When a Mind Breaks Down: A Brief History of Efforts to Understand Schizophrenia (original) (raw)

Schizophrenia: Solving the puzzle

Irish Journal of Medical Science, 2003

Background Schizophrenia is a common mental illness with an incidence of 15 new cases per 100,000 population per year. Aim To review evidence for current neurodevelopmental models of the aetiology of schizophrenia. Methods We performed a literature search using Medline and PsychINFO. We evaluated the relevance of each article and tracked other relevant articles through references. Results There is considerable evidence to support neurodevelopmental models of the aetiology of schizophrenia. One or more aetiological events occur between conception and birth that disturb central nervous system (CNS) development, leading to persisting alterations in brain structure and function. These early events, acting in concert with genetic loading and later influences or insults, predispose to the development of schizophrenia in early adulthood. C o n c l u s i o n s There have been considerable advances in schizophrenia research over the past 20 years. Future study of indices of neural development will help advance our understanding of this common, disabling mental illness.

What We Know: Findings That Every Theory of Schizophrenia Should Explain

Schizophrenia Bulletin, 2009

The article summarizes the process used to distill schizophrenia science into 22 facts. These facts consist of 6 basic facts, 3 etiological facts, 6 pharmacological and treatment facts, 5 pathology facts, and 2 behavioral facts that were critically reviewed by the scholarly community through a special initiative in cooperation with the Schizophrenia Research Forum. A subset of 10 of these facts was selected to form a common set of findings to be explained from the different theoretical perspectives included in this special section of Schizophrenia Bulletin. The rationale for this exercise is to distinguish more precisely the areas of agreement and disagreement between theories of schizophrenia and to highlight where more thought and data can make the greatest impact for understanding this disease.

Schizophrenia, “Just the Facts”: What we know in 2008

Schizophrenia Research, 2008

For every disorder, there is a set of established findings and accepted constructs upon which further understanding is built. The concept of schizophrenia as a disease entity has been with us for a little more than a century, although descriptions resembling this condition predate this conceptualization. In 1988, for the inaugural issue of Schizophrenia Research, at the invitation of the founding editors, a senior researcher, since deceased (RJ Wyatt) 1 published a summary of generally accepted ideas about the disorder, which he termed "the facts" of schizophrenia. Ten years later, in conjunction with two of the authors (MSK, RT), he compiled a more extensive set of "facts" for the purpose of evaluating conceptual models or theoretical constructs developed to understand the nature of schizophrenia. On the 20th anniversary of this journal, we update and substantially expand our effort to periodically summarize the current body of information about schizophrenia. We compile a body of seventy-seven representative major findings and group them in terms of their specific relevance to schizophreniaetiologies, pathophysiology, clinical manifestations, and treatments. We rate each such "fact" on a 0-3 scale for measures of reproducibility, whether primary to schizophrenia, and durability over time. We also pose one or more critical questions with reference to each "fact", answers to which might help better elucidate the meaning of that finding for our understanding of schizophrenia. We intend to follow this paper with the submission to the journal of a series of topic-specific articles, critically reviewing the evidence.

The Biological Basis of Schizophrenia

Social Work, 1987

A major obstacle which I have had to deal with both as I wrote this paper and designed my exhibit was the question, "who is this for?" Five people will have to read and approve this paper. Five people had to view and judge my exhibit. Many more may wish to read my paper and review the pieces from my exhibit in orderto decide whetherto hire me or not. There FOREWORD really understand the scientific theory, despite my best efforts. I cannot cover several years of premedical and medical education which I have not even had myself in this paper. I hope the person with minimal medical knowledge will be able to comprehend the fundamental theory behind the biological basis of schizophrenia. Non-artists may not be interested in my are many more people who saw my exhibit, as discussion of the media I chose. well.

