Social construction of schizophrenia
Encyclopedia
Social Constructionism, a branch of sociology, queries commonly held views on the nature of reality touching on themes of normality and abnormality within the context of power and oppression in societal structures.
The concept of a 'social construction of schizophrenia' denotes that the label of 'schizophrenia' is one that has been socially constructed through ideological systems, none of which are truly empirical
especially as currently there is no definitive evidence as to the cause(s) of schizophrenia
.
'. In summary it examines the basis of fact and truth / knowledge within culture. Whilst some 'truths' such as 'fire is hot' are universally agreed as objective, many others considered 'fact' are the result of a common subjective experience and the subsequent validation of that.
Schizophrenia
is one such term that can be viewed as a social construction. Walker has argued that psychiatric diagnoses are nothing but linguistic abstractions. He has criticized the DSM-IV's poor reliability and postulated that terms like 'schizophrenia' and 'mental illness' only exist by consensus and persist by convention. Further he argues that the pathologizing language which persists in the medical model of disability
is unuseful in working towards a recovery model.
Other notable practitioners and authors within the humanistic tradition that have viewed schizophrenia as a social construction include psychiatrist Thomas Szasz
(1920-___), Joseph Berke
, R.D. Laing and Mary Barnes
. Szasz viewed the diagnoses as a fabrication that is borderline abusive in terms of treatment. Szasz has protested against the taxonomic classifications of mental illness and reification of these as 'science' and has long argued against institutionalisation as a fundamental deprivation of liberty. In Joseph Berke's and Mary Barne's book: "two accounts of a journey through madness", Berke explores themes of psychosis as an enriching experience. Berke argues that the invalidation of schizophrenic experiences labelled 'sick or mad' is a uniquely western standpoint insofar as dream states and altered perception are not considered valid modes of interpolation of the truth within westernised culture.
Laing (1964) commented “the mad things done and said by the schizophrenic will remain essentially a closed book if one does not understand their existential context”.
Noll (1983) has explored the links between shamanism
and schizophrenia, testing the research evidence on shamanism against the DSM-III diagnostic criterion. Though he draws comparisons between the two states of mind in terms of the phenomenon experienced, he draws out important differences between shamanic and schizophrenic states, notably that many people on the schizophrenic spectrum do not voluntarily enter an altered state of consciousness whereas research into shamanism unilaterally shows that shamanic states are induced and controlled voluntarily by the shaman, who ultimately maintains a healthy world view between a base line level of consciousness and an altered state of consciousness. He concludes that differences between schizophrenic and shamanic states such as 'volition', means that the DSM-III cannot be used to define shamanism as the same state as schizophrenia.
and Wittgenstein centred around the differences between objective reality or that which is known or absolute and subjective reality or that which is observed by the knower. In Schizophrenia: A scientific delusion?, Mary Boyle
explores 'schizophrenia and its assumptions as truths or knowledges which are socially produced and managed'.
examines questions of identity in the concept of societal integration and discusses how change occurs when there is a legitimation crisis.
It assists the understanding of the social construction of schizophrenia and other illness in also understanding forces that shape power imbalances in aetiologies. Phil Brown in 'Naming and Framing: The social construction of diagnosis and illness' points out how professionals were very slow and unwilling to accept the diagnosis of 'Tardive dyskinesia
', despite many research indicated warnings on it, as it was iatrogenic (caused by) prescription drugs that had been plaudited to be successful in treatment of the associated condition of psychoses. Market forces in pharmacology and/or cultural embarrassment can shape the rate at which society adapts to include new frameworks such as those demonstrated in the DSM
.
Conrad writes on medicalization and social control. He looks at the process of science and medicalization. Science is heralded as the new religion in terms of ideological power and Conrad describes how medicalization can be used to police morals.
