Talk:Schizophrenia

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Neutrality and Facts Missing

The facts are that a great number of psychologists have asked schizophrenia to be declassified as a disease and call it a junk drawer diagnosis. That this fact is missing from your article, as well as the research that backs up these facts, shows that this article was written from the point of view of psychologists who are biased and stand to make money from this sickness as a disease. Also, this diagnosis is most often and American diagnosis. Neutrality is clearly missing. — Preceding unsigned comment added by 68.49.33.150 (talk) 13:06, 21 October 2011 (UTC)

I think there is tentative agreement among editors watching this article that it could do with more information about scholarly criticism of the syndrome. What we're waiting for is someone to write the section. Adding to Wikipedia medical articles is arduous because everything has to be attributed to a reliable source, so it's a question of hoping someone with the requisite motivation, intelligence, writing skill and access to sources turns up. --Anthonyhcole (talk) 21:15, 12 November 2011 (UTC)

Historically there was a lower threshold of diagnosis and broader concept in the US. Not sure if it still holds true now. Regarding junk diagnosis, point out a Review Article and we can digest. Casliber (talk · contribs) 21:35, 12 November 2011 (UTC)

Wow this is really absurd and wrong. There was a section in this article on exactly what is being raised here, for a long time. Perhaps Casliber has forgotten or never noticed it going. I just checked and it was moved in its entirety to a subarticle (Diagnosis of schizophrenia) in January 2011. The edit comment? 'moved to subpage'. Talk page comment there or here? NONE that i can see.

Now looking back at the archive I see that this exact same complaint was subsequently raised in May 2011 by several editors, under the title "Severely Lacking in Alternative Points of View". A discussion in which I noticed Casliber commented at one stage. Yet toward the end of that discussion several secondary sources were listed when requested (apparently in addition to and in ignorance of all the sourced material by then on the diagnosis subpage) including (from editor Morethanhuman I think):

"Also there's an excellent discussion on the validity of schizophrenia, the absence of biomarkers, and the clinical utility of category/dimensional approaches, validity of kraepelinian dichotomy etc, in the Feb 2011 issue of World Psychiatry. It's also open access. http://www.ncbi.nlm.nih.gov/pmc/issues/194727/ "

I have to say the current article here is really nicely and cleanly structured and everything, but it kinda represents a failure of Wikipedia because it blatantly doesn't achieve NPOV and due weight of notable views, even though it's a Featured Article. I am prepared to work on reintroducing bits or a section on these issues but not if it's going to just be removed at some point due to medic bias or issues with the length of the article or whatever. EverSince (talk) 23:45, 16 December 2011 (UTC)

I have not looked through all the articles but many of them appear to be primary research. We use review article or major textbooks per WP:MEDRS to provide overviews of topics. The content in question was removed as it was primarily based on primary sources and this article was about to fail FAR due to sourcing issues. If there are viewed supported by review articles we can add them with appropriate weight. Doc James (talk · contribs · email) 00:16, 17 December 2011 (UTC)

As per our core policy wp:verify "It has always been good practice to try to find and cite supporting sources yourself" rather than just removing material, let alone without edit comment or discussion on the article's talk page before or after. Especially if material already has peer-reviewed secondary sources including reviews of the literature. Especially if other editors then as in the past apparently proposed replacement sources but then got no reply. The absurd thing about trying to disown this whole area is that even general reviews routinely cover or make some of the points, including the van Os paper already used throughout. And that's not even mentioning WP:NOTTEXTBOOK. Eversense (talk) 18:47, 23 December 2011 (UTC)

The article discusses the glutaminergic theory of schiz. but I have found evidence of endocannabinoid systems impacting the glu systems which in turn could lead to excess dopamine. Since this article discusses cannabis as a linke to psychosis I think this also should be an added fact. Unfortunately, I still have to wait a few days to become confirmed. I'd like to hear opinions in the mean time. Zzaffuto118 (talk) 22:49, 26 December 2011 (UTC)

If I understand you correctly (and please set me straight if I'm wrong), you are talking about your own laboratory data. If so, it would be very premature to include it in this article at Wikipedia. Generally, we do not add information here until it has not only been published in a peer-reviewed journal, but it has also been cited as significant in a peer-reviewed review article. Otherwise, there would simply be too much stuff here, much of it changing frequently. --Tryptofish (talk) 15:19, 27 December 2011 (UTC) But congratulations on your research! It sounds like you are doing very interesting work. --Tryptofish (talk) 15:22, 27 December 2011 (UTC)

I think there is a bit of published literature on the topic, but it isn't clear to me that there is coverage at a level that would justify including a discussion in this top-level article. Looie496 (talk) 16:10, 27 December 2011 (UTC)

