The relationship of DSM-IV pathological gambling to compulsive buying and other possible spectrum disorders: results from the Iowa PG family study.

This study investigates the possible relationship between pathological gambling (PG) and potential spectrum disorders including the DSM-IV impulse control disorders (intermittent explosive disorder, kleptomania, pyromania, trichotillomania) and several non-DSM disorders (compulsive buying disorder, compulsive sexual behavior, Internet addiction). PG probands, controls, and their first-degree relatives were assessed with instruments of known reliability. Detailed family history information was collected on relatives who were deceased or unavailable. Best estimate diagnoses were assigned blind to family status. The results were analyzed using logistic regression by the method of generalized estimating equations. The sample included 95 probands with PG, 91 controls, and 1075 first-degree relatives (537 PG, 538 controls). Compulsive buying disorder and having "any spectrum disorder" were more frequent in the PG probands and their first-degree relatives vs. controls and their relatives. Spectrum disorders were significantly more prevalent among PG relatives compared to control relatives (adjusted OR=8.37), though much of this difference was attributable to the contribution from compulsive buying disorder. We conclude that compulsive buying disorder is likely part of familial PG spectrum.

Family history of alcoholism in violent offenders and impulsive fire setters.

Fifty-six of 58 violent offenders and impulsive fire setters fulfilled the DSM-III criteria for alcohol abuse. Information necessary for evaluation of family history of alcoholism was obtained on 54 subjects. Forty-four of the 54 subjects had first- or second-degree blood relatives with alcoholism. Thirty-five had alcoholic fathers. Subjects with alcoholic fathers had a lower mean cerebrospinal fluid 5-hydroxyindoleacetic acid concentration and were more often impulsive than subjects without alcoholic fathers.

[The role of genetic load in the development of reactive psychotic states leading to severe violence. Study of a case of "homicide arson" double and extended suicide]. / Zur Rolle genetischer Belastung bei der entstehung reaktiv-psychotischer Zustandsbilder, die zu schweren Gewaltdelikten führen. Studie anhand eines Falles von "Mordbrand", Doppel- und erweitertem Selbstmord.

Using the casuistic presentation of a case of arson with ensuing double murder and extended suicide by jumping over a rock face, we discuss to what extent genetic disposition is important for the formation of reactive-psychotic states that lead to crimes of extreme violence. From the results of protracted research on the previous history of the perpetrator and of his relatives, a multifactorial disposition toward affective psychoses, alcoholism, epilepsy, and suicide was discovered. On the other hand, in the long-term longitudinal observation of the perpetrator, manic depressiveness was diagnosed, which was characterized by a rapid bi-polar phase shift. This supports the opinion of the authors--partially contradictory to the literature--that such affective outbursts, which have apparently arisen purely reactively, but which lead to murder and suicide, in most cases arise on an endogenic basis. In such cases one should not speak of an exclusively reactive depression (mania) before the possibility of an endogenic component has been excluded. The latter, however, can only be detected through precise long-term longitudinal diagnosis and data on the family's psychiatric history. Otherwise, an endo-reactive depression (mania) must be diagnosed. This implies in these cases at least an "irresistible impulse" (Dispositionsunfähigkeit) of the perpetrator.