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Keski-Rahkonen A, Hoek HW, Linna MS, Raevuori A, Sihvola E, Bulik CM, Rissanen A, Kaprio J. Incidence and outcomes of bulimia nervosa: a nationwide population-based study. Psychol Med 2009; 39:823-831. [PMID: 18775085 DOI: 10.1017/s0033291708003942] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Little is known about the epidemiology of bulimia nervosa outside clinical settings. We report the incidence, prevalence and outcomes of bulimia nervosa using for the first time a nationwide study design. METHOD To assess the incidence and natural course and outcomes of DSM-IV bulimia nervosa among women from the general population, women (n=2881) from the 1975-79 birth cohorts of Finnish twins were screened for lifetime eating disorders using a two-stage procedure consisting of a questionnaire screen and the Structured Clinical Interview for DSM-IV (SCID). Clinical recovery was defined as 1-year abstinence from bingeing and purging combined with a body mass index (BMI) 19 kg/m2. RESULTS The lifetime prevalence of DSM-IV bulimia nervosa was 2.3%; 76% of the women suffered from its purging subtype and 24% from the non-purging subtype. The incidence rate of bulimia nervosa was 300/100000 person-years at the peak age of incidence, 16-20 years, and 150/100000 at 10-24 years. The 5-year clinical recovery rate was 55.0%. Less than a third of the cases had been detected by health-care professionals; detection did not influence outcome. After clinical recovery from bulimia nervosa, the mean levels of residual psychological symptoms gradually decreased over time but many women continued to experience significantly more body image problems and psychosomatic symptoms than never-ill women. CONCLUSIONS Few women with bulimia nervosa are recognized in health-care settings. Symptoms of bulimia are relatively long-standing, and recovery is gradual. Many clinically recovered women experience residual psychological symptoms after attaining abstinence from bingeing and purging.
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Veling W, Mackenbach JP, van Os J, Hoek HW. Cannabis use and genetic predisposition for schizophrenia: a case-control study. Psychol Med 2008; 38:1251-1256. [PMID: 18485264 DOI: 10.1017/s0033291708003474] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cannabis use may be a risk factor for schizophrenia. Part of this association may be explained by genotype-environment interaction, and part of it by genotype-environment correlation. The latter issue has not been explored. We investigated whether cannabis use is associated with schizophrenia, and whether gene-environment correlation contributes to this association, by examining the prevalence of cannabis use in groups with different levels of genetic predisposition for schizophrenia. METHOD Case-control study of first-episode schizophrenia. Cases included all non-Western immigrants who made first contact with a physician for schizophrenia in The Hague, The Netherlands, between October 2000 and July 2005 (n=100; highest genetic predisposition). Two matched control groups were recruited, one among siblings of the cases (n=63; intermediate genetic predisposition) and one among immigrants who made contact with non-psychiatric secondary health-care services (n=100; lowest genetic predisposition). Conditional logistic regression analyses were used to predict schizophrenia as a function of cannabis use, and cannabis use as a function of genetic predisposition for schizophrenia. RESULTS Cases had used cannabis significantly more often than their siblings and general hospital controls (59, 21 and 21% respectively). Cannabis use predicted schizophrenia [adjusted odds ratio (OR) cases compared to general hospital controls 7.8, 95% confidence interval (CI) 2.7-22.6; adjusted OR cases compared to siblings 15.9 (95% CI 1.5-167.1)], but genetic predisposition for schizophrenia did not predict cannabis use [adjusted OR intermediate predisposition compared to lowest predisposition 1.2 (95% CI 0.4-3.8)]. CONCLUSIONS Cannabis use was associated with schizophrenia but there was no evidence for genotype-environment correlation.