The article also claims schizophrenia can be caused by drugs, while the outcome of research shows it's hard to tell if that's the case (see Causes_of_schizophrenia and mentioned sources). This does not help the article's neutrality. At this point the article still lacks a neutral point of view. ViezeRick (talk) 17:27, 3 January 2012 (UTC)

Image query

I was interested in the image at the top "Cloth embroidered by a patient diagnosed with schizophrenia" but the diagnostic claim seems to only go to a Flickr user who took the photo. Seems the cloth is exhibited at the Glore Psychiatric Museum and may be this one in their brochure. But that's only described as "an embroidered sheet that was this patient’s only form of communication." (not sure what to make of that claim either...)

Maybe in the actual museum it says patient diagnosed with schizophrenia, but then what was their name so they can be credited. S/he may have given rights to the museum to exhibit it but their says privacy statement says "Copyright 2009 All Rights Reserved, St. Joseph Museums, Inc. Reproduction in whole or in part of any photographs, maps, and illustrations without prior written permission from the copyright holders is strictly prohibited."

I know these things are a real pain but it would also be better if image was specifically claimed to be a representation of symptoms associated with schizophrenia, as it can't really be assumed that everything someone with a diagnosis does is just a manifestation of that condition. Eversense (talk) 01:53, 24 December 2011 (UTC)

Possible source of an alternative in case the above is problematic or to use anyway - Altered spatial frequency content in paintings by artists with schizophrenia (2011) - Page 5 "Portions of the paintings by artists with schizophrenia analyzed in this study, shown with calculated amplitude spectrum slopes." The paper is open access published under Creative Commons license and in it they thank NARSAD Artworks for the original full images. Not totally sure if that means they can be used here or who would be credited. Eversense (talk) 06:33, 24 December 2011 (UTC)

I think we discussed the current one before (?) - I don't think I was especially keen on it and am happy to consider alternatives - that one you've linked to looks interesting on first impression. I'll try and read article later. Casliber (talk · contribs) 06:46, 24 December 2011 (UTC)

I also agree that this issue is well worth looking into. Thanks. --Tryptofish (talk) 16:57, 24 December 2011 (UTC)

Seems photos taken of the museum permitted, but the personal Flickr caption can't be relied on (which is the case anyway of course) - told was 'a patient who was mute and possibly schizophrenic'. Eversync (talk) 11:13, 11 February 2012 (UTC)

Prevention / Edit Request/ Discussion

I was thinking that a mention such as "Children of schizophrenics might try to avoid substance abuse so as not to increase their chances of developing schizophrenia" in the Prevention section might be warranted. Based on: "Thus, it seems that cannabis can be conceptualized as a cumulative causal factor in some individuals, acting in concert with other vulnerability factors to promote the manifestation of the illness in some individuals who might otherwise have remained schizophrenia free." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659306/ and other references.

The prevention section is bleak. Might we not suggest in the prevention section that environmental risks not be added to genetic risks as a method of prevention? Glennconti (talk) 20:41, 1 January 2012 (UTC)

We already state that cannabis is a risk factor under causes. As the ref in question does not say stopping is useful for prevention I am hesitant to state it here. But happy to hear others thoughts.Doc James (talk · contribs · email) 20:48, 1 January 2012 (UTC)

My gut reaction is that we should not say that anything is preventative without considerable sourcing saying explicitly that it is preventative. The quote from the source, above, says that it's a causal factor, but doesn't explicitly speak to prevention. (Making the inference could be WP:SYNTH.) --Tryptofish (talk) 20:52, 1 January 2012 (UTC)

Is this a reliable source? http://www.schizophrenia.com/prev2.htm#drugs It specifically states in their prevention section not to use illegal drugs.Glennconti (talk) 21:15, 1 January 2012 (UTC)

It might or might not pass WP:RS, but for our purposes here, it falls short of WP:MEDRS. But it links to the studies on which it is based. (I haven't clicked through to those links.) If there are peer-reviewed studies, and preferably review articles or medical textbooks, that specifically address prevention, then I'd say that those fit the bill. --Tryptofish (talk) 21:36, 1 January 2012 (UTC)

Melbourne University's Professor David Castle stated in a February, 2005 interview that heavy drug use during formative times of life, such as the years at school, could affect the way a teenager or young adult thought, impairing cognitive ability and having a long-term impact on job prospects....

Professor Castle, author of the book Marijuana and Madness, has said that those people with this "psychotic proneness" were those who had a family history of mental illness or who had had a bad response on their first use of cannabis or to a tiny amount. Others at risk included those who had experienced a psychotic episode where they had paranoid thinking or heard a voice calling their name. Professor Castle said experiencing such a one-off episode was far more common than people thought.

