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Cerebral ventricle dimensions as risk factors for schizophrenia and affective psychosis: an epidemiological approach to analysis

Published online by Cambridge University Press:  09 July 2009

P. B. Jones ,
I. Harvey ,
S. W. Lewis ,
B. K. Toone ,
J. Van Os ,
M. Williams  and
R. M. Murray
P. B. Jones*
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
I. Harvey
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
S. W. Lewis
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
B. K. Toone
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
J. Van Os
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
M. Williams
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
R. M. Murray
Affiliation:
Department of Pyschological Medicine, Institute of Psychiatry and King's College Hospital, London
*
1Address for correspondence: Dr P. B. Jones, Department of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
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Synopsis

A case–control study was undertaken of volumetric computerized tomographic scan measures in 216 consecutive admissions for functional psychosis and 67 healthy community controls. Odds ratio analysis demonstrated significant linear trends in the association between increasing lateral and third ventricle volumes, and both RDC schizophrenia (N = 121) and schizoaffective disorder (N = 41); cases were consistently associated with larger volumes than controls. There was an association between larger third, but not lateral, ventricle size in affective psychoses (N = 54). These associations were statistically independent of intracranial volume, sex, social class and ethnicity, factors which were significantly associated with ventricular measures in the controls. There was no evidence of a threshold corresponding to the notion of normal versus enlarged ventricles.

Within the schizophrenia group, there were no large or significant associations between ventricle dimensions and age at onset, duration of illness or pre-morbid social functioning. Neither obstetric complications nor a family history of schizophrenia or other psychiatric illness was associated with large ventricles in these cases.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 4 , November 1994 , pp. 995 - 1011
Copyright
Copyright © Cambridge University Press 1994

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References

Andreasen, N. C., Endicott, J., Spitzer, R. L. & Winokur, G. (1977). The family history method using diagnostic criteria. Archives of General Psychiatry 34, 1229–1235.CrossRefGoogle ScholarPubMed
Andreasen, N. C., Swayze, V. W., Flaum, M., Yates, W. R., Arndt, S. & McChesney, C. (1990 a). Ventricular enlargement in schizophrenia evaluated with computed tomographic scanning. Archives of General Psychiatry 47, 1008–1015.CrossRefGoogle ScholarPubMed
Andreasen, N. C., Ehrhardt, J. C., Swayze, V. W., Alliger, R. J., Yuh, W. T., Cohen, G. & Ziebell, S. (1990 b). Magnetic resonance imaging of the brain in schizophrenia. The pathophysiologic significance of structural abnormalities. Archives of General Psychiatry 47, 35–44.CrossRefGoogle ScholarPubMed
Andreasen, N. C., Swayze, V. W., Flaum, M., Alliger, R. & Cohen, G. (1990 c). Ventricular abnormalities in affective disorder: clinical and demographic correlates. American Journal of Psychiatry 147, 893–900.Google Scholar
