Beyond the brain: changing ideas on schizophrenia

[HiPointDem]

The 1980s saw a revolution in psychiatric science, and it brought enormous excitement about what the new biomedical approach to serious psychiatric illness could offer to patients like Susan. To signal how much psychiatry had changed since its tweedy psychoanalytic days, the National Institute of Mental Health designated the 1990s as the “decade of the brain.” Psychoanalysis and even psychotherapy were said to be on their way out. Psychiatry would focus on real disease, and psychiatric researchers would pinpoint the biochemical causes of illness and neatly design drugs to target them. Schizophrenia became a poster child for the new approach, for it was the illness the psychoanalysis of the previous era had most spectacularly failed to cure....

The first reason the tide turned is that the newer, targeted medications did not work very well. It is true that about a third of those who take antipsychotics improve markedly. But the side effects of antipsychotics are not very pleasant... The second reason the tide turned against the simple biomedical model is that the search for a genetic explanation fell apart...

The third reason for the pushback against the biomedical approach is that a cadre of psychiatric epidemiologists and anthropologists has made clear that culture really matters. In the early days of the biomedical revolution, when schizophrenia epitomized the pure brain disorder, the illness was said to appear at the same rate around the globe, as if true brain disease respected no social boundaries and was found in all nations, classes, and races in equal measure.

This piece of dogma was repeated with remarkable confidence from textbook to textbook, driven by the fervent anti-psychoanalytic insistence that the mother was not to blame. No one should ever have believed it. As the epidemiologist John McGrath dryly remarked, “While the notion that schizophrenia respects human rights is vaguely ennobling, it is also frankly bizarre.” In recent years, epidemiologists have been able to demonstrate that while schizophrenia is rare everywhere, it is much more common in some settings than in others, and in some societies the disorder seems more severe and unyielding. Moreover, when you look at the differences, it is hard not to draw the conclusion that there is something deeply social at work behind them...

http://www.wilsonquarterly.com/article.cfm?AID=2196

[tama]

1. kr

[LuvNewcastle]

2. People should never say that people with schiz. cannot get better.

While it is true that the disease can't be cured, it can be managed, and people with schiz. can be productive members of society. It's extremely important that people with schiz. have stability and hope. Homelessness is a major problem for those who suffer from the disease. It's important for everyone to know what to expect from tomorrow, and that is especially true for those with schiz. Schiz. patients already have difficulty in dealing with stressful situations and chaos and disorder in the life of a person with the disease can easily send them into a downward spiral. People with schiz. can be largely self-sufficient if they're given the proper re-enforcement. They need goals and a great deal of encouragement and they need others to believe in them so that they can believe in themselves. If you have someone in your life who suffers from schiz., don't give up on them. They can have wonderful lives and they can enrich your life as well.

[tama]

4. My father was diagnozed with that.

The symptoms appeared in stressing social environments and went away with those.

Or rather, whole Western culture is collectively insane and individual symptoms are best considered as signs of that and steps towards healing.

[ananda]

11. Geez, it makes me think that..

.. people who appear ostensibly are the ones who
have learned to cope with serious oppression and
collective insanity.

That's much more worrisome than what we consider
schizophrenia or bipolar or ADD or Asperger's or
whatever.

[Bernardo de La Paz]

3. Please read the referenced article. It is important and powerful. nt

[tama]

5. +1

[greiner3]

6. "...something deeply social at work behind them..."

As I life long sufferer of mental illness, I have been studying my own specific illness; bi-polar.

I have found that full onset of the illness is 'triggered' by factors unique to each individual and is also marked by unique sets of symptoms. These triggers can be environmental, socio-economic or brought on by physical or mental trauma.

Thus, this new study confirms, at least from the bi-polar stand point, that even those who are genetically inclined may not exhibit symptoms; phenotypical.

[HiPointDem]

8. two things that convinced me that schizophrenia wasn't what i'd thought it was was hearing

what recovered schizophrenics said about how they experienced it, and listening to what schizophrenics said while in their illness. it wasn't just random craziness.

[HiPointDem]

22. kick

[jwirr]

27. My family has a long history of bi-polar and we have all been able to see milder cases in our own

children and extended family members. Symptoms like anxiety, anger and others are very prevalent even though we show few other signs and can function normally.

[redqueen]

7. K&R

[Hubert Flottz]

9. K&R

A very good read.