. Nelson, Yung, Bechdolf and McGorry examine this in context of a phenomenological approach to the understanding of ultra high risk psychiatric disorders. They criticize psychiatric research that addresses subjectivity:
"When attempts have been made to address subjectivity, the psychiatric researcher is left without the requisite conceptual tools. Instead, this form of research has tended to live out Abraham Maslow’s statement ‘‘If the only tool you have is a hammer, you tend to treat everything as if it were a nail.’’ That is, the subjective has been approached in operational terms..."
which is on a spectrum
of psychotic disorders and is considered to be outmoded by many consumers of services. Several leading academic authorities, notably Professor Marius Romme
founder and principle theorist for the Hearing Voices Movement provide a rationale for the abandonment of this label. A symposium of some of the leading notions in this field from consumers of services and academics concluded:
and Autism
originated from the works of Eugene Bleuler (1857–1939) as different aspects of the same diagnostic condition. Bleuler was a contemporary of Sigmund Freud
and Carl Jung
. Prior to Bleuler's interventions schizophrenia
was referred to as Dementia praecox
(early insanity) and perceived as a single disorder. Schizophrenia is sometimes also referred to as hebephrenia, stemming in etymology from the Greek god Hebe
who was associated with adolescence and as it was thought the onset of schizophrenia came at adolescence. It is generally acknowledged that Schizophrenia can have early onset and late onset.
"He first advanced the term schizophrenia in 1908 in a paper based on a study of 647 Burghölzli patients. He then expanded on his paper of 1908 in Dementia Praecox oder Gruppe der Schizophrenie…Bleuler is credited with the introduction of two concepts fundamental to the analysis of schizophrenia: autism, denoting the loss of contact with reality, frequently through indulgence in bizarre fantasy; and ambivalence, denoting the coexistence of mutually exclusive contradictions within the psyche."
. Mind state on their website "Because of differences of opinion about schizophrenia, it's not easy to identify what might cause it." Mind have previously published an explanatory leaflet, prefaced by Michael Palin
that gives a definition of schizophrenia as people 'who think outside the normal range of human experience'. The National Alliance on Mental Health say:
"By changing the name, consumers with the symptoms of what actually may be a spectrum
of disorders would have a more accurate and descriptive name attached to their diagnosis. Ideally, they would also experience less stigma, as they left behind a name with Greek origins that roughly translates to “shattered mind” and which is often used in popular culture to mean "multiple personality disorder" or "split personality.".
/copy number variants/alleles that may explain the comorbidity
of various conditions.
Links between autism
and schizophrenia
have been studied. From clinical observation, both conditions cause a disruption in normative social functioning which may be mild or severe depending on the individual's position within the spectrum. Social cognition is under-developed in autism and highly developed in psychoses. Four genetic loci are diametrically opposed in terms of diagnoses of autism and schizophrenia, with corresponding deletions for one condition or duplications for the other. Researchers examining chromosome 16 (16p11.2) identified a heredity area on the short arm of human chromosome 16 (16p11.2) which contains microduplication and microdeletion of genome variation. Microduplication of hereditary factors in this heredity area increased the individual's risk of schizophrenia more than 8–14-fold and of autism over 20-fold. A corresponding microdeletion instead of microduplication in the area affected the risk of autism only, but not of schizophrenia. A recent study of de novo mutations, ie new mutations in people with both autism and schizophrenia spectrum conditions, concluded that schizophrenia and autism are due to "errors" during early organogenesis
.
The National Institute of Mental Health reported on 8 December 2009 that in spring 2010, major databases on autism research will be joined up to facilitate further research.
One study ascribes links between schizophrenia and bi-polar disorder by studying a total group of 6909 Europeans, both diagnosed and undiagnosed. Another study suggests that genetic markers may be very dissimilar among different lineages of DNA in people of different cultures, making an international commonality in genetics as a precipitating factor in schizophrenia difficult to identify.
The onset of the condition has also been ascribed to social factors. Some authors refute the argument that racism may contribute to more diagnoses from psychiatrists of schizophrenia amongst members of the Afro Caribbean community and ascribe more value to deprivation and social isolation as triggering factors in those with a propensity towards schizotype personalities.
Various studies have indicated chemical precipitating factors in the development of autism/schizophrenia and also suggested that environmental factors such as toxins in the air may have precipitated a rise in the number of children born with autism. Prenatally prescribed softenon in the 1960s and 1970s lead to an increase of children born with autism by 4% as opposed to a usual figure of 0.1%. Sodium valproate
, a drug used as an anti-epileptic and as a mood stabilizer, increased the chance of children being born with autism sevenfold. The active component of cannabis (THC)
in its "skunk" preparation was found by one study to increase the chances of psychosis sevenfold. Another study found cannabis to increase chances of a "psychotic-like experience" by 2.6 times, but concluded that "schizophrenia is a relatively rare condition so it's very hard to be sure about its causation
." There are many candidates for copy number variants that may predispose a likelihood of developing schizophrenia.
