Reduced Fertility and Fecundity among Patients with Bipolar I Disorder and Schizophrenia in Egypt

OBJECTIVE: To evaluate reproduction among patients with bipolar I disorder (BP1) or schizophrenia (SZ) in Egypt. METHODS: BP1 patients (n=113) were compared with community based, demographically balanced controls (n=124) and SZ patients (n=79, DSM-IV). All participants were evaluated using structured interviews and corroborative data were obtained from relatives. Standard indices of procreation were included in multivariate analyses that incorporated key demographic variables. RESULTS: Control individuals were significantly more likely to have children than BP1 or SZ patients (controls 46.8%, BP1 15.9%, SZ 17.7%), but the BP1-SZ differences were non-significant. The average number of children for BP1 patients (0.37+/-0.9) and SZ patients (0.38+/-0.9) was significantly lower than for controls (1.04+/-1.48) (BP1 vs controls, p<0.001; SZ vs controls, p<0.001). The frequency of marriages among BP1 patients was nominally higher than the SZ group, but was significantly lower than controls (BP1: 31.9% SZ: 27.8% control: 57.3%). Even among married individuals, BP1 (but not SZ) patients were childless more often than controls (p=0.001). The marital fertility, i.e., the average number of children among patients with conjugal relationships for controls (1.8+/-1.57) was significantly higher than BP1 patients (1.14+/-1.31, p=0.02), but not significantly different from SZ patients (1.36+/-1.32, p=0.2). CONCLUSION: Selected reproductive measures are significantly and substantially reduced among Egyptian BP1 patients. The reproductive indices are similar among BP1 and SZ patients, suggesting a role for general illness related variables. Regardless of the cause/s, the impairment constitutes important, under-investigated disability.

comparative profile of neurological soft signs [NSS] in first degree relatives of schizophrenia, and bipolar disorder

Evidence for the higher prevalence of NSS in schizophrenics and their 1[st] degree relatives is substantial whereas evidence for the specificity of the subtypes of the NSS is relatively sparse. This study was performed to find out if there is a subset of NSS discriminating 1[st] degree relatives of schizophrenic when compared with 1[st] degree relatives of bipolar disorder patients or control. The study included 52 healthy subjects having first degree relative with either schizophrenia or bipolar disorder and 20 healthy subjects with no first degree relative suffering from schizophrenia or bipolar disorder. These subjects were assessed psychiatrically to ensure that they don't suffer from any psychiatric disorder and to diagnose their related psychiatric patient. This assessment was done using Mini International Neuropsychiatric Interview and the diagnosis was done according to DSM IV TR. Then the subjects were assessed neurologically to ensure that they have no neurological disorders and to detect the presence of NSS using Cambridge Neurological Inventory [part 2]. The results showed that the first degree relatives of schizophrenics have significant higher scores on a subset of tests for integration of sensory information [namely graphesthesia and rhythm tapping]. This study encourage studying the first degree relatives of the patients to identify endophenotypes of psychiatric disorders, and also further research on the underlying neuroanatomy of the different subsets of NSS