Search for the Causes of Schizophrenia: Volume III PDF
Preview Search for the Causes of Schizophrenia: Volume III
Search for the Causes of Schizophrenia Volume III Edited by H. Hafner and W.F. Gattaz With 50 Figures Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Barcelona Budapest Prof. Dr. Dr. Dres. h.c. HEINZ HAFNER Prof. Dr. WAGNER FARID GATIAZ Central Institute of Mental Health P.O. Box 122120 68072 Mannheim, Germany ISBN-13:978-3-642-7943 1-5 e-ISBN-13:978-3-642-79429-2 DOl: 10.1007/978-3-642-79429-2 Library of Congress Cataloging-in-Publication Data. (Revised for vol. 3) Search for the causes of schizo phrenia. Papers from a conference held at the Forum of Science, Heidelberg University, Sept. 24-26, 1986, and organized by the Central Institute of Mental Health, Mannheim, and the Department of Psychiatry, University of Heidelberg. Vol. 2, edited by H. Hafner and W.F. Gattaz, presents papers from a second symposium held at the University of Heidelberg on May 24-26, 1989. Includes bibliographies and indexes. 1. Schizophrenia - Etiology - Congresses. I. Hafner, H. (Heinz), 1926- . II. Gattaz, W.F. (Wagner Farid), 1951- . III. lanzarik, W., 1920- . IV. Zentralinstitut fur Seelische Gesundheit (Mannheim, Germany) V. Universitat Heidelberg. Psychiatrische Klinik. RC514.S366 1987 616.89'82071 87-9504 ISBN-13:978-3-642-79431-5 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1995 Softcover reprint of the hardcover 1st edition 1995 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Typesetting: Best-set Typesetter Ltd., Hong Kong SPIN: 10480210 25/3130/SPS - 5 4 3 2 1 0 - printed on acid-free paper Preface This volume presents the contributions to the third symposium on the "Search for the Causes of Schizophrenia". The first symposium was organized by the Central Institute of Mental Health on the occasion of the 600th anniversary of the University of Heidelberg in 1986. Its objective was to give an overview of the rapid development in schizophrenia research in a situation characterized by an excessive variety of methods and topics. It was our intention, through substantial contributions to topical areas of schizophrenia research and through intensive discussions, to further the exohange of hypotheses and results and thus open up ways towards new concepts integrating different methodological approaches or towards new models of explanation. The first symposium was a great success. The publication of the proceedings (Hafner et al. 1987) was received with enthusiasm and recommended in leading journals "as the best available state-of-the-art analysis of current research on the aetiology of schizophrenia". For this reason we held a second and a third symposium entitled "Search for the Causes of Schizophrenia" under the same auspices and at the same place in 1989 and 1993. The variety and disparity of the disciplines and methods involved in schizo phrenia research makes it essential to focus on certain issues, even if the symposium is meant to bring together the divergent branches of research for an exchange of experience. Therefore, we endeavoured to discuss the latest research progress by concentrating on issues promising further knowledge on the aetiology of schizophrenia. The speakers and discussants were leading experts engaged at the frontline of schizophrenia research: several speakers have already developed concepts for comprehensive aetiological models even beyond their own approaches. The most intricate but also interesting task in this context was for the invited discussants to critically analyse four or five contributions of partly loosely connected issues. The concentration on a few focuses, which meant the disregard of other fields of schizophrenia research, was bound to meet with biased opinions. In "Search for the Causes of Schizophrenia II", we had taken up topics from the first symposmm such as genetics, biological and psychophysiological aspects, vulnerability models, epidemiology and the course of schizophrenia and had pursued them up to the latest developments of that time. Extensive information was provided about recent research in analytical and genetical epidemiology and about the few methodologically outstanding national and transnational comparative course studies. Intensive and critical attention was paid to the VI Preface vulnerability models; the descriptive genetics of schizophrenia was com plemented by aspects of molecular genetics, biological approaches by brain anatomy and brain function. The present volume of "Search