Talk:Mechanisms of schizophrenia

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Collapsed everything that is at least over one year old - MAMWhistler (talk) 23:16, 26 July 2015 (UTC)
== Taking this on ==

I am going to take on this article. Already I've merged sections and organized the neuroimaging. Please note that while many of my references seem like primary they are in fact review articles and have been deemed secondary sources by the WP:RS/N folks. For now I am going to focus on the neuroimaging. Basket of Puppies 17:57, 27 December 2010 (UTC)

Reviews[edit]

How are these reviews? I have removed them at least a couple times per [1]...

^ Jernigan TL, Zatz LM, Moses JA, Berger PA. Computed tomography in schizophrenics and normal volunteers. I. Fluid volume. Arch. Gen. Psychiatry. 1982;39(7):765–70. PMID 7165476. ^ Holinger DP, Faux SF, Shenton ME, et al.. Reversed temporal region asymmetries of P300 topography in left- and right-handed schizophrenic subjects. Electroencephalogr Clin Neurophysiol. 1992;84(6):532–7. PMID 1280199.

Doc James (talk · contribs · email) 18:19, 27 December 2010 (UTC)

I looked at both sources, and looked quickly at the linked FA discussion. I am confident in saying that both sources are primary research studies, not reviews. They are reliable sources as primary sources, but they are not reviews. --Tryptofish (talk) 18:53, 27 December 2010 (UTC)
They are nearly 10 and 20 years old. Involve small number of people. They in no way meet WP:MEDMOS which we follow as this is a medical article. Doc James (talk · contribs · email) 18:58, 27 December 2010 (UTC)
By the way, the Causes article from which much of this new page was moved was already full of badly written content that relied overly on primary sources, far below anything applicable to FA. I have been meaning to clean it up for an embarrassingly long time. --Tryptofish (talk) 19:02, 27 December 2010 (UTC)
Yes I agree completely and adding more will not improve things :-) Doc James (talk · contribs · email) 19:05, 27 December 2010 (UTC)
Yes, Typtofish, we all agree, but again, adding more of same, and BoP's edit warring is not the way to fix the obvious issues at Schizophrenia. SandyGeorgia (Talk) 19:14, 27 December 2010 (UTC)
The primary article to should be used for MRI findings should be A review of MRI findings in schizophrenia which is a review article, thus a secondary source. I asked about this sort of article on WP:RS/N and this is what they indicated. Regarding primary sources (published, peer-reviewed medical journal articles and the like) they can surely be used in an article that is not a FA, but should be replaced if/when this article goes for FA status. Basket of Puppies 19:11, 27 December 2010 (UTC)
I think you're misreading or misunderstanding the responses at RS/N, and no, WP:MEDRS does not apply only to FAs. BoP, we need a specific answer to why you want to include old primary research; please give one, or I will remove the info. SandyGeorgia (Talk) 19:14, 27 December 2010 (UTC)

SG, I ask at RS/N if a published review article is considered a secondary source. They said yes. Are you saying no? Regarding the primary source, please have a read of Wikipedia:MEDRS#Definitions says, "Reliable primary sources may occasionally be used". Please be aware that this article is in progress and I fully plan to use the neurology textbooks as soon as I humanly can. Basket of Puppies 19:21, 27 December 2010 (UTC)

Reliability of sources is always a matter of consensus; could you please answer the specific question? Why do you want to use those particular primary sources, and how do you justify them per WP:MEDRS? SandyGeorgia (Talk) 19:25, 27 December 2010 (UTC)
Reliability is always a matter of consensus? No. If a consensus of people says that "Joe's Awesome #1 News Site" that reports aliens caused 9/11 that would not be correct. Articles published in peer-reviewed science journals are reliable unless that particular journal is known to be unreliable. I already responded to your question about the use of primary sources- I am at the moment tracking down the secondary sources in the textbooks. This takes time. Your ultimatums are unhelpful. Please stop. Basket of Puppies 19:30, 27 December 2010 (UTC)
I refer you to WP:RS: "The reliability of a source depends on context. Each source must be carefully weighed to judge whether it is reliable for the statement being made and is the best such source for that context." We use the highest quality sources, that is determined by consensus and depending on context, and you haven't explained yet why you want to use primary sources in this particular instance when we have multiple, recent secondary reviews. If you are intending to say that secondary reviews report on those primary sources, please just say that, and we can move on while we wait for you to locate those review sources. SandyGeorgia (Talk) 19:36, 27 December 2010 (UTC)
SG, like I said, this is an effort in progress. I am putting the primary sources there because a) they are very reliable, b) just until I find the same in textbooks, c) so that there aren't any unreferenced statements. Ok? Basket of Puppies 19:39, 27 December 2010 (UTC)

