Patterns of Tobacco Consumption among Indian Men with Schizophrenia Compared to Their Male Siblings

OBJECTIVE: Tobacco consumption among patients with schizophrenia has been investigated extensively in western countries, but there is a dearth of studies in India, where socio-economic and cultural variables are different. This study aims to investigate the patterns of tobacco consumption among schizophrenia patients compared with their non-psychotic siblings. METHODS: Consenting, successive male outpatients diagnosed with schizophrenia (n=100, DSM-IV criteria), and their non-psychotic brothers (n=100) were compared. Following a structured diagnostic interview, detailed information about tobacco consumption (including smokeless tobacco) was obtained using the Fagerstrom Test for Nicotine Dependence for smoked tobacco, and FTND-smokeless tobacco. The University of Pennsylvania Computerized Neurocognitive battery (CNB) was administered to a sub-group of patients (n=48). RESULTS: Schizophrenia patients initiated tobacco use at a significantly earlier age than their brothers, but there was no significant difference with regard to type, quantity or frequency of tobacco use (smoke or smokeless varieties). Patients who consumed tobacco had significantly higher positive symptom scores compared with non-users (p=0.043). There were no significant differences between nicotine dependent and non-dependent patients with regard to CNB domains except attention. CONCLUSION: Patterns of tobacco consumption were similar among schizophrenia patients and their non-psychotic brothers. Tobacco use was associated with increased positive symptom scores, but there were no significant differences in cognitive measures among nicotine dependent and non-dependent patients.

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.

Differences among Men and Women with Schizophrenia: A Study of US and Indian Samples

OBJECTIVE: To test the hypothesis that similar differences in psychopathology are present across cultures among men and women with schizophrenia (SZ). METHODS: Sex based differences were tested systematically in two independent samples from the Northeastern USA and North India using the same procedures. The clinical variables were obtained from five interview instruments. RESULTS: Among the US participants, the number of significant differences exceeded chance predictions (15/240 variables significant at p<0.02, 6.25%; expected number of significant differences: 5). Similarly, a greater than expected number of variables differed significantly between men and women among the Indian subjects (13/230 differences at p<0.02, 5.65%; expected: 5). One of these variables significantly differed in both samples (lifetime abuse of cannabis). When multivariate analyses were conducted in the combined US and Indian samples sex based differences remained for only four variables: course of the illness, history of inappropriate emotions, marital status and number of children. CONCLUSION: Sex based differences in SZ/schizoaffective disorder are present in the USA and India at greater than chance probabilities. The majority of the variables differ across the samples. The biological underpinnings of these variables need further investigation.

Is Familiality Associated with Downward Occupation Drift in Schizophrenia?

OBJECTIVE: Downward occupational drift has been extensively investigated in schizophrenia. It is known that certain illness related factors, such as severity, affect drift, but the impact of familial factors has not been investigated. METHODS: Occupation drift was studied among patients with schizophrenia/schizoaffective disorder (SZ/SZA)(n=523) and 130 affected sib pairs (ASPs). Drift was analyzed in relation to familiality as well as demographic and clinical variables. For comparison one proband (one of the affected siblings) from each ASP was selected. Occupation drift was measured in relation to the most responsible job held, and with regard to head of the household (HOH) occupation status. RESULTS: There was no significant difference between single affected and ASP probands in terms of occupational drift from the most responsible job (drifted 39.2% and 38% respectively) and with regard to HOH's occupation (drifted 88% and 82.8% respectively). A significant part of the sample remained unemployed in both single affected and ASP samples. Thus, there was no significant impact of familiality on these variables. However, marital status, pattern of severity, age at onset, gender were found to be associated with downward occupation drift in single affected probands while the only significant factor in familial probands was pattern of severity of severity when measuring in terms of downward drift from most responsible job. CONCLUSION: Though there is occupation drift in schizophrenia, there is no detectable impact of familial factors. Employment is associated with severity of delete.