Timothy Crow has long argued that schizophrenia came about as a result of natural selection
. He has argued that schizophrenia is a by-product of the development of language, resulting from an evolutionary change approx 150,000 years ago, that persisted due to sexual selection. However, conversely to study in polygene
s or multiple allele combinations, he maintains that the answer lies in: "the evolutionary history of the Protocadherin11XY gene pair that characterizes the hominin lineage including the 'sapiens' event that represents the transition to modern Homo sapiens." Other medical model of disability
research directions corroborate the link between an evolutionary advantage to schizotype personalities. Studies into unfocussed or coarse semantic activation in the right hemisphere of the brain which is associated with creative associations as opposed to left hemisphere language control suggest:
From a social model of disability
perspective, this interlinks with the concept of salience syndrome:
include 'dysfunctional perception syndrome' and Salience Syndrome:
"The concept of 'salience
' has the potential to make the public recognize psychosis as relating to an aspect of human mentation and experience that is universal. It is proposed to introduce, analogous to the functional-descriptive term 'Metabolic syndrome
', the diagnosis of 'Salience syndrome' to replace all current diagnostic categories of psychotic disorders. Within Salience syndrome, three subcategories may be identified, based on scientific evidence of relatively valid and specific contrasts, named Salience syndrome with affective expression, Salience syndrome with developmental expression and Salience syndrome not otherwise specified."
In Japan "In order to contribute to reduce the stigma related to schizophrenia and to improve clinical practice in the management of the disorder, the Japanese Society of Psychiatry and Neurology changed in 2002 the old term for the disorder, "Seishin Bunretsu Byo" ("mind-split-disease"), into the new term of "Togo Shitcho Sho" ("integration disorder
"). Eighty-six percent of psychiatrists in the Miyagi Prefecture
found the new term more suitable to inform patients of the diagnosis as well as to explain the modern concept of the disorder."
This model is ascribed as a stress-vulnerability model rather than a kraepelian disease model.
The Japanese society of psychiatry and neurology report:
"This change is making psychoeducation much easier and is being useful to reduce misunderstandings about the illness and to decrease the stigma related to schizophrenia. The new term has been officially accepted by the Japanese medicine and media and is being adopted in the legislation in 2005."
The concept of a 'social construction of schizophrenia' denotes that the label of 'schizophrenia' is one that has been socially constructed through ideological systems, none of which are truly empirical
Empirical
The word empirical denotes information gained by means of observation or experimentation. Empirical data are data produced by an experiment or observation....
especially as currently there is no definitive evidence as to the cause(s) of schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
.
Introduction
In 1966, Berger and Luckman coined the term 'social constructionism' in their seminal work 'The Social Construction of RealityThe Social Construction of Reality
The Social Construction of Reality is a book about the sociology of knowledge written by Peter L. Berger and Thomas Luckmann and published in 1966....
'. In summary it examines the basis of fact and truth / knowledge within culture. Whilst some 'truths' such as 'fire is hot' are universally agreed as objective, many others considered 'fact' are the result of a common subjective experience and the subsequent validation of that.
Schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
is one such term that can be viewed as a social construction. Walker has argued that psychiatric diagnoses are nothing but linguistic abstractions. He has criticized the DSM-IV's poor reliability and postulated that terms like 'schizophrenia' and 'mental illness' only exist by consensus and persist by convention. Further he argues that the pathologizing language which persists in the medical model of disability
Medical model of disability
The medical model of disability is a sociopolitical model by which illness or disability, being the result of a physical condition, and which is intrinsic to the individual , may reduce the individual's quality of life, and causes clear disadvantages to the individual.It is today specifically...
is unuseful in working towards a recovery model.
Other notable practitioners and authors within the humanistic tradition that have viewed schizophrenia as a social construction include psychiatrist Thomas Szasz
Thomas Szasz
Thomas Stephen Szasz is a psychiatrist and academic. Since 1990 he has been Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. He is a well-known social critic of the moral and scientific foundations of psychiatry, and of the social...
(1920-___), Joseph Berke
Joseph Berke
-Early years:He studied at Columbia College of Columbia University and graduated from the Albert Einstein College of Medicine in New York. He moved to London in 1965 where Berke worked with R. D...
