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Underground > Laboratory >

Schizophrenia: What it is and where it comes from.

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19:14 / 24.03.06

I encourage you to keep posting, s3r3. One of the best reasons to post on barbelith is to have the opportunity to hear other people say why they think you are wrong. That's how I learn, anyway.

E. Coli from the Milky Way

13:21 / 25.03.06

hehehe, yes, reading it all the "better i shut up" sounds dramatic ... yes, i'll keep it posting, sure ;-) i mean i've to control digital verbiage, that's a good point :-)

17:36 / 22.01.08

In case you'd all forgotten about this, Johns Hopkins and Walter Reed Army Medical Center researchers have confirmed the causal link between toxoplasmosis and schizophrenia. As in the bug probably causes the disease.

“Until now, the only thing we could say is that some people with schizophrenia also had been infected with toxoplasma at some point, but we couldn’t tease out which came first,” Yolken says. “With our current study, we were able to show that infection came first.”

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18:07 / 22.01.08

While most people infected with toxoplasma never develop schizophrenia, the parasite may be a trigger in those genetically predisposed to the disorder, a classic example of how genes and environment come together in the development of disease, Yolken says.

Obviously a lot of other things can trigger the disorder in those genetically predisposed to it; adding one to the list of known potential triggers gets us closer to figuring out what they all have in common.

Baroness von Lenska

01:22 / 23.01.08

As interesting as this is, the study (as presented by the article) only concludes that toxoplasma infection came before a schizophrenia diagnosis in a small percentage of their patients, which is problematic for a number of reasons.

Even ignoring the troublesome nature of psychiatric diagnoses* (to my admittedly shaky and faded memory, anyone committed to a psychiatric institution in the US must be given a diagnosis before discharge, thus ruling out temporary personal crises in otherwise "healthy" individuals), most diagnosed with schizophrenia receive the badge later in life; late teens, early 20s at the earliest**. Toxoplasma's fairly common so there's plenty of wiggle room for infections prior to diagnosis simply being a matter of chance encounter.

Secondly, the study (article) treats schizophrenia both as a proven, solid neurological disorder and something we have the slightest clue about which certainly triggers some alarm bells. Research into schizophrenia is as messy as the subject itself, coming and going from any and all directions. The scope of schizophrenia research covers the whole spectrum: purely biological, purely environmental, purely societal, and mixes therein. As of now, there is no single and clear map as to what schizophrenia "is." So while it's interesting that some percentage of schizophrenic patients who participated in the study had previously been infected with toxoplasma, I'm going to have to go with more of a, "Huh. Fancy that." response until I better understand the study.

* Also see this essay on the difficulties in communication between a patient/doctor or schizophrenic/healthy relationship.

** Have been trying, and failing, to find a citation for this statement. It comes from a very faded memory of one or several popular psychiatric books I'd read some years ago. I'm hoping someone else with a fresher memory on the subject might be able to lend a hand.

15:32 / 10.03.08

Three interesting points I have encountered on this topic:

* A number of studies show a negative association between rheumatoid arthritis (RA) and schizophrenia (Sz).

* I have seen some recent (unpublished) data supporting a seasonal pattern in the occurrence of RA which is the opposite to that seen for Sz...

* RA is also seen to occur more frequently in patients who report owning a cat.

These are very alluring ideas which seem to speak of a mutually exclusive association between an infectious vector and the development of either RA or Sz.

However, the negative association between RA and Sz seems to be falling apart (with evidence from recent powerful and robust population studies - Eaton&Mortensen 2006) and so I am less convinced than when I first encountered this phenomenon.

On a slightly different note; there is a huge amount of literature on defining Sz. Many psychologists and psychiatrists argue that there is plenty of evidence showing that what is currently referred to as Sz is possibly a grouping of a variety of psychotic disorders (Prof. Richard Bentall is a major player in the UK in this debate). This is a rediculously complex topic and its unlikely to be resolved any time soon. However, it is obvious to me that attempts to understand the cause of Sz will be undermined by poor definitions of the disease of interest (whatever it may "truly" be).

