Talk:Schizophrenia

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Violence section deletion

Mihai, please stop deleting the violence section. This has already been discussed here, and you have already taken the fact that you disagree with its presence to mediation before pulling out of the process. The research presented in this section is from peer-reviewed scientific journals, if you can provide updated or contradictory evidence from similarly respected sources, it's inclusion would be much appreciated. Simply deleting the section is not acceptable, however.

- Vaughan 13:23, 28 June 2006 (UTC)

Wikipedia articles on other health disorders don't have violence sections, and there is no rational reason for schizophrenia to be singled out like that. --Mihai cartoaje 04:59, 29 June 2006 (UTC)

The reason schizophrenia has a violence section is because there are common misconceptions about violence and schizophrenia, and there is a huge amount of research and discussion on the issue. - Vaughan 07:03, 29 June 2006 (UTC)

Mihai, I have now referred this to mediation. - Vaughan 12:36, 29 June 2006 (UTC)

If he's already pulled out of a mediation, I don't think another one is going to help. You could try to appeal to a broader community for consensus by asking at the Village pump, posting a Wikiquette alert, or filing a Request for Comment. Ideogram 15:28, 29 June 2006 (UTC)

The issue is currently listed as requiring a new mediator, and I would be willing to do so on this case. I have a bit non-professional experience with mental health issues. - MSTCrow 00:04, 30 June 2006 (UTC)

Please avoid edit-warring during the mediation. That goes for all sides; if someone else makes an edit do not respond in kind. Ideogram 13:19, 30 June 2006 (UTC)

Wikipedia's rules about removing obvious vandalism are clear. This is the disputed section:

Schizophrenia and violence

Violence perpetrated by people with schizophrenia

Although schizophrenia is sometimes associated with violence in the media, only a small minority of people with schizophrenia become violentTemplate:Fn, and only a minority of people who commit criminal violence have been diagnosed with schizophreniaTemplate:Fn Template:Fn.

Research has suggested that schizophrenia is associated with a slight increase in risk of violence, although this risk is largely due to a small sub-group of individuals for whom violence is associated with concurrent substance abuse and ceasing psychiatric drugsTemplate:Fn. For the most serious acts of violence, long-term independent studies of convicted murderers in both New ZealandTemplate:Fn and SwedenTemplate:Fn found that 3.7%–8.9% had been given a previous diagnosis of schizophrenia.

There is some evidence to suggest that in some people, the drugs used to treat schizophrenia may produce an increased risk for violence, largely due to agitation induced by akathisia, a side effect sometimes associated with antipsychotic medication.Template:Fn Similarly, abuse experienced in childhood may contribute both to a slight increase in risk for violence in adulthood, as well as the development of schizophrenia.Template:Fn

Violence against people with schizophrenia

Research has shown that a person diagnosed with schizophrenia is more likely to be a victim of violence (4.3% in a one month period) than the perpetratorTemplate:Fn.

Mihai

Your first edit to the Schizophrenia page was on 09:49, 24 January 2006 when the text in question was already in existence, so replacing it after you've deleted it is hardly vandalism.

- Vaughan 06:47, 1 July 2006 (UTC)

This is very clearly not vandalism, just a content dispute. Ideogram 12:17, 1 July 2006 (UTC)

Vaughan and Mihai, do you agree to mediation by myself? - MSTCrow 03:12, 2 July 2006 (UTC)

Sounds good to me - Vaughan 07:54, 2 July 2006 (UTC)

Yes. --Mihai cartoaje 13:16, 2 July 2006 (UTC)

Ok, I'll start with Mihai. Mihai, do you disagree with Vaughan's assertion that many people perceive a high level of assocation between schizophrenics and violence, and that this assocation is a fallacy? - MSTCrow 15:39, 3 July 2006 (UTC)

I was not aware of any association between schizophrenia and violence before reading wikipedia's article. Websites on the internet that try to make readers think that people with schizophrenia are violent have something to gain by doing it. schizophrenia.com is a forced-drugging advocacy group which, according to our article, is pharmaceutical-sponsored. For example, if we click on their advocacy section, we get directed to tac. schizophrenia.com says that delusions cause violence; however, Vaughan presented a study in the archives in which the authors tried and failed to find a correlation between delusions and violence.

As to any actual link between schizophrenia and violence, almost all studies on the schizophrenia population found less than 4 times the normal rate, with one of them finding that people with schizophrenia were more often the victims than the victimizers. The actual rate might be even lower than that because those studies don't say how people with drug-induced mental problems were counted. Members of the schizophrenia population who have not abused drugs might have an even lower rate. --Mihai cartoaje 02:34, 5 July 2006 (UTC)

May I interject for a moment? I have had no involvement with this article in the past, but generally when violence and a mental disorder are mentioned together, I take heed. I have found from my personal experience that a lot of people assume that things like being tagged with diagnoses like schizophrenia and bipolar disorder automatically mean violent tendencies in a person. You're right, this is a misleading probability - but I saw nothing in the disputed section to make one think that schizophrenics are violent - to the contrary, the section did well to dispell that myth. In my humble opinion, I think that if just one person reads this article and become aware that schizophrenics aren't generally violent (as at least the US media would make you think), I think the article serves the interest of those folks who have the disorder. I'll crawl back into my hole now. CQJ 03:31, 5 July 2006 (UTC)

Mihai, If you can quote studies to back up your assertions it would aide the discussion. You are right about drug-induced mental health issues being responsible for many of the cases of violence in people with schizophrenia, as was noted in the original text. Delusions do have a small association with violence, however, as also noted in a recent review article on the topic.

As shown by surveys from mental health charities (e.g. this one from Mind), there is significant public misconception about the link between violence and mental illness. The original text in the article aims to dispell those myths by presenting the evidence from peer-reviewed scientific studies.

Therefore, schizophrenia.com's opinions on this matter are neither here not there as they are not quoted or used as a source.