, R.D. Laing and Mary Barnes
Mary Barnes
Mary Edith Barnes was an English artist and writer who suffered from schizophrenia but recovered to become a successful painter. She is particularly known for her documentation of her experience at R.D...
. Szasz viewed the diagnoses as a fabrication that is borderline abusive in terms of treatment. Szasz has protested against the taxonomic classifications of mental illness and reification of these as 'science' and has long argued against institutionalisation as a fundamental deprivation of liberty. In Joseph Berke's and Mary Barne's book: "two accounts of a journey through madness", Berke explores themes of psychosis as an enriching experience. Berke argues that the invalidation of schizophrenic experiences labelled 'sick or mad' is a uniquely western standpoint insofar as dream states and altered perception are not considered valid modes of interpolation of the truth within westernised culture.
Laing (1964) commented “the mad things done and said by the schizophrenic will remain essentially a closed book if one does not understand their existential context”.
Noll (1983) has explored the links between shamanism
Shamanism
Shamanism is an anthropological term referencing a range of beliefs and practices regarding communication with the spiritual world. To quote Eliade: "A first definition of this complex phenomenon, and perhaps the least hazardous, will be: shamanism = technique of ecstasy." Shamanism encompasses the...
and schizophrenia, testing the research evidence on shamanism against the DSM-III diagnostic criterion. Though he draws comparisons between the two states of mind in terms of the phenomenon experienced, he draws out important differences between shamanic and schizophrenic states, notably that many people on the schizophrenic spectrum do not voluntarily enter an altered state of consciousness whereas research into shamanism unilaterally shows that shamanic states are induced and controlled voluntarily by the shaman, who ultimately maintains a healthy world view between a base line level of consciousness and an altered state of consciousness. He concludes that differences between schizophrenic and shamanic states such as 'volition', means that the DSM-III cannot be used to define shamanism as the same state as schizophrenia.
Philosophy
Themes in social constructionism draw on various philosophies such as those espoused by KantKANT
KANT is a computer algebra system for mathematicians interested in algebraic number theory, performing sophisticated computations in algebraic number fields, in global function fields, and in local fields. KASH is the associated command line interface...
and Wittgenstein centred around the differences between objective reality or that which is known or absolute and subjective reality or that which is observed by the knower. In Schizophrenia: A scientific delusion?, Mary Boyle
Mary Boyle (psychologist)
Mary Boyle is a clinical psychologist. She is a Professor Emeritus at University of East London. Boyle is a Fellow of the British Psychological Society, Fellow of the Royal Society of Medicine, and Fellow of the Royal Society of Arts.- Books :...
explores 'schizophrenia and its assumptions as truths or knowledges which are socially produced and managed'.
Power and control
Post Structuralist Jurgen HabermasHabermas
People with the surname Habermas include:*German sociologist and philosopher, Jürgen Habermas*American philosophical theologian, Gary Habermas...
examines questions of identity in the concept of societal integration and discusses how change occurs when there is a legitimation crisis.
It assists the understanding of the social construction of schizophrenia and other illness in also understanding forces that shape power imbalances in aetiologies. Phil Brown in 'Naming and Framing: The social construction of diagnosis and illness' points out how professionals were very slow and unwilling to accept the diagnosis of 'Tardive dyskinesia
Tardive dyskinesia
Tardive dyskinesia is a difficult-to-treat form of dyskinesia that can be tardive...
', despite many research indicated warnings on it, as it was iatrogenic (caused by) prescription drugs that had been plaudited to be successful in treatment of the associated condition of psychoses. Market forces in pharmacology and/or cultural embarrassment can shape the rate at which society adapts to include new frameworks such as those demonstrated in the DSM
DSM
-Business:* DSM , an international life science and performance materials company from the Netherlands* Delhi school of music, a music school in India...
.
Conrad writes on medicalization and social control. He looks at the process of science and medicalization. Science is heralded as the new religion in terms of ideological power and Conrad describes how medicalization can be used to police morals.
The Self and Identity
Research directions here are on the importance of experiential narrative within psychiatric dialogue. Some Research is critical of modern psychiatric adoption of an 'empiricist-behavioural approach' within the DSMDSM
-Business:* DSM , an international life science and performance materials company from the Netherlands* Delhi school of music, a music school in India...
