Talk:Schizophrenia
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R.D. Laing
The brief discussion on R.D. Laing portrays him inaccurately (regardless of what you think of him or his ideas).
- Are you saying that he doesn't believe that Schizophrenia doesn't exist? -- RM
WikiProject Psychopathology
WikiProject Psychopathology started, please feel free to join. This entry seems to need a bit of work, perhaps this WikiProject might be useful for interested Wikipedians to get their heads together and consider some changes - Vaughan.
rewrite
Hello everyone,
I'm going to try and steadily rewrite parts of this entry, as I think it contains a few factual errors and red herrings. However, I'm keen not to step on anyone's toes, as there's much excellent information here. I'll try and reference the changes I make as I go, and if anyone has any objections, I'll keep an eye on the Talk page so we should be able to thrash them out.
I think I might have to deviate a little from the Wikipedia:WikiProject_Medical_Conditions format. As with all psychiatric diagnosis, the definition is based upon the presentation of signs and symptoms so it is necessary to list them to define the disorder, rather than further down the entry.
-- Vaughan
Changes to the Introduction
I've tried to give a brief summary of the important issues without going into too much detail at this point. The sections below do that quite well, and can be expanded upon where needed later.
The initial description is taken from the Diagnostic and Statistical Manual of Mental Disorders, as it is the most accepted definition of schizophrenia. I've been careful to define it as a label for a diagnosis rather than present it as a cut and dry illness and have mentioned the objections of the antipsychiatry movement and the dimensional approaches below.
People interested in the history of the psychiatric view of schizophrenia may wish to check out Chapters 1 and 2 of Bentall's Madness Explained (ISBN 0713992492) and Turner, T. (1999) Schizophrenia. In G.E. Berrios and R. Porter (eds) A History of Clinical Psychiatry (ISBN 0485242117) (from where the note about T.S. Eliot is from).
Information about the causes, neurodevelopment and medication of schizophrenia are taken from Michael Foster Green's Schizophrenia Revealed (ISBN 0393703347) and David Healey's The Creation of Psychopharmacology (ISBN 0674006194).
I've added Madness Explained and Schizophrenia Revealed to a section at the bottom called 'Recommended Reading' as these are both excellent and accesible books for the non-specialist as well as researchers and clinicians. Please add any other books which take a balanced approach and which you feel readers could benefit from.
I've changed the title of the section 'Famous Schizophrenics' to 'Famous people affected by schizophrenia' to try and not define people by their diagnosis. Have added Vaslav Nijinksy (ballet dancer), Syd Barret (past member of [[Pink Floyd) and Peter Green (from rock group Fleetwood Mac) and James Tilly Matthews.
Let me know if anyone wants references to specific academic papers for any the the points.
Comments, queries, complaints welcome !
- Vaughan
Very good
Very good article, many thanks to all who have contributed to it! -- poco poco 21:07 19 Jul 2003 (UTC)
References
Hello everyone,
I'm going to try and add references to the main body of the text. I'll try doing this by using superscripted numbers (like so1) and adding the reference to the reference list.
I'll try and keep the introduction reference free, and leave that to the sections that go into more detail.
-- Vaughan
Changes to history section plus note on neurocognitive deficits
I've added a note on neurocognitive deficits in schizophrenia and created neurocognitive entry.
History section expanded in light of Evans et al (2003) article (ref 1) and notes on Kraepelin and Bleuler.
-- Vaughan
Changes to diagnosis and presentation (signs and symptoms)
I've merged the Diagnosis and Presentation (signs and symptoms) sections, as the issues are heavily interlinked as with most mental illness.
I've cut some discussion on the types of hallucinations and delusions that might be present as this is general for all psychotic disorders, not just schizophrenia and I think it's adequately covered in the delusion and psychosis entries.
Maybe it's worth moving the 'Categories' section up here as well as it discusses lots of the same issues (the bit on 'sluggish schizophrenia' is great and also highlights the subjectivity in diagnosing mental illness).
-- Vaughan
Changes to Diagnostic Issues and Controversies
I've created this section to discuss the issues surrounding diagnoses of schizophrenia, both in terms of science and politics.
Particularly, added text about concerns about abuse of psychiatry to suppress the Falun Gong movement and form vs content diagnosis.
Moved text about 'one or many schizophrenias' to 'Incidence and Prevalence' section.
-- Vaughan
Changes to Cause section
There wasn't much here before so I've added info on possible causes including genetic evidence, environmental factors and neuropsychology.
-- Vaughan
Hi Vaughan
In the Cause section there should be mentions to research showing the effects that the social environment can have in children`s brain development, with profound consequences for the entire adult life. For example, see the following works:
John Read et al.`s "The Contribution of Early Traumatic Events to Schizophrenia in Some Patients: A Traumagenic Neurodevelopmental Model"; Repetti et al.`s "Risky families: family social environments and the mental and physical health of offspring"; Bruce Perry`s "What childhood neglect can tells us about nature and nurture"; DeVries et al.`s "Social modulation of stress responses";
And i know there is a lot more about these issues, for example, studies about the neurobiology of child abuse, showing that adults that suffered abuse in childhood have an anatomically different brain, because of this. Since there are also animals models for this phenomena (i mean the social environment influencing brain development), like Devries`et al.`s research, and many others, there are good reasons to believe in this studies.
Why would children`s brain be insensitive or invulnerable to our social environment, especially considering that cientists like Dunbar say that the main reason for humans to have evolved big brains is just for dealing with conspecifics, and not for controlling the physical (or nonsocial) environment ? (This is the "Machiavellian Hypothesis"...)