Regarding "A review of MRI findings in schizophrenia" other than being a little old (10 years) I do not have a problem with it. It would be better to use a newer one though if you could find it.Doc James (talk · contribs · email) 19:43, 27 December 2010 (UTC)

Working on it. I promise. Basket of Puppies 20:38, 27 December 2010 (UTC)
No problem for now, but please be aware that old textbooks will not trump newer secondary reviews. I'm going to unwatch here, but please don't place primary-source-referenced text in the main FA at schizophrenia when we are working hard to salvage its featured status; there are plenty of recent, secondary reviews that are higher quality and should be used there. SandyGeorgia (Talk) 20:42, 27 December 2010 (UTC)
(I had an edit conflict with Sandy before saving this, and I'm glad to see what Sandy just said in this regard.) As a general observation, not directed at any single editor, I'm not sure what all the urgency surrounding this page is about. I know that Schizophrenia is under FA review, but I don't think that this page is. I mentioned above that I'm a bit embarrassed over not having done more to fix Causes of schizophrenia, and I am, but I don't think the sky has fallen in the mean time. --Tryptofish (talk) 20:45, 27 December 2010 (UTC)
SG, 1. Ok? Basket of Puppies 20:49, 27 December 2010 (UTC)

Reliability[edit]

I've asked about the reliability of at least two articles. FYI. Basket of Puppies 01:51, 28 December 2010 (UTC)

Quotes[edit]

  • Adams & Victor quote for CT scans:

    The advent of CT and subsequently of magnetic resonance imaging (MRI) of the brain provided a new stimulus to the anatomic study of schizophrenia. Johnstone and coworkers were the first to describe ventricular enlargement and sulcal widening in 18 patients and correlate these findings with dulling of intellect and affect. In a study of 58 chronic schizophrenics under the age of 50 years, Weinberger and colleagues found enlargement of the lateral ventricles in 40 percent. In 9 of 11 CT studies, the third ventricle was found to be enlarged, and in 14 of 17 studies, the sulci were widened. In 15 pairs of monozygotic twins, one of whom had schizophrenia, the anterior hippocampi were found to be smaller and the lateral and third ventricles larger in the affected twin (Sud- dath et al). Shenton and colleagues demonstrated a reduction in the volume of gray matter in the posterior part of the left superior temporal gyrus, which includes Heschl’s gyri and the planum tem- porale. The degree of volumetric reduction correlated roughly with the severity of the thought disorder. A reduction in volume of the superior temporal gyrus has also been associated with the occur- rence of auditory hallucinations (Barta et al).

    Basket of Puppies 21:02, 28 December 2010 (UTC)
  • How does this relate to the (disputed, primary) 1982 Jernigan source, which I don't see mentioned in this quote? SandyGeorgia (Talk) 21:11, 28 December 2010 (UTC)
  • Jernigan is confirmed by Adams and Victor. Jernigan says there are sulcal widenings, which is exactly what Adams and Victor says. Also note that Adams and Victor quote Shenton by name. Basket of Puppies 21:26, 28 December 2010 (UTC)
  • If they cite Shenton, why are you citing Jernigan, which they don't cite? The reason we use secondary reviews is that they report on the specific primary sources-- we don't just go out and pick an unreviewed primary source, parts of which may happen to contain similar findings. SandyGeorgia (Talk) 21:29, 28 December 2010 (UTC)
  • Jernigan's results are confirmed in Adams and Victor. I don't understand or see the problem. They may not be listed by name but the results are the same. Shenton primarily uses sMRI and DT-MRI on sz brains, not CT. I was merely saying that Shenton is listed by name, indicating the high quality of her research. Basket of Puppies 21:32, 28 December 2010 (UTC)
  • So, again, why aren't you using Shenton? I'm concerned that you still aren't understanding why Wiki requires secondary reviews for medical articles, and hope that Colin's post helped make it clear. We don't report on unreviewed primary sources, because secondary reviews analyze them critically; if they aren't reported on, there may be problems in those sources. You should be reporting on the sources analyzed by secondary reviews. SandyGeorgia (Talk)
  • Shenton *is* being used. Ref number 18. I plan to expand Shenton as well in other parts of the article, but Adams and Victor is more recent than Shenton, something you said is important. Since A&V use Shenton and report on her findings then it doesn't really matter which one I use. Right? Shenton is not a primary source but a secondary source, as it Adams and Victor. Still not sure why you are talking about primary sources. We are beyond that. Basket of Puppies 22:17, 28 December 2010 (UTC)
  • I am talking about primary sources because the unreviewed by secondary sources Jernigan 1982 article is still cited. Why are you citing Jernigan and not Shenton? Jernigan was apparently not worthy of mention by your secondary source, presumably for a reason. SandyGeorgia (Talk) 22:21, 28 December 2010 (UTC)
  • I do not presume to know why Jernigan wasn't cited in the 2005 edition of Adams and Victors. Shenton says the following about CT:

    Research interest thus waned and did not ̄ourish again until 1976, following the pivotal computerassisted tomography (CT) ®nding of lateral ventricular enlargement in schizophrenia by Johnstone and colleagues.

    ,

    Research investigating brain abnormalities in schizophrenia thus came to a near standstill and was not rekindled until the first computer assisted tomography (CT)study o fschizophrenia (Johnstoneetal.,1976), which confirmed earlier pneumonencephalography findings of enlarged lateral ventricles (e.g. Haug, 1962;JacobiandWinkler,1928).

So, I will use Shenton. Basket of Puppies 22:32, 28 December 2010 (UTC)

  • EEG quote page 1324 of Adams and Victor's:

    Detailed neuropsychologic testing has disclosed deficits in at- tention and abnormalities of the P300 waves (cortical “event- related” potentials). These deficits correlate with reduced cognitive activation activity in functional MRI.

    Basket of Puppies 21:04, 28 December 2010 (UTC)
  • This isn't what is stated in our article?
  • I updated the article to indicate specific P300 abnormalities. I think the article now reflects the references rather accurately. Basket of Puppies 21:26, 28 December 2010 (UTC)
However, this is progress; locating secondary sources was a better use of everyone's time. I'll leave the fixing and adjusting of wording to others, pending answers to my two questions above. SandyGeorgia (Talk) 21:11, 28 December 2010 (UTC)
Yes, this is progress. Both primary and secondary sources are being used. I have the entire Adams and Victor's 8th editing on PDF and will be using it as a reference for the neurological section. I don't see your two questions- please restate. Basket of Puppies 21:21, 28 December 2010 (UTC)
I have bolded them for you. SandyGeorgia (Talk) 21:22, 28 December 2010 (UTC)
  • Hey folks, somebody please smack me with a Trypto-trout! I should have picked up on this before. The first of the two quotes is coming from a literature that I used to follow quite closely, and there are numerous studies finding those kinds of ventricular enlargements. I am sure that if you do a PubMed search, there will be multiple confirmatory primary studies (the quote above refers to some), and—yes!—mentions in reviews. The main caveats have been (1) that not all patients show these signs, and (2) some effects may reflect medication, rather than disease; I'm sure you'll find sourcing for both of those points. The second source may be, I think, more of a one-off as to its specifics, but there is certainly a literature about neurological measures reflecting deficits. There, it may be more a matter of using more sources so as not to become WP:UNDUE. --Tryptofish (talk) 21:17, 28 December 2010 (UTC)
  • I don't you need to be smacked; seeing text helps ... which is why the *first* order of business should have been to find secondary sources. But my two questions remain, and I'm not sure our article currently says what these quotes say, or where Jernigan 1982 comes into the picture. SandyGeorgia (Talk) 21:19, 28 December 2010 (UTC)
MRI studies p1324 Adams & Victor:

Other MRI studies have shown a volumetric change in the gray matter of the left hippocampus, parahippocampal gyrus, and amygdala (in right- handed patients). Equally compelling is the finding that young in- dividuals having two or more relatives with the disease, and there- fore being at risk for developing schizophrenia, have certain volumetric brain changes detected by imaging studies (Lawrie et al). In unaffected relatives, the left hippocampal-amygdaloid region was smaller than in healthy people but slightly larger than in af- fected relatives. In an attempt to organize the neuroradiologic findings, Murray and coworkers have raised the possibility that there are two types of this disease—one with ventricular enlargement and a negative family history and the other with normal ventricles and a positive family history. In the first group of sporadic, “acquired” schizo- phrenia, environmental factors, such as birth injury and EEG ab- normalities (see later) were thought to be more frequent. In sum- marizing the many cerebral changes observed in schizophrenic patients, Harrison concluded that several are quite consistent. These include mild enlargement of the lateral and third ventricles; de- creased cortical volume, perhaps disproportionate in the temporal lobe; and—microscopically—diminution in size of cortical and hippocampal neurons; a diminished number of neurons in the dor- sal thalamus; and a notable absence of gliosis.