. Nelson, Yung, Bechdolf and McGorry examine this in context of a phenomenological approach to the understanding of ultra high risk psychiatric disorders. They criticize psychiatric research that addresses subjectivity:
"When attempts have been made to address subjectivity, the psychiatric researcher is left without the requisite conceptual tools. Instead, this form of research has tended to live out Abraham Maslow’s statement ‘‘If the only tool you have is a hammer, you tend to treat everything as if it were a nail.’’ That is, the subjective has been approached in operational terms..."
Movement to reconstruct Schizophrenia
'Alternative Perception' is one of several names suggested by the schizophrenic user movement to replace the term schizophreniaSchizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
which is on a spectrum
Spectrum
A spectrum is a condition that is not limited to a specific set of values but can vary infinitely within a continuum. The word saw its first scientific use within the field of optics to describe the rainbow of colors in visible light when separated using a prism; it has since been applied by...
of psychotic disorders and is considered to be outmoded by many consumers of services. Several leading academic authorities, notably Professor Marius Romme
Marius Romme
Marius Anton Joannes Romme is a Dutch psychiatrist. He is best known for his work on hearing voices and regarded as the founder and principal theorist for the Hearing Voices Movement....
founder and principle theorist for the Hearing Voices Movement provide a rationale for the abandonment of this label. A symposium of some of the leading notions in this field from consumers of services and academics concluded:
Historical construction of Schizophrenia
The Terms SchizophreniaSchizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
and Autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
originated from the works of Eugene Bleuler (1857–1939) as different aspects of the same diagnostic condition. Bleuler was a contemporary of Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...
and Carl Jung
Carl Jung
Carl Gustav Jung was a Swiss psychiatrist and the founder of Analytical Psychology. Jung is considered the first modern psychiatrist to view the human psyche as "by nature religious" and make it the focus of exploration. Jung is one of the best known researchers in the field of dream analysis and...
. Prior to Bleuler's interventions schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
was referred to as Dementia praecox
Dementia praecox
Dementia praecox refers to a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginning in the late teens or early adulthood. It is a term first used in 1891 in this Latin form by Arnold Pick , a professor of psychiatry at the German branch of...
(early insanity) and perceived as a single disorder. Schizophrenia is sometimes also referred to as hebephrenia, stemming in etymology from the Greek god Hebe
Hebe
Hebe may refer to:*Hebe , the goddess of youth in Greek mythology*Hebe , a genus of plants native to New Zealand*Hebe , a comics character in the Marvel Comics universe*6 Hebe, a main-belt asteroid...
who was associated with adolescence and as it was thought the onset of schizophrenia came at adolescence. It is generally acknowledged that Schizophrenia can have early onset and late onset.
"He first advanced the term schizophrenia in 1908 in a paper based on a study of 647 Burghölzli patients. He then expanded on his paper of 1908 in Dementia Praecox oder Gruppe der Schizophrenie…Bleuler is credited with the introduction of two concepts fundamental to the analysis of schizophrenia: autism, denoting the loss of contact with reality, frequently through indulgence in bizarre fantasy; and ambivalence, denoting the coexistence of mutually exclusive contradictions within the psyche."
Charities committed to changing public perception
Charities that disagree with the notion of the schizophrenia label in the U.K. include Mind (charity) and RethinkRethink
Rethink Mental Illness is a charity in England. Its mission statement is "Working together to help everyone affected by severe mental illness recover a better quality of life." The organisation was founded in 1972 by relatives of people diagnosed with schizophrenia, following an article by a...
. Mind state on their website "Because of differences of opinion about schizophrenia, it's not easy to identify what might cause it." Mind have previously published an explanatory leaflet, prefaced by Michael Palin
Michael Palin
Michael Edward Palin, CBE FRGS is an English comedian, actor, writer and television presenter best known for being one of the members of the comedy group Monty Python and for his travel documentaries....
that gives a definition of schizophrenia as people 'who think outside the normal range of human experience'. The National Alliance on Mental Health say:
"By changing the name, consumers with the symptoms of what actually may be a spectrum
Spectrum
A spectrum is a condition that is not limited to a specific set of values but can vary infinitely within a continuum. The word saw its first scientific use within the field of optics to describe the rainbow of colors in visible light when separated using a prism; it has since been applied by...
of disorders would have a more accurate and descriptive name attached to their diagnosis. Ideally, they would also experience less stigma, as they left behind a name with Greek origins that roughly translates to “shattered mind” and which is often used in popular culture to mean "multiple personality disorder" or "split personality.".