"People with such a vulnerability should avoid cannabis like the plague," he said.

Without the effects of the drug, such a person might live their whole life without ever experiencing mental health problems. It has been estimated, for example, that between 8% and 13% of people that have schizophrenia today would never have developed the illness without exposure to cannabis.

Glennconti (talk) 21:43, 1 January 2012 (UTC)

Apparently there is a body of thought which supports my contention that there is a preventative aspect to schizophrenia not covered by our article. Is there anyone that can review the MEDRS to see if there should be an update to the Prevention section of this article? I am not qualified. Glennconti (talk) 21:47, 1 January 2012 (UTC)

If I understand correctly (again, I haven't looked at the sources, and I'm about to log off for the day), that's all from an interview, so it really isn't peer reviewed (yet). By the way, I see from your user page that we went to the same high school, but doubtless at different times. --Tryptofish (talk) 22:00, 1 January 2012 (UTC)

"Go Tigers!!!"Glennconti (talk) 22:57, 1 January 2012 (UTC)

"There is a small but significant minority of people who have a predisposition to psychosis and who would be well advised to steer clear of cannabis," Dr van Os said. http://www.nzherald.co.nz/technology/news/article.cfm?c_id=5&objectid=10116853 Glennconti (talk) 22:57, 1 January 2012 (UTC)

Cardiff University researcher Dr Stanley Zammit added: 'Nevertheless, we would still advise people to avoid or limit their use of this drug, especially if they start to develop any mental health symptoms, or if they have relatives with psychotic illnesses.' http://www.dailymail.co.uk/news/article-471106/Smoking-just-cannabis-joint-raises-danger-mental-illness-40.html Glennconti (talk) 23:34, 1 January 2012 (UTC)

"However, we conclude that there is now sufficient evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life." http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61162-3/abstract Glennconti (talk) 23:38, 1 January 2012 (UTC)

That Lancet review seems more than enough for you to include a point on this view. The full text says "The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis"..."The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness."

I agree with the broader point about views on prevention. This World Health Org review is a few years old but includes a section on possibilities for 'primary prevention' (a term this article could maybe use, to distinguish from the work on relapse prevention). This ia a more recent review on prevention, not as international, I've only scanned through it but seems to address both early intervention (identified high-risk individuals) and population-wide public health strategies, stating that there's lots of uncertainties & reasons why some approaches probably wouldn't be effective, but also outlining apparently notable work on how various causes could be prevented on a socio-economic and community level. Eversense (talk) 10:47, 2 January 2012 (UTC)

Yeah, I like the last few paras of this article as it makes a lot more sense - there being stronger associations between early developmental adversity and a host of subsequent problems, so taking a more holistic approach (remembering also Rutter's work on the Isle of Wight showing early adversity predisposing to any adult pathology), but I found the rest of the article a bit frustrating in that it ponders alot but stops short of firmly suggesting anything. Do others feel the suggestions of the last few paras are solid enough to summarise? Casliber (talk · contribs) 13:55, 2 January 2012 (UTC)

The lancet one I think we can use, and this one discusses the problems and barriers succinctly. Do we think we can add a bit from both? Our prevention section is pretty slim..... Casliber (talk · contribs) 13:55, 2 January 2012 (UTC)

Yes, I agree with Eversense and Casliber. Those are definitely appropriate sources, and it's a subject appropriate to address here. Just stick to where they explicitly make recommendations. Stuff where they ponder things but don't actually say "here is a recommendation for preventing or delaying schizophrenia" should instead be left for Causes of schizophrenia. --Tryptofish (talk) 16:09, 2 January 2012 (UTC)

My familiarity with this literature is very limited, so this is basically OR, but I think one should be alert to an important distinction. It seems unlikely to me that substance abuse could cause schizophrenia per se, but I have seen cases that gave a very strong impression that substance use can induce a psychotic break. I believe there is literature to support such an acute effect, but I wouldn't be able to point to specific articles. Looie496 (talk) 16:34, 2 January 2012 (UTC)

Apparently the medical literature does support the statement that cannabis use does cause schizophrenia in some people. Further it appears that the literature goes even further and suggests that schizophrenia can be prevented in some people if cannabis is not used. At least that's my take on it. Glennconti (talk) 17:09, 2 January 2012 (UTC)

That Lancet review seems quite clear in concluding that it "lends weight to the view that cannabis use precipitates schizophrenia and other psychotic disorders". And that avoidance could delay onset, and improve outcomes even if it did develop. It seems to leave open whether that could prevent these things altogether. Personally I don't see why you shouldn't be able to add/start a point on this in the prevention section. Eversense (talk) 12:29, 3 January 2012 (UTC)