Alberto
- Hi Alberto,
- I think John Read's work (for example) is excellent and highlights an important area in schizophrenia research that has been neglected in the past. However, I think it's important that the article does not over-emphasise certain areas of research that are not widely cited.
- Personally, I would like to see such research more widely known and cited, but I'm not sure Wikipedia is the correct place to promote this aim.
- I'm a bit concerned that individual studies should not be given more prominence in the article than they are given in the academic and scientific literature. For example, the article already cites reviews (see ref 7) that include the recently added NAS-NRC veterans study.
- - Vaughan 10:00, 30 Mar 2005 (UTC)
Changes to Treatment section
Moved the section above Prognosis, and rejigged to reflect current treatment methods.
-- Vaughan
I thought the atypicals only reduced the incidence of EPSE and not the NMS. NMS is already rare to begin with ... and still occurs with the newer drugs. Alex.tan 18:38 26 Jul 2003 (UTC)
- Will check up on this and I'll post results here. Thanks Alex. - Vaughan 09:37 27 Jul 2003 (UTC)
- After a brief lit search it seems the relatives risks of typical (older) and atypical (newer) antipsychotic medication is still a bit unclear. e.g.: "Although the newer, atypical antipsychotics have also been associated with NMS in published case reports, the relative risk of NMS with these new drugs compared to the typical antipsychotics remains uncertain" from here (http://www.nmsis.org/general_information.shtml).
- Article text changed to:
- "The newer atypical antipsychotic medication (such as olanzapine, risperidone and clozapine) is preferred over older typical antipsychotic medication (such as chlorpromazine and haloperidol), as the atypicals have fewer side effects, such the development of extrapyramidal side-effects. However, it is still unclear whether newer drugs reduce the chances of developing the rare but potentially life threatening neuroleptic malignant syndrome."
- ...pending further information. Thanks Alex, well spotted ! Vaughan 15:40 28 Jul 2003 (UTC)
Ive speculatively added a chunk on the User-based approaches that have been emerging in recent years with a link to the 'hearing voices movement'. The balance isnt right, and it could probably go under other sections -either alternative approaches or controversies.
Also the Treatment sect looks a little thin. There is a mass of evidence now about the value of psychological treatments -particularily CBT. The B.P.S. (2000), conclude that there is convincing evidence, now,’.... that psychological interventions are effective for many people in reducing psychotic experiences and the distress and disability they cause’. The recent developments in Cognitive Behavioural Psychotherapy (CBT) have been well documented in the literature demonstrating a broad range of clinical benefits across a range of client groups (such as the young, newly diagnosed; people with long-term, drug-resistant problems, through hospital and community settings). Indeed the most recent findings are extremely promising as acknowledged by a recent Cochrane review of the literature. “....a variety of CBT methods are associated with substantially reduced risk of relapse” CBT provides a range of interventions that can enable people who hear voices to empower themselves. Can anyone update?
- Hi there,
- The material you added is valuable and should certainly have a place in wikipedia, although I think it perhaps deserves an article of its own (perhaps Hearing Voices Network, which can include new philosophies and approaches to voice hearing outlined in Accepting Voices - ISBN 1874690138). It might be worth summarising the material you added in a sentence or two, and then linking to a fuller article on the HVN with much of the new material. I'll aim to do this in the next couple of weeks if it hasn't been done already. I also agree CBT should be highlighted. Comments, suggestions on this welcome as always - Vaughan 12:20, 14 Oct 2004 (UTC)
- Great, thats perfect. The bit I included has got pulled for copyvio despite being a selection from an original article (and me as the author!). Not too sure why I keep attracting these. But thanks for your responseJinko 13:24, 14 Oct 2004 (UTC)
- Jinko, I almost pulled the section as a copyvio except I couldn't find it on the internet so I accepted on good faith that it was not. (It was too good and came in one insert so take it as a compliment.) If I had found it on the internet then I would have pulled it. Firstly, great stuff but I tend to agree with Vaughan that it deserves it's own area. The schizophrenia article is too big already. What about putting it in Hallucinations and then leaving a one sentence reference to this in the schizophrenia article. Alternatively, it's own article with references in the relevant articles such as schizophrenia and hallucination. Secondly, it is really worth putting a brief paragraph in the talk page with a new heading to say you have added your own info that you have written when you put in a big chunk like this. That way any copy editor can check the talk page and see that it is NOT a copyvio. Thirdly, if you put an article in with references, please also put in the references in the same format as the rest of the article. "Baker (2000) in OpenMind ..." does not really allow the reader to access what Baker said in full. All picky points but the bottom line is, thanks for the great contribution. --CloudSurfer 18:58, 14 Oct 2004 (UTC)
- Yes Understood -all the points you make -make sense. Lots to learn aboutfor me here. The work is from articles I have published so a bit sad you didnt find on the internet! I will try and follow these directions when I have a little time. If any one else wants to help or have a go, please do! Jinko 23:27, 14 Oct 2004 (UTC)
Changes to Prevalence and Incidence section
Added info from recent studies.
-- Vaughan
Changes to Prognosis section
Referenced 'thirds' recovery figure and added information about suicide risk . -- Vaughan
I thought the prognosis was more on the order of 1/5 have full recovery, a bit less than 1/5 have very poor prognosis and most people are somewhere in between ... Alex.tan 18:35 26 Jul 2003 (UTC)
Misc Changes
I brought back an incorrectly deleted reference which was not cited inline using superscripts but was nonetheless (in the style of an encyclopedia) correctly referencing a source. In addition some of the information that was pruned from that source was deleted. I merged it back into the article. I am not sure why it was removed.