Andreasen, N. C., Flaum, M., Swayze, V., O'Leary, D. S., Alliger, R., Cohen, G., Ehrhardt, J. & Yuh, W. T. (1993). Intelligence and brain structure in normal individuals. American Journal of Psychiatry 150, 130–134.Google ScholarPubMed
Armitage, P. & Berry, G. (1987). Statistical Methods in Medical Research. Oxford: Blackwell Scientific Publications: Oxford.Google Scholar
Bebbington, P., Wilkins, S., Jones, P. B., Foerster, A., Murray, R. M., Toone, B. K. & Lewis, S. W. (1993). Life events and psychosis. British Journal of Psychiatry 162, 72–79.CrossRefGoogle ScholarPubMed
Birley, J. L. T. (1992). Ventricle size in schizophrenia. British Journal of Psychiatry 161, 278.Google Scholar
Breslow, N. E. & Day, N. E. (1980). Statistical Methods in Cancer Research, Vol. 1. The Analysis of Case–Control Studies. WHO International Agency for Research on Cancer: Lyon.Google Scholar
Buka, S. L., Tsuang, M. T. & Lipsitt, L. P. (1993). Pregnancy/delivery complications and psychiatric diagnosis. A prospective study. Archives of General Psychiatry 50, 151–156.Google Scholar
Castle, D. J., Phelan, M., Wessely, S. & Murray, R. M. (1994). Which patient with a non-affective functional psychosis are not admitted at first psychiatric contact. British Journal of Psychiatry 165, 1101–1106.Google Scholar
Cazullo, C. L., Sacchetti, E., Vita, A., Illeni, M. T., Bellodi, L., Maffei, C., Alciati, A., Bertrando, P., Calzeroni, A., Ciussani, S., Conte, G., Pennati, A. & Invernizzi, G. (1985). Cerebral ventricular size in schizophrenic spectrum disorders: relationship to clinical, neuropsychological and immunogenetic variables. In: Biological Psychiatry, 1985 (ed. Shagass, C., Josiassen, R. C., Bridger, W. H., Weiss, K. J., Stoff, D. and Simpson, G. M.), pp. 1060–1062. Elsevier Science Publishers: Amsterdam.Google Scholar
Coffey, C. E., Wilkinson, W. E., Weiner, R. D., Parashos, I. A., Djang, W. T., Webb, M. C., Figiel, G. S. & Spritzer, C. E. (1993). Quantitative cerebral anatomy in depression; a controlled magnetic resonance imaging study. Archives of General Psychiatry 50, 7–16.CrossRefGoogle ScholarPubMed
Cook, R. D. & Weisberg, S. (1982). Residuals and influence in Regression. Chapman & Hall: London.Google Scholar
Crawford, J. R., Besson, J. A. O., Bremner, M., Ebmeir, K. P., Cochrane, R. H. B. & Kirkwood, K. (1992). Estimation of premorbid intelligence in schizophrenia. British Journal of Psychiatry 161, 69–74.CrossRefGoogle ScholarPubMed
Daniels, D. G., Goldberg, T. E., Gibbons, R. D. & Weinberger, D. R. (1991). Lack of a bimodal distribution of ventricular size in schizophrenia: a Gaussian mixture analysis of 1056 cases and controls. Biological Psychiatry 30, 887–903.CrossRefGoogle Scholar
Degreef, G., Ashtari, M., Wu, H. W., Borenstein, M., Geisler, S. & Lieberman, J. (1991). Follow-up MRI study in first episode schizophrenia. Schizophrenia Research 5, 204–206.Google Scholar
Degreef, G., Ashtari, M., Bogerts, B., Bilder, R. M., Jody, D. N., Alvir, J. & Lieberman, J. A. (1992). Volumes of ventricular system subdivisions measured from magnetic resonance images in first-episode schizophrenic patients. Archives of General Psychiatry 49, 531–537.Google Scholar
DeLisi, L. E., Goldin, L. R., Hamovit, J. R., Maxwell, M. E., Kurtz, D., Nurnberger, J. I. & Gershon, E. S. (1986). A family study of the association of increased ventricular size with schizophrenia. Archives of General Psychiatry 43, 148–153.CrossRefGoogle ScholarPubMed
