Original article| Volume 40, ISSUE 12, P1255-1266, December 15, 1996

Is computerized tomography ventricular abnormality related to cycloid psychosis?

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      Twenty-eight psychiatric patients with computerized tomography (CT) findings of ventricular abnormality most likely to result from prenatal/perinatal lesions (VA group) were compared to 28 sex- and age-matched psychiatric patients with normal neuroradiological findings (NCT group). The neuroradiological rater was blind to clinical psychiatric diagnoses and, vice versa, clinical diagnoses were established without knowledge of neuroradiological findings. A polydiagnostic approach (DSM-III-R, ICD-10, Leonhard Classification) was used for psychiatric diagnostic workup. Significantly more patients with cycloid psychoses (according to Leonhard's original description) were found in VA as compared to NCT patients. According to DSM-III-R and ICD-10, VA and NCT groups did not differ significantly regarding diagnostic distribution. Ventricular abnormalities that may reflect sequels of birth complications and/or adverse events during pregnancy may constitute one of the risk factors for developing cycloid psychosis as originally described by Leonhard.

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        • Akbarian S
        • Bunney W
        • Potkin SG
        • et al.
        Altered distribution of nicotin-amide-adenine dinucleotide phosphatediaphorase cells in frontal lobe of schizophrenics implies disturbances of cortical development.
        Arch Gen Psychiatry. 1993; 50: 169-177
        • American Psychiatric Association
        3rd ed rev. Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Press, New York1987
        • Andreasen NC
        • Ehrhardt JC
        • Swayze VW
        • et al.
        Magnetic resonance imaging of the brain in schizophrenia.
        Arch Gen Psychiatry. 1990; 47: 35-44
        • Arnold SE
        • Hyman BT
        • van Hoesen GW
        Cytoarchitectural abnormalities of the entorhinal cortex in schizophrenia.
        Arch Gen Psychiatry. 1991; 48: 625-632
        • Barkovich AJ
        • Truwit CL
        Brain damage from perinatal asphyxia: Correlation of MR findings with gestational age.
        Am J Neuroradiol. 1990; 11: 1087-1096
        • Barr CE
        • Mednick SA
        • Munk-Jorgensen P
        Exposure to influenza epidemics during gestation and adult schizophrenia.
        Arch Gen Psychiatry. 1990; 47: 869-874
        • Becker T
        • Stöber G
        • Lanczik M
        • Hofmann E
        • Franzek E
        Cranial computed tomography and differentiated psychopathology—Are there patterns of abnormal CT findings?.
        in: Beckmann H Neumärker KJ Endogenous Psychoses. Leonhard's Impact on Modern Psychiatry. Mosby, Washington, DC1995: 230-234
        • Beckmann H
        • Franzek E
        Deficit of birthrates in winter and spring months in distinct subgroups of mainly genetically determined schizophrenia.
        Psychopathology. 1992; 25: 57-64
        • Beckmann H
        • Jakob H
        Prenatal disturbances of nerve cell migration in the entorhinal region: A common vulnerability factor in functional psychoses?.
        J Neural Transm Gen Sect. 1991; 84: 155-164
        • Beckmann H
        • Fritze J
        • Lanczik M
        Prognostic validity of the cycloid psychoses.
        Psychopathology. 1990; 23: 205-211
        • Bergström K
        • Bille B
        Computed tomography of the brain in children with minimal brain damage: A preliminary study of 46 children.
        Neuropädiatrie. 1978; 9: 378-384
        • Bergström K
        • Bille B
        • Rasmussen F
        Computed tomography of the brain in children with minor neurodevelopmental disorders.
        Neuropediatrics. 1984; 15: 115-119
        • Breslin NA
        • Weinberger DR
        Neurodevelopmental implications of findings from brain imaging studies of schizophrenia.
        in: Mednick SA Fetal Neurol Development and Adult Schizophrenia. Cambridge University Press, Berlin, Wiesbaden, Ullstein1991: 199-215
        • Brockington IF
        • Perris C
        • Kendell RE
        • Hillier VF
        • Wainwright S
        The course and outcome of cycloid psychosis.
        Psychol Med. 1982; 12: 97-105
        • Brockington IF
        • Perris C
        • Meltzer HY
        Cycloid psychoses.
        J Nerv Ment Dis. 1982; 170: 651-656
        • Campion E
        • Tucker G
        A note on twin studies, schizophrenia and neurological impairment.