-- Ram-Man 00:27 23 Jul 2003 (UTC)
Minor changes and discussion
Hi Mandark,
I've moved the new information on genetic linkage out of the summary to keep it lay-person friendly. It's now in the 'Causes' section.
I'd like to tone down the sentence "overwhelming evidence (including causative gene findings) argue for a genetic cause modified by enviromental stressors in the etiopathogenesis of schizophrenia" as its impossible to seperate genetic and environmental influences in a cause of a disorder.
My version would be:
- While the reliability of the schizophrenia diagnosis introduces difficulties in measuring the relative effect of genes and environment (for example, symptoms overlap to some extent with severe bipolar disorder or major depression), there is evidence to suggest that genetic vulnerability modified by enviromental stressors can act in combination to cause schizophrenia.
Great information on the COMT linkage (good ref here (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12402217&dopt=Abstract)) but perhaps a little selective ? A recent review paper (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12573388&dopt=Abstract) (I've uploaded the full version here (http://bak.spc.org/tha/Harrison_Owen_2003.pdf) for those that are interested) identified 7 gene candidates. Certainly COMT seems the only gene with a obvious functional linkage in terms of dopamine function, but perhaps it is either worth discussing this or briefly mentioning the other candidates. Also, I would argue over-emotional mothers do seem to be an environmental influence on schizophrenia (see ref 8) but perhaps it is worth mentioning that it is not mothers in particular but any people with high levels of 'expressed emotion'. Would you mind if I rejigged it a little in light of this ?
Please reply if you think otherwise or would rather do your own rejigging !
-- Vaughan
- FWIW, I think your rewording sounds better. -- Ram-Man 22:56 24 Jul 2003 (UTC)
Changes to 'Alternative Approaches' section
Rewrote part of it because of distortion of message (i.e.. 'anti-psychiatry says schizophrenia doesn't exist'). Added Tim Crow theory. Moved info about higher rates of schizophrenia minority communities to causes section.
Vaughan 11:12 25 Jul 2003 (UTC)
Changes to 'Causes' section
Reworded new info on genetics for flow and to take the academic edge off it. Added ref to COMT study. Took out sentence which mention family stress and drugs / alcohol as it's handled by existing sections.
Vaughan 16:05 25 Jul 2003 (UTC)
Genetic causation
Recent edits related to genetic causation in schizophrenia are weak and might stem from a failure to keep current with the literature. There is NO debate regarding the heritability of schizophrenia and the hesitancy to clearly state this reminds one of past unwillingness of the psychiatric community to view mental illnesses as biological in origin. What purpose does it serve the lay reader to suggest that this issue is under debate? As for specifics of COMT, there have been no other papers to demonstrate a functional link between any gene and this illness. This is not a selective discussion, but simply a paucity (at the time of this writing) of findings. There will be published reports on at least two other genes in the upcoming year (dysbindin and disc-1) to add to the list.
Mandark 14:53 14 Aug 2003 (UTC)
- Hi Mandark, From looking at the text as it is, I don't think it leaves any doubt that inheritance plays an important role in the development of schizophrenia. It is the amount of hereditory influence in general, and role of specific genes in particular, which seem to be the subject of debate among researchers.
- I'm not sure what you mean about 'no debate' but recent exchanges in The Lancet (http://www.thelancet.com) after Harrison and Owen's recent review of 'Genes for Schizophrenia' (http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12573388&dopt=Abstract) seemed to show quite a strident debate, with Tim Crow (http://www.psychiatry.ox.ac.uk/powic/staff%20webpages/timcrow.htm) going as far as to say that there is "little firm evidence of genetic linkage to psychosis" (I've put the whole exchange here (http://bak.spc.org/tha/KarayiorgouGogosCrow2003.pdf) and here (http://bak.spc.org/tha/HarrisonOwenReply2003.pdf) for those without access to The Lancet). Whilst you may not agree with him (and few people do) I think it's important to communicate that there is an ongoing debate to be make the article fully NPOV.
- On a related note I was interested to read a recent paper (http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12908672&dopt=Abstract) again suggesting that epigenetic factors may be important, but I'm not a geneticist (although I try and keep up with the literature as best I can). Could you (or anyone else) comment on how important this is and whether it's worth a mention in the article ?
- Also, I notice we got listed on the Wikipedia:Brilliant_prose_candidates page. Excellent work all round I think, although I'm sure as Mandark mentions, there's probably still work to be done !
- Vaughan 07:44, 15 Aug 2003 (UTC)
- Hi Vaughn
Pretty weak retort. Tim Crow is a famous for biased and selective reviews the literature and never provides data of this own or of others to back up his point (as in the Lancet exchange you cite). Funny, I'm not surprised you see his response as support for your points. Please see American Journal of Human Genetics Sept. 2003 for a series of meta-analyses that answer Dr. Crow's suggestion that heritability is not high. As for epigenetics, in our lab we too feel this is important and are investigating alternate splicing, methylation, etc. But, until more is known about the transmission of these modifications, much will remain conjectural. I have re-read the schizophrenia section and notice a number of "controversies" that are no longer seriously considered valid, yet are of historic importance and appear to be cited (as you have done with Tim Crow) with little critical evaluation, but rather in deference to the notoriety of the author(s). I guess this does liven things up and interested readers are provided with numerous links to outside reading.
- Mandark 14:00, 25 Sept 2003 (UTC)
- Hi Mandark,
- I don't cite Crow's suggestion as support for any point except that there is a debate about the role of genetic factors in schizophrenia (and mental illness in general). As it happens both you and I are of the same opinion that genetic factors are important in schizophrenia, but this is not a universally held view. For example, the recent book The Gene Illusion by Jay Joseph (ISBN 1898059470) is extremely critical of genetic research in psychiatry and this is not an isolated example. Hence I think both sides of the debate should be reflected in the article to be fully NPOV, rather than purely our (or anyone else's) opinions on the matter, no matter how well supported we feel them to be.
