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What the History of Schizophrenia Can Teach Us About the Present

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Every year, the World Health Organization (WHO) celebrates October 10 as World Mental Health Day to raise awareness. This year, they are focusing on schizophrenia. To add my little bit to awareness, I would like to explore the history and the controversy of this malady.

As a contrast to WHO is the group called Mad in America whose efforts, in my opinion, can be damaging to people who need medication. They are holding a film festival Oct 9 to 12 and on World Mental Health Day, they are screening "Where's the Evidence? A Challenge to Psychiatric Authority."

That film is of a hunger strike carried out by members of Mind Freedom who do not believe "that mental illnesses are biologically-based brain disorders."

Starting in the 1800s, doctors began to cluster similar symptoms that had been seen for years together and to give them names. Up to that point, each sufferer was considered to have a unique problem of his or her own, likely caused by some kind of curse or possession. This new disease model resulted in Dr. James Parkinson describing symptoms that became known as Parkinson's disease. The German neurologist, Alois Alzheimer, described a form of dementia in 1906 later called Alzheimer's Disease.

Then, Emil Kraepelin, first described the cluster of symptoms of what was to become schizophrenia. He called it Dementia praecox. His colleague, Eugen Bleuler, changed the name to the schizophrenias in 1908. Note the use of the plural as that is becoming significant.

Parkinson's, Alzheimer's, schizophrenia are all clusters of symptoms afflicting people. No one suggests that Parkinson's or Alzheimer's are not real medical problems but many still doubt that schizophrenia is a medical problem. The understanding of the causes of the first two are more advanced than for schizophreni, but still not perfect. Why schizophrenia is treated as a non-medical ailment by many does not make sense.

As a society, we show compassion and concern for those with Parkinson's and Alzheimer's and their families but very little for those with schizophrenia. If we did, so many would not remain untreated and relegated to homelessness or jail as a result. Does it not make sense that if we consider Parkinson's and Alzheimer's to be diseases of the brain, that schizophrenia is also? The brain is an organ just like any other organ and is capable of having something go wrong. Considering that it is comprised of 100-billion nerve cells, it is miraculous that more does not go wrong.

For science to understand and to develop treatments, it formulates logical hypotheses which are then tested for validity and either rejected or built upon. At one time, the causes of schizophrenia and autism were blamed on cold mothers but that has been long disproved. Even the naysayers of mental illness as a medical condition have hypotheses. Intervoice is a group that considers hearing voices (one symptom only of schizophrenia) to be normal. Their hypothesis is that in "77% of the people diagnosed with schizophrenia the hearing of voices was related to traumatic experiences."

That hypothesis requires extensive verification and replication by independent sources which I have never seen.

And both Mad in America and Intervoice are mostly opposed to the use of medication for schizophrenia. While all drugs for any malady are not perfect and have side effects, Dr. Fredric Neuman provides an excellent description in Psychology Today on the positive impact that antipsychotic medications have had.

Geneticists and neuroscientists are making headway in understanding schizophrenia although it will be quite some time before that can be translated into effective treatments. One recent study found that brain development in those with schizophrenia differs from those without it. That study compared 106 people with child onset schizophrenia versus 102 healthy volunteers with repeated brain imaging over the course of several years. They found that the brain's cortex develops differently in people with schizophrenia.

Another recent study compared the genetics of 4,200 individuals diagnosed with schizophrenia and 3,800 healthy controls. The study looked at almost 700,000 single nucleotide polymorphisms (SNPs) which are common locations for genetic variation. They found that a total of 42 genetic clusters working together were responsible for bringing out the symptoms for not one but eight separate disorders or variants of schizophrenia. That is consistent with what Bleuler pointed out when he coined the term the schizophrenias.

Certain genetic variations, they found, were 95 per cent accurate in predicting delusions and hallucinations, while other SNPs were 100 per cent accurate in estimating speech and behaviour anomalies associated with schizophrenia. The researchers added that though there are environmental factors such as drug use and emotional trauma that contribute to the onset of schizophrenia symptoms, the disorder is attributed to genetics about 80 per cent of the time.

There are always skeptics who may still consider that the earth is flat, that vaccines cause autism, and that schizophrenia is not an illness, but we should pay attention to science.

If we believe the science that has proven that schizophrenia is a malfunction of the brain and not a problem of the family or a moral failure by the individual, then we should show more compassion for those afflicted. As a society, we should do more to provide treatment, support and comfort. As author Katherine Flannery Dering said of her late brother who had treatment-resistant schizophrenia:

"My younger brother Paul was more than a 'schizophrenic'. He was a brother, a son, and above all, a person that my eight siblings and I loved."

This is Paul before the onset of schizophrenia, and shortly before he died.

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The Pauls of this world are not like that by choice, but by illness. They need more than our society is willing to provide. We should at the very least, give them the care and understanding that those with Parkinson's, Alzheimer's and other medical problems receive. It is, after all, the humane and civilized thing to do. If we call ourselves a civilized society, then we will do more to help.

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