- Vaughan 09:02, 5 July 2006 (UTC)

Mihai, what do you mean by a forced-drugging group? Do you disagree that it would be reasonable for a pharma company to be most likely to be knowledgeable about the mental illness in question, as they seek to produce treatments for the illness? - MSTCrow 13:52, 6 July 2006 (UTC)

If I may say so, MSTCrow, this is a distraction from the issue at hand. The issue is Mihai's reasons for wanting the violence section deleted (he has given none so far except alluding to the idea that people may think people with schizophrenia are violent if they read the actual research in this area - which in my opinion, dispells this myth), not whether he thinks drug companies are most knowledgeable about mental illness.

- Vaughan 16:08, 9 July 2006 (UTC)

pharmaceutical companies don't always know everything, as shown by this experiment [1]. --Mihai cartoaje 09:39, 10 July 2006 (UTC)

Mihai, I'm having difficulty understanding why you believe the violence section should be deleted. Is it something related to the perceived connection between schizophrenia and violence, or because a link that states there is a misperception between violence and schizophrenia originated from a pharmaceutical company? - MSTCrow 03:26, 11 July 2006 (UTC)

Mihai, are you intending to continue with mediation? - Vaughan 06:02, 14 July 2006 (UTC)

Wikipedia articles on other health disorders don't have violence sections, and there is no rational reason for schizophrenia to be singled out like that. --Mihai cartoaje 05:13, 15 July 2006 (UTC)

That is not a reason to delete the violence section on schizophrenia. Schizophrenia has a violence section because a) there is a lot of public misconception about the link (i.e. the media singles out schizophrenia - which the section aims to address with the actual statistics) b) there is a huge amount of research into violence and schizophrenia, which doesn't exist to the same degree (although there is some) for other disorders.

This is just going round in circles. Mihai has produced exactly the same reasons for deleting the section again and again, despite the fact that it is proportional to the scientific concern over the subject, is proportional to the public concern over the issue, and it represents the research accurately. I really don't think it is acceptable that one person can remove large parts of an article on a whim and then have other people have to defend its reinclusion. MSTCrow, your input would be appreciated. - Vaughan 09:03, 15 July 2006 (UTC)

Deleting a section repeatedly is a form of blanking, which is considered a form of vandalism on Wikipedia. Mihai, the reason that other mental health disorders do not have a violence section is because none of them that I am aware of have a wide public misperception that those with the mental illness are significantly more prone to acts of violence than the general population. - MSTCrow 08:11, 18 July 2006 (UTC)

So, the violence section has now been removed for over a month. I would very much like to replace it, as in my view it is accurate and appropriate, and was only removed on the behest of one person. What is the best way of going about this? Do I call for a vote on the Village Pump page or ask for consensus here? - Vaughan 19:53, 23 July 2006 (UTC)

I've contacted Mihai on the talk page, asking if they have withdrawn from the mediation, and/or have decided the section is appropriate for inclusion. If they don't get back to me by the end of the week, I suppose they must have abandoned any concern with it. If they still believe that the section should not be included, I don't think mediation will work. In which case, I suggest referring to Resolving Disputes. - MSTCrow 16:30, 29 July 2006 (UTC) (forgot to add the tag)

I have not been asked any more questions. --Mihai cartoaje 09:31, 27 July 2006 (UTC)

Mihai, it's a discussion not an interview. There are points above which you have not answered. This all sounds like delaying tactics to me. - Vaughan 08:19, 28 July 2006 (UTC)

Place the data into the article. If Mihai removes it, then you must seek more formal means of resolution. It is my belief that the data should be in the article, and I don't understand at this point why Mihai is against the data being included. There is a fundemental difference of perspectives here that I do not believe can be mediated. As such, I am removing the case from mediation, and hope that it can be worked out via other avenues. - MSTCrow 23:38, 1 August 2006 (UTC)

I looked at the disputed section and decided to throw in my two cents as a neutral third party - I don't see anything inherently wrong with the section, and if violence is sometimes associated with Schizophrenia, the section seems to have a place here. It is properly sourced and is verifiable, and there doesn't appear to be much reason to removing the section. I don't believe the reasoning that other articles don't have similar sections is one that has much backing, as people could always add one should there be misconceptions about them. I don't think the section violates anything on WP:NOT, so it could indeed have a place on this article. Cowman109^Talk 00:04, 2 August 2006 (UTC)

Thank you both for your comments. I've restored the section on violence. - Vaughan 06:54, 2 August 2006 (UTC)

Mihai has just deleted the violence section again after a number of people have expressed their views that it is accurate, balanced and should stay. I'll look for other avenue's for getting this addressed as mention above. - Vaughan 15:28, 2 August 2006 (UTC)

I have re-added the section, as there does not appear to be any policy-related reasoning for removing it. It is verifiable and does clear up a common misconception. There appears to be a growing consensus to keep the section, but just to make sure, I will leave a note on the village pump to see if I can get another opinion or two. Cowman109^Talk 16:18, 2 August 2006 (UTC)

From an outside perspective (having never edited the article before), I would keep the section. I don't see amy arguments here which would motivate me to think the presence of the section is intrinsically pov or such. It seems well referenced, and the references go a long way to establishing notability. Lack of similar sections in other articles is not a good motivation to remove it in my mind. In short, I think the section should be kept. --The preceding unsigned comment was added by TeaDrinker (talk * contribs) .

• I would agree, as this is an issue much discussed in the popular press as well as in the professional literature. NothingMuch 10:52, 31 August 2006 (UTC)

We all know(?) that schizophrenics are more likely to be poor, and that poor people are more likely to be both schizophrenic and violent. But do we know whether schizophrenics are any more or less violent than other poor people? --londheart 15:17, 31 August 2006 (UTC)

Zelda Fitzgerald

Isn't it misleading to call her a "painter"? If some activity other than being Scott Fitzgerald's wife is called for "writer" would be more accurate--she published a novel and helped Scott with his writing. ⅔

Cannabis association

"Nevertheless, some previous research in this area has been criticised as it has often not been clear whether cannabis use is a cause or effect of schizophrenia."