        Arch Gen Psychiatry. 1973; 29: 460-464
        • Cannon TD
        Genetic and perinatal sources of structural brain abnormalities in schizophrenia.
        in: Mednick SA Fetal Neural Development and Adult Schizophrenia. Cambridge University Press, Cambridge, New York, Port Chester, Melbourne, Sydney1991: 174-198
        • Caparulo BK
        • Cohen DJ
        • Rothman SL
        • et al.
        Computed tomographic brain scanning in children with developmental neuropsychiatric disorders.
        J Am Acad Child Psychiatry. 1987; 20: 338-357
        • Casanova MF
        • Zito M
        • Goldberg T
        • et al.
        Shape distortion of the corpus callosum of monozygotic twins discordant for schizophrenia.
        Schizophr Res. 1990; 3: 155-156
        • Cioni G
        • Bartalena L
        • Biagioni E
        • Boldrini A
        • Canapicchi R
        Neuroimaging and functional outcome of neonatal leucomalacia.
        Behaviour Brain Res. 1992; 49: 7-19
        • Cohen JA
        A coefficient of agreement of nominal scales.
        Educ Psychol Measurements. 1960; 20: 37-46
        • Cutting JC
        • Clare AW
        • Mann AH
        Cycloid psychosis: An investigation of the diagnostic concept.
        Psychol Med. 1978; 8: 637-648
        • DeLisi LE
        • Stritzke PH
        • Holan V
        • et al.
        Brain morphological changes in 1st episode cases of schizophrenia: Are they progressive [Letter]?.
        Schizophr Res. 1991; 5: 206-208
        • DeLisi LE
        • Hoff AL
        • Kushner M
        • Calev A
        • Stritzke P
        Left ventricular enlargement associated with diagnostic outcome of schizophreniform disorder.
        Biol Psychiatry. 1992; 32: 199-201
        • DeLisi LE
        • Stritzke P
        • Riordan H
        • et al.
        The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome.
        Biol Psychiatry. 1992; 31: 241-254
        • de Vries LS
        • Eken P
        • Groenendaal F
        • van Haastert IC
        • Meiners LC
        Correlation between the degree of periventricular leucomalacia diagnosed using cranial ultrasound and MRI later in infancy in children with cerebral palsy.
        Neuropediatrics. 1993; 24: 263-268
        • Endicott J
        • Spitzer R
        A diagnostic interview: The Schedule for Affective Disorders and Schizophrenia.
        Arch Gen Psychiatry. 1978; 35: 837-862
        • Falkai P
        • Bogerts B
        • Romuzek M
        Limbic pathology in schizophrenia: The entorhinal region—a morphometric study.
        Biol Psychiatry. 1988; 24: 515-521
        • Falkai P
        • Bogerts B
        • Klieser E
        • Mooren I
        • Waters H
        • Schlüter U
        Cranial computed tomography in schizophrenics, patients with cycloid psychosis and controls.
        in: Beckmann H Neumärker KJ Endogenous Psychoses. Leonhard's Impact on Modern Psychiatry. Mosby, Cambridge, New York, Port Chester, Melbourne, Sydney1995: 213-215
        • Franzek E
        • Beckmann H
        Season-of-birth effect reveals the existence of etiologically different groups of schizophrenia.
        Biol Psychiatry. 1992; 32: 375-378
        • Franzek E
        • Beckmann H
        Schizophrenia: Not a disease entity?.
        Eur J Psychiatry. 1992; 6: 97-108
        • Franzek E
        • Beckmann H
        A study of genetic heterogeneity in schizophrenia.
        International Psychiatry Today. 1995; 4: 9-12
        • Holsenbeck III, LS
        • Davidson LM
        • Hostetter RE
        • et al.
        Ventricle-to-brain ratio and symptoms at the onset of first-break schizophrenia.
        Schizophr Bull. 1992; 18: 427-435
        • Jakob H
        • Beckmann H
        Clinical-neuropathological studies of developmental disorders in the limbic system in chronic schizophrenia.
        Congress CINP. Ricerca Scientifica ed Educatione Permanente. 1984; vol 39 (suppl): 81
        • Jakob H
        • Beckmann H
        Prenatal developmental disturbances in the limbic allocortex in schizophrenia.
        J Neural Transm (Gen Sect). 1986; 65: 303-326
        • Johnstone EC
        • Crow TJ
        • Frith CD
        • Husband J
        • Kreel L
        Cerebral ventricular size and cognitive impairment in chronic schizophrenia.
