LilMtnCbn
05-22-2004, 06:34 AM
http://pn.psychiatryonline.org/cgi/content/full/39/10/36?maxtoshow=&HITS=2
0&hits=20&RESULTFORMAT=&stored_search=&FIRSTINDEX=0&tocsectionid=Clinical*
&displaysectionid=Clinical+and+Research+News&journalcode=psychnews
Genes May Hold Key, But Families Turn It
Joan Arehart-Treichel
Children who have a genetic risk for schizophrenia may remain free of the
disorder if they are raised in homes with a healthy family environment.
Certainly genes play a causative role in schizophrenia, but new research
provides more evidence that family environment can influence a genetic
susceptibility to the illness.
Pekka Tienari, M.D., professor emeritus of psychiatry at the University of
Oulu, Finland; Lyman Wynne, M.D., Ph.D., professor emeritus at the University
of Rochester; and other psychiatric researchers at the University of Oulu
studied the issue.
As they reported in the March British Journal of Psychiatry, it looks as though
family environment can have some influence on whether a child with a genetic
risk for schizophrenia develops the illness.
If a child with a genetic risk for schizophrenia grows up in a dysfunctional
family, it may tip the scales toward developing the disorder, but if the child
grows up in a well-functioning family, it may possibly keep him or her from
developing the illness.
Tienari and his colleagues reviewed the hospital records of some 19,000 women
who had been in Finnish psychiatric hospitals between 1960 and 1979. After they
had identified the women with schizophrenia, they examined census data and
parish registers in Finland to find out which of those women had given birth to
a child that she put up for adoption.
A total of 145 of those offspring were identified and then matched with 158
offspring who had been adopted but had not come from mothers with
schizophrenia.
Psychiatrists then visited the adoptees and their adoptive families at home
over a two-day period. This was when the adoptees were, on average, 23 years of
age. The psychiatrists interviewed all individual family members, then the
parents, and then all family members together. The psychiatrists also observed
how members in each family interacted with each other.
Interview results and clinical observations were then used to rate how well
each family functioned via a 33-item Finnish-language instrument called the
Oulu Family Rating Scale. The scale had been developed for clinical evaluation
of family relationships during interviews and observations in the family home.
The scales assessed such factors as criticism, parent-parent conflict, lack of
empathy, parent-offspring conflict, inflexibility, constricted communication,
and lack of humor. Families were rated at five levels, from "healthy" to
"severely dysfunctional."
The adoptees were also interviewed when they were on average 23 years of age to
determine whether they had schizophrenia or schizophrenia-spectrum disorders.
They were re-evaluated 12 years later.
Forty of the 303 adoptees (13 percent) were found to have schizophrenia or a
schizophrenia-spectrum disorder. Of the 40, 32 came from a high-genetic-risk
background.
The researchers then attempted to determine whether there were any
relationships between family dysfunction and adoptees developing a
schizophrenia-type disorder. They found that there was a significant link
between being reared in a dysfunctional family and developing a schizophrenia
disorder in the adoptees whose mothers had had schizophrenia. In contrast, no
link could be found between being reared in a dysfunctional family and
developing a schizophrenia disorder in adoptees whose mothers had not had
schizophrenia.
These results, the researchers noted in their study report, "can be interpreted
as an example of genotype-environment interaction; that is, adoptees at genetic
risk are more sensitive to problems in the adoptive family. . . . An
alternative way to view the findings is that there appears to be a protective
effect in having been reared in a ‘healthy’ adoptive family. . . .
High-genetic-risk adoptees reared in families with low Oulu Family Rating Scale
ratings had significantly fewer schizophrenia-spectrum outcomes than
high-genetic-risk adoptees reared in families with high Oulu Family Rating
Scale ratings."
Another interesting implication of their findings, the researchers said, is
that "there is no specific, sharply delimited form of environmental problem and
that the biological and psychosocial environment has multiple components,
perhaps like multifactorial genetics."
Their findings are also striking, they added, in "that neither
high-genetic-risk nor dysfunctional family environment alone predicted adoptee
illness. This can be interpreted as meaning that genetic risk and the rearing
environment have an interactive effect, both in promoting the emergence of
illness and protecting against such an outcome."
All in all, Wynne told Psychiatric News, the study’s findings challenge the
concept that genetic risk in schizophrenia is destiny, and they mesh with some
current efforts to prevent schizophrenia (Psychiatric News, November 15, 2002).
The researchers noted some of their study’s limitations. For instance,
parents who had adopted children with a high genetic risk for schizophrenia
might have interacted with them in a less favorable way than if they had
adopted youngsters without such a risk simply because the former might have
shown some early signs of the illness. If such is the case, then such
interaction might have skewed study results.
The study was funded by the National Institute of Mental Health, the Scottish
Rite Schizophrenia Research Programme, the National Research Board in Finland,
and the Signe och Ane Gyllenberg Foundation.
-------------------------
A good friend will come and bail you out of jail . . . but, a true friend will
be sitting next to you saying, "Damn . . . that was fun!"