DeLisi, L. E., Stritzke, P., Riordan, H., Holan, V., Boccio, A., Kushner, M., McClelland, J., Van Eyl, O. & Anand, A. (1992). The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome. Biological Psychiatry 31, 241–254.Google Scholar
Dewan, M. J., Haldipur, C. V., Lane, E. E., Ispahani, A., Boucher, M. F. & Major, L. F. (1988). Bipolar affective disorder: comprehensive quantitative computed tomography. Acta Psychiatrica Scandinavica 77, 670–676.Google Scholar
Dolan, R. J., Calloway, S. P. & Mann, A. H. (1985). Cerebral ventricular size in depressed subjects. Psychological Medicine 15, 873–878.Google Scholar
Done, J., Johnstone, E. C., Frith, C. D., Golding, J., Shepard, P. M. & Crow, T. J. (1991). Complications of pregnancy and delivery in relation to psychosis in adult life: data from the British Perinatal Mortality Survey. British Medical journal 302, 1576–1580.CrossRefGoogle ScholarPubMed
Farmer, A., Jackson, R., McGuffin, P. & Storey, P. (1987). Cerebral ventricular enlargement in chronic schizophrenia. British Journal of Psychiatry 150, 324–330.Google Scholar
Foerster, A., Lewis, S. W., Owen, M. J., Murray, R. M. (1991 a). Premorbid adjustment and personality in psychosis. Effects of sex and diagnosis. British Journal of Psychiatry 158, 171–176.Google Scholar
Foerster, A., Lewis, S. W., Owen, M. J., Murray, R. M. (1991 b). Low birth weight and a family history of schizophrenia predict poor premorbid functioning in psychosis. Schizophrenia Research 5, 13–20.CrossRefGoogle Scholar
Gado, M., Hughes, C. P., Danziger, W., Chi, D., Jost, G. & Berg, L. (1982). Volumetric measurements of the cerebrospinal fluid spaces in demented subjects and controls. Radiology 144, 535–538.Google Scholar
Goetz, K. L. & van Kammen, D. P. (1986). Computerized axial tomography scans and subtypes of schizophrenia. Journal of Nervous and Mental Disease 174, 31–41.CrossRefGoogle ScholarPubMed
Gross, G., Huber, G. & Schuttler, R. (1982). Computerized tomography studies on schizophrenic diseases. Archiv für Psychiatrie und Nervenkranheiten 231, 519–526.Google Scholar
Gur, R. E., Mozley, D. P., Resnick, S. M., Shtasel, D., Kohn, M., Zimmerman, R., Herman, G., Atlas, S., Grossman, R., Erwin, R. & Gur, R. C. (1991). Magnetic resonance imaging in schizophrenia: volumetric analysis of brain and cerebrospinal fluid. Archives of General Psychiatry 48, 407–412.CrossRefGoogle ScholarPubMed
Halbreich, U., Bakhai, Y., Bacon, K. B., Goldstein, S., Asnis, G. M., Endicott, J. & Lesser, J. (1989). The normalcy of self-proclaimed normal volunteers. American Journal of Psychiatry 146, 1052–1055.Google ScholarPubMed
Harvey, I., McGuffin, P., Williams, M. & Toone, B. K. (1990 a). The ventricle-brain ratio (VBR) in functional psychoses: an admixture analysis. Psychiatry Research: Neuroimaging 35, 61–69.CrossRefGoogle ScholarPubMed
Harvey, I., Williams, M., Toone, B., Turner, S., Lewis, S. W. & McGuffin, P. (1990 b). The ventricular-brain ratio in functional psychoses: the relationship of lateral ventricular and total intracranial area. Psychological Medicine 20, 55–62.Google Scholar
Hounsfield, G. N. (1973). Computerised transverse axial scanning (tomography): Part I. Description of a system. British Journal of Radiology 46, 1016–1022.Google Scholar
Iacono, W. G., Smith, G. N., Moreau, M., Beiser, M., Fleming, J. A., Lin, T-Y. & Flak, B. (1988). Ventricular and sulcal size at the onset of psychosis. American Journal of Psychiatry 145, 820–824.Google ScholarPubMed