The Moore/Lancet Review was highly recommended to me today at work and I am reading the fulltext now, to figure out what to add. Casliber (talk · contribs) 12:53, 3 January 2012 (UTC)

I don't have access to the full text of the Moore/Lancet review and therefore will defer to others to please make the desired edit to the prevention section. Thank you. Glennconti (talk) 13:50, 3 January 2012 (UTC)

However, it was my hope, among other things, that we might be able to provide a clear warning to children of schizophrenics that they are not powerless and that they can do something to avoid onset of the problem. If we can craft an edit that does this, I will be 100% satisfied. Glennconti (talk) 14:38, 3 January 2012 (UTC)

The Moore et al. full text can be found here btw (& i noticed some informal criticisms of it in reply just as a sidenote). Seems to suggest there's enough connection, at least on a population-wide level, to raise it as an issue despite the uncertainty. Only just realised the other one was another more recent Large et al. one. Eversense (talk) 16:30, 3 January 2012 (UTC)

I am still reading the Moore/Lancet Review. This http://bjp.rcpsych.org/content/184/2/110.full specifically states in the conclusion that "Cases of psychotic disorder could be prevented by discouraging cannabis use among vulnerable youths." I am going to use this to start a change to the prevention section as per EverSince's suggestion. Please revert if I am being too bold. Glennconti (talk) 14:51, 4 January 2012 (UTC)

Only thing not sure on unfortunately is the source seems to only say "An analysis of the Edinburgh High Risk Study found that both individuals at high genetic risk of schizophrenia (by virtue of two affected relatives) and individuals with no family history of schizophrenia were at increased risk of psychotic symptoms after cannabis use". Though it does identify younger people in general as at particular risk... Eversense (talk) 15:36, 4 January 2012 (UTC)

My take on this [1] is that familial risk is associated with an increased sensitivity to cannabis induced psychosis ie patients with a family history of psychosis should not use cannabis. Can we use this to establish this point in the prevention section?? Glennconti (talk) 16:51, 4 January 2012 (UTC)

Article seems to make a good point but it might be problematic in coming more from their primary study than a review, and not explictly linking it to prevention that I could see (it does say that while "relative effect sizes of differential sensitivity were high, absolute effect sizes, for example, of cannabis on schizotypy in unaffected siblings, were small."). There does seem to be a general mental health review that cites it (google scholar, open access) which does also mention prevention, not sure if that would be considered to fit the bill... Eversense (talk) 17:47, 4 January 2012 (UTC)

NPOV tag

Per comment

Quote ViezeRick: "The article also claims schizophrenia can be caused by drugs, while the outcome of research shows it's hard to tell if that's the case (see Causes_of_schizophrenia and mentioned sources). This does not help the article's neutrality. At this point the article still lacks a neutral point of view."

Did you read this section and the associated references? Schizophrenia#Environment Doc James (talk · contribs · email) 17:42, 3 January 2012 (UTC)

User in question has also made changes to the text of the lead without consensus.Doc James (talk · contribs · email) 18:01, 3 January 2012 (UTC)

I am not sure what NPOV issue is? "Causes of schizophrenia" is not as well written or sources as this article and I agree is in need of improvement. Tagging here though is not appropriate without sufficient justification.Doc James (talk · contribs · email) 18:26, 3 January 2012 (UTC)

I disagree with the use of the NPOV tag. It is an overly heavy-handed approach to the issue. Please remove the tag and resolve on the Talk page. Glennconti (talk) 18:42, 3 January 2012 (UTC)

A dispute about the neutrality of the article should be enough justification. Besides that, I am not the only person disputing parts of the article's neutrality. Disputes about the neutrality have started in October 2011 and where still ongoing last week. I see no reason why we can't edit the article to become more NPOV, or work out a solution on this talk-page. The rules do not allow removal of the tag until the dispute is resolved, so the less time we talk about the tag, the faster we can resolve the dispute. I've already asked some questions (below) which, when answered, might help me make an edit proposal. ViezeRick (talk) 19:35, 3 January 2012 (UTC)

You are only disputing the neutrality of a very small part of the article. Basically whether or not to say "may cause" versus "appears to cause". Do you really want to flag a FA for that for a week or so? Glennconti (talk) 19:41, 3 January 2012 (UTC)

No, I was hoping to solve the issue as soon as possible.