Could someone please explain to me how cannabis use is an effect of schizophrenia? Is this saying people with schizophrenia are more prone to use cannabis? If so, I think there should be a linked study. At the very least this sentence should be rephrased.

Hi there,

People with mental illness are many times more likely to use drugs and alcohol, partly in an attempt to relieve the distressing symptoms and experiences.

If you read the reference 48 paper, it deals with exactly these issues.

- Vaughan 15:21, 9 July 2006 (UTC)

Also, patients are more likely to be long-term unemployed, and therefore less likely to behave in ways unconducive to job retention, which would include admitting to technically illicit recreations. --londheart 08:02, 24 August 2006 (UTC)

'Viral cause' section

Someone has added to the article viral claims which come from a dubious source and have not been independently replicated. If you look through my edit history, you would see that everything I have added to Wikipedia has been independently replicated. --Mihai cartoaje 03:21, 6 July 2006 (UTC)

The claims do not come from a dubious source. They are published in a peer-review scientific journal. However, I agree with your general point. The section is derived from a single study which actually shows no clear causal link, so I've removed the section and have included it below.

I note, however, that you're quite happy to remove sections from the article which contains research from respected sources that has been widely and extensively independently verified.

- Vaughan 08:15, 6 July 2006 (UTC)

A 2001 study by Johns Hopkins University Children's Center found the moloecular "footprint" of a retrovirus in the cerebrospinal fluid of 30 percent of people with accute schizophrenia and about 7 percent of those with chronic schizophrenia. The "footprint" was created by retroviral RNA by active expression of an endogenous retrovirus known as HERV-W.Template:Fn Researchers at Johns Hopkins have also found associations between a high level of maternal Herpes Simplex Type 2 antibodies and onset of adult psychosis in offspring. Researchers have also found a 508 percent increase in the risk of developing schizophrenia if born in the winter or early spring when indections deseases are more rampant.Template:Fn

Template:FnbKarlsson,H.; Bachmann, S.; Schröder, J.; McArthur, J; Torry, E.F.; Yolken, R.H. (2001)Retroviral RNA identified in the cerebrospinal fluids and brains of individuals with schizophrenia. PNAS, 98(8), 4634-4639.

Template:FnbYolken, R.H. (2004)Viruses and Schizophrenia: A Focus on the Herpes Simplex Virus

Why not just add some kind of note explaining that the study has not been verified by other sources since then and that the result is preliminary because it is only based on a single study? It might still be useful information. Since the source is apparently legitimate, why not include the information? Ram-Man 11:34, 6 July 2006 (UTC)

Because hundreds of studies are published on schizophrenia every month. Including every single finding would make a mess of the article. Hence, the article should really represent the most significant knowledge about the condition, and not just list individual research findings.

- Vaughan 11:52, 6 July 2006 (UTC)

I've given this some more thought and I wanted to point out that the section under "Prognosis" that talks about the "World Health Organization" taking couple of "long-term" studies. In that case, the information suggested that there is some link to developed nations and schizophrenia. Yet, nothing more is said about the link or whether it was proven or disproven. Yet we consider the source to be reliable. Most likely that same standard would eliminate large chunks of this article. There is no precedent for not including data simply because we don't personally think it is legitimate. Information that is early or speculative but authoritative should be included, but with a proper explanation. If it turns out the viral link was wrong, well then it is an interesting historical fact. If it turns out that the link is something, well we don't want to miss out on that either. The same could be said about the studies I mentioned at the start of this post. For all we know it is just errors in methodology, but maybe not. Ram-Man 11:57, 6 July 2006 (UTC)

Schizophrenia patients having better long-term recovery without neuroleptics has been independently replicated. The NIMH pitted chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine (Mellaril) and a wonder drug named Placebo(TM) and the winner was Placebo(TM) [2].--Mihai cartoaje 17:09, 6 July 2006 (UTC)

Mihai,

You are citing a single 1967 paper to back up your point. You need to consider the research as a whole to fully back up an argument. There are many more research studies which do not support this result. I encourage you to look them up on PubMed.

- Vaughan 15:24, 9 July 2006 (UTC)

Given I just read your post as I was typing the above, I will say this: Why is the World Health Organization study still included then? Ram-Man 11:57, 6 July 2006 (UTC)

Your point is well taken that single studies (or multiple studies by a single group) are suspect and highly speculative in nature, because they have not been repeated by others in the field. But perhaps in this case that can be overridden. We are not asked to make a choice between good information and speculative information. We are making a choice between no information (not letting the article contain information on a potential viral cause) and some early information. Of course if at any time there is clearer information available, then we should use that instead. Ram-Man 12:00, 6 July 2006 (UTC)

Actually, if you read the study, you'll find that it is not a study by a single organization, but a study co-published by many different organizations around the world. (Including Johns Hopkins, the University of Heidelberg, and a NAMI institute). The article saw print 5 years ago, and, according to PubMED, there is extensive research being done on the the retrovirus itself and its effects on human DNA. In the four years that I have been studying schizophrenia, I have not found any research that claims this study to be false, and it's only a five-year-old study, which could explain why it has yet to be replicated (that I know of, at least.) Dlmccaslin 22:39, 6 July 2006 (UTC)

Upon thinking, I tried some more searching, and found a study conducted in Germany published by the Journal of Virology (American Society of Microbiology) that found HERVs overrepresented in the spinal fluids of pateirts with schizophrenia and bipolar disorder [3]. Dlmccaslin 23:10, 6 July 2006 (UTC)

It's the University of Heildelberg again. --Mihai cartoaje 20:38, 10 July 2006 (UTC)

Might I suggest using this source: Seasonality of births in schizophrenia and bipolar disorder: a review of the literature, Schizophr Res. 1997 Nov 7;28(1):1-38 rather than this source: A systematic review and meta-analysis of Northern Hemisphere season of birth studies in schizophrenia, Schizophr Bull. 2003;29(3):587-93 for the seasonality citation? It's from several years earlier, but it reviews over 250 studies rather than 8, and also covers both hemispheres -- Josh 05:08, 16 July 2006 (UTC)

508 percent increase

Researchers have also found a 508 percent increase in the risk of developing schizophrenia if born in the winter or early spring when indections deseases are more rampant.Template:Fn

Is this legitimate? We have another reference in the article to this where it states a "small" increase. If we have another source that is claiming a major influence, we should be taking that into consideration. Ram-Man 12:03, 6 July 2006 (UTC)

Hi Ram-Man,

The point of not including the viral stuff into the article is an essentially editorial decision. Studies shouldn't simply be included because they've been published, but because of the quality of the study, and the significant of the study.

