A book I read about schizophrenia said that the disease occured in about 1 in 100 people, but in western Ireland it was much more common, possibly up to 1 in 25 people.
Has anyone ever heard of this? If it’s true, what’s going on in western Ireland? Is there a bad gene in circulation? Some envirnmental factor? Or is a case of bogus statistics?
No one knows the exact cause of schizophrenia-- well, actually, they know what’s happening in your brain, they just don’t know why. However, it doesn’t appear to be genetic-- at least in the “biology is destiny” sense, because the identical twin of a schizophrenic doesn’t usually have schizophrenia. I don’t know if the odds are slightly higher for the twin or not, but it’s not like blue eyes-- if one identical twin has blue eyes, the other will too.
The last theory I heard implicated a viral infection in schizophrenia, but I don’t remember the name of the virus.
Schizophrenia is NOT environmental in the sense that it is caused by trauma. It’s environmental if you consider a virus to be part of the environment, but if you’re thinking that the stress of politically turbulent Ireland is a factor-- No.
–Rowan
Shopping is still cheaper than therapy. --my Aunt Franny
It’s a case of bogus statistics.
Quoted from: http://www.iol.ie/lucia/si/schiz.htm
The estimated population of Ireland is 3,557,000. Therefore, roughly 1% of the people in Ireland suffer from Schizophrenia.
“[He] beat his fist down upon the table and hurt his hand and became so
further enraged… that he beat his fist down upon the table even harder and
hurt his hand some more.” – Joseph Heller’s Catch-22
You know what just occurred to me? The diagnosis of schizophrenia is made mostly on the basis of the patient’s behavior and subjective reporting (“Do people stare at you in restaurants”). A country could have a high incidence of schizophrenia because the psychiatric profession in that country over-diagnoses it (or other countries under-diagnosis it).
I realize that someone has already demonstrated that the statistics are bogus-- I just thought I’d add this FYI.
Just as an example, school districts in the US have wide variences for the occurrance of ADD/ADHD, which is diagnosed on the basis of behavior; there is no subjective test, like a strep throat culture. The difference in school districts is a product of certain schools over-referring students, and local doctors over-diagnosing ADD and ADHD.
–Rowan
Shopping is still cheaper than therapy. --my Aunt Franny
Not to be a nitpicker, Rowan, but you mean that there is no objective test for schizophrenia.
“I had a feeling that in Hell there would be mushrooms.” -The Secret of Monkey Island
Actually, according to DSM IV, the psychiatrists’ bible, the diagnosis of schizophrenia is entirely based on the patient’s behaviour. If you have something like 3 out of of the 6 listed symptoms, you’ve got it, supposedly. There were studies in the sixties that showed that diagnosis varied wildly between the US and the UK. I imagine it’s still largely true. It isn’t exactly science, after all.
Rowan:
Yes, and welcome to my (our) nightmare! (I have been so diagnosed).
Does schizophrenia exist, in the same sense that, let’s say, cerebral palsy exists? Or is it more akin to a diagnosis of “hysteria”, or “stress”? There is no test for it; it exists wherever the psychiatric professional sees it. The inter-rater reliability (the ability in blind tests for subsequent psychiatric diagnosticians to arrive at the same diagnosis after interviewing the same potential patient) is no better than random chance. The profession’s declarations regarding the cause or etiology of schizophrenia never clarify previous declarations as more data becomes available, but instead contradicts the wisdom of previous articles. What used to be the result of dopamine receptor hypersensitivity is now understood to be related to serotonin uptake, although the statements issued in the 80s regarding dopamine were released as if with final clinical authority. If truth be known, no other branch of medicine, let alone science, could get away with the fuzzily defined variables and assumptions that permeate clinical psychiatry.
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Back to the original question:
My wife lived in Ireland for 13 years and she informs me that the three largest mental institutions in that country are all located in the west. They are located in Galway, Sligo, and Mayo.
My university days are a little hazy now, but I recall two germain facts. The first one was that many things that a psychologist or psychiatrist can’t accurately diagnose are labelled “Atypical Schizophrenia” simply because, as there are so many possible symptoms you can’t go wrong. Secondly, some time in the late 70’s the definition of schizophrenia was altered in the US but not in Europe, leading to huge discrepancies in how many people were diagnosed in the US and the UK, I can’t remember which way ireland went, but I presume it was the same as the rest of Europe. One would think that everybody would use the same standards to diagnose schizophrenia, but such definitions have huge consequences on public health budgets and the like, and as such setting these standards is almost always a politicised process.
It only hurts when I laugh.
Just saw this today & thought I’d share:
reference schizophrenia being caused by in utero exposure to poliovirus.
Sue from El Paso
members.aol.com/majormd/index.html
I always thought that “Tommy” was the better album overall, but that the situation was reversed with the movies. What’s that? Oh, schizophrenia. . .never mind.
Diceman is right, I said subjective when I meant objective. Brain cramp.
I haven’t read the polio link yet, although I am just about to, but while it’s on my mind-- polio cases are on the decline due to vaccinations. Wouldn’t schizophrenia also be on the decline? But it’s not.
I’m going to bet there are multiple causes of schizophrenia.
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The hypothesis as I understand it, is that in utero exposure to polio (other viruses may also be causative) is NECESSARY but not SUFFICIENT to cause schizophrenia. Other factors such as genetic susceptibility, and timing of the infection during a critical period of brain development, would also have to be present.
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Polio virus, unlike smallpox, has not been eradicated. Immunized individuals still get polio infections; the infections stay confined to the GI tract, however, and do not result in the neurologic comlications which occurred prior to immunizations. Thus pregnant women can & do get poliovirus infections, often without ever realizing it.