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Hillebrand JJG, Kas MJH, van Elburg AA, Hoek HW, Adan RAH. Leptin's effect on hyperactivity: potential downstream effector mechanisms. Physiol Behav 2008; 94:689-95. [PMID: 18495181 DOI: 10.1016/j.physbeh.2008.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Accepted: 04/02/2008] [Indexed: 10/22/2022]
Abstract
Up to 80% of patients with Anorexia Nervosa (AN) demonstrate hyperactivity. Hyperactivity counteracts weight gain during treatment and is associated with poor outcome of the disease. We hypothesized that hyperactivity in AN patients has a neurobiological basis and used an animal model-based translational approach to gain insight in mechanisms underlying this hyperactivity. Previously we and others showed that leptin treatment attenuates hyperactivity in the rat activity-based anorexia (ABA) model. The mechanisms involved in this process are, however, unknown. Here we describe potential downstream effector mechanisms involved in the attenuation of hyperactivity by leptin treatment in ABA rats.
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Jong Baw PG, van Veen MM, Hoek HW. [Thiamine deficiency caused by malnutrition: a rare cause?]. TIJDSCHRIFT VOOR PSYCHIATRIE 2008; 50:611-615. [PMID: 18785108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A 50-year-old man was admitted to our psychiatric clinic with symptoms of depression, comorbid neurological disturbances and cardiomyopathy. The condition was diagnosed as beriberi and Korsakov's syndrome, on the basis of thiamine deficiency. The patient's diet was unbalanced and restricted, but he was not an alcohol abuser. Thiamine suppletion led to a partial remission of symptoms. If a patient presents with depressive symptoms combined with neurological disturbances or heart irregularities, the Wernicke-Korsakov syndrome should be ruled out, even if the patient does not abuse alcohol. If in doubt, always opt for thiamine suppletion.
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Hoek HW, Vandereycken W. [Eating disorders; 25 years of research and treatment]. TIJDSCHRIFT VOOR PSYCHIATRIE 2008; 50 Spec no.:85-89. [PMID: 19067305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
As a result of the publication of DSM-III(-R) bulimia nervosa was recognised as a separate eating disorder, distinct from anorexia nervosa. Eating disorders occur mainly in young females. The incidence of anorexia nervosa in Dutch females aged 15 to 19 doubled between the 1980s and the 1990s. Over the past 25 years there have been many improvements in the treatment of patients with eating disorders, but only a very few of them utilise the health care facilities that are now available.
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Sommer IEC, de Weijer AD, Daalman K, Neggers SF, Somers M, Kahn RS, Slotema CW, Blom JD, Hoek HW, Aleman A. Can fMRI-guidance improve the efficacy of rTMS treatment for auditory verbal hallucinations? Schizophr Res 2007; 93:406-8. [PMID: 17478084 DOI: 10.1016/j.schres.2007.03.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 03/13/2007] [Indexed: 11/19/2022]
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Veen N, Selten JP, Hoek HW, Feller W, van der Graaf Y, Kahn R. Use of illicit substances in a psychosis incidence cohort: a comparison among different ethnic groups in the Netherlands. Acta Psychiatr Scand 2002; 105:440-3. [PMID: 12059848 DOI: 10.1034/j.1600-0447.2002.01222.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Use of illicit substances has been suggested as an explanation for the increased incidence of psychosis among some immigrant groups. The aim of the present study is to compare the rates of illicit substance use among immigrants with a first psychosis with that among non-migrants. METHOD A population-based, first-contact incidence study in the Netherlands. Patients and key informants were interviewed about drug use in the preceding year. RESULT One hundred and eighty-one subjects were examined. Proportions of patients who misused any illicit substance were 23% for Dutch, 17% for Moroccans, 27% for Surinamese, 30% for Turkish subjects, and 33% for other immigrants. Logistic regression analysis, controlling for age and sex, showed that ethnicity did not significantly contribute to the prediction of substance misuse. CONCLUSION A higher rate of drug misuse is an unlikely explanation for the increased incidence of psychotic disorders among Moroccan and Surinamese immigrants to the Netherlands.