The quality of the study can be judged by understanding its methodology. For example, a single study well-conducted study that has a methodology that allows a causal inference and has significant power to draw strong enough conclusions is worth many more correlational studies.

The significance of a study is based on a wider theoretical understanding of the field. A study (particularly of the high quality type mentioned above) might be particularly influential, and hence worth of note in an encyclopaedia article.

Simply listing study results does not make for a good article. As far as I know, there have been no studies on schizophrenia that have demonstrated a causal role for viruses in schizophrenia. As a consequence, it is rarely discussed in textbooks, lectures or research papers.

Hence, I would argue that devoting a whole paragraph to it as a 'cause' is both misleading (there is only circumstantial evidence for any causal role) and overstating its importance in the field.

Perhaps, it could be added to the 'alternative approaches to schizophrenia' section, though? As this section has the more speculative stuff in it.

As for the 508% result, it sounds highly suspect to me, and I have never heard it stated elsewhere, although I've not read the paper which was linked to.

- Vaughan 15:18, 9 July 2006 (UTC)

Proposed pre-pulse inhibition merge

I don't see any reason to merge this article with schizophrenia as it is an experimental method that is not specific to schizophrenia. Although it has been used widely in schizophrenia research, it has also been used to investigate anxiety, depression and panic disorder to name but a few.

Unfortunately, the prepulse inhibition article is so badly written as to suggest that it is purely a model of schizophrenia.

So, if there are no objections, I'll remove the merge tag at the top of the article.

- Vaughan 15:48, 11 July 2006 (UTC)

Etymology

Regarding "the term 'schizophrenia' translates roughly as 'shattered mind,'" -- when I took a seminar in college where we discussed schizophrenia, the professor translated the term literally, as "split mind." There are also 111 results on Google Scholar for "schizophrenia 'split mind'" as compared to 14 for "schizophrenia 'shattered mind'".

...following up on one of those Google Scholar hits, I've found this: "Eugene Bleuler (1857-1939) ... introduced the term schizophrenia (Gr: 'split mind')... . Bleuler intended the term to describe a division between thought, emotion and behaviour in affected patients." in Schizophrenia: Genesis, Receptorology and Current Therapeutics, Capuano et al., Current Medicinal Chemistry 2002, 9, 521-548. Bleuler and his contribution to schizophrenia have been addressed elsewhere in the article, but I think we should a) change the rough translation to "split mind" as it's more commongly used, b) add in the citation, and c) maybe add a little bit about why Bleuler chose the term that he did. Thoughts?

- Josh 05:23, 12 July 2006 (UTC)

My thoughts are, a) Seems like a pointless debate over two words that are essentially the same, b) Why? The article cited attempts to assign motives for Bleuler, which the authors cannot possibly know, c) See b. As in, no one could possibly know that, so why waste time and space with pointless speculation. Change the translation, the rest is useless and unnecessary.

I agree that the translation we use should match the most common usage unless there is compelling evidence in print form that the other translation is used. Ram-Man 11:45, 17 July 2006 (UTC)

The English rendering 'split' of the Greek 'schizo-' converts it into an adjectival verbal past participle, which, arguably, makes the diagnosis seem more drastic, final, irreversible and stigmatising. 'Splitting' accurately depicts the social circumstances likely to precede and result from diagnosis. --Etaonsh 18:48, 7 August 2006 (UTC)

I very much doubt that there is any such thing as 'schizophrenia'. It is essentially a psuedo scientific term for a psuedo science. As a piece of software the brain is miraculous. Anyone who claims to understand a 'normally' funtioning brain is lying. Thus anyone claiming to understand - still less rectify - an abnormally functioning brain - is a double-liar. Thus we have the non-science of psychiatry. In parts of Africa and other places where this Western terminology has not penetrated they called people presenting similar symptoms possessed by evil spirits. This makes as much - or as little - sense. And their treatments, such as chewing a specific piece of tree bark, are just as successful. They just don't make so much money for multinational drug companies. SmokeyTheFatCat 18:01, 25 July 2006 (UTC)

Evidence of effectiveness in community

BMJ this week a nice study on the effects of clozapine & olanzapine on needs for readmission etc. JFW | T@lk 09:55, 28 July 2006 (UTC)

Cleanup-Spam

I have added a clean-up spam tag because there are external links to E. Fuller Torrey and schizophrenia.com which promote the forced use of drugs. --Mihai cartoaje 15:26, 2 August 2006 (UTC)

Mihai, I've removed the tag as these are not spam. They are not trying to sell any particular product, they just promote a view that you don't agree with. Alternative viewpoints to your own are not spam, and the article should link to a diverse range of opionions. - Vaughan 15:31, 2 August 2006 (UTC)

I am removing schizophrenia.com because it breaks multiple wikipedia rules:

• Wikipedia's rule about external links which don't have content which cannot be included in the article.
• Wikipedia's rule about external links with false statements.
• It was added to the article to increase its ranking in google, so it meets the requirements of spam (promoting a website). --Mihai cartoaje 06:49, 3 August 2006 (UTC)

There appears to be an inappropriate double negative there, perhaps written in the heat of POV bluster(?). Continueddonations 07:42, 13 September 2006 (UTC)

can i barge in?