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The whole history of polio is a fascinating study of man’s attempts to free himself from one type of disease only to face something far worse. 200 years ago, polio was nearly unknown. In the early part of this century, hygiene & cleanliness among the middle & upper classes improved to the point where children seldom became exposed to the virus until entering school. Just as chicken pox is rarely serious in kids, but can be life-threatening to adults, polio is just one more 24 hour diarrhea in toddlers, but can cause deafness & paralysis in older kids & teens who get it.
Sue from El Paso
members.aol.com/majormd/index.html
I know what you mean: the hand-washing and bathing that were supposed to get rid of typhus, dysentery, cholera, and other diseases, in part caused the polio outbreak in the 50’s.
As I understand it, though, there was another factor: prior to frequent washing and bathing with soap, most people were exposed to, recovered from, and were thus innoculated against polio as babies. But the age of the person wasn’t the only consideration. Before the 1950’s, babies were almost without exception breast-fed, and were thus getting antibodies from their mothers when they had their first polio exposure.
Children first exposed to polio in grade school weren’t being breast-fed, but in the 50’s, neither were babies; they were mostly formula fed, so babies who happened to be exposed to polio weren’t getting breast milk antibodies.
Anyway, in utero exposure to a virus is a tricky thing. I know several people who are Deaf from pre-natal rubella, and at least two who are JUST Deaf, but had still-born twins.
As I noted before, they are many cases of schizophrenia in people whose IDENTICAL twins are unaffected.
I checked out the article someone posted (well, the address anyway), and it notes that in utero polio isn’t necessarily associated with all schizophrenia.
However, I’m no expert-- I’m pretty well-read on the subject, because a couple of schizophrenic people are served by my agency, but I’m not a psychologist or a doctor. If you know of another article with more info about in utero viruses, please post the info: I’d be really interested.
SOmthing I do know: schizophrenia is a “default” diagnosis, in that when certain symptoms present themselves, and no other cause is found (MRI’s don’t show brain tumors or leisons, toxicity screens are negative, there’s been no stroke or head injury, no drug history), then the diagnosis is schizophrenia. This is why I suggest that there may be multiple causes; there’s no real evidence that schizophrenia is one thing.
–Rowan
Shopping is still cheaper than therapy. --my Aunt Franny
This is my view as well. Some cases are probably misdiagnoses of other known diseases, some cases may have an as-yet-unknown medical cause, and some cases are probably non-medical in origin, being instead rather extreme instances of ‘normal’ reactions to particular circumstances. This is an important issue, as schizophrenics are routinely given medication, often involuntarily, with very serious side effects and no known curative properties.
I always liked Galway and Sligo, but you can hold the Mayo.
Well, I don’t think many cases of schizophenia are traumatic in origin, since there need to be several episodes of dissociative behavior over a period of time to make a schizophrenia diagnosis.
And while it’s true that medications such as Haldol are not curative, in the sense that you don’t take it for ten days and your schizophrenia is gone, they can be enormously effective. Insulin injections aren’t a cure for diabetes, but they’re an extremely effective treatment.
However, we probably mostly agree about medical mishandling of schizophrenia. Once a person gets that label, his doctors stop looking for other things. Treatment is reduced to monitoring medication side-effects.
I would add that people who are forced to take medications by law are, in my experience, people who have committed violent crimes, and taking medication is a condition of probation.
A much bigger problem, if you ask me, is people who yo-yo between institutions and the streets. People are institutionalized and given meds, stabilize on the meds, and are released. Then they get no support whatsoever after release, and sometimes can’t get the meds anymore, even when they want them, and end up back in an institution, long enough to get meds and stabilize…
–Rowan
Shopping is still cheaper than therapy. --my Aunt Franny
Sorry for the delay. Been away for a while.
I’m not sure how this rules it out (depending on what you mean by ‘traumatic’). In any case, I think in practice the diagnosis of schizophrenia can be pretty lax.
I have a less sanguine view of Haldol. Maybe some patients like it, but I think with many it’s the staff who are the fans. It really deadens people.
Though I don’t know that much about insulin, I doubt it has such serious side effects as a matter of course. Haldol is not good for the noodle in the long run. It seems to me that by prescribing it for an extended period, a doctor is more or less writing off the possibility of a full recovery. And while schizophrenics are officially not supposed to recover, I think this is far from being the case in reality.
I am not very up on this. It was my impression that the family had a bit of sway here. In any case, I believe there are initiatives in several places in North America to give psychiatrists the right to prescribe drugs like Haldol involuntarily solely on their own judgement.
I think we agree on the other stuff.
Roses are red,
Violets are blue.
I’m a schizophrenic,
And so am I
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a) Schizophrenia is not a Haldol-deficiency disease. Non-schizzies are not walking around with a normal serum level of Haldol that schizophrenics lack unless they take their pills.
b) Haldol is extremely effective at disabling neurons. It isn’t very specific; it goes after motor neurons, affective neurons; neurons in the spinal cord, neurons in the brain; etc.
c) With the exception of individuals brought in involuntarily, the only things meaningfully correlated with receiving a diagnosis as schizophrenic are prior psychiatric diagnoses as schizophrenic and exposure to psychiatric professionals. It’s less funny if you think about it for awhile. If you come into contact with one in ‘assessment mode’, you are no more and no less likely to receive the schizzy label than the subway guy with the box cutter, up until he hauls off and slices someone up.
d) I’m schizophrenic. Since there is no criterion by which a diagnosis is ever ruled out or rescinded (such as “on the basis of blood test for the schz protein”), the disease consists of the diagnosis thereof. However, I like my mind as it is and fortunately have been able to avoid psychiatric professionals and their pharmaceuticals and shock machines. Unless I do something that constitutes a legally defined offense, my behavior is none of your damn business, and my biochemistry isn’t under any circumstances. Put that needle down!
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