Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-13T01:38:55.145Z Has data issue: false hasContentIssue false
  • English
  • Français

Increased Intracerebral Cerebrospinal Fluid Spaces Predict Unemployment and Negative Symptoms in Psychotic Illness a Prospective Study

Published online by Cambridge University Press:  02 January 2018

Jim Van Os ,
Thomas A. Fahy ,
Peter Jones ,
Ian Harvey ,
Shôn Lewis ,
Maureen Williams ,
Brian Toone  and
Robin Murray
Jim Van Os*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, London
Thomas A. Fahy
Affiliation:
Maudsley Hospital, London
Peter Jones
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, London
Ian Harvey
Affiliation:
Coventry Mental Health Unit, Walsgrave, Coventry
Shôn Lewis
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London
Maureen Williams
Affiliation:
Department of Psychological Medicine, King's College and Maudsley Hospitals, London
Brian Toone
Affiliation:
King's College and Maudsley Hospitals, London
Robin Murray
Affiliation:
Institute of Psychiatry and King's College Hospital, London
*
Dr Jim van Os, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Extract

Background

It has been suggested that the dimensions of cerebral ventricles are a risk factor for poor outcome in psychotic illness.

Method

A cohort of 140 patients with functional psychoses of recent onset who had undergone CT scanning, were followed up for an average of 46 months and assessed on six dimensions of course and outcome of illness.

Results

Left and right sylvian fissure volumes and, to a lesser extent, third ventricular volume predicted negative symptoms and unemployment over the course of follow-up, the latter association being mediated by poor cognitive functioning. There was a significant linear trend in risk over the distribution of sylvian fissure volumes in the cohort, and associations were especially evident in schizophrenic patients. No associations were found with global severity of illness, duration of hospital stay, homelessness, or affective symptoms.

Conclusions

These findings support the notion that dimensions of the cerebral ventricles are a continuous risk factor for some measures of outcome in the functional psychoses.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 6 , June 1995 , pp. 750 - 758
Copyright
Copyright © Royal College of Psychiatrists, 1995 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Andreasen, N. C., Olsen, S. A., Dennert, J., et al (1982) Ventricular enlargement in schizophrenia: relationship to positive and negative symptoms. American Journal of Psychiatry, 139, 297.Google ScholarPubMed
Bartko, J., Carpenter, W. & McGlashan, T. (1988) Statistical issues in long-term follow-up studies. Schizophrenia Bulletin, 14, 575–587.CrossRefGoogle Scholar
Bogerts, B., Meertz, E. & Schonfeldt-Bausch, R. (1985) Basal ganglia and limbic system pathology in schizophrenia: a morphometric study of brain volume and shrinkage. Archives of General Psychiatry, 42, 784–791.CrossRefGoogle ScholarPubMed
Breier, A., Schreiber, J. L., Dyer, J., et al (1992) Course of illness and predictors of outcome in chronic schizophrenia: implications for pathophysiology. British Journal of Psychiatry, 161 (suppl. 18), 38–43.Google Scholar
DeLisi, L. E., Schwartz, C. C., Targum, S. D., et al (1983) CT scan finding and outcome in acute schizophreniform disorder. Psychiatry Research, 9, 169–171.Google Scholar
DeLisi, L. E., Stritzke, P., Riordan, H., et al (1992) The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome. Biological Psychiatry, 31, 241–254.CrossRefGoogle ScholarPubMed
Dunn, G. (1989) Design and Analysis of Reliability Studies: Statistical Evaluation of Measurement Errors, p. 117. London: Edward Arnold.Google Scholar
Golden, C. J., Moses, J., Zelazowski, R., et al (1980) Cerebral ventricular size and neuropsychological impairment in young schizophrenics. Archives of General Psychiatry, 37, 619.CrossRefGoogle Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Harvey, I., Williams, M., Toone, B., et al (1990a) The ventricular-brain ratio in functional psychoses: the relationship of lateral ventricular and total intracranial area. Psychological Medicine, 20, 55–62.CrossRefGoogle Scholar
Harvey, I., Williams, M., McGuffin, P., et al (1990b) The functional psychoses in Afro-Caribbeans. British Journal of Psychiatry, 157, 515–522.Google Scholar
Iager, A. C., Kirch, D. G. & Wyatt, R. J. (1985) A negative symptom rating scale. Psychiatry Research, 16, 27–36.Google Scholar
Jablensky, A., Schwartz, R. & Tomov, T. (1980) WHO collaborative study of impairments and disabilities associated with schizophrenic disorders. A preliminary communication. Objective and methods. Acta Psychiatrica Scandinavica (suppl. 285), 152–163.Google Scholar
Jones, P. B., Bebbington, P., Foerster, A., et al (1993) Premorbid social underachievement in schizophrenia. Results from the Camberwell Collaborative Psychosis Study. British Journal of Psychiatry, 162, 65–71.CrossRefGoogle ScholarPubMed
Jones, P. B., Harvey, I., Lewis, S., et al (1994) Cerebral ventricle dimensions as risk factors for schizophrenia and affective psychosis. An epidemiological approach to analysis. Psychological Medicine, 24, 995–1011.Google Scholar
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A poly-diagnostic application of operational criteria in psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.CrossRefGoogle Scholar
Owens, D. G., Johnstone, E. C., Crow, T. J., et al (1985) Lateral ventricular size in schizophrenia: relationship to the disease process and its clinical manifestations. Psychological Medicine, 15, 27–41.Google Scholar
Penn, R. D., Belanger, M. G. & Yasnoff, W. A. (1978) Ventricular volume in man computed from CAT scans. Annals of Neurology, 3, 216–223.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1958) Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.Google Scholar
Shenton, M. E., Kikinis, R., Jolesz, F., et al (1992) Abnormalities of the left temporal lobe and thought disorder in schizophrenia. New England Journal of Medicine, 327, 604–612.CrossRefGoogle ScholarPubMed
Spitzer, R., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Suddath, R., Christison, G., Torrey, E. F., et al (1990) Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine, 322, 789–794.Google Scholar
van Os, J., Fahy, T., Bebbington, P., et al (1994) The influence of life events on the subsequent course of psychotic illness. Psychological Medicine, 24, 503–513.Google Scholar
van Os, J., Fahy, T., Jones, P., et al (1995) Course of illness in the functional psychoses: outcome dimensions and effect of diagnosis and demographic characteristics. Psychological Medicine, in press.Google Scholar
Vita, A., Dieci, M., Giobbio, S. M., et al (1991) CT scan abnormalities and outcome of chronic schizophrenia. American Journal of Psychiatry, 148, 1577–1579.Google Scholar
Weinberger, D., Bigelow, L., Kleinman, J., et al (1980) Cerebral ventricular enlargement in chronic schizophrenia: an association with poor response to treatment. Archives of General Psychiatry, 37, 11–13.Google Scholar
Williams, A. O., Reveley, M. A., Kolakowska, T., et al (1985) Schizophrenia with good and poor outcome. II. Cerebral ventricular size and its clinical significance. British Journal of Psychiatry, 146, 239–246.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1992) WHO Coordinated Multicenter Study on the Course and Outcome of Schizophrenia. Geneva: WHO.Google Scholar
Zatz, L. M. & Jernigan, T. (1983) The ventricle-brain ratio on computed tomography scans: validity and proper use. Psychiatry Research, 8, 207–214.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.