did not predict the development of comorbid psychiatric disorder among the probands. However, psychiatric disorder in the probands correlated significantly with cannabis use, more so with early age at onset of its use. Conclusions: Familial psychiatric morbidity risk was not associated with psychiatric disorder in patients with drug dependence.

Quality of life, family burden and associated factors in relatives with obsessive–compulsive disorder

ObjectiveThe aim of this study is to assess the quality of life (QoL), family burden and psychiatric disorders in first-degree relatives of patients with obsessive–compulsive disorder (OCD) and to compare them with healthy controls and their relatives. MethodsForty patients with OCD and 47 of their first-degree relatives as well as 40 healthy subjects and 45 of their first-degree relatives were recruited in this study. OCD and comorbid anxiety or mood disorders were determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Personality Disorders. Type and severity of obsessive–compulsive symptoms were assessed with the Yale–Brown Obsessive–Compulsive Scale, and the disability of patients with OCD was evaluated with the WHO DAS II. Family burden and QoL in the relatives were evaluated with the Zarit Burden Interview (ZBI) protocol and the World Health Organization Quality of Life Assessment—Brief, respectively. ResultsThe mean ZBI score of family members of OCD patients was higher than the control relatives. Linear regression analysis indicated that the independent factors associated with ZBI were duration of OCD, comorbid major depressive disorder and poorer insight. Compared with those of control relatives, the QoL of relatives of patients with OCD was significantly lower in all domains. While the diagnosis of major depressive disorder in relatives of OCD patients was significantly higher than the control relatives, the diagnosis of any anxiety disorder did not differ. ConclusionsOur study provides evidence that OCD not only affects the lives of patients but also their family members.

Irritability Without Elation in a Large Bipolar Youth Sample: Frequency and Clinical Description

ObjectiveTo determine whether some children with bipolar disorder (BP) manifest irritability without elation and whether these children differ on sociodemographic, phenotypic, and familial features from those who have elation and no irritability and from those who have both. MethodThree hundred sixty-one youths with BP recruited into the three-site Course and Outcome of Bipolar Illness in Youth study were assessed at baseline and for most severe past symptoms using standardized semistructured interviews. Bipolar disorder subtype was identified, and frequency and severity of manic symptoms were quantified. The subjects were required to have episodic mood disturbance to be diagnosed with BP. The sample was then reclassified and compared based on the most severe lifetime manic episode into three subgroups: elated only, irritable only, and both elated and irritable. ResultsIrritable-only and elated-only subgroups constituted 10% and 15% of the sample, respectively. Except for the irritable-only subjects being significantly younger than the other two subgroups, there were no other between-group sociodemographic differences. There were no significant between-group differences in the BP subtype, rate of psychiatric comorbidities, severity of illness, duration of illness, and family history of mania in first- or second-degree relatives and other psychiatric disorders in first-degree relatives, with the exception of depression and alcohol abuse occurring more frequently in the irritability-only subgroup. The elated-only group had higher scores on most DSM-IV mania criterion B items. ConclusionsThe results of this study support the DSM-IV A criteria for mania in youths. Irritable-only mania exists, particularly in younger children, but similar to elated-only mania, it occurs infrequently. The fact that the irritable-only subgroup has similar clinical characteristics and family histories of BP, as compared with subgroups with predominant elation, provides support for continuing to consider episodic irritability in the diagnosis of pediatric BP.

S06-03 Controversy over the diagnosis of ‘cannabis-induced psychosis’

Background:Both the ICD-10 and the DSM-IV operate with a diagnosis of cannabis-induced psychotic disorder. Despite this, the diagnosis is controversial.A number of studies have shown that cannabis can induce short-lived psychotic symptoms, and that this could depend on factors such as genetic predisposition. To qualify for a diagnosis of ‘cannabis-induced psychosis’, however, the symptoms must last for at least 48 hours according to the ICD-10. This diagnosis has traditionally been regarded as benign, but this is based on a very limited number of studies.Methods:We have conducted two studies based on Danish treatment registers. Firstly, all patients who had received psychiatric treatment for cannabis-induced psychosis were followed for at least 3 years to determine the rate of subsequent treatment for schizophrenia-spectrum disorders. Secondly, familial predisposition for psychiatric disorders among subjects treated for cannabis-induced psychosis and schizophrenia was compared using competing risk analyses.Results:Schizophrenia spectrum disorders were diagnosed in 44.5% of the 535 subjects included in the first study. New psychotic episodes of any type were diagnosed in 77.2% and 47.1% received a diagnosis of schizophrenia spectrum disorders more than a year after the cannabis-induced psychosis.Those who develop cannabis-induced psychosis and schizophrenia spectrum disorders both show elevated levels of predisposition for schizophrenia, other psychotic conditions, and other psychiatric disorders in first-degree relatives. In general, the level of predisposition is of similar magnitude in individuals treated for cannabis-induced psychosis and schizophrenia.Conclusion:Cannabis-induced psychosis could be an early sign of schizophrenia rather than a distinct clinical entity.