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Selten JP, Veen N, Feller W, Blom JD, Schols D, Camoenië W, Oolders J, van der Velden M, Hoek HW, Rivero VM, van der Graaf Y, Kahn R. Incidence of psychotic disorders in immigrant groups to The Netherlands. Br J Psychiatry 2001; 178:367-72. [PMID: 11282817 DOI: 10.1192/bjp.178.4.367] [Citation(s) in RCA: 150] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Previous reports on the incidence of schizophrenia in immigrant groups to The Netherlands were based on hospital data. AIMS To compare the incidence of psychotic disorders in the immigrant groups to that in natives. METHOD Two-year first-contact incidence study in The Hague. RESULTS The risks of schizophrenia, schizophreniform or schizoaffective disorder (DSM-IV criteria) were increased for subjects born in Morocco (gender and age-adjusted relative risk=4.5; 95% Cl 1.4-8.5), Surinam (relative risk=3.2; 1.8-5.7), The Netherlands Antilles (relative risk=2.9; 0.9-9.5) and other non-Western countries (relative risk=2.4; 1.3-4.7). This risk was also increased for Moroccans (relative risk=8.0; 2.6-24.5) and Surinamese (relative risk=5.5; 2.5-11.9) of the second generation. The risks for Turkish immigrants, first or second generation, and for immigrants from Western countries were not significantly increased. CONCLUSIONS This study indicates that the incidence of schizophrenia is increased in several, but not all, immigrant groups to The Netherlands. It is possible that factors associated with a process of rapid westernisation precipitate schizophrenia in people who are genetically at risk.
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Keski-Rahkonen A, Hoek HW, Treasure J. [Viewpoints about prevalence and risk factors of anorexia and bulimia nervosa]. DUODECIM; LAAKETIETEELLINEN AIKAKAUSKIRJA 2001; 117:863-8. [PMID: 12116455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
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Selten JP, van Vliet K, Pleyte W, Herzog S, Hoek HW, van Loon AM. Borna disease virus and schizophrenia in Surinamese immigrants to the Netherlands. Med Microbiol Immunol 2000; 189:55-7. [PMID: 11138637 DOI: 10.1007/pl00008256] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Borna disease virus (BDV) has been suggested to play a role in the etiology of schizophrenia. We tested the hypothesis that markers of BDV infection are more frequent in Surinamese immigrants to the Netherlands, diagnosed with schizophrenia, than in Dutch-born healthy subjects. For reasons that are poorly understood there is an increased incidence of schizophrenia in this immigrant group. Blood was obtained from 29 male schizophrenic patients (DSM-IV criteria) and from 26 healthy males. For detection of anti-BDV antibodies an indirect immunofluorescence assay (IFA) was performed. A nested, reverse-transcriptase-PCR, using primers specific for the p24 and p40 BDV genes, was used to determine BDV-RNA in peripheral blood mononuclear cells. Contrary to our expectations, the frequencies of BDV markers in the group of healthy subjects, as determined by IFA and both PCRs, exceeded that in the group of patients. The results do not support an association between markers of BDV infection in blood and schizophrenia. It is unlikely that the high incidence of schizophrenia in Surinamese immigrants is caused by BDV, but the small number of subjects examined do not warrant definitive conclusions.
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Hulshoff Pol HE, Hoek HW, Susser E, Brown AS, Dingemans A, Schnack HG, van Haren NE, Pereira Ramos LM, Gispen-de Wied CC, Kahn RS. Prenatal exposure to famine and brain morphology in schizophrenia. Am J Psychiatry 2000; 157:1170-2. [PMID: 10873931 DOI: 10.1176/appi.ajp.157.7.1170] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors assessed the effects of nutritional deficiency during the first trimester of pregnancy on brain morphology in patients with schizophrenia. METHOD Nine schizophrenic patients and nine healthy comparison subjects exposed during the first trimester of gestation to the Dutch Hunger Winter were evaluated with magnetic resonance brain imaging, as were nine schizophrenic patients and nine healthy subjects who were not prenatally exposed to the famine. RESULTS Prenatal famine exposure in patients with schizophrenia was associated with decreased intracranial volume. Prenatal Hunger Winter exposure alone was related to an increase in brain abnormalities, predominantly white matter hyperintensities. CONCLUSIONS Nutritional deficiency during the first trimester of gestation resulted in an increase in clinical brain abnormalities and was associated with aberrant early brain development in patients with schizophrenia. Stunted brain development secondary to factors that affect brain growth during the first trimester of gestation may thus be a potential risk factor for developing schizophrenia.