for the Causes of Schizophrenia III" opens up new perspectives for schizophrenia research: On the assumption that, at the beginning, the symptoms and course of schizophrenia are not so greatly modified by secondary processes such as medication, environmental and per sonality factors, and on the assumption that antecedents of the psychosis can offer an approach to aetiological hypotheses, we focused in Part I on the precursors, onset and early course of schizophrenia. In this field, the British Child Development Study has provided substantial progress. This study of a representative birth cohort of the British population assessed in several cross sections during childhood and adolescence has for the first time provided generalizable data about the antecedents of schizophrenia on the basis of emotional, behavioural, cognitive and neuromotor deficits (see T.J. Crow, p. 3). The results of the high-risk studies (J. Parnas, p. 67), which are neces sarily based on a selectively defined proportion of schizophrenic individuals, i.e. the children of schizophrenic mothers, could thus be complemented by epidemiologically founded results concerning the functional and developmental deficits of individuals who later develop schizophrenia. These results have proved to be of theoretical importance for both genetic and exogenous developmental deficits. The variety and severity of the neuro behavioural deficits, above all in early-onset schizophrenia, starting before the age of 12, was demonstrated by Asarnow et al. (p. 87) with a multi-level approach. Altogether these results showed that the aetiological model of schizophrenia is no longer adequate without taking into account the neuro developmental aspects with their genetic and exogenous causes (R. M. Murray, p. 186). They also emphasized that a comprehensive or an exclusive interpreta tion of schizophrenia as a neurodevelopmental disorder is not or perhaps not yet feasible, since a great amount of schizophrenias break out without preceding symptoms of neurodevelopmental deficits. The systematic investigation into onset and early course on the basis of a large first-episode sample and the explanation of the higher age of onset in women by the estrogen hypothesis (H. Hiifner, p. 43; E.F. Walker, p. 21; L.E. DeLisi, p. 114) was also an important contribution towards generating new theories. The fact that the maximum of social consequences of schizo phrenia already occur during the prodromal phase and are determined by the time when the disease breaks into the social biography, and thus by the age at onset, is not only of theoretical but also of practical importance (see H. Hiifner, p. 43). Part II, entitled "Schizophrenia: Disease or Syndrome?", deals with the complex relationships between brain function assessed by brain imaging and neuropathology and specific psychopathology of schizophrenia at the level of morphological, functional and regional brain abnormalities (P.F. Liddle, p. 150; E.C. Johnstone, p. 129). At these levels, the first steps are made towards elucidating the associations between localized brain function and Preface VII psychopathology. They are firmly supported by M.R. Trimble (p. 141) with regard to the organic presentation of the schizophrenia syndrome or the com parison of symptomatic schizophrenia and its neuropathological causes with idiopathic schizophrenia. The issue of the genetics of schizophrenia was pursued by means of epidemiological family studies of sound methodological standard, coming up with the result of limited genetic heterogeneity (see W. Maier, p. 157). Part III, entitled "Brain, Receptors and Schizophrenia", presents the as sociations between brain function, receptors and schizophrenia at the level of biochemical analyses, their molecular basis (P. Sokoloff, p. 195; W.F. Gattaz, p. 215), at the level of a 31p spectroscopic magnetic resonance study of the brain phospholipid metabolism (l.W. Pettegrew, p. 227) and with positron emission tomography (PET) studies of receptor ligands and regional changes in metabolism (F.