Illowsky, B., Juliano, D. M., Bigelow, L. B. & Weinberger, D. R. (1988). Stability of CT scan findings in schizophrenia. Journal of Neurology, Neurosurgery and Psychiatry 51, 209–212.CrossRefGoogle ScholarPubMed
Jernigan, T. L., Press, A. & Hesselink, J. R. (1990). Methods for measuring brain morphologic features on magnetic resonance images. Archives of Neurology 47, 27–32.Google Scholar
Johnstone, E. C., Owens, D. G., Crow, T. J., Frith, C. D., Alexandropolis, K., Bydder, G. & Colter, N. (1989 a). Temporal lobe structure as determined by nuclear magnetic resonance in schizophrenia and bipolar affective disorder. Journal of Neurology, Neurosurgery, and Psychiatry 52, 736–741.Google Scholar
Johnstone, E. C., Owens, D. G., Bydder, G., Colter, N., Crow, T. J. & Frith, C. D. (1989 b). The spectrum of structural brain changes in schizophrenia: age of onset as a predictor of cognitive and clinical function and their cerebral correlates. Psychological Medicine 19, 91–103.Google Scholar
Jones, P. B. & Rogers, B. (1993). Estimating premorbid IQ in schizophrenia. British Journal of Psychiatry 162, 273–274.Google Scholar
Jones, P. B., Bebbington, P., Foerster, A., Lewis, S., Murray, R. M., Russell, A., Sham, P. C., Toone, B. K. & Wilkins, S. (1993 a). Premorbid social underachievement in schizophrenia. Results from the Camberwell Collaborative Psychosis Study. British Journal of Psychiatry 162, 65–71.Google Scholar
Jones, P. B., Owen, M. J., Lewis, S. W. & Murray, R. M. (1993 b). A case–control study of family history and cerebral cortical abnormalities in schizophrenia. Acta Psychiatrica Scandinavica 87, 6–12.Google Scholar
Kaiya, H., Uematsu, M., Ofuji, M., Nishida, A., Morikiyo, M. & Adachi, S. (1989). Computerized tomography in schizophrenia: familial versus non-familial forms of illness. British Journal of Psychiatry 155, 444–450.Google Scholar
Kemali, C., Maj, M., Galderisi, S., Salvati, A., Starace, F., Valente, A. & Pirozzi, R. (1986). Clinical, biological and neuropsychological features associated with lateral ventricular enlargement in DSM-III schizophrenic disorder. Psychiatry Research 21, 137–149.Google Scholar
Khang-Cheng, H., Roessman, U., Straumfjord, J. V. & Monroe, G. (1980). Analysis of brain weight. Archives of Pathology and Laboratory Medicine 104, 635–645.Google Scholar
Lewis, G. & Pelosi, A. J. (1990). The case–control study in psychiatry. British Journal of Psychiatry 157, 197–207.CrossRefGoogle ScholarPubMed
Lewis, S. W. (1990). X-Ray CT in schizophrenia: 15 years on. British Journal of Psychiatry 157 supplement 9, 16–24.CrossRefGoogle Scholar
Lewis, S. W. (1993). A controlled quantitative study of computed tomography in functional psychosis. MD thesis, University of London.Google Scholar
Lewis, S. W., Owen, M. J. & Murray, R. M. (1989). Obstetric complications and schizophrenia: methodology and mechanisms. In Schizophrenia – A Scientific Focus. (ed. Schulz, S. C. and Tamminga, C. A.), pp. 56–68. Oxford University Press: New York.Google Scholar
Luchins, D. J., Lewine, R. R. J. & Meltzer, H. Y. (1984). Lateral ventricular size, psychopathology and medication response in the psychoses. Biological Psychiatry 19, 29–44.Google ScholarPubMed
Mantel, N. & Haenszel, W. (1959). Statistical analysis of data from the retrospective study of disease. Journal of the National Cancer Institute 22, 719–748.Google Scholar
