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October 1995

The New York High-Risk ProjectPsychoses and Cluster A Personality Disorders in Offspring of Schizophrenic Parents at 23 Years of Follow-up

Author Affiliations

From the Departments of Medical Genetics (Drs Erlenmeyer-Kimling and Squires-Wheeler and Mss Adamo and Roberts) and Child Psychiatry (Dr Kestenbaum), New York State Psychiatric Institute, the Departments of Psychiatry (Drs Erlenmeyer-Kimling, Squires-Wheeler, and Kestenbaum) and Genetics and Development (Dr Erlenmeyer-Kimling), College of Physicians and Surgeons, Columbia University, and the Department of Psychiatry, Mt Sinai School of Medicine (Dr Cornblatt), New York, NY; Queen Street Mental Health Centre, University of Toronto, Ontario (Dr Bassett); Educational Testing Service, Princeton, NJ (Dr Rock); and the Department of Psychology, University of Virginia, Charlottesville (Dr Gottesman).

Arch Gen Psychiatry. 1995;52(10):857-865. doi:10.1001/archpsyc.1995.03950220067013

Background:  We herein present lifetime prevalence rates of psychoses and DSM-III-R cluster A personality disorders in sample A of the New York High-Risk Project, a prospective study following offspring of parents with schizophrenia (HRSz subjects) and affective illness (HRAff subjects) and of psychiatrically normal parents (NC subjects) from midchildhood to adulthood.

Methods:  We interviewed the offspring in adulthood with the Schedule for Affective Disorders and Schizophrenia, Lifetime Version, for Axis I disorders and the Personality Disorder Examination for Axis II disorders.

Results:  Lifetime prevalence rates (±SE) of schizophrenia and unspecified psychosis were 11.1%±4.3% and 5.6%±3.1%, respectively, in the HRSz group and 0% in the HRAff and NC groups. Rates of schizoaffective disorder subclassified as mainly schizophrenic, however, were highest in the HRAff group. Rates of psychotic affective disorders did not differ between the HRSz and other groups. Age-corrected morbidity risks were similar to lifetime prevalence rates. Rates of the three cluster A personality disorders did not differ among the groups, but the combined rate was greater in the HRSz and HRAff groups than in the NC group.

Conclusions:  Our data strongly support a specific familial liability to narrowly defined schizophrenia that is not shared by families of probands with affective disorder. Schizoaffective disorder and cluster A personality disorders, however, occur in families of both schizophrenic probands and probands with affective disorder. Psychotic affective disorders, which are not increased in HRSz subjects, do not appear to be an expression of the liability to schizophrenia.