Science of schizophrenia and comorbid conditions
Whilst the definitive cause(s) of schizophrenia remain unknown, research has indicated links between genetic make-up, social predisposing factors/stressors, and environmental conditions in relation to the development and onset of schizophrenia and other conditions. Geneticists are working towards identifying a gene for schizophrenia, and combined efforts are reported at the SzGene database. In the course of this research geneticists have identified specific genesGênes
Gênes is the name of a département of the First French Empire in present Italy, named after the city of Genoa. It was formed in 1805, when Napoleon Bonaparte occupied the Republic of Genoa. Its capital was Genoa, and it was divided in the arrondissements of Genoa, Bobbio, Novi Ligure, Tortona and...
/copy number variants/alleles that may explain the comorbidity
Comorbidity
In medicine, comorbidity is either the presence of one or more disorders in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.- In medicine :...
of various conditions.
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
and schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
have been studied. From clinical observation, both conditions cause a disruption in normative social functioning which may be mild or severe depending on the individual's position within the spectrum. Social cognition is under-developed in autism and highly developed in psychoses. Four genetic loci are diametrically opposed in terms of diagnoses of autism and schizophrenia, with corresponding deletions for one condition or duplications for the other. Researchers examining chromosome 16 (16p11.2) identified a heredity area on the short arm of human chromosome 16 (16p11.2) which contains microduplication and microdeletion of genome variation. Microduplication of hereditary factors in this heredity area increased the individual's risk of schizophrenia more than 8–14-fold and of autism over 20-fold. A corresponding microdeletion instead of microduplication in the area affected the risk of autism only, but not of schizophrenia. A recent study of de novo mutations, ie new mutations in people with both autism and schizophrenia spectrum conditions, concluded that schizophrenia and autism are due to "errors" during early organogenesis
Organogenesis
In animal development, organogenesis is the process by which the ectoderm, endoderm, and mesoderm develop into the internal organs of the organism. Internal organs initiate development in humans within the 3rd to 8th weeks in utero...
.
The National Institute of Mental Health reported on 8 December 2009 that in spring 2010, major databases on autism research will be joined up to facilitate further research.
One study ascribes links between schizophrenia and bi-polar disorder by studying a total group of 6909 Europeans, both diagnosed and undiagnosed. Another study suggests that genetic markers may be very dissimilar among different lineages of DNA in people of different cultures, making an international commonality in genetics as a precipitating factor in schizophrenia difficult to identify.
The onset of the condition has also been ascribed to social factors. Some authors refute the argument that racism may contribute to more diagnoses from psychiatrists of schizophrenia amongst members of the Afro Caribbean community and ascribe more value to deprivation and social isolation as triggering factors in those with a propensity towards schizotype personalities.
Various studies have indicated chemical precipitating factors in the development of autism/schizophrenia and also suggested that environmental factors such as toxins in the air may have precipitated a rise in the number of children born with autism. Prenatally prescribed softenon in the 1960s and 1970s lead to an increase of children born with autism by 4% as opposed to a usual figure of 0.1%. Sodium valproate
Sodium valproate
Sodium valproate or valproate sodium is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy, anorexia nervosa, panic attack, anxiety disorder, posttraumatic stress disorder, migraine and bipolar disorder, as well as other psychiatric conditions requiring...
, a drug used as an anti-epileptic and as a mood stabilizer, increased the chance of children being born with autism sevenfold. The active component of cannabis (THC)
Tetrahydrocannabinol
Tetrahydrocannabinol , also known as delta-9-tetrahydrocannabinol , Δ1-THC , or dronabinol, is the main chemical psychoactive substance found in the cannabis plant. It was first isolated in 1964. In pure form, it is a glassy solid when cold, and becomes viscous and sticky if warmed...
in its "skunk" preparation was found by one study to increase the chances of psychosis sevenfold. Another study found cannabis to increase chances of a "psychotic-like experience" by 2.6 times, but concluded that "schizophrenia is a relatively rare condition so it's very hard to be sure about its causation
Correlation does not imply causation
"Correlation does not imply causation" is a phrase used in science and statistics to emphasize that correlation between two variables does not automatically imply that one causes the other "Correlation does not imply causation" (related to "ignoring a common cause" and questionable cause) is a...