Nasrallah, H. A., Kuperman, S., Hamra, B. J. & McCalley-Whitters, M. (1983). Clinical differences between schizophrenic patients with and without large ventricles. Journal of Clinical Psychiatry 44, 407–409.Google Scholar
Nasrallah, H. A., Olsen, S. C., McCalley-Whitters, M., Chapman, S. & Jacoby, E. C. (1986). Cerebral ventricular enlargement in schizophrenia: a preliminary follow-up study. Archives of General Psychiatry 43, 157–159.Google Scholar
Nelson, H. E. (1982). National Adult Reading Test (NART): Test Manual. NFER-Nelson: Windsor.Google Scholar
Nelson, H. E. & O'Connell, A. (1978). Dementia: the estimation of premorbid intelligence levels using the new adult reading test. Cortex 14, 234–244.Google Scholar
Nimgaonkar, V. L., Wessely, S. & Murray, R. M. (1988). Prevalence of familiality, obstetric complications and structural brain damage in schizophrenic patients. British Journal of Psychiatry 153, 191–197.CrossRefGoogle ScholarPubMed
O'Callaghan, E., Larkin, C. & Waddington, J. L. (1990). Obstetric complications in schizophrenia and the validity of maternal recall. Pyschological Medicine 20, 89–94.CrossRefGoogle ScholarPubMed
Owen, M. J., Lewis, S. W. & Murray, R. M. (1988). Obstetric complications and schizophrenia: a computed tomographic study. Psychological Medicine 18, 331–339.Google Scholar
Owen, M. J., Lewis, S. W. & Murray, R. M. (1989). Family history and ventricular enlargement in schizophrenia – a case–control study. British Journal of Psychiatry 154, 629–634.Google Scholar
Owens, D. G., Johnstone, E. C., Crow, T. J., Frith, C. D., Jagoe, J. R. & Kreel, L. (1985). Lateral ventricular size in schizophrenia – relationship to the disease process and its clinical manifestations. Psychological Medicine 15, 27–41.Google Scholar
Pearlson, G. D., Garbacz, D. J., Moberg, P. J., Ahn, H. S. & DePaulo, J. R. (1985). Symptomatic, familial, perinatal and social correlates of computerized axial tomography (CAT) changes in schizophrenics and bipolars. Journal of Nervous and Mental Diseases 173, 42–50.Google Scholar
Pearlson, G. D., Kim, W. S., Kubos, K. L., Moberg, P. J., Jayaram, G., Bascom, M. J., Chase, G. A., Goldfinger, A. D. & Tune, L. E. (1989). Ventricle-brain ratio, computed tomographic density, and brain area in 50 schizophrenics. Archives of General Psychiatry 46, 690–697.Google Scholar
Penn, R. D., Belanger, M. G. & Yasnoff, W. A. (1978). Ventricular volume in man computed from CAT scans. Annals of Neurology 3, 216–223.CrossRefGoogle ScholarPubMed
Pfefferbaum, A., Zipursky, R. B., Lim, K. O., Zatz, L. M., Stahl, S. M. & Jernigan, T. L. (1988). Computed tomographic evidence for generalized sulcal and ventricular enlargement in schizophrenia. Archives of General Psychiatry 45, 633–640.Google Scholar
Phillips, L. (1953). Case history data and prognosis in schizophrenia. Journal of Nervous and Mental Diseases 117, 515–525.Google Scholar
Raz, S., Raz, N., Weinberger, D. R., Boronow, J., Pickar, D., Bilgler, E. D. & Turkheimer, E. (1987). Morphological brain abnormalities in schizophrenia determined by computed tomography: a problem of measurement? Psychiatry Research 22, 91–98.Google Scholar
Raz, S., Raz, N. & Bigler, E. D. (1988). Ventriculomegaly in schizophrenia: is choice of controls important? Psychiatry Research 24, 71–77.CrossRefGoogle ScholarPubMed
Reddy, R., Mukherjee, S. & Schnur, D. (1989). Family history of psychosis, obstetric complications, premorbid functioning and CT scan findings in schizophrenic patients. Schizophrenia Research 2, 19.Google Scholar