[intheflow]

12. What makes you say that?

The article was authored by Tanya Marie Luhrmann, a Stanford University professor. This article seems the epitome of her research focus.

[alcibiades_mystery]

14. It's a magazine article

The citation conventions are different than a scientific journal article. That said, if you read the actual article, it's fairly easy to track down the references for the substantive points, especially those on culture. Ten seconds on Google will reveal the now 25 year longitudinal study of schizophrenia in Chennai. Dr. Sousa's research is easily identified and retrieved, as is Dr. Eliacin's, or Jean-Paul Selten's - all that research appears in respected, peer-reviewed publications. The article, despite being a "popularization" piece that describes (and makes a point about) the existing scientific research, does, in fact, provide most of the tools you'd need to follow up on the claims, evaluate the studies it relies on, etc.

To call this junk science because it doesn't have a list of references as it would in a scientific journal is unfair, since 1) it is not in a scientific journal, 2) it is not a scientific article, but a meta-discussion of scientific trends, and 3) even given these two points, it does, indeed, point you to scientific articles and sources for its information.

[HiPointDem]

19. yeah, that's it. because there's such a huuuuge market for scholarly books. everybody wants

to read stuff like:

1989: Persuasions of the Witch's Craft: ritual magic in modem culture. Harvard University Press (and Basil Blackwell).

1996: The Good Parsi: the postcolonial anxieties of an Indian colonial elite . Harvard University Press.

2000: Of two minds: the growing disorder in American psychiatry. Alfred A. Knopf; paperback edition 2001, new subtitle: Of two minds: an anthropologist looks at American psychiatry. Vintage.

Delivered 2011: When God talks back: understanding the American evangelical relationship with prayer. Knopf. [Publication March 2012]

Under contract: Other minds: essays on the complex construction of subjective experience. [The Lewis Henry Morgan lectures] University of Chicago.

In preparation: Uptown: living on the street with psychosis.

[alcibiades_mystery]

20. Are you joking?

Providing a meta-discussion of current scientific research is a perfectly legitimate kind of communication for a magazine article. Either you're being obtuse, or you don't know as much about science as you're pretending to. There's nothing "junk" or anti-scientific or purely advertisement-based about a senior scholar summarizing work in a field for a lay audience. Indeed, it not only happens all the time, but it is one of the rather happy functions of scientific communities - that they feel a need to make science understandable to lay audiences.To pretend that this is some weird kind of operation is just bizarre at this point.

I'm not sure what your beef is here, but it's starting to border on absurdity. You can follow out the scientific studies she's summarizing by searching them out. The information she provides for you to do so is more than adequate.

[intheflow]

17. Third hit on my google search brought up Rousseau's Second Discourse as posted by Fordham U.

Here ya go: Modern History Sourcebook: Jean-Jacques Rousseau: Discourse on Inequality, No 2. The year is irrelevant; Michael Servetis discovered the human circulatory system in the 1540's, but that doesn't mean it's not applicable to humans today.

A little more digging finds this link to a pdf. from Oxford Journals that reports on the adverse effect of clozapine (cited in the ninth and tenth paragraph of the original article): http://schizophreniabulletin.oxfordjournals.org/content/24/3/381.full.pdf. I found this in less than 10 minutes with very little background in medical research.

The idea that all articles have to be indexed is ridiculous. TIME doesn't source it's articles, nor does the NY Times or any other mainstream publications. Does that mean everything they publish is rubbish? Of course not. If you find reason to be skeptical, by all means research it for yourself and draw your own conclusions. But one shouldn't dismiss it out of hand just because all the information isn't served to you on a plate.

[nolabear]

16. Wonderful article. Thanks for posting it!

[intheflow]

21. Very interesting how you've changed your tune completely.

And deleted the evidence to the contrary.

[nolabear]

23. Stop it.

[undergroundpanther]

24. This is the problem

being no community in the community.

Too many psychopaths enjoy destroying communities,relationships,people's lives,sanity,really they do.
The psychopaths don't care they make people crazy,they want what they want and they'll tear apart a mind,a family a whole community to get it. We are stuck living around psychopaths that make our communities no community.What can be done to STOP these cruel cold monsters in human suits?? Our very functionality as a species depends on this.

http://www.psychologytoday.com/blog/pathological-relationships/201008/60-million-people-in-the-us-negatively-affected-someone-elses

[HiPointDem]

25. +1

[BOG PERSON]

26. Schizophrenia