        Lancet. 1976; ii: 924-926
        • Kaiya H
        • Uematsu M
        • Ofuji M
        • Nishida A
        • Morikiyo M
        • Adachi S
        Computerized tomography in schizophrenia: Familial versus non-familial forms of illness.
        Br J Psychiatry. 1989; 155: 444-450
        • Kemali D
        • Maj M
        • Galderisi S
        • Milici N
        • Salvati A
        Ventricle-to-brain ratio in schizophrenia: A controlled follow-up study.
        Biol Psychiatry. 1989; 26: 756-759
        • Kringlen E
        An epidemiological-clinical twin study on schizophrenia.
        in: Rosenthal D Ketty SS Transmission of Schizophrenia. Pergamon Press, Berlin, Wiebaden, Ullstein1968: 49-63
        • Kuban KCK
        • Leviton A
        Cerebral palsy.
        N Engl J Med. 1994; 330: 188-195
        • Kulakowski S
        • Larroche JC
        Cranial computerized tomography in cerebral palsy.
        Neuropediatrics. 1980; 11: 339-353
        • Leonhard K
        Genese der zykloiden Psychosen.
        Psychiatr Neurol Med Psychol. 1976; 133: 145-157
        • Leonhard K
        The Classification of Endogenous Psychoses.
        Irvington, Oxford, London1979
        • Leonhard K
        Aufteilung der endogenen Psychosen und ihre differenzierte Ätiologie.
        George Thieme Verlag, New York, London, Sydney, Toronto1995
        • Lewis SW
        • Reveley AM
        • Reveley MA
        • Chitkara B
        • Murray RM
        The familial/sporadic distinction as a strategy in schizophrenia research.
        Br J Psychiatry. 1987; 151: 306-313
        • Maj M
        Cycloid psychotic disorder: Validation of the concept by means of a follow-up and a family study.
        Psychopathology. 1990; 23: 196-204
        • Mednick SA
        • Machon RA
        • Huttunen MO
        • Bonett D
        Adult schizophrenia following prenatal exposure to an influenza epidemic.
        Arch Gen Psychiatry. 1988; 45: 189-192
        • Morrison J
        Congenital malformations in one of monozygotic twins.
        Arch Dis Child. 1949; 24: 214-218
        • Nasrallah HA
        • Schwarzkopf SB
        • Coffman JA
        • Olson SC
        Developmental brain abnormalities on MRI in schizophrenia: The role of genetic and perinatal factors.
        in: Mednick SA Fetal Neural Development and Adult Schizophrenia. Cambridge University Press, Stuttgart, New York1991: 216-223
        • Nelson KB
        • Ellenberg JH
        Antecedents of cerebral palsy: Multivariate analysis of risk.
        N Engl J Med. 1986; 315: 81-86
        • Nimgaonkar VL
        • Wessely S
        • Murray RM
        Prevalence of familiality, obstetric complications, and structural brain damage in schizophrenic patients.
        Br J Psychiatry. 1988; 153: 191-197
        • Owen MO
        • Lewis SH
        • Murray RM
        Obstetric complications and schizophrenia: A computed tomographic study.
        Psychol Med. 1988; 18: 331-339
        • Owens DGC
        • Johnstone EC
        • Crow TJ
        • Frith CD
        • Jagoe JR
        • Kreel L
        Lateral ventricular size in schizophrenia: Relationship to the disease process and its clinical manifestations.
        Psychol Med. 1985; 15: 27-41
        • Pearlson GD
        • Garbacz DJ
        • Moberg PJ
        • Ahn HS
        • dePaulo JR
        Symptomatic, familial, perinatal, and social correlates of computerized axial tomography (CAT) changes in schizophrenics and bipolars.
        J Nerv Ment Dis. 1985; 173: 42-50
        • Pedersen H
        • Taudorf K
        • Melchior JC
        Computed tomography in spastic cerebral palsy.
        Neuroradiology. 1982; 23: 275-278
        • Perris C
        A study of cycloid psychoses.
        Acta Psychiatr Scand Suppl. 1974; 253
        • Pollin W
        • Stabenau JR
        Biological, psychological and historical differences in a series of monozygotic twins discordant for schizophrenia.
        in: Rosenthal D Kety SS The Transmission of Schizophrenia. Pergamon Press, Cambridge, New York, Port Chester, Melbourne, Syndney1968: 317-332
        • Pollin W
        • Stabenau JR
        • Tupin J
        Family studies with identical twins discordant for schizophrenia.