Finally, I read an article in the latest scientific american (which imho is SO much better than the new scientist!) about the role of white matter in the brain White Matter Matters which seems to provide a possible new direction for research into the cause/treatment of schizophrenia (which partly helps explain the patter of onset by age). This was very interesting and I highly recommend reading the full article if you are interested in neuroscience or psychopathology.

J.

09:12 / 11.03.08

** Have been trying, and failing, to find a citation for this statement. It comes from a very faded memory of one or several popular psychiatric books I'd read some years ago. I'm hoping someone else with a fresher memory on the subject might be able to lend a hand.

Well... it's tricky to find links to open access jourals on this topic through pubmed. However, if you have (or can obtain...) institutional access, I recommend going to pubmed and entering "schizophrenia [ti] AND epidemiology [ti]" into the search. You should be able to find a review in which this issue is discussed, if only in a few sentences.

If you want a primary source, you will need to search "schizophrenia [ti] AND (incidence [ti] OR prevalence [ti])" or something similar... this is not as straight forward. Alternatively, any decent review will cite primary sources to support any statement of an age trend in Sz incidence.

Off the top of my head, peak incidence of schizophrenia occurs in the late teens to mid-late 20's in men. Interestingly, in women the peak incidence is seen to occur from the early 20's to early 30's... There are many theories as to why this may be but not much agreement.

J.

09:14 / 11.03.08

confirmed the causal link between toxoplasmosis and schizophrenia.

Unfortunately, this link is broken

Otherwise I could contribute directly to the discussion surrounding this paper.

J.

16:03 / 11.03.08

Well, hmm. I think it's summarized at Science Daily here.

10:08 / 12.03.08

Thanks, original article here... I *think* this might actually be open access...

Will try and read soon...

10:24 / 19.03.08

That article is on Affective disorders, Dr Jab, and is looking at the effect of medication on the toxoplasmosis parasite.

The article grant referred to is here (not open access unfortunately).

I can have a read in work, particularly because I don't like this ambiguous sentence in the abstract: "The association between IgG and schizophrenia varied by the time between the serum specimen collection and onset of illness."

Fungus of Consciousness

08:54 / 24.03.08

Here is an interesting article about the fact that LSD seemingly imitates schizophrenia.

LSD reveals schizophrenia treatment

Which is obviously an excellent advertisement for LSD use.....

Syzygy Stardust

21:30 / 06.04.08

This conversation about Schizopherina is quite interesting.

I think that if nothing else it falls squarely into the category of things not very well understood. With possible causes ranging from parasites to lack of sunshine I think its safe to say no one really knows.

The symptoms can also be stretched to serve as some kind of catch all to describe anything for which there is no other name. Actually 5 minutes into reading this thread it brought to mind yet another form of schizophrenia "Sluggishly progressing schizophrenia" which was conviniently "diagnosed" in many Soviet dissidents. This serve in excuse to imprison them in mental institutions.

14:00 / 09.04.08

With possible causes ranging from parasites to lack of sunshine I think its safe to say no one really knows.

... yet

I agree that the argument of "causes" of schizophrenia is unfortunately muddied (and will be for some time yet) by a parallel argument over defining sz itself. At this stage there is no objective way of identifying who has/doesn't have Sz - its more art than science, although, don't tell your psychiatrist I said that.

It is understood in epidemiology that when the outcome of a study (in this case does the patient have sz) is poorly defined, any associations will either be severly weakened (ie we will see no association when there is one) or completely biased (ie we will see a false association). I think this explains part of what we are seeing here with sz (and many other conditions).

Sz is relatively special in that two patients can have completely distinct disease histories/patterns and yet share the same label. However, I suspect that it is also possible for two people to have essentially the same symptoms (ie their pattern of disease appears identical to a physician) but their conditions can be attributable to a distinct cause.

We can already see a form of this in conditions such as arthritis: two patients can have essentially the same symptoms but one has a particularly high level of a certain anti-body in their blood which implies a relatively poor prognosis (of course, in this case we have a physical sign, well test result, which indicates the patients' distinctiveness).

This is what I refer to as the emergent theory of disease. It certainly muddies the waters further but I have to admit that if there is going to be any evidence that this can happen, it will be found in those disease known to have a basis in the dysfuntion of the brain (likely the most complex organ in the human body). It is this complexity which leads to problems in the first place

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