." There are many candidates for copy number variants that may predispose a likelihood of developing schizophrenia.
Timothy Crow has long argued that schizophrenia came about as a result of natural selection
Natural selection
Natural selection is the nonrandom process by which biologic traits become either more or less common in a population as a function of differential reproduction of their bearers. It is a key mechanism of evolution....
. He has argued that schizophrenia is a by-product of the development of language, resulting from an evolutionary change approx 150,000 years ago, that persisted due to sexual selection. However, conversely to study in polygene
Polygene
A polygene, multiple factor, multiple gene inheritance, or quantitative gene is a group of non-allelic genes that together influence a phenotypic trait. The loci or identities of the non-allelic genes are often unknown to biologist...
s or multiple allele combinations, he maintains that the answer lies in: "the evolutionary history of the Protocadherin11XY gene pair that characterizes the hominin lineage including the 'sapiens' event that represents the transition to modern Homo sapiens." Other medical model of disability
Medical model of disability
The medical model of disability is a sociopolitical model by which illness or disability, being the result of a physical condition, and which is intrinsic to the individual , may reduce the individual's quality of life, and causes clear disadvantages to the individual.It is today specifically...
research directions corroborate the link between an evolutionary advantage to schizotype personalities. Studies into unfocussed or coarse semantic activation in the right hemisphere of the brain which is associated with creative associations as opposed to left hemisphere language control suggest:
From a social model of disability
Social model of disability
The social model of disability is a reaction to the dominant medical model of disability which in itself is a Cartesian functional analysis of the body as machine to be fixed in order to conform with normative values...
perspective, this interlinks with the concept of salience syndrome:
Global moves to change the construction of 'Schizophrenia'
In the Netherlands alternative proposals for the name schizophreniaSchizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
include 'dysfunctional perception syndrome' and Salience Syndrome:
"The concept of 'salience
Salience (neuroscience)
The salience of an item – be it an object, a person, a pixel, etc – is the state or quality by which it stands out relative to its neighbours...
' has the potential to make the public recognize psychosis as relating to an aspect of human mentation and experience that is universal. It is proposed to introduce, analogous to the functional-descriptive term 'Metabolic syndrome
Metabolic syndrome
Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. It affects one in five people in the United States and prevalence increases with age...
', the diagnosis of 'Salience syndrome' to replace all current diagnostic categories of psychotic disorders. Within Salience syndrome, three subcategories may be identified, based on scientific evidence of relatively valid and specific contrasts, named Salience syndrome with affective expression, Salience syndrome with developmental expression and Salience syndrome not otherwise specified."
In Japan "In order to contribute to reduce the stigma related to schizophrenia and to improve clinical practice in the management of the disorder, the Japanese Society of Psychiatry and Neurology changed in 2002 the old term for the disorder, "Seishin Bunretsu Byo" ("mind-split-disease"), into the new term of "Togo Shitcho Sho" ("integration disorder
Integration disorder
Tōgō-shitchō-shō or integration disorder is a Japanese psychiatric diagnosis that replaced the previous diagnostic category of Seishin Bunretsu Byo which was equivalent to the DSM-IV or ICD-10 diagnosis of schizophrenia....
"). Eighty-six percent of psychiatrists in the Miyagi Prefecture
Miyagi Prefecture
is a prefecture of Japan in the Tōhoku Region on Honshu island. The capital is Sendai.- History :Miyagi Prefecture was formerly part of the province of Mutsu. Mutsu Province, on northern Honshu, was one of the last provinces to be formed as land was taken from the indigenous Emishi, and became the...
found the new term more suitable to inform patients of the diagnosis as well as to explain the modern concept of the disorder."
This model is ascribed as a stress-vulnerability model rather than a kraepelian disease model.
The Japanese society of psychiatry and neurology report:
"This change is making psychoeducation much easier and is being useful to reduce misunderstandings about the illness and to decrease the stigma related to schizophrenia. The new term has been officially accepted by the Japanese medicine and media and is being adopted in the legislation in 2005."