Mihai! Schizophrenia.com is a good, respected site. "Promoting the forced use of drugs" is not against the law, besides, people having psychosis should be medicated for the sake of their own health.

You clearly trying to impose your own rules on this article.

You say: "Wikipedia's rule about external links with false statements."

Well, there is not a single website on the web without some false statements of some sort. Besides, according to this "rule", you clearly should delete all the links to the "anti-psychiatric" websites critical of genetic factors etc., because they are sure brimful with false statements.

You say: " Wikipedia's rule about external links which don't have content which cannot be included in the article."

Too many "donts" and "cannots" to me. I'm not that good in understanding English. What do you mean by this rule and where can I read it in the original (link, please)? --CopperKettle 03:14, 7 August 2006 (UTC)

'Should' implies opinion (POV), not information. I think your English is better than you suggest, on the other hand - too many double negatives giving the opposite meaning to that intended. --Etaonsh 20:32, 7 August 2006 (UTC)

Here: http://en.wikipedia.org/wiki/Wikipedia:External_links. --Mihai cartoaje 19:09, 7 August 2006 (UTC)

There have been reports of abuse, like this [4]. --Mihai cartoaje 18:48, 4 September 2006 (UTC)

Treatment addition

I just reverted an addition to the article about Schizophrenia being cured by a certain doctor for some time, referring the reader to some references. There is already a treatment section in the article, so I think the added content there is unnecessary (not to mention doesn't seem to be in a proper tone as it refers to the reader as 'you', and seems to read as more of an advertisement for the doctor). Hopefully the IP will come here and discuss his or her reasoning for including such information. Thanks. Oh, and there was a typo in the edit summary that was meant to say 'unencyclopedic', not 'unencyclopedia' :)Cowman109^Talk 18:22, 6 August 2006 (UTC)

Vandalism: Mention of genetic background is deleted

Whenever I have an opportunity, I will revert any vandalism considering the genetic factors in schizophrenia. Also, I'm planning to add a couple of lines on Reelin's role in schizophrenia (and RELN gene). These, along with the mentioned in the article genetic findings, are independently confirmed, even several times confirmed, by different groups of scientists. I'm quite irked by consistent vandalism on a part of Mihai (violence section deletion, for example). The Schizophrenia page is on my watchlist now. --CopperKettle 03:01, 7 August 2006 (UTC)

I find your own attitude aggressive and vandalous - towards patients and offspring - your lack of objectivity is such that the reader can conclude with certainty that you yourself are not stigmatised in a group of this kind. 'Schizophrenia' is well-known in the mental health community to be a vague, 'catch-all' diagnosis, more likely to be applied to those who, often thru poverty, unemployment, social exclusion, and social group peccadilloes, happen to come to the attention of diagnosticians, and we should consider all relevant scientific research in that light. Excessive claims are made in the article on the basis of the existing scientific research. The latter might show similarities between separated twins but this is in fact no certain guarantee of a genetic explanation. Furthermore, research on actual genes themselves does not support a socially contrived diagnosis of 'illness,' it merely supports the existence of inherited difference, which is a wholly different thing and not necessarily pathological - in fact, it often has survival value. Please approach this delicate subject with more care, humility, sensitivity and objectivity - tread softly, for you tread on our life chances. Also, such overt offensiveness re genes would not be tolerated in the case of physical disability and/or ethnicity, and it shouldn't be tolerated here. If you keep shooting your mouth off about large sub-groups of the population, you could well find your own health and survival chances affected. --Etaonsh 11:21, 7 August 2006 (UTC)

I don't think threats of violence are either wanted or necessary. However, it's important to note that your point is discussed in the article under the 'Diagnostic issues and controversies' section, which notes that the diagnostic approach is subject to a number of significant flaws. The article aims to present all main approaches to schizophrenia, however, so also discusses the results from genetic studies which typically focus on people who have been diagnosed, regardless of the possible flaws with this approach. Hence, deleting this section of the article because it doesn't fit your opinion is hardly in the spirit of NPOV to which Wikipedia adheres. - Vaughan 12:55, 7 August 2006 (UTC)

I don't think threats of violence are warranted or necessary either, but sadly that is what a diagnosis of schizophrenia in the modern world equates to. I agree that the 'Diagnostic issues and controversies' section is well crafted, but its important conclusions seem to be ignored in e.g., the section under discussion. It needs to be stated clearly in the article that what genetic research shows is genetic difference, not 'illness,' which is a non-value-free social construct. You are quite incorrect to associate me with the deletion of any of this article - do your homework. --Etaonsh 13:45, 7 August 2006 (UTC)

I concur with Vaughan. Etaonsh: I never "shoot my mouth off" anything. Watch your language, you're much too eloquent. You say: "your lack of objectivity is such that the reader can conclude with certainty that you yourself are not stigmatised in a group of this kind" - Well, my uncle did have schizophrenia, and I have some problems too, and this sparked my interest in psychiatry, but I did not come to Wikipedia to discuss this. I agree that schizophrenia is today a 'catch-all' diagnosis, but I beleive that the genetic linkage studies and subsequent unravelling of underlying pathways is the main way to make the diagnosis in the future more specific, maybe - sometime - split schizophrenia into several diagnostic forms, thus prompting the doctors to approach the sufferers with, as you aptly put it, more "care, humility, sensitivity and objectivity". Deleting the confirmed medical findings only hampers the understanding and research, not to mention the NPOV rule violation. --CopperKettle 13:56, 7 August 2006 (UTC)