-A. Wiesel, p. 252). The discussants (L.E. DeLisi, R.E. Murray and F.A. Henn) performed the complex critical synthesis leading to integrative approaches and initiated the creative general discussion. Unfortunately, for reasons of expense, the general discussion could not be included in this volume. "Search for the Causes of Schizophrenia III" was for the first time connected with the symposium "Schizophrenia - Psychotic Continuum or Distinct Entities" organized by A. Marneros (University of Halle, Germany), N.C. Andreasen (University of Iowa, USA) and M.T. Tsuang (Harvard Medical School, USA). The latter is also the third symposium in a series of internationally renowned research symposia. It was the intention of the organizers to hold the two symposia at the same place and in immediate succession so as to enable the exchange of experience between the participants of the two groups. This experiment was greatly estimated by all the participants. However, both groups had to put up with a limited time and programme compared to the preceding symposia. The proceedings of the symposium "Schizophrenia - Psychotic Con tinuum or Distinct Entities" will be published in a separate volume (Marneros et al. 1995). Mannheim, September 1994 H. HAFNER W.F. GATIAZ Contents Part I Antecedents, Onset, and Early Course of Schizophrenia Birth Cohort Study of the Antecedents of Psychosis: Ontogeny as Witness to Phylogenetic Origins. T.J. CROW, D.J. DONE, 3 and A. SACKER ................................................. . Antecedents of Schizophrenia: Moderating Effects of Development and Biological Sex. E.F. WALKER, J. WEINSTEIN, K. BAUM, and C.S. NEUMANN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Onset and Early Course of Schizophrenia. H. HAFNER, K. MAURER, W. LOFFLER, S. BUSTAMANTE, W. AN DER HEIDEN, A. RIECHER-RosSLER, and B. NOWOTNY................................................ 43 Early Predictors of Onset and Course of Schizophrenia: Some Results from the Copenhagen High-Risk Study. J. PARNAS, T.D. CANNON, S.A. MEDNICK, and F. SCHULSINGER ............................... 67 Neurobehavioral Studies of Schizophrenic Children: A Developmental Perspective on Schizophrenic Disorders R.F. ASARNow, R. CAPLAN, and J.R. ASARNOW ..................... 87 Antecedents, Onset, and Early Course of Schizophrenia: Discussion L.E. DELISI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Part II Schizophrenia: Disease or Syndrome? Brain Imaging, Psychopathology and Neuropathology E.C. JOHNSTONE ................................................ 129 Idiopathic and Organic Presentations of Schizophrenia M.R. TRIMBLE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Associations Between Regional Brain Abnormalities and Specific Syndromes in Schizophrenia. P.F. LIDDLE. . . . . . . . . . . . . . 150 Genetic Heterogeneity and Phenotype Variation of Schizophrenia W. MAIER...................................................... 157 Schizophrenia: Disease or Syndrome? Discussion. R.M. MURRAY and P. JONES ................................................... 186 X Contents Part III Brain, Receptors and Schizophrenia Multiple Dopamine Receptors: Implications for Schizophrenia P. SOKOLOFF, M.-P. MARTRES, D. LEVESQUE, J. DIAZ, C. PILON, N. GRIFFON, and J.-C. SCHWARTZ. . . . . . . . . . . . . . . . . .. . . .. . . . . . ... . . . 195 Increased Breakdown of Membrane Phospholipids in Schizophrenia: Implications for the Hypofrontality Hypothesis. W.F. GATIAZ, J. BRUNNER, A. SCHMITT, and A. MARAS. . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 31p Magnetic Resonance Spectroscopy Study of Brain Metabolism in Schizophrenia. R. MCCLURE, M. KESHAVAN, N.J. MINSHEW, K. PANCHALINGAM, and J.W. PETTEGREW ........................... 227 Positron Emission Tomography, Receptors, and Schizophrenia F.-A. WIESEL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252 Brain Receptors and Schizophrenia: Discussion. F.A. HENN . . . . . . . . . 263 SUbject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269 List of Contributors You will find the addresses at the beginning of the respective contributions. AN DER HEIDEN, W. 43 MARAS, A. 215 ASARNOW, J.R 87 MARTRES, M.-P. 195 ASARNOW, RF. 87 MAURER, K. 43 BAUM, K. 21 MCCLURE, R 227 BRUNNER, J. 215 MEDNICK, S.A. 67 BUSTAMANTE, S. 43 MINSHEW, N.J. 227 CANNON, T.D. 67 MURRAY, RM. 186 CAPLAN, R 87 NEUMANN, C.S. 21 CROW, T.J. 3 NOWOTNY, B. 43 DELISI, L.E. 114 PANCHALINGAM, K. 227 DIAZ, J. 195 PARNAS, J. 67 DONE, D.J. 3 PETTEGREW, J. W. 227 GATTAZ, W.F. 215 PILON, C. 195 GRIFFON, N. 195 RIECHER-RosSLER, A. 43 lliFNER, H. 43 SACKER, A. 3 HENN, F.A. 263 SCHMITT, A. 215 JOHNSTONE, E.C. 129 SCHULSINGER, F. 67 JONES, P. 186 SCHWARTZ, J.-C. 195 KESHAVAN, M. 227 SOKOLOFF, P. 195 LEVESQUE, D. 195 TRIMBLE, M.R 141 LIDDLE, P.F. 150 WALKER, E.F. 21 LOFFLER, W. 43 WEINSTEIN, J. 21 MAIER, W. 157 WIESEL, F.-A. 252 Part I Antecedents, Onset, and Early Course of Schizophrenia
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