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Brown AS, van Os J, Driessens C, Hoek HW, Susser ES. Further evidence of relation between prenatal famine and major affective disorder. Am J Psychiatry 2000; 157:190-5. [PMID: 10671386 DOI: 10.1176/appi.ajp.157.2.190] [Citation(s) in RCA: 227] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In a previous study, the authors demonstrated an association between prenatal famine in middle to late gestation and major affective disorders requiring hospitalization. In this study, they sought to examine the association by using newly identified cases from the Dutch birth cohort used previously to examine the gender specificity of the association and to assess whether this relation is present for both unipolar and bipolar affective disorders. METHOD The authors compared the risk of major affective disorder requiring hospitalization in birth cohorts who were and were not exposed, in each trimester of gestation, to famine during the Dutch Hunger Winter of 1944-1945. These cases of major affective disorder requiring hospitalization were newly ascertained from a national psychiatric registry. A larger data set from this registry was used for analysis by gender and diagnostic subtype. RESULTS For the newly ascertained cases, the risk of developing major affective disorder requiring hospitalization was increased for subjects with exposure to famine in the second trimester and was increased significantly for subjects with exposure in the third trimester, relative to unexposed subjects. For the cases from the entire period of ascertainment, the risk of developing affective disorder was significantly increased for those exposed to famine during the second and the third trimesters of gestation. The effects were demonstrated for men and women and for unipolar and bipolar affective disorders. CONCLUSIONS These results provide support for the authors' previous findings on the association between middle to late gestational famine and affective disorder.
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van Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ (CLINICAL RESEARCH ED.) 1999; 319:623-6. [PMID: 10473482 PMCID: PMC1116493 DOI: 10.1136/bmj.319.7210.623] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Neugebauer R, Hoek HW, Susser E. Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood. JAMA 1999; 282:455-62. [PMID: 10442661 DOI: 10.1001/jama.282.5.455] [Citation(s) in RCA: 267] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Several observational epidemiological studies report an association of pregnancy and obstetric complications with development of antisocial personality disorder (ASPD) in offspring. However, the precise nature and timing of the hypothesized biological insults are not known. OBJECTIVE To test whether severe maternal nutritional deficiency early in gestation is associated with risk for ASPD in offspring. DESIGN AND SETTING Retrospective cohort study. From October 1944 to May 1945, the German army blockaded food supplies to the Netherlands, subjecting the western Netherlands first to moderate (official food rations, 4200-6300 kJ/d) then to severe (<4200 kJ/d) nutritional deficiency. The north and south were subjected to moderate nutritional deficiency only. PARTICIPANTS Dutch men born in large urban areas in 1944-1946 who were given psychiatric examinations for military induction at age 18 years (N = 100543) were classified by the degree and timing of their prenatal exposure to nutritional deficiency based on their birthdate and birthplace. MAIN OUTCOME MEASURE Diagnosis of ASPD by psychiatric interview at time of medical examination for military induction, using the International Classification of Diseases, Sixth Revision (ICD-6). RESULTS Men exposed prenatally to severe maternal nutritional deficiency during the first and/or second trimesters of pregnancy exhibited increased risk for ASPD (adjusted odds ratio [OR], 2.5; 95% confidence interval [CI], 1.5-4.2). Third-trimester exposure to severe nutritional deficiency and prenatal exposure to moderate nutritional deficiency were not associated with risk for ASPD. CONCLUSIONS Our data suggest that severe nutritional insults to the developing brain in utero may be capable of increasing the risk for antisocial behaviors in offspring. The possible implications of these findings for both developed countries and developing countries, where severe nutritional deficiency is widespread and often exacerbated by war, natural disaster, and forced migration, warrant study.