- I'd be interested to hear which controversies you no longer feel are valid, as I'm keen to keep the article up-to-date. However, I have tried to draw most points from ongoing debates I encounter from current books, articles and conference so a few pointers would be handy. Thanks - Vaughan 17:24, 26 Sep 2003 (UTC)
- Hello Everyone,
Nobody can say the debate about the genetics of mental ilnesses and schizophrenia is over. For example, Jay Joseph`s works show clearly it is not over. Also of importance is the article "Psychiatric hospitalization in twins", which analysed more than 16 thousand pairs of twins, from the finnish cohort, showed that monozygotic twins have only 11.0 % concordance in schizophrenia diagnoses; if schizophrenia were of genetic origin, how could it be explained that monozygotics are discordant in 89% of the cases ? Or Horwitz et al.`s article "Rethinking twins and environments: possible social sources for assumed genetic influences in twin research", in which it is shown that monozygotic twins have higher concordance rates than dizygotics because they share the same environment to a greater extent. Or, altenatively, Jay Joseph`s article "Potential confounds in psychiatric genetic research: the case of pellagra" showing that a twin study about pellagra (or even lepra perhaps), had it been performed, would show monozygotic twins having higher concordance rates than dizygotics, for the same reasons. And what about the articles trying to confirm the genetic patterns of mental illnesses, supposedly found in different loci, in previous researchs, which do not replicate the expected results, or even give the opposite results ? For me it seems that Wikipedia`s articles about psychiatric issues are being dominated by biopsychiatry`s advocates, and because of this "The Free Encyclopedia" is spreading false informations for lay people. It makes me feel sad: systematic lies about schizophrenia are being spread in Wikipedia.
Alberto 20:53, 12 March 2005 (Brasilia City Time)
- Hi there Alberto,
- I agree that the current article does not seem to represent the debate adequately, so have edited it a little to hopefully better represent the ongoing controversy.
- - Vaughan 12:00, 13 Mar 2005 (UTC)
Saying "Famous people afflicted with schizophrenia" is POV. --Daniel C. Boyer 21:38, 18 Dec 2003 (UTC)
- Actually says "Famous people affected by schizophrenia" - Vaughan 12:12, 21 Dec 2003 (UTC)
Symptom prevalence
Removed the following. Useful information, but I think 1973 is a little out of date for a survery of symptoms. Any chance of finding a more up-to-date report on this ?
- The World Health Organization in 1973 characterized these symptoms as most common in schizophrenia:
- 97% Lack of insight
- 74 Auditory hallucinations
- 70 Ideas of reference
- 66 Suspiciousness
- 66 Flatness of affect
- 65 Voices speaking to the patient
- 64 Delusional mood
- 64 Delusions of persecution
- 52 Thought alienation
- 50 Thoughts spoken aloud
- Vaughan 23:02, 8 Jan 2004 (UTC)
I couldn't find anything analogous to the list above but the 2001 WHO report on mental illness might provide some starting points. This seemed the most useful chapter. Mazzy 17:38, 14 Jul 2004 (UTC)
http://www.who.int/whr2001/2001/main/en/chapter2/index.htm
I can't see any reason to delete this useful list just because it is 30 years old. With the same justification you could ignore Schneider. Until there is a more up to date reference why not keep it in? Are you really suggesting that schizophrenia has changed so much in the last 30 years that this is no longer valid? I doubt it.
- Hi there
- I would argue that an out-of-date list is not worth including as symptom prevalence may be affected by factors such as, population demographics, social environment and diagnostic standards, all of which have changed to varying degrees since 1973. For example, delusions have been found to vary with country (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10494061), gender and social class (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14504453), culture (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12182508) and exposure to urban environment (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15056569) and in the same vein, diagnostic standards are being increasingly challenged (e.g. recent Appelbaum study (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15332193)).
- Schneiderian first rank symptoms are still relevant because they are still used as diagnostic criteria (see Sims, 2004 - ISBN 0702026271), although the article mentions problems as to their reliability, so they are not presented without criticism. - Vaughan 09:31, 8 Sep 2004 (UTC)
- I agree with your reasons but perhaps a compromise until better data were available would be to reinsert the list with these caveats. As a psychiatrist I very much appreciate your reasons but I do feel that the many non psychiatrists who read this article would better understand schizophrenia with this list reinstated. By the way, apologies as a newbie for not signing my initial comment. CloudSurfer 09:39, 9 Sep 2004 (UTC)
- Hi CloudSurfer
- Fair point, but perhaps we can look for some more up-to-date information. This article (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3493497) supposedly has WHO symptom prevalence data from 1986. I have not read the article in full yet, but I shall do so and keep looking for more recent information. If you come up a pointer to anything more recent please post it here. If none of our leads look useful after a brief investigation (perhaps we can give it a week or two), I think we have a good case for including the 1973 data. - Vaughan 10:10, 9 Sep 2004 (UTC)
This is my first time posting to a Wikipedia section, so bear with me with any mistakes I may have made while adding this post. :) Okay what I have to say is: Why isn't there any mention of "Memoirs of My Nervous Illness" by Daniel Paul Schreber? I would think this would be recommended reading! Thanks for reading this feedback note.
Sincerely,
The Puzzle Fish Who Is A Real Fish! But At The Same Time A Snack Good For Parties.