Familial Predisposition for Psychiatric Disorder

Cannabis-induced psychosis is considered a distinct clinical entity in the existing psychiatric diagnostic systems. However, the validity of the diagnosis is uncertain. To establish rate ratios of developing cannabis-induced psychosis associated with predisposition to psychosis and other psychiatric disorders in a first-degree relative and to compare them with the corresponding rate ratios for developing schizophrenia spectrum disorders. A population-based cohort was retrieved from the Danish Psychiatric Central Register and linked with the Danish Civil Registration System. History of treatment of psychiatric disorder in family members was used as an indicator of predisposition to psychiatric disorder. Rate ratios of cannabis-induced psychosis and schizophrenia associated with predisposition to psychiatric disorders were compared using competing risk analyses. Nationwide population-based sample of all individuals born in Denmark between January 1,1955, and July 1, 1990 (N = 2,276,309). Patients During the 21.9 million person-years of follow-up between 1994 and 2005, 609 individuals received treatment of a cannabis-induced psychosis and 6476 received treatment of a schizophrenia spectrum disorder. In general, the rate ratios of developing cannabis-induced psychosis and schizophrenia spectrum disorder associated with predisposition to schizophrenia spectrum disorder, other psychoses, and other psychiatric disorders in first-degree relatives were of similar magnitude. However, children with a mother with schizophrenia were at a 5-fold increased risk of developing schizophrenia and a 2.5-fold increased risk of developing cannabis-induced psychosis. The risk of a schizophrenia spectrum disorder following a cannabis-induced psychosis and the timing of onset were unrelated to familial predisposition. Predisposition to both psychiatric disorders in general and psychotic disorders specifically contributes equally to the risk of later treatment because of schizophrenia and cannabis-induced psychoses. Cannabis-induced psychosis could be an early sign of schizophrenia rather than a distinct clinical entity.

Psychosis risk for parents and siblings of Dutch and Moroccan-Dutch patients with non-affective psychotic disorder

BackgroundStudies in the UK compared psychosis risks for first-degree relatives of White and African-Caribbean patients and found “normal” risks for the parents of Caribbean patients, but very high risks for siblings of second-generation Caribbean patients. AimTo compare the risk of non-affective psychotic disorder (NAPD) for the parents and siblings of Moroccan-Dutch patients to that for the parents and siblings of Dutch patients. The “Moroccan-Dutch” are Dutch residents of Moroccan origin (first or second generation). MethodInformants related to 29 Moroccan-Dutch and 63 Dutch patients were interviewed about the presence of psychiatric disorders in first-degree relatives (N=508), by means of the Family Interview for Genetic Studies. ResultsThe risks for NAPD in both parent groups were similar (age and sex-adjusted odds ratio 1.0; 95% CI: 0.3–3.8). However, among the siblings, the risk for NAPD was significantly higher for the Moroccan-Dutch than for the Dutch (sex-adjusted hazard ratio 4.5; 95% Confidence Interval: 1.5–14.0). This was due to a large number of cases among the brothers of the Moroccan-Dutch patients (N=14), not among their sisters (N=1). Owing to small numbers separate hazard ratios for the first and the second generation were not calculated. ConclusionThese preliminary results suggest that environmental factors in the Netherlands have a great impact on the psychosis risk for male immigrants from Morocco.