In my opinion the lead is not a small part of the article, on the contrary... The lead sets the further tone of the article, so the lead should be as neutral as possible. It does not have a neutral tone at the moment, I don't understand why we cannot use the information from Causes_of_schizophrenia (which has a npov) to change the tone of the lead.ViezeRick (talk) 19:48, 3 January 2012 (UTC)

As no description of the neutrality "issue" has been presented along with reliable sources and there is no consensus for said tag will be removing the it shortly.Doc James (talk · contribs · email) 17:23, 4 January 2012 (UTC)

Lead text

I removed the edits I made to the lead text. Could you please explain why you disagree with my attempt to make the lead take more neutral? ViezeRick (talk) 18:16, 3 January 2012 (UTC)

The lead is just a summary with " some recreational and prescription drugs appear to cause or worsen symptoms." summarizing "A number of drugs have been associated with the development of schizophrenia, including cannabis, cocaine, and amphetamines.[3] About half of those with schizophrenia use drugs and/or alcohol excessively.[33] The role of cannabis could be causal,[34] but other drugs may be used only as coping mechanisms to deal with depression, anxiety, boredom, and loneliness.[33][35] Cannabis is associated with a dose-dependent increase in the risk of developing a psychotic disorder.[36] Frequent use has been correlated with twice the risk of psychosis and schizophrenia;[35] however, the causality of this link has been questioned, and it remains controversial.[25][37][38] Amphetamine, cocaine, and to a lesser extent alcohol, can result in psychosis that presents very similarly to schizophrenia.[3][39] Although not generally believed to be a cause of the illness, people with schizophrenia use nicotine at much greater rates than the general population.[40]" Doc James (talk · contribs · email) 18:19, 3 January 2012 (UTC)

But isn't that summary about drug abuse, instead of prescribed use? And even if it is not, doesn't my edit make the lead more neutral? What alternatives to my edit would you suggest? ViezeRick (talk) 18:26, 3 January 2012 (UTC)

Amphetamines are prescription drugs and they may worsen schizophrenia. The term "recreational drug use" is preferred over "drug abuse" as it is more neutral.Doc James (talk · contribs · email) 18:31, 3 January 2012 (UTC)

Ah, they may worsen schizophrenia. That sounds more neutral than "appear to cause or worsen" to me. I'm still confused though... The summary is clearly titled: "Substance abuse". And I still don't understand why you believe that my edit would not have made the lead more neutral, it is taken literally from Causes_of_schizophrenia (section: substance use) ViezeRick (talk) 19:01, 3 January 2012 (UTC)

Thanks and fixed. I think the majority of reviews support "appear to cause or worsen" but am happy to hear what others think.Doc James (talk · contribs · email) 19:45, 3 January 2012 (UTC)

In the "appear to cause" VS "may cause" debate, I feel the ever so slight "appear to cause" version is more appropriate in that if there is some uncertainty in a health issue we should err on the side that promotes a healthier outcome. Glennconti (talk) 19:56, 3 January 2012 (UTC)

But Wikipedia does not give medical advice. When even scientist have not reached consent, we must be careful not to push our views. ViezeRick (talk) 20:07, 3 January 2012 (UTC)

This is not POV pushing. If the majority say "appear to cause" and few say "may cause" why are we bound to say "may cause"? Glennconti (talk) 20:10, 3 January 2012 (UTC)

I did not say anyone was pov pushing, I just said we should be careful not to. I don't think promoting a healthier outcome over neutrality is the right thing to do here, since wikipedia does not give medical advice, but aims to be a neutral encyclopedia. When there is not enough evidence for (any) claims, it's better to remain neutral (when editing wikipedia). ViezeRick (talk) 20:18, 3 January 2012 (UTC)

If I drop the dispute, will you help improve the lead text? ViezeRick (talk) 20:20, 3 January 2012 (UTC)

If you wish to suggest an edit, please do so. I feel the "appear to cause" language is NPOV in that it tempers the certainty of the direct cause position with some uncertainty. So I am not currently in favor of any change to the lead. Glennconti (talk) 21:01, 3 January 2012 (UTC)

"some studies show that recreational and prescription drugs appear to cause or worsen symptoms. The relationship between schizophrenia and drug use is complex, meaning that a clear causal connection between drug use and schizophrenia has been difficult to tease apart."