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Smeets MA, Ingleby JD, Hoek HW, Panhuysen GE. Body size perception in anorexia nervosa: a signal detection approach. J Psychosom Res 1999; 46:465-77. [PMID: 10404481 DOI: 10.1016/s0022-3999(99)00005-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated whether individuals with anorexia nervosa (AN) visualize themselves as fatter than they are because they perceive themselves as fatter. Females with AN who overestimated their own body size judged size differences between pictures of their own body, and then again of someone else's body. Signal detection analysis of the results showed no differences in perceptual sensitivity between the AN and normal and thin control groups. No significant correlations were found between body size estimates and perceptual sensitivity. The anorexic group did, however, show a bias to report seeing "thin" differences, which was opposite to that of thin controls. Because bias differences between the groups were significant while sensitivity differences were not, it was concluded that abnormalities of body image most probably arise during reconstruction of the visual body image, rather than during perception of the body.
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Hoek HW, van Furth EF. [Anorexia nervosa and bulimia nervosa: I. Diagnosis and treatment]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 1998; 142:1859-63. [PMID: 9856166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Disturbed eating behaviour and disturbed body experience are important features for the differential diagnosis of eating disorders from other disorders. Eating disorders occur mainly in young females. The one-year prevalence of anorexia nervosa is 0.4% and that of bulimia nervosa 1.5% among young females. To motivate patients for treatment it is important to discuss physical problems and the high risk of severe complications with them. It is difficult to motivate patients for treatment, because anorexia nervosa patients deny their illness and bulimia nervosa patients are ashamed and hide their disturbed eating behaviour. The treatment of anorexia nervosa consists of two partly overlapping phases: normalizing the eating pattern to improve weight restoration and psychotherapeutic treatment for underlying emotional problems. Family therapy is effective for patients younger than 18 years with a short duration of illness. Cognitive behaviour therapy is the most important form of treatment for bulimia nervosa.
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Abstract
In the Dutch Hunger Winter at the end of World War II a combination of circumstances created the conditions of a natural experiment. Unlike other famines, the Dutch famine struck at a precisely circumscribed time and place, and in a society able to document the timing and severity of the nutritional deprivation as well as the effects on fertility and health. Because the Dutch maintained comprehensive military and health records, it was possible to compare the incidence of neurodevelopmental disorders in adulthood for birth cohorts exposed versus those unexposed to prenatal famine. We have conducted several studies guided by the hypothesis that prenatal micronutrient deficiencies can cause neurodevelopmental schizophrenia or related personality disorders. In this paper we shall summarize our previous work and combine the outcome data of the different studies. Early prenatal famine was found to be specifically and robustly associated with each of three conditions: (1) congenital anomalies of the central nervous system, (2) schizophrenia, and (3) schizophrenia spectrum personality disorders. We found that the greatest increase in the risk of schizophrenia spectrum disorder- schizophrenia plus spectrum personality disorder- occurred among males born in the famine cities in December 1945 (relative risk = 2.7; 95% confidence interval = 1.5-5.1). Persons born in December 1945 were generally conceived at the absolute peak of the famine (March-April 1945). In the hope that the associations we have found may offer clues to the aetiology of schizophrenia, we are currently tracing and examining the cases of schizophrenia after prenatal exposure to famine.