-----Unknown
0&hits=20&RESULTFORMAT=&stored_search=&FIRSTINDEX=0&tocsectionid=Clinical*
&displaysectionid=Clinical+and+Research+News&journalcode=psychnews
Genes May Hold Key, But Families Turn It
Joan Arehart-Treichel
Children who have a genetic risk for schizophrenia may remain free of the
disorder if they are raised in homes with a healthy family environment.
Certainly genes play a causative role in schizophrenia, but new research
provides more evidence that family environment can influence a genetic
susceptibility to the illness.
Pekka Tienari, M.D., professor emeritus of psychiatry at the University of
Oulu, Finland; Lyman Wynne, M.D., Ph.D., professor emeritus at the University
of Rochester; and other psychiatric researchers at the University of Oulu
studied the issue.
As they reported in the March British Journal of Psychiatry, it looks as though
family environment can have some influence on whether a child with a genetic
risk for schizophrenia develops the illness.
If a child with a genetic risk for schizophrenia grows up in a dysfunctional
family, it may tip the scales toward developing the disorder, but if the child
grows up in a well-functioning family, it may possibly keep him or her from
developing the illness.
Tienari and his colleagues reviewed the hospital records of some 19,000 women
who had been in Finnish psychiatric hospitals between 1960 and 1979. After they
had identified the women with schizophrenia, they examined census data and
parish registers in Finland to find out which of those women had given birth to
a child that she put up for adoption.
A total of 145 of those offspring were identified and then matched with 158
offspring who had been adopted but had not come from mothers with
schizophrenia.
Psychiatrists then visited the adoptees and their adoptive families at home
over a two-day period. This was when the adoptees were, on average, 23 years of
age. The psychiatrists interviewed all individual family members, then the
parents, and then all family members together. The psychiatrists also observed
how members in each family interacted with each other.
Interview results and clinical observations were then used to rate how well
each family functioned via a 33-item Finnish-language instrument called the
Oulu Family Rating Scale. The scale had been developed for clinical evaluation
of family relationships during interviews and observations in the family home.
The scales assessed such factors as criticism, parent-parent conflict, lack of
empathy, parent-offspring conflict, inflexibility, constricted communication,
and lack of humor. Families were rated at five levels, from "healthy" to
"severely dysfunctional."
The adoptees were also interviewed when they were on average 23 years of age to
determine whether they had schizophrenia or schizophrenia-spectrum disorders.
They were re-evaluated 12 years later.
Forty of the 303 adoptees (13 percent) were found to have schizophrenia or a
schizophrenia-spectrum disorder. Of the 40, 32 came from a high-genetic-risk
background.
The researchers then attempted to determine whether there were any
relationships between family dysfunction and adoptees developing a
schizophrenia-type disorder. They found that there was a significant link
between being reared in a dysfunctional family and developing a schizophrenia
disorder in the adoptees whose mothers had had schizophrenia. In contrast, no
link could be found between being reared in a dysfunctional family and
developing a schizophrenia disorder in adoptees whose mothers had not had
schizophrenia.
These results, the researchers noted in their study report, "can be interpreted
as an example of genotype-environment interaction; that is, adoptees at genetic
risk are more sensitive to problems in the adoptive family. . . . An
alternative way to view the findings is that there appears to be a protective
effect in having been reared in a ‘healthy’ adoptive family. . . .
High-genetic-risk adoptees reared in families with low Oulu Family Rating Scale
ratings had significantly fewer schizophrenia-spectrum outcomes than
high-genetic-risk adoptees reared in families with high Oulu Family Rating
Scale ratings."
Another interesting implication of their findings, the researchers said, is
that "there is no specific, sharply delimited form of environmental problem and
that the biological and psychosocial environment has multiple components,
perhaps like multifactorial genetics."
Their findings are also striking, they added, in "that neither
high-genetic-risk nor dysfunctional family environment alone predicted adoptee
illness. This can be interpreted as meaning that genetic risk and the rearing
environment have an interactive effect, both in promoting the emergence of
illness and protecting against such an outcome."
All in all, Wynne told Psychiatric News, the study’s findings challenge the
concept that genetic risk in schizophrenia is destiny, and they mesh with some
current efforts to prevent schizophrenia (Psychiatric News, November 15, 2002).
The researchers noted some of their study’s limitations. For instance,
parents who had adopted children with a high genetic risk for schizophrenia
might have interacted with them in a less favorable way than if they had
adopted youngsters without such a risk simply because the former might have
shown some early signs of the illness. If such is the case, then such
interaction might have skewed study results.
The study was funded by the National Institute of Mental Health, the Scottish
Rite Schizophrenia Research Programme, the National Research Board in Finland,
and the Signe och Ane Gyllenberg Foundation.
-------------------------
A good friend will come and bail you out of jail . . . but, a true friend will
be sitting next to you saying, "Damn . . . that was fun!"
-----Unknown