Just wondering, what would be wrong or nonfactual about the above change? ViezeRick (talk) 23:21, 3 January 2012 (UTC)

What's wrong about the above is a clear causal connection between drug use and schizophrenia has NOT been difficult to tease apart. A review as of 2010 [2] states "Existing reviews generally conclude that these cohort studies show cannabis has a causal relationship to psychosis". The contention is whether cannabis use can cause serious psychotic disorders that would not otherwise have occurred cannot be answered from the existing data so therefore more studies with different methodologies are being called for. Glennconti (talk) 00:48, 4 January 2012 (UTC)

This is just one review? Causes_of_schizophrenia mentions several other sources, but those claim the opposite. Sweden and Japan, where self-reported marijuana use is very low, do not have lower rates of psychosis than the U.S. and Canada do. ViezeRick (talk) 01:28, 4 January 2012 (UTC)

The 2010 review looked at at least 10 other studies all of which concluded a causal relationship or the lack of ability to exclude one. This certainly does not imply a causal link has been difficult to find. Can the similar rates in Sweden and Japan be currently explained? No; but, Japanese do a lot of urban living which has also be identified as a risk factor which could be an explanation. More questions can always be asked and more studies proposed. Glennconti (talk) 03:04, 4 January 2012 (UTC)

"Thus, cannabis use is now widely accepted as a modest contributory cause of schizophrenia and similar illnesses" [3] Glennconti (talk) 16:18, 4 January 2012 (UTC)

Substance misuse / Edit request / Discussion

Can we beef up the substance misuse section as far as causality and cannabis is concerned using Moore/Lancet? Apparently there is a misunderstanding of the current position on causality as evidenced by the recent NPOV tag discussion. Can we add "cannabis use is now widely accepted as a modest contributory cause of schizophrenia" as does this article [4] using Moore/Lancet or others? Glennconti (talk) 18:54, 4 January 2012 (UTC)

I just came across this paper Do patients think cannabis causes schizophrenia? which couldn't be used as a source for its specific results as it's only one small study, though in its discussion & conclusion it reviews findings, and well anyway it seems to give another point of view/caution on this... Eversense (talk) 01:44, 7 January 2012 (UTC)

Concerns regarding recent refs

A couple of recent refs are of questionable quality IMO. This summary of a presentation to congress in 1998 is a little old and not peer reviewed http://www.loc.gov/loc/brain/brkfast.html

Sources that where not of the highest quality per WP:MEDRS or most recent (last 3-5 years) was what brought this article to FAR. Wish to avoid going in that direction again.Doc James (talk · contribs · email) 01:45, 6 January 2012 (UTC)

Of course, so shall we delete the section on the biomedical viewpoint on prevention, or consider the source either not necessary for an obvious point, or easily replaceable i.e. via the NIMH webpage on schizophrenia? Not sure re. that description of last FAR, it seems to have been described as initiated 'improperly' by someone wanting to dipute the content, though tied up with primary sourcing issues both ways. Eversense (talk) 03:21, 6 January 2012 (UTC)

Do not have any problem with the content just the references thus left it for discussion. Will see if I can dig up better refs unless someone beats me to it. Doc James (talk · contribs · email) 04:00, 6 January 2012 (UTC)

ok i'll keep looking as and when too, tho seems to be covered by just the latter refs for now anyway. Eversense (talk) 04:29, 6 January 2012 (UTC)

A section on violence under "Signs and symptoms"

I think I may have removed content regarding violence a while ago as it was not previously supported by reviews. As I look there appears to be a number of reviews available. What do people think of the following?

While schizophrenia is associated with violence and homicide these behaviors are primarily attributed to the higher rates of drug misuse within this population. Rates of homicide also parallel those within the population as a whole. What role schizophrenia has on violence independent of drug misuse is controversial. Those with severe mental illness including schizophrenia are at a significant greater risk of being victims of both violent and non violent crime.

Doc James (talk · contribs · email) 05:13, 6 January 2012 (UTC)

Well that simply isn't true regarding the prior content that's now in the prognosis subarticle... it was sourced to reviews and national surveys, while some very specific studies on the rarer homicide issue had been in there since someone started the section. It wasn't saying anything much different to the above, although these are all more recent now which is progress. Personally I think extra caution against misinterpretation is justified in this area so - since it's not itself a sign or symptom, I suggest it goes in the society section, which already addresses the issue from one side; I would object to any statement simply saying its associated with schizophrenia - only in a very specific sense is it in a minority; the independence point is down also to other key factors incl. socioeconomic; a key issue re the more severe acts is what specific individual histories or mental states they may be related to, as well as the fact that random stranger homicides are even rarer despite that being (understandably) a stand-out fear. Eversense (talk) 11:12, 6 January 2012 (UTC)

Yes you are correct I moved it rather than removed it. I think only one of the refs is described as a review by pubmed. Have added to the section on society and culture.Doc James (talk · contribs · email) 19:01, 6 January 2012 (UTC)

Several were reviewing the evidence - tagged as review or meta-analysis, or titled an overview in journal of world psychiatry, US national govt-funded surveys, a seminal paper on relationship to neighbourhood. Pubmed & biomedical indexing doesn't dicate reliable secondary sourcing on wikipedia anyway, esp. in social contexts or on other points of view. Eversense (talk) 20:24, 6 January 2012 (UTC)

