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Meta-analyses of Studies of Ventricular Enlargement and Cortical Sulcal Prominence in Mood Disorders:  Comparisons With Controls or Patients With Schizophrenia

Helio Elkis, MD, PhD; Lee Friedman, PhD; Alexandria Wise; Herbert Y. Meltzer, MD
Arch Gen Psychiatry. 1995;52(9):735-746. doi:10.1001/archpsyc.1995.03950210029008.
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Background:  The findings of ventricular enlargement and increased sulcal prominence are well documented in schizophrenia, but the consistency of similar findings in mood disorders is less well appreciated. Reliable documentation of the presence of these structural abnormalities in mood disorders would require a reassessment of their significance for both schizophrenia and mood disorders. In this article, we meta-analytically review the literature on ventricular enlargement and cortical sulcal prominence in patients with mood disorders compared with controls and patients with schizophrenia.

Methods:  Four meta-analytic reviews were conducted, two comparing patients with mood disorders with normal controls on ventricular enlargement (meta-analysis 1) or sulcal prominence (meta-analysis 2) and two comparing patients with mood disorders with schizophrenic patients on these same measures (meta-analyses 3 and 4).

Results:  Meta-analyses 1 and 2 revealed statistically significant (P<.001) moderate composite effect sizes (d) for the comparisons of patients with mood disorders with controls on both ventricular enlargement (d=0.44) and sulcal prominence (d=0.42). Meta-analysis 3 further revealed that patients with schizophrenia have significantly greater ventricular enlargement than patients with mood disorders (P=.002), but the effect size was small (d= -0.20). There were too few studies comparing these patient groups on sulcal prominence to support a quantitative meta-analysis.

Conclusions:  This review documents the presence of ventricular enlargement and increased sulcal prominence in mood disorders. Patients with mood disorders have less ventricular enlargement than patients with schizophrenia, but this effect is small. These results reinforce previous suggestions of the nonspecificity of structural brain changes in schizophrenia and mood disorders.

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