An anthropometric comparison of psychiatric patients and their siblings

Meta-analysis of brain and cranial size in schizophrenia

Several meta-analyses are presented that address the issue of brain and/or cranial size reductions in schizophrenia. Separate meta-analyses were conducted for brain size (n = 27 studies), intracranial size (n = 18) or extracranial size (n = 8). For each meta-analysis, the weighted composite effect size (d) was tested for statistical significance (the direction of the effect size was negative if patients with schizophrenia had smaller structure size than controls). The influence of several potential modifiers of effect size (age, methods, region, gender) was individually evaluated. The composite effect sizes for studies of brain, intracranial and extracranial measures were d = -0.26, (p < 0.0001), d = -0.18, (p = 0.0012), and d = +0.14, (p = 0.16), respectively. Thus, the review found evidence for a small, but statistically significant reduction in brain and intracranial size in schizophrenia, but no evidence for a reduction in extracranial size. Studies based on axial image slices had significantly larger effects (d = -0.60) than the studies based on sagittal images (d = -0.09) (chi(2) = 14.0, p = 0.0002). In summary, the findings clearly support a small yet highly significant reduction of brain and intracranial size in schizophrenia.

Head circumference in elderly long-stay patients with schizophrenia

The head circumference of a long-stay population with schizophrenia was compared with that of a population with dementia, matched for sex and year of birth. Schizophrenics had a smaller head circumference, even after correction for height and weight. This confirms earlier but inconclusive and controversial reports, and might be taken as supporting a neurodevelopmental hypothesis of the aetiology of schizophrenia.

Age at puberty and mental illness. Towards a neurodevelopmental aetiology of Kraepelin's endogenous psychoses

The hypothesis of a neurodevelopmental aetiology of manic-depressive psychosis and schizophrenia is based on the relation between onset of puberty and the final regressive events in the central nervous system (elimination of 40% of neuronal synapses), and the discrepancy in body build in the two disorders which is similar to that between early- and late-maturing individuals. The marked rise in manic-depressive psychoses and decline in schizophrenia, particularly the non-paranoid categories, accompanying the decline in mean pubertal age by some four years during the past hundred years are taken as evidence that manic-depressive psychosis affects early maturers and schizophrenia particularly affects late maturers. Gender differences and social differentials accord with this theory. Redundancy of neuronal synapses characterises manic-depressive psychosis, and reduced density of synapses is a characteristic of schizophrenia, whereas 'normality', with optimal synaptic density, is in between.

Mental illness and cognition in relation to age at puberty: a hypothesis

Onset of puberty is usually considered to coincide with the last major step in brain development: the elimination of some 40% of neuronal synapses. Mean pubertal age has declined by some 4 years during the last 100 years. There is a relation between age at puberty and body build, and between body build and mental illness. The difference in body build between schizophrenia (S) and manic-depressive psychosis (MDP) is similar to that between late and early maturers. It is suggested that S affects late-maturing individuals and MDP very early maturers. The observed marked rise in MDP and decline in the most malignant forms of S (non-paranoid) are in agreement with MDP and S as neurodevelopmental disorders occurring at the extremes of maturation. Maturational irregularities are most likely to occur at the extremes, and it is suggested that abbreviation of the regressive process may have led to persistent redundancy of neuronal synapses in MDP and that prolongation of the process past the optimal has yielded an inadequate synaptic density in S. The lack of cerebral abnormality in the majority of MDP and the presence of only subtle structural deficits in S, are in agreement with this. The two disorders are probably as old as mankind, and early puberty is the necessary factor for the development of MDP and late puberty is the necessary factor for that of S. There is an inverse relation between spatial ability and rate of maturation, whereas verbal ability is unaffected by maturational rate. From a previous predominance in both sexes, spatial ability (Performance IQ scores) has been reduced to below verbal ability (Verbal IQ scores) in the female sex and in early maturing males.

Physique, personality and mental illness in southern Chinese women

A number of anthropometric measurements were made on Southern Chinese women. These were 317 schizophrenics, 44 with affective disorder, 47 neurotics and normal controls. All groups and sub-groups compared were matched for mean age and socio-economic status. It was found that the intercorrelations between body build, personality and type of mental illness were on the whole similar to those reported for Caucasians.

Physique, personality and mental illness in the Southern Chinese

Studies on the relationship between physical constitution, personality and mental illness have been mostly confined to the Caucasian race. There has been no investigation, to our knowledge, of Oriental subjects, though a number of investigations of body type, composition and physiological functions without relation to mental aspects have been carried out on them. It is clearly important that work in this field should be extended to include subjects of different racial composition and socio-cultural background. The intercorrelations found between physical and mental characteristics in Caucasians may not apply to others.

Androgen excretion and physique in schizophrenia

A proportion of individuals suffering from schizophrenia show either physical or psychological signs of gonadal underfunction or incomplete sexual maturation (Hoskins, 1943; Hoskins and Pincus, 1949; Bleuler, 1954; Sands, 1957; Reiss, 1958; cf. Shader and Grinspoon, 1967). Rey and Coppen (1959) reported significantly lower, that is more feminine, androgyny scores (Tanner, 1962) in schizophrenic patients, although reduced scores were also found to a lesser extent in depressive and neurotic patients. Sex chromosome anomalies were not found in those patients with abnormally low androgyny scores (Cowie, Coppen and Norman, 1960), and it is possible that the abnormal physique is caused by some hormonal malfunction during development which also may be associated with a predisposition to psychiatric illness.