- I think that Schreber needs an article of his own really, as he's a pivotal psychiatric case, especially since James Tilly Matthews is already written up. Definitely one for the 'to do' list. I'll see if I can make a start shortly, then perhaps we can link it in with the schizophrenia page. - Vaughan 21:20, 16 Feb 2004 (UTC)
Schizophrenia vs. D.I.D
Shouldn't there be a paragraph explaining the common misconception that Schizophrenia is Multiple Personality Disorder (aka Dissociative Identity Disorder)? I can't count the number of times I've heard people confuse the 2.
- Although a quick review of this paragraph suggests that it needs a bit of work for clarity. To be completed shortly. - Vaughan 17:15, 14 Jul 2004 (UTC)
Removed image
Hi there,
I've removed the image 'SchizophreniaBrain.jpg' from the schizophrenia page, as it's from a copyrighted source, as far as I know. Unfortunately, it comes from the following article:
- Paul M. Thompson, Christine Vidal, Jay N. Giedd, Peter Gochman, Jonathan Blumenthal, Robert Nicolson, Arthur W. Toga, and Judith L. Rapoport. (2001) From the Cover: Mapping adolescent brain change reveals dynamic wave of accelerated gray matter loss in very early-onset schizophrenia. Proceedings of the National Academy of Sciences, 98, 11650-11655.
See this link (http://www.pnas.org/cgi/content/abstract/98/20/11650?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=schizophrenia+grey+matter&searchid=1089980953483_2197&stored_search=&FIRSTINDEX=0) for online version.
- Vaughan 12:33, 16 Jul 2004 (UTC)
Image ideas
Barring good (meaningful) images of schizophrenic brains, what other images could this article utilize? A common example in psychology books is the degeneration of Louis Wain's artwork in the 1930s (link (http://www.schizophrenia.org/cat.jpg)) as he apparently suffered from schizophrenia and some think it was responsible for his shift away from realism (some don't think it had much to do with it, though). It's from the 1930s at the very latest which, I think, makes it copyright a-ok, but I don't know. Other ideas? This topic is lacking in visual stimulation, so to speak... --Fastfission 17:13, 16 Jul 2004 (UTC)
Gene Ray
With reference to Gene Ray been listed in the 'Famous people affected by...' section, he mentions he has been diagnosed with schizophrenia on his webpage timecube.com. Someone kindly pointed this out to me on my talk page, so I thought I better reiterate it here. - Vaughan 12:41, 11 Oct 2004 (UTC)
Recommended reading
I've removed a couple of books from the recommended reading list. They're both excellent books but very academic, and perphaps not suitable for the general reader as the others are.
Anyway, they're listed here so as to not remove them entirely as they're certainly worth tackling if you're interested in the neuropsychology of schizophrenia and psychosis:
- Green, K. J. (1998). Schizophrenia from a Neurocognitive Perspective. Boston, Ally and Bacon
- David, A. S., et. al. Eds. (1997). The Neuropsychology of Schizophrenia. Brain Damage, behaviour, and cognition Series. East Sussex, UK, Psychology Press.
Objects, comments etc welcome. - Vaughan 15:42, 27 Oct 2004 (UTC)
Congratulations
Congratulations are in order for anyone who has worked on this article - it's fantastic! zaius 15:19, 14 Feb 2005 (UTC)
Recommended reading
The books below were added to the recommended reading section of the article. They have all been influential books, but are very much in the anti-psychiatry / critical psychiatry camp, certainly, Breggin's work has received a great deal of criticism from mainstream psychiatry, so I'm concerned that they do not provide a NPOV in this section.
The books which were originally chosen for the recommended reading section were for their reasonably balanced approach to schizophrenia (although Green would be more inclined towards the mainstream view, and Bentall towards a critical approach) and have been well received by the research and clinical community.
Perhaps books for this section are best suggested here and voted on or something similar ? Otherwise, endless lists of books arguing for a certain political angle on schizophrenia (or as with the books below, psychiatry in general - which should really be in the psychaitry article) can be added.
Books recently added:
- Louis Sass (1994) "Madness and Modernism", ISBN 0674541375, argues that schizophrenia has some 'super-normal' aspects and is not necessarily always degenerative.
- Jay Joseph (2004) "The Gene Illusion: Genetic Research In Psychiatry And Psychology Under The Microscope", ISBN 0875863434. The most cited genetic studies about schizophrenia have gross methodological flaws.
- Robert Whitaker (2002) "Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill", ISBN 0738203858. The World Health Organization showed that people labeled schizophrenic fare much better in poor countries (like India, Columbia and Nigeria) than in developed countries (like USA and 8 others); Whitaker argues that it occurs because neuroleptic drugs, being toxic and without healing power, worsen long-term outcomes in rich countries`patients. This book also reports of unethical experiments being conducted nowadays in the USA, with schizophrenic patients.
- Peter Breggin (1994) "Toxic Psychiatry : Why Therapy, Empathy and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the "New Psychiatry"", ISBN 0312113668, criticizes mainstream psychiatry and shows psychiatric drugs do not have healing power and may even cause irreversible neurological diseases.
Hey You Wikipedia "Sheriff",
Jay Joseph`s book is a science-based and statistic-based critic; it should be included, in order to allow lay people to exert their right to know some facts, and think by themselves; he criticizes genetic psychiatric studies not with ideology or political views, but with strong facts and arguments.
Robert Whitaker`s book is not above criticism, because his way of interpreting the results is debatable, but he has done an excelent synthesis of World Health Organization`s long-term follow-up cross-cultural studies about schizophrenia in different countries; he deserves a place among the critics of (bio)psychiatry.