My guess is that your admonition, 'Watch your language, you're much too eloquent' was intended in good humour, but it serves to show how positive attributes can become stigmatised in a social setting. Your reluctant personal 'admissions' still fail to counter my original deduction, and your reference to 'diagnosis' still fails to acknowledge the points made already about what genetic research does and doesn't show. Without wishing to offend, I expect a lot of Russian uncles were 'diagnosed' with schizophrenia - and worse. It is not in my interests, in the circumstances, to delete material which exposes the writers' misuse of psychiatric labelling - I have an interest in exposing, not deleting. --Etaonsh 14:00, 7 August 2006 (UTC)

P.S. to the "If you keep shooting your mouth off about large sub-groups of the population, you could well find your own health and survival chances affected." - Well, I value my health, but I am not so degraded and selfish yet as to put my "own health and survival chances" above the scientific facts (like genetic studies' results) that may bring hope to the millions of people , so your threat doesnt much work here, besides showing your own aggressivenes. --CopperKettle 13:56, 7 August 2006 (UTC)

Pseudo-scientific 'diagnosis' by a global monetarist conglomerate is not, I assure you, a hopeful experience for patients. A statement of likely consequences of actions does not constitute threat, and unsubstantiated assumption of threat is, again, not in the spirit of rational inquiry, and symptomatic of paranoia, albeit shared. --Etaonsh 14:05, 7 August 2006 (UTC)

P.P.S. As long as Schizophrenia is considered an "illness" by the world scientific community, it is an illness. And the Wikipedia article must state this, mentioning the non-mainstream views but not being governed by them. As soon as Schizophrenia-as-illness concept is abolished, you can put it as "non-value-free social construct" and erase all the linkage studies' data. But for now, such deletion is vandalism. --CopperKettle 13:56, 7 August 2006 (UTC)

Your first two sentences are authoritarian and compliant rather than informative, the third is fanciful, and the fourth exemplifies the type of non-evidential, blithely wrongful accusation which is characteristic of psychiatric misdiagnosis and all those who play a part therein. --Etaonsh 14:13, 7 August 2006 (UTC)

The paragraph says:

Evidence comes from research suggesting multiple chromosomal regions are transmitted to people who are later diagnosed as having schizophrenia.

That's not what the abstract says. The abstract says "Replication has been inconsistent for reports of significant genetic linkage." I tried to correct it but Skinnyweed reverted me without any explanation. --Mihai cartoaje 18:22, 7 August 2006 (UTC)

Hi Mihai, I can't find this statement in any of the three abstracts (refs 12, 13 or 75) that are used in this paragraph. Which abstract are you thinking of? - Vaughan 18:48, 7 August 2006 (UTC)

The one Coroebus added in the archives. --Mihai cartoaje 19:05, 7 August 2006 (UTC)

Neglected diagnostic issue/controversy: sociology of diagnosis

The section 'Diagnostic issues & controversies' fails to make mention of the fact, widely reported, that diagnosis is significantly more likely to affect some social and ethnic groups more than others, arguably reflecting inequalities compounded by correspondingly restricted diagnostic perceptions. Could someone assist me with the relevant stats, studies, and references, please? --Etaonsh 18:37, 7 August 2006 (UTC)

Misdiagnosis section

The recently added misdiagnosis section is a valuable addition, but I think the source should be from the peer-reviewed scientific literature rather than a book on nutrition

I shall look on PubMed, for relevant articles, but for those also wanting to search out there own articles 'differential diagnosis' and 'misdiagnosis' are good keywords.

Original text it below. - Vaughan 08:10, 9 August 2006 (UTC)

The section you refer to appears only here on the Talk page.

Accepting the view that the 'schizophrenia' diagnosis is and has been used as a general 'catch-all,' is it possible to diagnose it incorrectly? And, conversely, given individual differences in causation, is it not possible that all such diagnoses have some explanatory sub-diagnosis, rendering any diagnosis of 'schizophrenia' as such arguably inadequate, incorrect? --Etaonsh 07:49, 12 August 2006 (UTC)

---

Mis-Diagnosis

There are many conditions which sometimes present symptoms similar to schizophrenia. In the book Nutrition and Mental Illness by the late Carl C. Pfeiffer, Ph.D., M.D (of the Princeton Brain Bio Center) there is a list of 29 different conditions which have been mis-diagnosed as Schizophrenia. These include:

Well-known

1. Dementia paralytica 2. Pellagra 3. Porphyria 4. Hypothyroidism 5. Drug intoxications 6. Homocysteinuria 7. Folic acid/B12 deficiency 8. Sleep deprivation 9. Heavy metal toxicity 10. Conspiratorial defamation, where victim has no access to legal defence for financial or other reasons

Less Well-known

1. Hypoglycemia 2. Psychomotor epilepsy 3. Cerebral allergy 4. Wheat-gluten sensitivity 5. Histapenia � copper excess 6. Histadelia 7. Pyroluria 8. Wilson's disease 9. Chronic Candida infection 10. Huntington's chorea

Almost Unknown

1. Prostaglandins 2. Dopamine excess 3. Endorphins 4. Serine excess 5. Prolactin excess 6. Dialysis therapy 7. Serotonin imbalance 8. Leucine, histidine imbalance 9. Interferon, amantadine, anti-viral drugs 10. Platelets deficient in MAO (monoamine oxidase)

If we include fevers, environmental pains, and drug reactions, there must be dozens of additional ways to be diagnosed as schizophrenic due to some other existing condition. Competent diagnosis would require the ability to eliminate these as a possible diagnosis.

---

Rehabilitation and Recovery: a sub-section under 'Prognosis'?