Either way I hope what we have now wrt violence makes everyone sufficiently happy. Eversense changes has definitely improved on what I wrote. Doc James (talk · contribs · email) 02:34, 7 January 2012 (UTC)

I thought what you put together was great and I hope others are ok with what's there or to edit it too. Eversense (talk) 03:33, 7 January 2012 (UTC)

Doc James what you have put together is excellent. Thank you. Topgunn9 (talk) 00:01, 8 January 2012 (UTC)

Edit request on 20 January 2012

{{edit semi-protected}} In the history section, please change:

The term schizophrenia is commonly misunderstood to mean that affected persons have a "split personality". Although some people diagnosed with schizophrenia may hear voices and may experience the voices as distinct personalities, schizophrenia does not involve a person changing among distinct multiple personalities. The confusion arises in part due to the literal interpretation of Bleuler's term schizophrenia. The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933.[124]

to:

The term schizophrenia is commonly misunderstood to mean that affected persons have a "split personality". Although some people diagnosed with schizophrenia may hear voices and may experience the voices as distinct personalities, schizophrenia does not involve a person changing among distinct multiple personalities. The confusion arises in part due to the literal interpretation of Bleuler's term schizophrenia (Bleuler originally associated Schizophrenia with dissociation and included split personality in his category of Schizophrenia). Dissociative identity disorder (having a "split personality") was also often misdiagnosed as Schizophrenia based on the loose criteria in the DSM-II . The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933.[124]

because:

I looked up "split personality" on Wikipedia and read the same information on the Dissociative Identity Disorder page and after some googling I found some more sources to back this up. The last source (Putnam, Frank W. (1989)) is also referred to on the DID page.

There's a lot of information to be found on Schizophrenia being misdiagnosed as DID (or visa versa - but that's a topic of debate) because of vague criteria in the DSM-II and DSM-III (being explained as delusions of control, thought insertion, hearing of voices or atypical psychosis) but I don't think all of that belongs on this page, so I tried to keep the addition as simple and unbiased as I could.

I hope this will be a useful contribution but I am human, so please check for mistakes and such...

sources:

[1] Stotz-Ingenlath G: Epistemological aspects of Eugen Bleuler’s conception of schizophrenia in 1911. Med Health Care Philos 2000; 3:153—159 [2,3] Hayes, J. A., & Mitchell, J. C. (1994). Mental health professionals' skepticism about multiple personality disorder. Professional Psychology: Research and Practice, 25, 410-415 [4] Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press. pp. 351. ISBN 0-89862-177-1

JGM73 (talk) 01:12, 21 January 2012 (UTC)

Done. Request, WP:BRD  Chzz  ►  02:22, 28 January 2012 (UTC)

Y Done

Neurodevelopmental insults

I would like to suggest that the first paragraph of this article describe schizophrenia as a neurodevelopmental disease, possibly in addition to being a mental illness. I am reading the book The Origins of Schizophrenia, published 2012 by Columbia University Press, and chapter 1 (page 25) says:

In recent years, evidence has accumulated in support of a role for neurodevelopmental insults in the etiopathogenesis of schizophrenia (Brown, 2011). The dramatic changes in brain structure and function from conception to birth underscore the particular vulnerability to insults during this stage of development with regard to both short- and long-term disease outcomes (Tau & Peterson, 2010). Hence, the determinants of detal brain development- both genes and environmental factors- deserve consideration as potential risk factors for schizophrenia.

The Origins of Schizophrenia, published 2012 by Columbia University Press, and chapter 1 (page 25), source: http://cup.columbia.edu/book/978-0-231-15124-5/the-origins-of-schizophrenia

This scholarly book is summarizing the most recent scientific consensus on this terrible disease and it is pointing to schizophrenia as a neurological issue more than it is a mental health issue. Thank you. 140.247.141.165 (talk) 22:41, 29 January 2012 (UTC)

Oh, and another thing, this book discredits/updates a lot of information that is presented in this article. I would suggest that this article be demoted from being a FEATURED ARTICLE until such time that this article can be sufficiently updated with the most recent scientific findings. Thank you. 140.247.141.165 (talk) 22:57, 29 January 2012 (UTC)

I think you are misreading the book. "Evidence has accumulated in support of a role of neurodevelopmental insults" is by no means the same thing as "evidence conclusively demonstrates that neurodevelopmental insults are the main cause". Given the current distribution of scientific opinion, that would be a massive overstatement. Looie496 (talk) 03:19, 30 January 2012 (UTC)