Peter Breggin`s book warns against psychiatric drugs, because they do not have healing power, they only block symptoms, and they will create irreversible neurological diseases like tardive akathisia and tardive dyskinesia, in a high percentage of patients, if taken for prolonged time. His theory of chronic powerlessness as a cause of psychosis is also interesting, and deserves consideration.
Please Wikipedia "Sheriff", give lay people a chance of knowing about these books.
Alberto, from Brazil
- Hi Alberto,
- I am not a "sheriff" but someone who has a good (professional) working knowledge of the area, so often move recently added section to the talk page for discussion, particularly when they are known as controversial. Certainly, Joseph's book has been influential, but it is not without its critics.
- However, it's worth noting that none of the books listed above (including Joseph's) are specifically on schizophrenia, so I think they might be better placed in psychiatry, as they address more general issues to do with mental illness and mental health.
- - Vaughan 09:10, 15 Mar 2005 (UTC)
Hi Vaughan,
OK, now i understood it is Wikipedia`s practice to debate new stuff before add it to the articles. I agree with you these books address more general issues, so they should be placed in a section about broader issues. But i think this stuff has to be mentioned somewhere in Wikipedia.
Another issue: I would like to know your opinion about the phenomena of children`s neurodevelopment being influenced by the social environment (and also by the physical environment; i mean, for example, by pollutants); and i would like to see that stuff be discussed and added somewhere in Wikipedia, in a more general section. Please read my comment in "Changes to Cause section" about this.
Thank you,
Alberto
Hi Vaughan,
I added Jay Joseph`s book again, because it is hard to find any defense of biological psychiatry that does not mention genetic studies, like twin studies about schizophrenia, and his book contains one of the most devastating criticism of these. As far as i know, the other kinds of genetic studies, like linkage studies, that have supposedly found proofs of the genetic patterns of mental illnesses were never replicated, so they are only speculative, not scientific, therefore they shouldn`t be mentioned in the article.
Alberto
- Hi Alberto,
- I won't remove the book, but I am concerned about its place in the recommended reading list, as it is not specific to schizophrenia (rather to psychiatry in general), and when it does address schizophrenia, it specifically addresses genetic studies rather than the condition as a whole.
- The recommended reading section is intended for books that give a general and comprehensive introduction to schizophrenia.
- While Joseph's book undoubtedly contains some important criticisms for the genetic work in this field, I'm not sure we should be directing people to such specific issues, when they would be better as references in appropriate places in the text (which Joseph's book already is).
- Vaughan 09:16, 30 Mar 2005 (UTC)
- Hi Alberto,
- A further quick thought... Maybe a compromise might be to list Read et al's book Models of Madness: Psychological, Social and Biological Approaches to Schizophrenia (ISBN 1583919066) in the recommended reading list, rather than Joseph's The Gene Illusion.
- Models of Madness is a critical book (and could be noted as such) and covers a whole range of areas in schizophrenia (not just genetics) but also contains a chapter by Joseph summarising his work and his main arguments from The Gene Illusion.
- Other chapters include work by Read on the impact of social factors and trauma on schizophrenia, and critiques of strictly neurobiological theories of the condition.
- - Vaughan 10:08, 30 Mar 2005 (UTC)
- I've replaced the reference to Jay Joseph's book with a reference to Methods of Madness in the recommended reading section. The chapter by Joseph in this book is called 'Schizophrenia and heredity: Why the emperor has no genes', so gives a good review of this important area of critical analysis, whilst the book also has many other chapters on all aspects of schizophrenia.
- Please let me know if anyone has any objections.
- - Vaughan
Hi Vaughan,
OK, no objections, i did not know about the book "Models of Madness". It`s better not to give excessive amounts of information to the readers. Sometimes more information means less learning, and vice-versa.
Alberto
Shamanism updates
- It has also been suggested that the widespread cross-cultural presence of shamanic traditions in ancient cultures may reflect an evolutionary advantage of such altered states in guiding the shaman's tribe via some form of ESP. To the degree that schizophrenia is correlated with shamanism, then schizophrenia may have been selected out for its supra-normal aspects.
Seems a little speculative to me, although I'd be happy to see some research cited to back up the points.
- Vaughan 20:46, 27 Feb 2005 (UTC)
Sounds like twaddle to me, unfortunately, written by someone who has never met a schizophrenic. -- The Anome 23:29, Mar 12, 2005 (UTC)
Introduction needs expansion
Now that it has a satisfactory picture, I'd like to put this article on the main page. However, the introduction is totally insuffecient and needs expansion. →Raul654 02:02, Mar 31, 2005 (UTC)
Criminality issue was not addressed
Added paragraph on ciminality. It is a very acute problem. I cannot understand how people (like ladies riding alone) can still trust mad-looking aliens and give then a hitchike, then end up murdered. This typicial madman faced scum of the earth gutted seven women at least, shall he get gassed for good: http://www.cnn.com/2005/LAW/03/31/interstate.slaying/index.html
Medication skipping schizos murder people everywhere
Medication abandoning known schizo man shots girl for refusing to kiss him. http://www.cnn.com/2005/US/04/02/killed.for.kiss.ap/index.html
Why the fuck these assholes are still not radio tagged with blood sensor, so police will known when they abandon medication and then they are immediately arrested to prison hospital for forced treatment? How many more innocent healthy humans will have to fall because these genetic junk want to indulge in their sick minds? How the fuck can a schizo own a firearm? Now this piece of junk will claim insanity in court and get away with murder. He is responsible for abandoning medication and he should pay for that!
The article is totally partisan without mention of the schizo-crime issue! I demand even representation of facts!