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Abstract
In the Dutch Hunger Winter at the end of World War II a combination of circumstances created the conditions of a natural experiment. Unlike other famines, the Dutch famine struck at a precisely circumscribed time and place, and in a society able to document the timing and severity of the nutritional deprivation as well as the effects on fertility and health. Because the Dutch maintained comprehensive military and health records, it was possible to compare the incidence of neurodevelopmental disorders in adulthood for birth cohorts exposed versus those unexposed to prenatal famine. We have conducted several studies guided by the hypothesis that prenatal micronutrient deficiencies can cause neurodevelopmental schizophrenia or related personality disorders. In this paper we shall summarize our previous work and combine the outcome data of the different studies. Early prenatal famine was found to be specifically and robustly associated with each of three conditions: (1) congenital anomalies of the central nervous system, (2) schizophrenia, and (3) schizophrenia spectrum personality disorders. We found that the greatest increase in the risk of schizophrenia spectrum disorder- schizophrenia plus spectrum personality disorder- occurred among males born in the famine cities in December 1945 (relative risk = 2.7; 95% confidence interval = 1.5-5.1). Persons born in December 1945 were generally conceived at the absolute peak of the famine (March-April 1945). In the hope that the associations we have found may offer clues to the aetiology of schizophrenia, we are currently tracing and examining the cases of schizophrenia after prenatal exposure to famine.
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van Harten PN, Hoek HW. [For how long should antipsychotic medication be continued after the first psychotic episode in schizophrenics?]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 1998; 142:1361-4. [PMID: 9752021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Four patients, two women aged 24 and 62 years and two men aged 25 and 24, respectively, were admitted because of psychosis. A Dutch consensus paper advises treating patients with a first episode of schizophrenia or schizophreniform disorder with neuroleptics for two years as secondary prophylaxis. However, this advice should be tailored to the individual patient's characteristics. Thus, the first patient was given prophylactic medication for five years because she had many schizophrenic symptoms and a positive family history. In the second patient, the diagnosis was much less certain and, because of her advanced age, the risk of developing tardive dyskinesia was considerable. Prophylaxis was given for three months only. The third patient used drugs and did not really want to be treated. In the fourth patient the affective symptoms could not be interpreted for certain as part of a basic schizophrenic defect. In addition, he would be seriously handicapped professionally if he developed tardive dyskinesia. In his case, two years of secondary prophylaxis was advised.
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Hoek HW, van Harten PN, van Hoeken D, Susser E. Lack of relation between culture and anorexia nervosa--results of an incidence study on Curaçao. N Engl J Med 1998; 338:1231-2. [PMID: 9556399 DOI: 10.1056/nejm199804233381717] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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van Harten PN, Hoek HW, Matroos GE, Koeter M, Kahn RS. Intermittent neuroleptic treatment and risk for tardive dyskinesia: Curaçao Extrapyramidal Syndromes Study III. Am J Psychiatry 1998; 155:565-7. [PMID: 9546009 DOI: 10.1176/ajp.155.4.565] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The authors examined the association between three lifetime medication variables (cumulative amount of neuroleptics, number of interruptions in neuroleptic treatment, cumulative amount of anticholinergics) and the occurrence and severity of tardive dyskinesia. METHOD The study was conducted in the only psychiatric hospital of a well-defined catchment area (the Netherlands Antilles). For all patients who had a history of taking neuroleptics for at least 3 months and were currently using neuroleptics (N = 133, mean age = 51.5 years), the presence and severity of tardive dyskinesia were measured with the Abnormal Involuntary Movement Scale. RESULTS Of the three lifetime medication variables, only the number of neuroleptic interruptions was significantly related to tardive dyskinesia. The risk of tardive dyskinesia was three times as great for patients with more than two neuroleptic interruptions as for patients with two or fewer interruptions. CONCLUSIONS This finding supports the schizophrenia protocol of long-term neuroleptic treatment rather than targeted or intermittent neuroleptic treatment.