Does the biology go around the symptoms? A copernican shift in schizophrenia paradigms

Clinical Psychology Review, 1996

the physiological leoel in schiz~hnsnia. Copyright 0 1996 Elsevier Science Ltd THE PREVAILING paradigm within biological psychiatry is that the symptoms of schizophrenia are caused by physiological abnormalities -a view apparently so sub stantially underpinned by evidence that it may seem self-evident (Murray, 1994). However, in the critical scientific spirit of Copernicus,l we make the case that tbe Correspondence should he addressed to C. E. Harrop, %opernicus is credited with being one of the first people to claim that the Earth went around the sun, a view considered heretical at the time. Kuhn (19'70) demonstrated how this Copemican revolution symbolizes the essential process of postulating alternative theories to counter established paradigms. 641 642 C. E. Ha*, R Tmq and 1.J Mitchell opposite view is equally compellingthat is, that a psychosocial model of cause, whereby the physiological differences would be caused by psychological mechanisms.

Explaining Schizophrenia from Medical and Philosophical Perspective

2022

Background: Schizophrenia is a multifactorial two-faced disease with the cognitive impairment being the core of both positive and negative group of symptoms. It is characterized by abnormal behavior, strange speech (word salad) and a decreased ability to understand reality. Methods: Using literature review, author's own experience and reflections about the subject, schizophrenia is explained and conceptualized from both medical and philosophical perspective. Conclusion: Schizophrenia is a serious illness, treatment of which remains a challenge. Many factors may contribute to the development of schizophrenia including (neuro) immune system dysregulation, genetic susceptibility, pregnancy and birth complications, childhood trauma, social isolation, substance abuse, and many others. Multidisciplinary approach in the treatment of schizophrenia should be preferred and may include, except for psychopharmacology and psychotherapy (psychiatrist, clinical psychologist), nutritional advice (clinical nutritionist), spiritual support (for religious individuals and in the case of religious delusions being present), social support (social worker), cognitive therapy, art and work therapy.

Schizophrenia: Etiology and Course

Annual Review of Psychology, 2004

Decades of research on schizophrenia have not produced major breakthroughs, but gradual progress has been made in identifying risk factors and clarifying the nature of the etiologic process. This article provides an overview of trends in research findings as well as current assumptions about the interplay between environmental and genetic factors in the etiology of schizophrenia. Based on the cumulative findings, it appears that both genetic and prenatal factors can give rise to constitutional vulnerability. Subsequent neuromaturational processes, especially those that occur during adolescence, and exposure to stressful events can trigger the behavioral expression of this vulnerability.

Schizophrenia, “Just the Facts” What we know in 2008. 2. Epidemiology and etiology

Schizophrenia Research, 2008

Although we have studied schizophrenia as a major disease entity over the past century, its causes and pathogenesis remain obscure. In this article, we critically review genetic and other epidemiological findings and discuss the insights they provide into the causes of schizophrenia. The annual incidence of schizophrenia averages 15 per 100,000, the point prevalence averages approximately 4.5 per population of 1000, and the risk of developing the illness over one's lifetime averages 0.7%. Schizophrenia runs in families and there are significant variations in the incidence of schizophrenia, with urbanicity, male gender, and a history of migration being associated with a higher risk for developing the illness. Genetic factors and gene-environment interactions together contribute over 80% of the liability for developing schizophrenia and a number of chromosomal regions and genes have been "linked" to the risk for developing the disease. Despite intensive research and spectacular advances in molecular biology, however, no single gene variation has been consistently associated with a greater likelihood of developing the illness and the precise nature of the genetic contribution remains obscure at this time. Environmental factors linked to a higher likelihood of developing schizophrenia include cannabis use, prenatal infection or malnutrition, perinatal complications, and a history of winter birth; the exact relevance or nature of these contributions is, however, unclear. How various genetic and environmental factors interact to cause schizophrenia and via which precise neurobiological mechanisms they mediate this effect is not understood. Etiological heterogeneity, complex patterns of gene-gene and gene-environment interaction, and inadequately elucidated schizophrenia pathophysiology are among the explanations invoked to explain our inadequate understanding of the etio-pathogenesis of schizophrenia. The ability to question some of our basic assumptions about the etiology and nature of schizophrenia and greater rigor in its study appear critical to improving our understanding about its causation.