Added reworked material on schizo and crime
I add below material on schizo and crime. If this is removed or edited destructively, I will contract wiki top admins and tell cnn and generally make a scandal. The previous article was totally partisan without any mention of crime issue. Note, I don't mention lesser crimes, because they are irrevelant. Homicide is the only category of crime that cannot be undone by any means. I find it offensive that liberal-enacted censorship tries to muzzle those who say schizos are in fact dangerous and they must be forced to take medication, because untreated they are a danger to society. Of course the deceased, whom the schizos stabbed or choked cannot come here to complain. Responsible people have to stand up and tell the public about the dangers.
Regards, Tamas Feher <etomcat@freemail.hu>
- Hi Tamas,
- I have reverted the recent inclusion of the text below. Please cite reliable sources for these figures, as the article is based on peer reviewed research. I have not been able to find any that back up the points you make, so if you have references for it, please provide them.
- The most recent reviews of the research on schizophrenia and homocide suggests that a sub-group of people diagnosed with schizophrenia have a two fold risk of homocide (Schanda et al., 2004 (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15233710)) (a very minor absolute increase in risk) and are more likely to be victims of violence than perpetrators (Barkataki et al., 2005 (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15701066)). In other words, society is more a threat to them, than they are to society.
- Furthermore, threatening to "contract (sic) wiki top admins and tell cnn and generally make a scandal" really doesn't help your case. I agree the issue of risk and schizophrenia should be discussed in the article, but threating to cause trouble if your (currently unsupported) points are not included is hardly the way to go about it.
- - Vaughan 15:35, 3 Apr 2005 (UTC)
- I noticed the 'crime' section (now renamed to 'Schizophrenia and violence') had been re-inserted. I've rewritten it to reflect the research findings in this area, rather than the wild speculations and anecdotal evidence that keeps getting included.
- - Vaughan 11:23, 4 Apr 2005 (UTC)
Crime and schizophrenia
Some schizophrenic people do commit serious violent acts, including murder and suicide. According to criminal records, 80% of all serial killers apprehanded had a mental condition and half of those were diagnosed with schizophrenia. The risk of violent crime is increased when schizophrenic people abandon their prescribed medication. Contrary to great advances made by the psychotropic pharmaceutical research since the 1950s, relatively few countries have enacted legislation to this day to require that schizophrenic patients adhere their prescribed medication protocol, even though the benefits greatly outweight the few side effects caused by modern pills.
Homicide committed by any schizophrenic patient usually attracts widespread media attention, in no small part because in many legal systems murderers can evade death penalty or inprisonment, provided they are found insane. It is generally perceived that many violent schizophrenic criminals are released from custody after relatively brief treatment at mental facility, receive little supervision thereafter and the authorities fail to take responsibility if he/she perpetrates another violent crime. Mass media, including the film industry often presents the diagnosis of schizophrenia as a state-issued licence to kill. There is an abundance of "psychopatic serial killer" themed thriller movies.
Schizo and violence: split minds are 9x likely to kill
You said: 8.7-8.9% percent of murderers are schizos in Sweden and ANZAC => you show schizos are 9x more likely to kill because only 1 out of 100 people are schizos on average.
Also Sweden and NZ are countries with low crime rate in world comparison, they are bad examples. They also don't have those notorious serial killers fond elsewhere.
So I added info and statements with links to back them up.
On a related note, two days ago a 24-year old twice-convicted rapist and hostage taker schizo beat to death a 14 year old schoolgirl and threw her into a lavatory pit to die, in Hungary. There is huge public uproar.
- Hello there
- Please read the actual research rather than just making figures up off the top of your head.
- You said: 8.7-8.9% percent of murderers are schizos in Sweden and ANZAC => you show schizos are 9x more likely to kill because only 1 out of 100 people are schizos on average.
- This does not even make mathematical sense let alone having any relevance to the actual findings.
- BTW, the 1 in 100 figure is not accurate (as is mentioned and referenced in the article). The 1 in 10 suicide rate is accurate however, and has been mentioned elsewhere in the article.
- Please read the article and the relevant research properly.
- - Vaughan 10:26, 6 Apr 2005 (UTC)
Hello everyone,
This section seems unfair to me: if the article is to debate schizophrenia & harm & self-harm, i demand a consideration of the issues:
- - Iatrogenic factors: neuroleptic drug-induced akathisia (neurological disease, often permanent, characterized by extreme unpleasant feelings, caused by the drugs, not by the mental condition), and withdrawal-induced psychosis (overcompensation mechanisms of the brain leading to an increase in psychiatric symptoms during drug withdrawal after prolonged drug use).
- - Biographical factors: psychiatric patients in general, and schizophrenics included, were shown to have suffered child abuse and chronic humiliation much more often than non-patients.
Unfortunately, it is true that people labeled schizophrenic perform harm (for example homicides) and self-harm (for example suicide) more often than non-psychiatric patients, but if this is to be shown in Wikipedia, it is necessary to also show some possible explanations, like these 2 i mentioned.
Otherwise, this public encyclopedia will be sensationalist and misinform the readers. Mainstream media already does this disservice, so this article has to be careful.
