July 11, 2006

Psychosis Among Siblings of Schizophrenia Patients

A Summary Review of Psychosis among "healthy" siblings of schizophrenia patients

A recently published study of Finnish patients with schizophrenia and their families has confirmed previous study findings that the incidence of schizophrenia and psychotic disorders is much greater for siblings of people with schizophrenia than it is in the general population. 16% of the siblings were diagnosed with psychotic disorders compared to the control group in the general population with only 2% psychotic diagnoses.

Contrary to other studies, the frequency of anxiety disorders (general anxiety disorder, social anxiety, PTSD, Phobias, etc) was also higher among siblings than the comparison group. In addition, the siblings also had more co-existing diagnoses (24%) than the comparison group (6%).

The evidence suggests that family liability for schizophrenia not only increases the risk for schizophrenia itself but for other psychotic disorders of the schizophrenia spectrum as well as related illnesses (schizoaffective disorder, bipolar disorder, major depressive episodes, anxiety, OCD, etc.).

Furthermore, family background for schizophrenia may make the mental health status of patients much more complicated. Previous studies have shown that patients with first-degree relatives with psychotic disorder have more severe negative symptoms (paucity of expressive gestures, lack of vocal inflections, inability to experience pleasure, etc.) than patients without the inherited risk for schizophrenia.

7.7% of the siblings that were presumed to be healthy at the beginning of the study in 1991 actually presented with psychotic symptoms upon follow-up. In addition to this, 8.7% of initially healthy siblings developed psychotic symptoms during a relatively short follow-up period.

Genetic analysis should take into consideration the high rate of development of psychotic disorders in relatives of schizophrenia patients; the complicated clinical status of these individuals suggests that there are many different genes at work.

The exact combination of genes and/or environmental influences that causes such a diverse spectrum of symptoms in varying severity is yet to be known with high certainty. Researchers have linked a number of environmental factors (see link for list) to development of, what in medical terms is called the schizophrenia spectrum disorders and research is ongoing to validate these suspected factors.

The take home message here is that there is a higher risk for siblings of those who have schizophrenia to also have mental health problems (another way of saying this is that family members may be biologically more sensitive to environmental stressors) - and its important for families to seek professional assistance from qualified psychologists, psychiatrists and family therapists (if there is stress or dysfunction in the family) as soon as possible if any mental health issues arise in the siblings.

Its probably also a good idea to take pro-active approaches to minimize potential environmental stressors that seem to be linked to schizophrenia and related disorders - see the following links for more information on this topic:

Child and young adult Schizophrenia Risk Factors

Child Development Education Programs to Help Maximize Mental Health

More information: Causes and Prevention of Schizophrenia

Source: Psychosis among "healthy" siblings of schizophrenia patients
Authored By: Ritva Arajarvi, Jonna Ukkola, Jari Haukka, Jaana Suvisaari, Jukka Hintikka, Timo Partonen and Jouko Lonnqvist
Published In: BMC Psychiatry 2006, 6:6.


I wasn't schizophrenic until I had several untreated psychotic episodes from using LSD. Once I stopped using the drugs I very slowly began to recover but still suffer from the symptoms.

Posted by: Mike at July 18, 2006 12:08 PM

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