gottesman

• aim


  to use a larger sample to investigate the hereditary of schizophrenia and bipolar if one or both parents have a diagnosis
• method


  secondary data using danish civil registration system from 1968-1997
• sample


  people born in denmark etween 1968 - 1997

  danish psychiatric central register - admission to hospitals etween 1970 and 1907 ased on ICD8 or IDC10

  279 couples both admitted

  20000 couples where one was admitted
• procedure


  researchers identified any person with a diagnosis of schizophrenia, bipolar or major depression

  data on offspring was linked with parents psychiatry history

  using the civil registration researchers could establish who their parents were adn check if they had ever been admitted
• findings


  1 parent with bipolar = 4.4% chance of a disorder

  1 parent with schizophrenia = 7% chance

  2 parents with bipolar = 24.9% S and 44.2% BP

  2 parents with schizophrenia = 27.3% S and 67.5% BP
• summary of results


  children with one parent with mental illness are more likely to have the same disorder than the general population

  if both a child's parents have a disorder this risk increases significantly

  those with one parent with schizophrenia have a 7% risk of S compare to the general population of 1%

  this increases to 27% with 2 parents
• conclusions


  offspring for dual mating diagnosed with psychosis constitute a super high risk sample of psychosis

  strong role of genetics

  can be used by families and physicians in family planning to consider the impact on future children
• diathesis stress model


  people may be predisposed to a mental health condition but a trigger or stressor is needed to cause symptoms

  diathesis = genetic, biological or early childhood predisposition

  stress = new experience or environmental trigger
• nature / individual / biological

  gottesman - 2 parents with S = 27%, 2 parents with BP = 24.95%

  one parent with S = 7%, one parent with BP = 4.4%

  brain abnormality - overall size was 2.6% smaller

  twin studies - MZ = 52%, DZ = 12%

  adoption studies - 9.4% biological mother

  enlarged ventricles

  dopamine - levels cause positive symptoms
• nurture / situational / environmental 


  more DZ receptors due to brain injury or illness
• reductionism


  excessive DZ receptors

  enlarged ventricles

  reduction in grey matter in temporal and frontal lobes

  genetics - MZ = 85%, DZ = 12%
• holism


  Ripke - 108 genetic variations

  enlarged ventricles leads to reduced grey matter
• socially sensitive


  IS- gottesman/genetics = blames parents, cant change genes

  IS - influence eugenics policies to reduce gene pool
• usefulness


  treatment options - antipsychotics

  drug treatment is a circular agreement

  genetics -family planning and monitoring high risk children and interventions
• free will


  people with schizophrenia can develop coping mechanisms to reduce the impact of hallucinations
• reliability


  PET scans, MRI scans

  research has shown a 0.90 correlation when studying the larger region of the thalamus

  gottesman - sample didnt incude out patients so only most severe
• validity


  large sample

  IDC is a valid tool

  validity of independent diagnosis - meyer found 45% of patients with BP were misdiagnosed first
• ethnocentrism 


  gottesman - rooted in individual western cultures

  in other cultures MI may focus on social/cultural/spiritual factors
• sampling bias


  gottesman - danish

  only in patients