Alberto
About Neurosciences and Schizophrenia and Mental Disorders in General
Dear Sirs of Wikipedia,
I protest against the section about Neurobiological Influences of the article about Schizophrenia, because it grossly underestimates how much social environment can influence children`s neurodevelopmental processes, in some cases leading to consequences throughout the whole lifespan. I have some articles about this in my computer, but most of them are not specific about schizophrenia, they are about broader psychiatric issues, like stress reactivity, social dominance, anxiety, and depression, and even functional gastrointestinal disorders. Some of the best of them are animal models showing the early social environment (events and features) clearly influencing neural circuits, sometimes for the entire lifetime. Therefore, showing that people labeled schizophrenic or psychotic have differences in brain functioning&anatomy do not prove this is the ultimate cause of the very inadequate (sometimes criminal) behavior. I demand the section Neurobiological Influences in the Schizophrenia article to be rewritten. I can provide the papers with complete references and even links. But most of them are not specifically about schizophrenia or psychosis. How could children`s brain neurodevelopment be insensitive to the social environment ? It is absurd to think it could be insensitive. If even the bowels are sensitive to the social environment, why wouldn`t the human children`s brain be a "socially sensitive" organ ? I also have some papers showing psychotherapy can influence the brain, and the social environment can influence even genetic expression, through messenger RiboNucleicAcid (mRNA).
Thank you,
Alberto
- Hi Alberto,
- Everything we experience changes the brain in some way, but the neurobiology section is intended to discuss neurobiological mechanisms of influence and studies using the neurobiological paradigm. Environmental influences are discussed in the previous section at some length, so I don't think there is a need to muddy the waters by putting evidence for their effect in the neurobiology section as well.
- - Vaughan
Hi Vaughan,
I really think the issues of environment and neurobiology are connected; for example, social events (like negative social events in childhood, or psychotherapy in adulthood) can change brain activation patterns, which, by its turn, if sustained for long enough (especially during childhood, when neuroplasticity is very high), could change even brain anatomy. This way environment can be linked to a different neurobiological paradigm, in which brain phenomena are proximate causes, but not ultimate causes, in a "causal chain" which generates schizophrenic behaviours.
Thank you for your attention,
Alberto
- Hi Alberto,
- I entirely agree. Your addition to this section is excellent, and I have just edited it to make it a little more clear. I think it's important to separate the research evidence into sections that make the article easier to read and point out the different approaches to understanding schizophrenia, but your addition definitely added a 'missing link' in the neurobiology section.
- - Vaughan 08:08, 12 Apr 2005 (UTC)
Hi Vaughan,
I added 3 new articles with links, about schizophrenia and child abuse, and removed 1 previous article, because it was not very specific about the issue. But these 3 are now cited only in the section "Schizophrenia and Violence", and i think they should be cited also in other sections like that about cause of scz. Correlation does not necessarily imply causation, but in this case it does.
Thank you for your attention,
Alberto
- Hi Alberto,
- Thanks for the additions. I've replaced the reference you took out, as this was relevant to the issue of both violence and schizophrenia. The role of abuse in the development in schizophrenia is mentioned in the 'Neurobiological influences' section, but I agree it should be highlighted elsewhere, so I've added a bit to the 'Genetic and environmental influences' section as well.
- Also, I've just reformatted the references a little. As a future note, if you can link to the PubMed entries in preference to the online journal it would be useful. The PubMed entries remain static, and often have links to the articles when they become publicly available.
- Thanks - Vaughan 10:39, 5 Jun 2005 (UTC)
Hi Vaughan,
I added 1 more reference about child abuse and schizophrenia, authored by READ and ARGYLE, please don`t delete because it shows correlations among different kinds of child abuse, and "positive" symptoms, including command hallucinations and paranoid ideation, which are also involved in cases of violence and suicide. It has a link for PubMed with free full text.
In my opinion you should change the link of reference about the "Traumagenic Neurodevelopmental Model", because PubMed does not give access to full text, but CHILD TRAUMA ORGANIZATION web site does: www.childtrauma.org/CTAMATERIALS/Psychiatry_02.pdf
Alberto
- Hi Alberto,
- Thanks for the full text link. I've kept the PubMed link there, as that will always remain the same, whereas a full text link might change. However, like with some other psychopathology articles on Wikipedia, I've added a 'full text' link after the reference.
- I think perhaps we might need to cut down the amount of child abuse references we have, as there are now five about the same thing. Perhaps we can select two or three at most that give a good review of the area and provide the best evidence for the link, as has been done with the rest of the article. It's always possible to add more references to back up any point, but for the sake of brevity I think it's best to choose the ones that give the reader 'best value' for their reading time.
- Certainly the Janssen study (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14674957&query_hl=3) is considered one of the best (see John Read's recent letter (http://bjp.rcpsych.org/cgi/content/full/186/1/76) to the British Journal of Psychiatry - also see this letter for a debate on whether the link is between a diagnosis of schizophrenia or non-specific psychotic symptoms) - and Read's most recent view of this area is this:
- Read, J., Goodman, L., Morrison, A., et al (2004) Childhood trauma, loss and stress. In Models of Madness: Psychological, Social and Biological Approaches to Schizophrenia (eds J. Read, L. Mosher & R. Bentall), pp. 223 -252. Hove: Brunner-Routledge.
- Perhaps the Janssen study and the most recent review article might provide good evidence and a good general overview of the area ? Also, both of these review the other studies currently referenced.
- - Vaughan 19:27, 5 Jun 2005 (UTC)
Hi Vaughan,
Sorry, i took so long to answer your question. I think Schenkel et al.`s article has to be included, because it has very good very recent literature review, and full-text available. Read et al.`s article about the "Traumagenic Neurodevelopmental Model" also should remain included, because it is about how social environment can cause biological changes relevant to the issue of Scz. Harrier L Macmillan et al.`s NOTE 46 could be removed, because it is not specific to Scz. I would like to keep reference to Read & Argyle`s article, because i think it is very good and has full text available.
Alberto
Created pages
68.169.113.246 I have created stub articles for the following psychiatrists:
I have also just created stubs on the following people:
Pleas help by adding more content to these pages. Thanks.
17:00, 2 Jun 2005 (UTC)