Resnick, S. M. (1992). Matching for education in studies of schizophrenia. Archives of General Psychiatry 49, 246.Google Scholar
Reveley, M. A. (1985). Ventricular enlargement in schizophrenia: the validity of computerised tomographic findings. British Journal of Psychiatry 147, 233–240.Google Scholar
Reveley, A. M., Reveley, M. A., Clifford, C. A. & Murray, R. M. (1982). Cerebral ventricular size in twins discordant for schizophrenia. Lancet i, 540–541.Google Scholar
Reveley, A. M., Reveley, M. A. & Murray, R. M. (1984). Cerebral ventricular enlargement in non-genetic schizophrenia: a controlled twin study. British Journal of Psychiatry 144, 89–93.CrossRefGoogle ScholarPubMed
Reveley, M. A., Chitkara, B. & Murray, R. M. (1988). Ventricular and cranial size in schizophrenia: a 4 to 7 year follow-up.Paper presented to the 4th Winter workshop on schizophrenia, Badgastein,Austria,24 January.Google Scholar
Romani, A., Merrelo, S., Gozzoli, L., Zerbi, F., Grassi, M. & Cosi, V. (1987). P300and CT scan in patients with chronic schizophrenia. British Journal of Psychiatry 151, 506–513.Google Scholar
Sacchetti, E., Vita, A. & Conte, G. (1987). Brain morphology in major affective disorders; clinical and biological correlates.Proceedings of The International Meeting on Plasticity and Morphology of the Central Nervous System.Milan,October 22–24, pp. 49–51.Google Scholar
Sacchetti, E., Calzeroni, A., Vita, A., Terzi, A., Pollastro, F. & Cazzullo, C. L. (1992). The brain damage hypothesis of the seasonality of births in schizophrenia and major affective disorders: evidence from computed tomography. British Journal of Psychiatry 160, 390–397.Google Scholar
Sandercock, P. (1989). The odds ratio: a useful tool in neurosciences. Journal of Neurology, Neurosurgery and Psychiatry 52, 817–820.Google Scholar
Schlegel, S. & Kretzschmar, K. (1987). Computed tomography in affective disorders: ventricular and sulcal measurements. Biological Psychiatry 22, 4–14.Google Scholar
Scott, M. L., Golden, C. J., Ruedrich, S. L. & Bishop, R. J. (1983). Ventricular enlargement in major depression. Psychiatry Research 8, 91–93.Google Scholar
Shelton, R. C. & Weinberger, D. R. (1986). X-ray computerized tomography studies in schizophrenia: a review and synthesis. In Handbook of Schizophrenia, Vol. 1. The Neurology of Schizophrenia (ed. Nasrallah, H. A. and Weinberger, D. R.), pp. 207–250. Elsevier Science Publishers B. V.: New York.Google Scholar
Shtasel, D. L., Gur, R. E., Mozley, P. D., Richards, J., Taleff, M. M., Heimberg, C., Gallacher, F. & Gur, R. C. (1991). Volunteers for biomedical research – recruitment and screening of normal controls. Archives of General Psychiatry 48, 1022–1025.Google Scholar
Smith, G. N. & Iacono, W. G. (1986). Lateral ventricular size in schizophrenia and choice of control group. Lancet i, 1450.Google Scholar
Smith, G. N., Iacono, W. G., Moreau, M., Tallman, K., Beiser, M. & Flak, B. (1988). Choice of comparison group and computed tomography findings in schizophrenia. British Journal of Psychiatry 153, 667–674.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria (RDC) for a Selected Group of Functional Psychoses, 3rd edn.Biometrics Research Division, New York State Psychiatric Institute: New York.Google Scholar
Stafford, J. L., Albert, M. S., Naeser, M. A., Sandor, T. & Garvey, A. J. (1988). Age-related differences in computed tomographic scan measurements. Archives of Neurology 45, 409–415.Google Scholar