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van Harten PN, van Trier JC, Horwitz EH, Matroos GE, Hoek HW. Cocaine as a risk factor for neuroleptic-induced acute dystonia. J Clin Psychiatry 1998; 59:128-30. [PMID: 9541156 DOI: 10.4088/jcp.v59n0307] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND A prospective study was conducted to test the hypothesis that cocaine use is a risk factor for neuroleptic-induced acute dystonia (NIAD). METHOD The study sample consisted of a high-risk group for NIAD, males aged 17-45 years who had received high-potency neuroleptics within 24 hours of admission and had not used neuroleptics in the month prior to admission. Patients were excluded if they suffered from a neurodegenerative disorder or were exposed to anticholinergics, benzodiazepines, promethazine, carbamazepine, phenytoin, or levodopa during the study. Twenty-nine patients--9 cocaine users and 20 nonusers--entered the study, which lasted 2 years. Patients were followed for 7 days. RESULTS Cocaine-using psychiatric patients developed significantly more NIAD than did nonusers (relative risk = 4.4, 95% CI = 1.4 to 13.9). CONCLUSION Cocaine use is a major risk factor for NIAD and should be added to the list of well-known risk factors. The authors strongly suggest that cocaine-using psychiatric patients who are started on a regimen of neuroleptics should also be administered an anticholinergic for at least 7 days to prevent NIAD.
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Susser E, Hoek HW, Brown A. Neurodevelopmental disorders after prenatal famine: The story of the Dutch Famine Study. Am J Epidemiol 1998; 147:213-6. [PMID: 9482494 DOI: 10.1093/oxfordjournals.aje.a009439] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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van Harten PN, Hoek HW, Matroos GE, Koeter M, Kahn RS. The inter-relationships of tardive dyskinesia, parkinsonism, akathisia and tardive dystonia: the Curaçao Extrapyramidal Syndromes Study II. Schizophr Res 1997; 26:235-42. [PMID: 9323356 DOI: 10.1016/s0920-9964(97)00058-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A study of the four extrapyramidal syndromes (EPS), tardive dyskinesia, parkinsonism, akathisia and tardive dystonia, was performed in the Netherlands Antilles, a well-defined catchment area with only one psychiatric hospital. The population under study (N = 194; mean age 53.1) was mainly Afro-Caribbean, and most patients were chronic. The severity of each EPS was measured with valid and reliable rating scales. The purpose was to study both the strength of the inter-relationships of EPS and the prevalence of combinations of EPS. The inter-relationships between the EPS were analyzed by means of logistic regression. The adjusted odds ratios between the various EPS revealed strong connections between the hyperkinetic syndromes (tardive dyskinesia, tardive dystonia and akathisia). Parkinsonism was found to be inversely related to tardive dyskinesia and to tardive dystonia. Almost 30% of the patients suffered from two or more EPS. The highest prevalence rates of combinations were: tardive dyskinesia combined with parkinsonism 12.9%, tardive dyskinesia combined with tardive dystonia 9.8%, and tardive dyskinesia combined with akathisia 5.2%. Our findings show a strong positive correlation between hyperkinetic forms of EPS. Furthermore, chronic psychiatric inpatients regularly suffer from combinations of EPS. Different treatment strategies are suggested for various combinations of EPS.
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Hoek HW, Susser E, Buck KA, Lumey LH, Lin SP, Gorman JM. Schizoid personality disorder after prenatal exposure to famine. Am J Psychiatry 1996; 153:1637-9. [PMID: 8942466 DOI: 10.1176/ajp.153.12.1637] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The authors tested whether early prenatal exposure to famine was associated with schizophrenia spectrum personality disorder in addition to being associated with schizophrenia per se as shown in a previous study. METHOD The risk of schizoid personality disorder, as defined by ICD-6 to ICD-9, in men at age 18 years was compared in birth cohorts that were conceived at the height of the Dutch Hunger Winter famine and in unexposed birth cohorts of 1944-1946 in the famine region of Holland. RESULTS The exposed cohort had a significantly greater risk (relative risk = 2.01) of schizoid personality disorder. CONCLUSIONS Prenatal nutritional deficiency was associated with a greater risk of schizoid personality disorder in men at age 18 years.
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