Note the wording above, that appears to be part of the confusion that continues here:
  • ... Murray and coworkers have raised the possibility that there are two types of this disease—one with ventricular enlargement and a negative family history and the other with normal ventricles and a positive family history.
It is still classified as a mental disorder, AFAIK. We can't treat a hypothesis as fact in the article. SandyGeorgia (Talk) 23:12, 28 December 2010 (UTC)
PET changes:

ttention has also been drawn to the regional alterations of cerebral blood flow in chronic stable schizophrenic patients, as re- vealed by positron emission tomography (PET) and functional MRI. Weinberger and colleagues and Liddle and Barnes have re- ported a decrease in blood flow in the prefrontal areas during cog- nitive performances. Friston and associates found consistent ab- normalities in the left parahippocampal region in all forms of chronic schizophrenia. Studies of regional glucose metabolism and postmortem norepinephrine measurements have yielded equivocal data, although most patients show a reduction in glucose metabo- lism in the thalamus and frontal cortex. Several lines of investi- gation point to the medial part of the left temporal lobe and related limbic and frontal systems as being the focus of a developmental abnormality (see Tsuang et al and Friston et al for pertinent refer- ences). According to Sabri et al, the inconsistent findings on functional imaging may be accounted for by correlations between cer- tain blood flow patterns and specific symptoms. For example, the formal thought disorder corresponded to increased flow in the fron- tal and temporal regions, while delusions and hallucinations were associated with reduced flow in the cingulate, left frontal, and tem- poral areas. Silbersweig et al have performed PET studies in schiz- ophrenic patients while they were experiencing auditory halluci- nations and found increased blood flow mainly in both thalami, left hippocampus, and right striatum, but also in the parahippocampal, orbitofrontal, and cingulate areas. One of their drug-naive patients with visual and auditory hallucinations showed activation in these regions.

Basket of Puppies 21:45, 28 December 2010 (UTC)

Neural, neurological and neurodevelopmental[edit]

In spite of progress above, and a long explanatory post by Colin at the OR noticeboard that should have helped explain the problems in how this article is being developed,[2] we're back to the same problem that has been present for almost a week.[3] Documentation of neural differences does not make schizophrenia a neurodevelopmental disorder (at least until we have firm secondary reviews that call it that).[4] Documented neural differences don't establish causation. That schizophrenia is neurodevelopmental is still a hypothesis as far as I know, so we don't state it as fact, much less in the lead of an article. Do you have a recent reliable secondary review that establishes it as a neurodevelopmental disorder?

And we still have the incorrect change from neural to neurological back at schizophrenia; perhaps this will help?

  • Neurology–noun: the science of the nerves and the nervous system, esp. of the diseases affecting them.
  • Neural-–adjective: of or pertaining to a nerve or the nervous system.
Correlation is not causation: the documentation of neural deficits or differences does not establish causation. The more correct heading appears to be neural, as it was originally, and that confusion persists in the development of this article. SandyGeorgia (Talk) 23:09, 28 December 2010 (UTC)
Yes, I do. Shenton writes:

The most parsimonious explanation is that some brain abnormalities are neurodevelopmental in origin but unfold later in development, thus setting the stage for the development of the symptoms of schizophrenia. Or there may be additional factors, such as stress or neurotoxicity, that occur during adolescence or early adulthood and are necessary for the development of schizophrenia, and may be associated with neurodegenerative changes

and

There is also evidence from both post- mortem and MRI ®ndings to suggest that at least some of these brain abnormalities may originate from neurodevelopmental anomalies )e.g. Akbarian etal.,1993a,b;Benes,1989;HeymanandMurray,

1992; Jakob and Beckmann, 1986, 1989; Kikinis etal.,1994;MurrayandLewis,1987:seealsoreviews inMcCarleyetal.,1999b;Shentonetal.,1992,1997, 2001;Weinberger,1986,1987,1996). and

thus lending more credence to the theory that schizophrenia has a neurodevelopmental etiology.

and

These findings suggest that, at least among some patients with schizophrenia, a neurodevelopmental factor may play a critical role in the etiology of theillness.

and

In summary, MRI findings of CSP are among the most robust in the literature and suggest that this neurodevelopmental anomaly is relevant to the neuropathology of schizophrenia for at least a subgroup of individuals diagnosed with this disorder.