This is generally a long-term condition with, as the article states, some negative prognosis. Would it improve the article, and the situation, to have a special sub-section, under 'Prognosis,' devoted to 'Recovery and Rehabilitation?' --Etaonsh 17:28, 16 August 2006 (UTC)

Hi Etaonsh, I think this is an excellent idea. Especially with all the recent research interest in criteria for remission and recovery outcomes. - Vaughan 08:00, 17 August 2006 (UTC)

What you really should have said, what you really meant, here, was: 'Yes - why didn't I think of that? Go ahead and write something and then I will delete most of it if it fails to conform to my authoritarian predilections.' Cestlogique 12:17, 16 September 2006 (UTC)

Hi there,

The paragraphs I deleted from the section you mention were as follows:

The developed world, in spite of a greater set of resources, tends to hamper rehabilitation with difficult welfare regulations, competitive recruitment and political correctness. This often leads to a failure to give due consideration to groups not always equally able to deal with the diagnostic stigma, such as male breadwinners and displaced ethnic minorities. Instead of assisting in recognising group problems, there may be an imposed sense of equality that does not accurately reflect the true situation.

Social stigma is also a factor in undermining the image of recovery from schizophrenia. Given the prevalence of the diagnosis and the role of chance in personal success, it is likely that that the number of famous, successful people who received the diagnosis is far greater than indicated on this page. Stigma is the likely factor for non-disclosure of many people.

Given the implications of work-incompetence of the schizophrenia diagnosis, patients inevitably become the scapegoat for all these cultural and local shortcomings.

This contains both unreferenced claims and contains a number of POV claims (e.g. the whole of the first paragraph, "patients inevitably become the scapegoat...", "it is likely that...", "the implications of work-incompetence of the schizophrenia diagnosis...") and hence is not suitable for an encyclopedia entry.

I have left the initial paragraph in the article, which, incidentially, still needs referencing.

- Vaughan 15:06, 18 September 2006 (UTC)

Intro

The introduction seems to put too much emphasis on positive symptoms, which are not present in the case of simple schizophrenia, a catch-all term for non-manic clinical depression. --Etaonsh 21:38, 21 August 2006 (UTC)

Also, 'primarily thought to affect cognition' - says who? --londheart 23:44, 22 August 2006 (UTC)

Hi Etaonsh,

Simple schizophrenia is only present in the ICD-10 diagnostic critera, and is not listed is the DSM (the same presentation would be classifed under either residual or undifferentiated). Simple schizophrenia is actually rare, however, and is quite distinct from clinical depression.

'Primarily thought to affect cognition' is from the large amount of scientific literature and is really redescribing the symptoms as disturbances to the cognitive structure of perception, thought etc etc.

- Vaughan 09:56, 23 August 2006 (UTC)

Positive symptoms: It puzzled me that it takes so long for the article to get make the point that the positive symptoms are those of a psychosis. On reflection I believe that this may be a good thing, as the reader is not early on given the mistaken idea that schizophrenia = psychosis, or vice versa - and equally wrong - that psychosis = schizophrenia (which is what the above post on "Mis-diagnosis" / differential diagnosis was about).

Simple schizophrenia: Etaonsh's description of simple schizophrenia as a "catchall for clinical depression" is not my experience (but may be his/her's). The two may co-exist. The simple schizophrenic has an almost un-understandable shallowness of affect, such that achieving a state of empathy with the sufferer becomes a potentially exhausting exercise. The major difference seems to me that the "ordinary" depressive person has a sadness and hurt-suffering which one can relate to, whereas communicating with the simple schizophrenic does not cause that sense of sadness-hurt-suffering in the person.

Cognition: As to cognition, one could not conceive of a person being described as schizophrenic without there being clear disturbances of the information processing functions - which is one definition of cognition. Conversely, a person who demonstrates normal cognitive function - however one defines that - cannot be conceived of as being schizophrenic. Or am I wrong? --Seejyb 14:36, 27 August 2006 (UTC)

If someone's 'affect' or emotional range appears shallow, it could be a defensive cover. Be that as it may, I could understand empathy with a patient with deep emotionality to be a 'potentially exhausting exercise,' but the idea that you become exhausted by attempting to fathom that which you simultaneously diagnose as 'shallow' seems an obvious contradiction in terms, suggesting over-concentration/over-involvement on your, the diagnostician's part, or at least, failure to adopt a more fruitful strategy. Continueddonations 23:28, 12 September 2006 (UTC)

Notable People

I have read that Phil Spector is bipolar, not schizophrenic. This area really should be checked as the two are significantly different although they share some symptoms. Great page, otherwise.

A man in his position would surely demand, as you suggest, an extra pole(?). --londheart 23:46, 22 August 2006 (UTC)

Stigma

Schizophrenia surely deserves a separate section on 'stigma,' somewhere between 'Diagnosis' and 'Violence'(?). --londheart 08:05, 24 August 2006 (UTC)

(Reply by vandal Vaughan deleted).

"Violence" section wording

I do not wish to fiddle with this excellent article as it is, but have the following comments / suggestions: A family member was recently diagnosed as schizophrenic, and in six months I have had two questions about whether I feel it is safe to leave my kids alone with her in the house. Both instances were related to perceptions of uncontrollable violence. So as far as I am concerned, yes, the lay public seems to relate schizophrenia to violence. If the idea is general, then I would expect an encyclopedia to inform me as to whether such opinions are scientifically based.
However, the sentence under "Violence against people with schizophrenia" was difficult to interpret until I read the reference. As formulated, I had interpreted it to mean that the persons who were attacked were more likely to be schizophrenic than the persons who had done the attacking [were likely to be schizophrenic], or that the schizophenic was more likely to be the victim of violence than he was to be the perpetrator of violence, but the reference seems to have nothing to do with these interpretations. It seems to be making the point that the schizophrenic is more likely to be a victim of violence than a "normal" person is. May I suggest, using the same reference (which I unfortunately have available only as an abstract - bless the scientific publishers, whose prices for reading science are way beyond my financial capability):

"An Australian study has concluded that patients with schizophrenia spectrum disorders are at increased risk of victimization. Of the 348 patients studied, 4.3% of them were victims of a violent crime, during the one month follow-up period. This compares to a figure of X.X% for the general population. or This is X.X times the figure for the general population over the same period. or The expected figure for the general population in the area studied was X.X%."

