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Published on: November 21, 2013
Hereditary spastic paraparesis and psychosis
P McMonagle1, M Hutchinson, B Lawlor
1Department of Neurology, St Vincent's University Hospital, Elm Park, Dublin, Ireland. paul.mcmonagle@sjhc.london.on.ca
Psychosis, including schizophrenia and schizo-affective disorder, is more common in Irish patients with hereditary spastic paraparesis (HSP) than previously reported. This increased risk is linked to Kjellin
Area of Science:
- Neurology
- Psychiatry
- Genetics
Background:
- Hereditary spastic paraparesis (HSP) typically involves leg spasticity and weakness.
- Psychiatric disorders in HSP patients are usually mood-related, not psychotic.
- Previous observations suggested a higher incidence of psychosis in Irish HSP patients.
Purpose of the Study:
- To investigate the frequency and nature of psychosis in a nationwide cohort of Irish patients with HSP.
- To identify specific HSP subtypes associated with an increased risk of psychosis.
Main Methods:
- A nationwide epidemiological and clinical study identified HSP patients with psychotic illness.
- Psychiatric case notes were reviewed.
- Operational Diagnostic Criteria Checklist (OPCRIT) was applied for diagnosis.
Main Results:
- Six patients from four families presented with HSP and psychosis.
- OPCRIT diagnoses included narrow schizophrenia (n=2), broad schizophrenia (n=2), and schizo-affective/manic disorder (n=2).
- Psychosis occurred in patients with Kjellin's syndrome and SPG4-HSP, but not in family members without HSP.
Conclusions:
- The rate of psychosis in the Irish HSP population is higher than expected.
- Patients with Kjellin's syndrome and SPG4-HSP may have an increased risk of developing psychosis.
- This study highlights a potential link between specific HSP genetic subtypes and psychotic disorders.
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