Suddath, R. L., Christison, G. W., Torrey, E. F., Casanova, M. F. & Weinberger, D. R. (1990). Anatomical abnormalities in the brains of monozygotic twins discordant for schizophrenia. New England Journal of Medicine 322, 789–794.CrossRefGoogle ScholarPubMed
Swayze, V. W., Andreasen, N. C., Alliger, R. J., Erhardt, J. C. & Yuh, W. T. C. (1990). Structural brain abnormalities in bipolar mood disorder: ventricular enlargement and focal signal hyper-intensities. Archives of General Psychiatry 47, 1054–1059.Google Scholar
Takahashi, R., Inabi, Y., Inanaga, K., Kato, N., Kumashiro, H., Nishimura, T., Okuma, T., Otsuki, S., Sakai, T., Sato, T. & Shimazono, Y. (1981). CT scanning and the investigation of schizophrenia. In Developments in Psychiatry, Vol. 5 (ed. Perris, C., Struwe, G. and Jansson, B.), pp. 259–268. Elsevier/North Holland Biomedical Press: Amsterdam.Google Scholar
Targum, S. D., Rosen, L. N., DeLisi, L. E., Weinberger, D. R. & Citrin, C. M. (1983). Cerebral ventricular size in major depressive disorder: association with delusional symptoms. Biological Psychiatry 18, 329–336.Google ScholarPubMed
Tizard, J. (1975). Race and IQ: the limits of probability. New Behaviour 1, 6–9.Google Scholar
Tsuang, M., Hsieh, C-C. & Fleming, J. A. (1992). Group comparison approaches in psychiatric research. In Research in Psychiatry, Issues, Strategies and Methods (ed. Hsu, L. K. G. and Hersen, M.), pp. 107–132. Part of Critical Issues in Psychiatry. An Educational Series for Residents and Clinicians. Series Editor: Sherwin M. Woods. Plenum Medical Book Co: New York.Google Scholar
Turner, S. W., Toone, B. K., Brett-Jones, J. R. (1986). Computerised tomographic scan changes in early schizophrenia – preliminary findings. Psychological Medicine 16, 219–225.CrossRefGoogle ScholarPubMed
Vita, A., Sacchetti, E., Valvassori, G. & Cazzullo, C. L. (1988). Brain morphology in schizophrenia: a 2 to 5 years CT scan follow-up study. Acta Psychiatrica Scandinavica 78, 618–621.Google Scholar
Van Horn, J. D. & McManus, I. C. (1992). Ventricular enlargement in schizophrenia – a meta analysis of studies of the ventricle: brain ratio (VBR). British Journal of Psychiatry 160, 687–697.Google Scholar
Weinberger, D. R., Torrey, E. F., Neophytides, A. N. & Wyatt, R. J. (1979). Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry 36, 735–739.Google Scholar
Weinberger, D. R., DeLisi, L. E., Neophytides, A. N. & Wyatt, R. J. (1981). Familial aspects of CT scan abnormalities in chronic schizophrenic patients. Psychiatry Research 4, 65–71.Google Scholar
Wechsler, D. (1955). Wechsler Adult Intelligence Scale: Manual. Psychological Corporation: New York.Google Scholar
Wechsler, D. (1958). The Measurement and Appraisal of Adult Intelligence, 4th edn.Williams and Wilkins: Baltimore.Google Scholar
Wechsler, D. (1975). Intelligence defined and undefined. American Psychologist 30, 135–139.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Zatz, L. M., Jernigan, T. L. & Ahumada, A. J. (1982). Changes on computed cranial tomography with aging: intracranial fluid volume. American Journal of Neuroradiology 3, 1–11.Google ScholarPubMed
Zatz, L. M. & Jernigan, T. L. (1983). The ventricle-brain ratio on computed tomography scans: validity and proper use. Psychiatry Research 8, 207–214.CrossRefGoogle ScholarPubMed
Zipursky, R. B., Lim, K. O. & Pfefferbaum, A. (1991). Brain size in schizophrenia. Archives of General Psychiatry 48, 179–180.Google Scholar