LEVEL OF EDUCATION AND CANNABIS USE IN FIRST EPISODE OF PSYCHOSIS: GAP STUDY

s / Schizophrenia Research 102/1–3, Supplement 2 (2008) 1–279 175 358 – LEVEL OF EDUCATION AND CANNABIS USE IN FIRST EPISODE OF PSYCHOSIS: GAP STUDY Manuela Russo1, Abraham Reichenberg1 , Marta Di Forti1, Monica Aas1, Laura Gittens1, Rowena Handley1, Sonija Luzi1, Tiago Marquez1 , Valeria Mondelli2 , Corinne Prescott1 , Heather Taylor1, Ben Wiffen1, Arshia Seddigh1, Carmine Pariante2 , Paola Dazzan1 , Kathy Aitchinson3 , Robin Murray1 1Adult Psychiatry, Institute of Psychiatry, London, United Kingdom; 2Clinical Neuropharmacology and MRC SGDP Centre, Institute of Psychiatry, London, United Kingdom; 3MRC SGDP Centre, Institute of Psychiatry, London, United Kingdom manuela.russo@iop.kcl.ac.uk Introduction: Psychosis is an aetiologically complex disorder for which increasing evidences suggest an interaction between genetic risk factors and environment. Recent studies demonstrated social factors can influence the posibility of developing psychosis (Morgan et al., 2006). Furthermore, certain style of life like smoking cannabis could increase the risk of developing this disorder (Arseneault et al., 2004; Henquet et al., 2005; Caspi et al., 2005). We hyphothesize that level of education might be associated with cannabis use in first-episode psychosis. Methods: We collected clinical and demographic data in 158 firstepisode psychosis individuals and 75 matched healthy volunteers. Subjects were recruited as part of GAP study (Genetic and Psychosis) which included cases who presented to the South London Maudsley Trust.Of the above sample, 32 cases and 43 healthy volunteers were assessed with the Working Memory Scale III to analyze any possible diff erences in cognitive functions. Results: 63.3% of cases and 62.7% of controls are cannabis users. 48.73% of cases and 90.67% of controls achieved high level of education (greater than GCSES). Patients have significantly lower education th an controls (p<0.001). We found that cannabis users in both groups have lower education than non users (p=0.032).There is not significant evidence in neuropsychological function between cases and controls. Conclusions: We demonstrated that a t highest level of education corresponds lower use of cannabis. No significant difference in cognitive functions was found between patients and controls and cannabis use. 359 – PSYCHOSIS RISK FOR PARENTS AND SIBLINGS OF DUTCH AND DUTCH-MOROCCANPATIENTSWITH NON-AFFECTIVE PSYCHOTIC DISORDER Jean-Paul Selten1, Jan-Dirk Blom2, Ingeborg van der Tweel3, Wim Veling2, Boukje Leliefeld2 , Hans Hoek2 1University Medical Centre, Utrecht., Utrecht; 2Parnassia Bavo Group, The Hague; 3Centre for Biostatistics, University Medical Centre, Utrecht, The Netherlands j.p.selten@umcutrecht.nl Introduction: Studies in the UK compared psychosis risks for firstdegree relatives of White and African-Caribbean patients and found normal risks for the parents of Caribbean patients, but very high risks for siblings of second-generation Caribbean patients. The aim of this study was to compare the risk of Non-Affective Psychotic Disorder (NAPD) for the parents and siblings of Dutch-Moroccan patients to that for the parents and siblings of Dutch patients. Methods: Informants related to 29 Dutch-Moroccan and 63 Dutch patients were interviewed about the presence of psychiatric disorders in first-degree relatives (N=508), by means of the Family Interview for Genetic Studies. Results: The risks for NAPD in both parent groups were similar (ageand sex-adjusted odds ratio 1.0; 95% CI: 0.3-3.8). However, among the siblings, the risk for NAPD was significantly higher for the Dutch-Moroccans than for the Dutch (sex-adjusted hazard ratio 4.5; 95% CI: 1.5-14.0). This was due to a large number of cases among the brothers of the Dutch-Moroccan patients (N=14), not among their sisters (N=1). Owing to samll numbers separate hazard ratios for the first and the second generation were not calculated. Conclusions: These results suggest that environmental factors in the Netherlands have a great impact on the psychosis risk for male immigrants from Morocco, not that for female immigrants. Acknowledgements: The authors thank Marjolijn van Zeeland for her help in data-collection. 360 – SELF-REPORTED AND TEST-BASED MOBILITY LIMITATIONS IN PERSONSWITH PSYCHOTIC DISORDER Satu Viertio1, Paivi Sainio1, Seppo Koskinen1, Jonna Perala1, Samuli I. Saarni1, Marja Sihvonen2, Jouko Lonnqvist1 , Jaana Suvisaari1 1National Public Health Institute, Helsinki; 2University of Helsinki,

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.