        Psychiatry. 1965; 28: 60-78
        • Pollin W
        • Stabenau JR
        • Mosher L
        • Tupin J
        Life history differences in identical twins discordant for schizophrenia.
        Am J Orthopsychiatry. 1966; 36: 492-509
        • Price D
        Primary biases in twin studies: A review of prenatal and natal difference-producing factors in monozygotic pairs.
        Am J Hum Genet. 1959; 2: 293
        • Rausen AR
        • Seki M
        • Strauss L
        Twin transfusion syndrome.
        J Pediatr. 1965; 66: 613-628
        • Reveley AM
        • Reveley MA
        • Clifford CA
        • Murray RM
        Cerebral ventricular size in twins discordant for schizophrenia.
        Lancet. 1982; i: 540-541
        • Schröder J
        • Niethammer R
        • Geider FJ
        • et al.
        Neurological soft signs in schizophrenia.
        Schizophr Res. 1992; 6: 25-30
        • Schwarzkopf SB
        • Olson SC
        • Coffman JA
        • Nasrallah HA
        Third and lateral ventricular volumes in schizophrenia: Support for progressive enlargement of both structures.
        Schizophr Bull. 1990; 26: 385-391
        • Schwarzkopf SB
        • Nasrallah HA
        • Olson SC
        • Bogerts B
        • McLaughlin JA
        • Mitra T
        Family history and brain morphology in schizophrenia: An MRI study.
        Psychiatry Res: Neuroimaging. 1991; 40: 49-60
        • Sham P
        • O'Callaghan E
        • Takei N
        • Murray GK
        • Hare EH
        • Murray RM
        Schizophrenia following pre-natal exposure to influenza epidemics between 1939 and 1960.
        Br J Psychiatry. 1992; 160: 451-466
        • Shelton RC
        • Weinberger DR
        Brain morphology in schizophrenia.
        in: Meltzer HY Psychopharmacology: The Third Generation of Progress. Raven Press, Oxford1987: 773-781
        • Shields J
        Monozygotic Twins.
        Oxford University Press, New York1962
        • Stabenau JR
        • Pollin W
        Early characteristics of monozygotic twins discordant for schizophrenia.
        Arch Gen Psychiatry. 1967; 17: 723-734
        • Stöber G
        • Franzek E
        • Lesch KP
        • Beckmann H
        Periodic catatonia: A schizophrenic subtype with major gene effect and anticipation.
        Eur Arch Psychiatr Clin Neurosci. 1995; 245: 135-141
        • Suddath RL
        • Christison GW
        • Torrey EF
        • Casanova MF
        • Weinberger DR
        Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia.
        N Engl J Med. 1990; 322: 789-794
        • Torrey EF
        • Bowler AE
        • Rawlins R
        Schizophrenic births and viral diseases in two states.
        Schizophr Res. 1988; 1: 73-77
        • Turner SW
        • Toone KB
        • Brett-Jones JR
        Computerized tomographic scan changes in early schizophrenia—Preliminary findings.
        Psychol Med. 1986; 16: 219-225
        • van Bogaert P
        • Baleriaux D
        • Christophe C
        • Szliwowski HB
        MRI of patients with cerebral palsy and normal CT scan.
        Neuroradiology. 1992; 34: 52-56
        • Weinberger DR
        Implications of normal brain development for the pathogenesis of schizophrenia.
        Arch Gen Psychiatry. 1987; 44: 660-669
        • Wiklund LM
        • Uvebrand P
        • Flodmark O
        Morphology of cerebral lesions in children with congenital hemiplegia.
        Neuroradiology. 1990; 32: 179-186
        • Woods BT
        • Yurgelun-Todd D
        • Benes FM
        • Frankenburg FR
        • Pope Jr, HG
        • McSparren J
        Progressive ventricular enlargement in schizophrenia: Comparison to bipolar affective disorder and correlation with clinical course.
        Biol Psychiatry. 1990; 27: 341-352
        • World Health Organization
        Mental Disorders: Glossary and Guide to Their Classification in Accordance with the Ninth Revision of the International Classification of Disease.
        WHO, London1979
        • World Health Organization
        Mental and behavioural disorders.
        in: Clinical descriptions and diagnostic guidelines. Tenth Revision of the International Classification of Diseases. WHO, Geneva1991 (Chapter V (F))
        • Zaudig M
        • Vogl G
        Zur Frage der operationalen Diagnostik schizoaffektiver und zykloider Psychosen.
        Arch Psychiatr Nervenkr. 1983; 233: 385-396