Q:How concerned should I be about the diagnosis
of schizophrenia in the medical records of my child's parent?
The report says that her mother suffers from
schizophrenia. I know how serious it is, and that it has
a hereditary component but is not well understood. However,
I have been told that the Russian translation may not really
be referring to the same disease, which we would call schizophrenia.
They may use this term for a person, who has not actually
been diagnosed with schizophrenia as we know it. Are you
aware of the use of this term for other conditions? It is
difficult to judge the risk realistically. How concerned
should I be?
A:
Indeed, the term and diagnosis of
"schizophrenia" had been abused in the former Soviet Union
in the 60s and 70s. I do not think this is the case now: within
the last ten years, I happened to examine a number of the original
medical documents from Russia and found psychiatrists generally
following the guidelines of the International Classification of
Diseases (ICD, 9th revision), which is closely related to our DSM-4.
The likeliness of a "correct" diagnosis (that is, this
person would be labeled similarly having the same symptomatology)
is high. How concerned should you be? It is really "Russian
roulette": the children of the schizophrenic parents have a
predisposition for this disorder. It may never actually happen,
but the probability is much higher than in the general population,
in particular under stressful living conditions and in disorganized
homes. I do not have any numbers at hand, but do remember that the
probability of schizophrenia in children with BOTH parents affected
is about 50%. With one parent diagnosed it is much lower. Try to
obtain a "second opinion" on this. The best bet would
be a pediatrician who knows Russian.