The last (italicized) sentence is for giving the figure for what the "normal" rate of violent crimes would be, to give some meaning to the figure for schizophrenia. Does the complete article text give the figure for non-schizophrenics? If not, then any conclusion of "increased risk for victimization" does not seem to make sense/science. --Seejyb 15:15, 27 August 2006 (UTC)

There are people who relate african-americans, muslims and jews to violence. Do you also expect an encyclopedia to inform you whether such opinions are scientifically based? How does it work? --Mihai cartoaje 18:58, 27 August 2006 (UTC)

Notable people thought to be affected by schizophrenia

In the List of people believed to have been affected by bipolar disorder there is an insistence that verifiable source citations must be included. There seems to be no such request in Notable people thought to be affected by schizophrenia.

There are no references for this list in spite of references being requested for quite some time. If this list is not referenced it will have to be deleted. --WikiCats 11:57, 3 September 2006 (UTC)

There has been no references added to this section, so it will have to be deleted. --WikiCats 09:56, 6 September 2006 (UTC)

This is what has been removed. When references are found for these entries they can be reinstated.--WikiCats 15:25, 9 September 2006 (UTC)

In many of those people's articles, their schizophrenia is mentioned, such as Ron Karenga and Roky Erickson.

Notable people thought to have been affected by schizophrenia

File:ClaraBow23.jpg

Actress Clara Bow was diagnosed with schizophrenia in 1949.

• 6025 (former rhythm guitarist of the Dead Kennedys)
• Walter Inglis Anderson (artist,writer 1903-1965)
• Talal ibn Abdullah (King of Jordan from 1951 to 1952)
• Lionel Aldridge (American football player, Green Bay Packers)
• Antonin Artaud (artist, poet, actor, theater philosopher)
• John Balance (vocalist and percussionist of Coil)
• Syd Barrett (founder of Pink Floyd)
• Maria Bernoulli (wife of German novelist Hermann Hesse)
• Nick Blinko (founder, singer, songwriter, guitarist and artist for Rudimentary Peni)
• Buddy Bolden (jazz pioneer)
• Clara Bow (actress)
• Bryan Charnley (artist)
• Eduard Einstein (son of Albert Einstein)
• Don Elkins, (engineer, metaphysician, writer, ufologist)
• Roky Erickson (founder of 13th Floor Elevators)
• Zelda Fitzgerald (painter and wife of F. Scott Fitzgerald)
• Frederick Frese (psychologist in Ohio and current Vice President of the National Alliance on Mental Illness)
• The Genain quadruplets (a set of four girls who each developed schizophrenia)
• Kurt Gödel (mathematician)
• Andy Goram (former footballer)
• Jim Gordon (drummer for the rock group Derek and the Dominos)
• Peter Green (founder of rock group Fleetwood Mac)
• Josef Hassid (violinist)
• Houston (R&B artist)
• H.R. Hudson (affected lightly by schizophrenia, leader of hardcore punk band Bad Brains)
• Lucia Joyce (dancer, daughter of James Joyce)
• Theodore Kaczynski (the Unabomber)
• Ron Karenga (author, academic, activist)
• Veronica Lake (actress)
• James Tilly Matthews (subject of first book-length psychiatric case study)
• William Chester Minor (army surgeon and major contributor to the Oxford English Dictionary)
• John Forbes Nash Jr (mathematician)
• Vaslav Nijinsky (ballet dancer and choreographer)
• Per Yngve Ohlin A.K.A. Dead (vocalist of black metal band Mayhem)
• Gene Ray (self-proclaimed doctor of cubicism)
• Daniel Paul Schreber (German judge)
• Ingo Schwichtenberg (original drummer for rock group Helloween)
• Dr Vashishtha Narayan Singh (mathematician and scientist)
• Phil Spector (music producer credited with creating the "Wall of Sound"
• Skip Spence (band member of Moby Grape and Jefferson Airplane)
• Nancy Spungen (girlfriend of Sid Vicious of the punk rock band The Sex Pistols)
• Vincent van Gogh (artist)
• Mark Vonnegut (son of the writer Kurt Vonnegut)
• Louis Wain (artist)
• Wesley Willis (musician)
• Adolf Wolfli (artist)
• Brian Wilson (member of The Beach Boys)
• Ronnie Kray (infamous British gangster)

Treatment-resistant schizophrenia

I saw in the Clozapine article that there's a variant of schizophrenia called "treatment-resistant schizophrenia", which apparently resists the effects of almost all other drugs but clozapine. (Or I'm assuming; it says the FDA hasn't approved any other drug for it). A Google search turned up the term "treatment-refractory" schizophrenia, as well. If anyone has access to a good resource on this, I think it's important to include something about it in the article -- I feel like I know way too little to try myself. Phoenix-forgotten 16:51, 15 September 2006 (UTC)

Genetics section

I've replaced the following paragraph with the previous version:

A recent review of linkage studies listed seven genes as likely to be involved in the diagnosis of schizophrenia or the risk of developing diagnosis of the disease. Evidence from linkage studies has stongly implicated different genetic loci chromosomal causing different genetic subtypes of schizophrenia in different families. Genetic association studies have suggested some strong candidate genes which may contribute to risk of getting the diagnosis. The strongest evidence points towards genes called NRG1 DAOA PCM1 and Epsin 4. Others such as dysbindin and COMT are still to be replicated fully.

Partly because the information seems to be at odds with recent reviews of the genetics literature (for example, the COMT statement seems to be correct, but not the statement on dysbindin - e.g. see review, and partly because the person changed the text and yet left the original references intact - which contain contradictory information.

I'll work on updating the section to be more accurate based on the latest reviews.

As an aside, if you wish to add new information, please also add new references. Otherwise we can't verify if the information is correct and it makes the text article confusing to have the references saying different things from the writing.

Thanks - Vaughan 14:39, 18 September 2006 (UTC)

I've now update the Schizophrenia#Genetic section with the candidate genes from the latest reviews. - Vaughan 14:57, 18 September 2006 (UTC)