Substance use and other psychiatric disorders in first‐degree relatives of opioid‐dependent males: a case–controlled study from India

To assess the prevalence of substance use and other psychiatric disorders in first-degree relatives of males with opioid dependence compared to normal controls. Observational, case-control study using family history method. A drug addiction treatment centre in northern India. First-degree relatives of 100 male probands with opioid dependence and no comorbidity (n=493) and those of 50 matched probands from normal population (n=254). Measurement Family interview of probands and family members, using the Family Interview for Genetic Studies. The main outcome measure was relative risk (expressed as odds ratio after controlling for confounding variables using logistic regression) of familial aggregation of psychiatric and substance use disorders. First-degree relatives of opioid-dependent males were more likely to have a psychiatric disorder than those of normal controls [adjusted odds ratio (OR) 4.47; 95% confidence interval (CI) 1.97-10.11; P<0.001], especially for opioid use disorders in the brothers (adjusted OR 6.55; 95% CI 1.44-29.88; P=0.015) and for alcohol use disorders in the fathers of the probands (adjusted OR 5.64; 95% CI 2.39-13.24; P<0.001). Other disorders (major depression, chronic psychosis and obsessive compulsive disorder) did not have significant aggregation in the first-degree relatives of opioid-dependent subjects. This study provides further evidence for the higher rates of alcohol and opioid dependence in first-degree relatives of opioid-dependent patients. The exact pattern of this familial aggregation may be influenced by the gender of the relatives and their relation to the proband.

Morbid risk for psychiatric disorder among the relatives of methamphetamine users with and without psychosis

It is not clear why some methamphetamine (MAMP) abusers develop psychotic symptoms, while others use MAMP regularly over long periods and remain unscathed. We tested the hypotheses that those users who develop MAMP-induced psychosis (MIP) have greater familial loading for psychotic disorders than users with no psychosis. Four hundred forty-five MAMP users were recruited from a psychiatric hospital and a detention center in Taipei, and were assessed with the Diagnostic Interview for genetic studies (DIGS-C) and the Family Interview for genetic study (FIGS-C). Morbid risk (MR) for psychiatric disorders in first-degree relatives was compared between those MAMP users with a lifetime diagnosis of MAMP psychosis and those without. The relatives of MAMP users with a lifetime diagnosis of MAMP psychosis had a significantly higher MR for schizophrenia (OR = 5.4, 95% CI: 2.0-14.7, P < 0.001) than the relatives of those probands who never became psychotic. Furthermore, the MR for schizophrenia in the relatives of the subjects with a prolonged MAMP psychosis (MIP-P) was higher than in the relatives of those users with a brief MAMP psychosis (MIP-B) (OR = 2.8, 95% CI: 1.0-8.0, P = 0.042). The greater his or her familial loading for schizophrenia, the more likely a MAMP user is to develop psychosis, and the longer that psychosis is likely to last.

The clinical characteristics of unipolar vs. bipolar major depression in ADHD youth

ObjectiveTo investigate the characteristics of unipolar vs. bipolar depression in youth using a sample of children referred for a study on attention deficit hyperactivity disorder (ADHD). MethodsWe compared children with unipolar depression (N=109) to those with bipolar depression (N=43) using boys and girls (N=280) referred for a study on ADHD. Comparisons were made in characteristics of depression, comorbidity and family history. All diagnoses were made using the KSADS-E. ResultsIn comparison to children with unipolar depression, children with bipolar depression were more likely to have met criteria for depression due to both “sad” and “mad” mood states as stated in the KSADS-E, have severe depression with suicidality, anhedonia and hopelessness. Children with bipolar depression were more likely to have comorbid conduct disorder, severe oppositional defiant disorder, agoraphobia, obsessive compulsive disorder and alcohol abuse, compared to children with unipolar depression. Bipolar depressed children had lower GAF scores and higher rates of hospitalization. Bipolar depression is associated with higher levels of psychiatric disorders in first-degree relatives. ConclusionsIn youth, bipolar depression is distinct from unipolar depression in quality and severity of symptoms, comorbidity and family history. This presentation can aid clinicians in identifying children and adolescents with bipolar disorder.