Um hi. I agree that this article should reflect the leading theories of scientists and agree that this book represents a very reliable secondary source, and is also the most recent secondary source. The quote seems to be saying that there is a lot of evidence to show that schizophrenia is a disease caused by a neurodevelopmental problem. Surely there is no statement saying that it is 100% certain (I don't know if scientists ever say something if 100% certain) but they are saying that the evidence has "accumulated", which I think might significant for scientist-speak. I also think that this article should reflect the opinion that schizophrenia is much more than just a mental disorder but is also an actual neurological problem. 76.118.180.210 (talk) 04:00, 30 January 2012 (UTC)

Thanks for presenting a potential new reliable source for the article. I'd like to highlight that it says neurodevelopmental insults "deserve consideration as potential risk factors for schizophrenia" (my emphasis). That is weak in my opinion. As such, if this kind of statement is significant enough for inclusion, it would first go to Causes of schizophrenia or maybe mechanisms. Posting this on the talk page there might be a good next step. Thanks. Biosthmors (talk) 17:47, 30 January 2012 (UTC)

PreNatal Estrogen

Excessive prenatal estrogen exposure may play a role in gene expression for schizophrenia.(see study) In addition, a 2009 animal study determined that in utero and inordinate estrogen exposure may disrupts specialized brain cells and their ability to regulate brain chemistry in the left hemisphere, specifically altering the way cells release and reabsorb dopamine. (see study)

It is thought that excessive prenatal testosterone exposure plays a role in autism and may cause damage to the right pre-frontal cortex (see study), which may evince the flip side to schizophrenia.....(see study) Witch Hazell (talk) 21:16, 4 February 2012 (UTC)

Interesting, but those are not sources that would be usable in an article like this. Per WP:MEDRS, there is a strong preference for using review papers as sources rather than primary research studies. The reason for that policy is that when it comes to topics with a very extensive literature, it is generally possible to find individual studies that support pretty much any idea one can imagine. We as Wikipedia editors are not in a good position to judge which studies stand the test of time and which don't -- it's much better to leave that judgement to the authors of high-quality review papers. Looie496 (talk) 00:33, 5 February 2012 (UTC)

T. gondii

See no discussion in the article of T. gondii 's possible involvement in the rise or development of schizophrenia. The Atlantic 's "How Your Cat is Making You Crazy" is off-puttingly titled, but fairly thorough on the research being done on the subject. If medical journal cites are necessary for the article, someone with access to a database could use the researchers' names to find their papers and the corroboration/disputes so far. 101.229.79.243 (talk) 00:31, 11 February 2012 (UTC)

Edit request on 24 February 2012

Patients involved in violence or the refusal to use violence often complain of immediate talking and remote viewing by people who communicate in the mind through the use of hypnogogic mental language acoustics and claim to organize violence and violent crime syndication within or beyond the community. Easily Scared Persons report the condition is similar to being viewed or sensed by persons unseen, in places unknown, for deceptive or hostile purposes, while talking or listening to a host audience, not within the perception of the individual, or otherwise being threatened or intimidated without the support or assistance of lawful community.

Make-believe emotional information and fake working solutions are often considered options by those coping and dealing with chronic confusion or other acute pressures of the mind that accompany the cognitive disability. Most sufferers of schizophrenia report being able to modify the antagonism of 'voices' by performing constructive forms of counter-confrontation, without the use of violence, however, all 'voices' evidence an intention to exploit the perception and risk of being remotely viewed and immediately sensed by others for purposes of creating fear and poverty. The mental abuse and emotional torment experienced by the sufferer may or may not cause extreme states of agitation or confusion (delusion) that result in the condition of violence. Much of the illness of provoked emotion or hearing voices can be remedied by strategies that remove conditions that cause fear and poverty, whether the cognitive disability of 'hearing of voices of people in the mind,' is considered people or not.

64.136.124.223 (talk) 07:14, 24 February 2012 (UTC)

Not done: please be more specific about what needs to be changed.--Ankit Maity^Talk_Contribs 11:43, 24 February 2012 (UTC)

Thanks for your suggestions. It makes sense to me that relieving poverty and fear would reduce the intensity of emotional symptoms and auditory hallucinations. The social pain inflicted on the mentally ill is something I'd like to learn more about. As for the remainder of your comment, I know next to nothing about auditory hallucinations. Hearing Voices Movement looks interesting and I intend reading that one day. But we can only add information to medical articles that has already been published in a reliable source. Our own analysis, if it's not backed up by a reliable source, can't be included in Wikipedia articles. --Anthonyhcole (talk) 15:47, 24 February 2012 (UTC)