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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.
 

 

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