and

The general assumption is that changes over time are indicative of neurodegeneration, although such changes might also re ̄ect neurodevelopmental anomalies.

and

These prefrontal and orbitofrontal asymmetry findings also favor a neurodevelopmental origin as the sulco-gyral patterns are established in utero.

and

Feinberg (1982) proposes that neurodevelopmental abnormalities in schizophrenia result from errors in synaptic pruning that occur at the onset of this disorder, during adolescence and early adulthood.

and

Weinberger and coworkers (1992; Weinberger, 1987, 1995) describe schizophrenia as a neurodevelopmental encephalopathy

and

A focus on shape deformations of brain regions, as opposed to only volume measures, may also provide important information relevant to neurodevelopmental theories of schizophrenia, because such deforma- tions may be associated with neurodevelopmental abnormalities.

Multiple sources (as cited in Shenton) state that SZ is neurodevelopmental/neurodegenerative. Is this sufficient? Basket of Puppies 23:13, 28 December 2010 (UTC)
Others may want to clarify or better inform both of us, but no, it doesn't-- all of those are tentative statements, or related to a hypothesis. Do you have a source that says that schizophrenia is classified by anyone as a neurodevelopmental disorder, as compared to describing hypotheses or supportive evidence indicating that it may be? Look carefully at all of the language above, and you may see the problem. Your final sentence, using the wording "is neurodevelopmental", isn't supported by the suggestions, hypotheses, or proposals, AFAICT. SandyGeorgia (Talk) 23:17, 28 December 2010 (UTC)
SG, did you miss this one?

Weinberger and coworkers (1992; Weinberger, 1987, 1995) describe schizophrenia as a neurodevelopmental encephalopathy

This very clearly describes SZ as a neurodevelopmental disorder. It's in Shenton's review article. Basket of Puppies 23:20, 28 December 2010 (UTC)
No, but pending further feedback, that may just be cherrypicking-- as far as I know, it's still a hypothesis (I could be wrong). A good place to look for the best info on this would be the most recent, broad reviews published by highly reputable journals; I don't have the full text, but I suggest checking van Os J, PMID 19700006 and Picchioni MM, PMID 17626963. Do they classify it as neurodevelopmental and what do they have to say on the topic? Remember, WP:DUE is also an issue, which is why we use the highest quality sources, and give due weight to a preponderance of sources, to avoid cherry picking sources supportive of one position. I'm sorry I can't check those sources for you, but if you're working on this article, you should have the full text of them anyway, to guide your work. Further, you seem to be misinterpreting Shenton, based on your post above-- she seems to be saying that someone else describes it as neurodevelopmental, which is quite different from saying that there is consensus that it *is* neurodevelopmental-- even when using reviews, you need to know how to use them carefully and correctly. SandyGeorgia (Talk) 23:25, 28 December 2010 (UTC)
I've cited a major secondary review article that repeatedly says SZ is a neurodevelopmental/neurodegenerative disorder. Not every article is going to say this but it is clear that the ones that do say it are making their way into the review articles. As you said there is a reason why they were selected to be included in the review article. Now, can we agree on this matter? Basket of Puppies 23:26, 28 December 2010 (UTC)
But you still need to learn how to use sources, even review sources, to avoid drawing your own (original research) conclusions. Do you see the difference between saying somewhere in the body of the article something like "Shenton et al. (year) state that several researchers believe that SZ is a neurodevelopmental disorder" and stating in the lead as fact that it is? If you don't, you need to read reviews with a better critical understanding of their purpose, conclusions, and their discussion sections. Further, your argument that not every review says that doesn't hold water: remember WP:DUE and selective use of sources to promote a POV. Again, rather than repeat a time-consuming pattern, have you checked the two sources I listed above, for example? What do they say? We can't give undue weight to a hypothesis by stating it as fact in the lead. SandyGeorgia (Talk) 23:31, 28 December 2010 (UTC)
I am drawing no conclusions of my own. Ever. I only ever report what the articles say. Shenton's article clearly cites SZ to be a neurodevelopmental disorder. Do you agree? Basket of Puppies 23:33, 28 December 2010 (UTC)
Yes, you are again engaging in OR, using one source to promote a POV, unless and until you answer the question about what other sources say. This is frustrating and tiresome; I had hoped that Colin's explanation at the OR noticeboard would have helped you see how to better edit medical articles. Please address my specific questions above-- perhaps you don't read critically when you are trying to work too fast? Do you understand the issue of due weight, and not stating one editor's hypothesis as fact in the lead, versus exploring that hypothesis in the body of the article? SandyGeorgia (Talk) 23:36, 28 December 2010 (UTC)
I grow tired of this. SG, which part of the quotes above is ambiguous or difficult to understand? You say it's OR. How? In what way? I have only faithfully reported what the peer-reviewed secondary source says. Nothing more. Please reply only with specifics, not generalizations. If you feel so strongly then file for a third opinion. Ok? Basket of Puppies 23:40, 28 December 2010 (UTC)
I have filed for a 3O. Basket of Puppies 23:45, 28 December 2010 (UTC)
Actually, you're more likely headed for an WP:RFC/U. Although at least half a dozen editors have disagreed with you so far (and no one has supported your position, see Talk:Schizophrenia where this started a week ago), and this is still clearly under discussion, and you continue to fail to engage talk page queries, you have now also removed a well-justified maintenance tag while alleging edit warrring. This is becoming more and more tenditious and disruptive, as you have been told by several others on the various noticeboards. It took five days, and a lot of editor time, for you to realize what you were told from the beginning about MEDRS and secondary sources; please learn from that experience. I have clearly laid out several questions above, and explained the due weight issue, and you have not yet answered my question, after more than three queries. Do you read what is posted to you? Considering that a good portion of this dispute has been conducted by you off-Wiki and on IRC, 3O is not likely to resolve this, and an RFC/U on your editing behavior might be more helpful. I would be greatly encouraged if you would simply read the posts above, read the policy pages as was advised to you at the OR noticeboard, and then answer my direct questions. SandyGeorgia (Talk) 23:55, 28 December 2010 (UTC)
SG, you have tried every which way to get me to conform to your method of editing. You've accused me of everything under the sun from 3rr, TEND, disruptive editing, forum shopping, insulting other editors and OR. I think it's time to stop the insults and work together. I've filed for a 3O. Why don't you let it happen before jumping to an RFC/U. Or do you have something against the dispute resolution process? Basket of Puppies 23:57, 28 December 2010 (UTC)
This talk page is for discussing the article; the place to discuss your behavior is here, and you've been told repeatedly that discussing with other editors is the first step in dispute resolution, yet remove all attempts at discussion. If you'd like to reinstate that post and discuss on your talk, we can do so; otherwise, it looks like an RFC/U is the next step. SandyGeorgia (Talk) 00:15, 29 December 2010 (UTC)
  • From Adams and Victor p 1322:

    One widely held contemporary hypothesis is that this disease reflects an underlying developmental disorder, determined either genetically or because of an environmental insult, leading to abnormalities of synaptic connectivity, prominently affecting the hippocampus and prefrontal cortex.

    SZ is widely held to be neurodevelopmental according to this text. Basket of Puppies 00:19, 29 December 2010 (UTC)
  • Thank you for proving my point: "One widely held contemporary hypothesis is that this disease reflects an underlying developmental disorder, ... " and notice that you have rephrased that as fact in the lead, misrepresenting the source, Shenton. This is exactly what I've said above, and to which you have yet to respond. We don't state a hypothesis as fact in the lead; we explore the hypothesis, including both sides of the issue, in the body of the article. The article is now POV, as it presents one side of a debate as fact. Since you have now edit warred away the dubious fact tag, I won't bother placing the POV tag, but one is warranted. SandyGeorgia (Talk) 00:23, 29 December 2010 (UTC)
  • Not a review article. BoP, please answer the direct questions above as to what the other sources say. Since you're working on this article and advancing a specific POV, I assume you have the full text of the other sources, which I do not. Do you know what a medical hypothesis is? Do you understand why we don't state hypotheses as fact? Are you aware of the concept of cherry picking of sources? Do you understand that we need to know what the most recent highly reputable sources say, and give them due weight? Do you understand that this paper, too, is advancing a hypothesis, and that we have to give due weight to all reliable sources rather than representing only one argument as fact, per WP:NPOV? If you don't simply answer these questions, or engage on user talk as I've tried multiple times, I see no option but to proceed with an RFC/U. SandyGeorgia (Talk) 00:30, 29 December 2010 (UTC)
  • Further, this article also includes an entire section and an abundance of text critical of and explaining the problems with the hypothesis, concluding that more study is needed. Hypothesis, not fact. We need to reflect mainstream viewpoints, not just hypotheses, and not state hypotheses as fact. SandyGeorgia (Talk) 01:30, 29 December 2010 (UTC)

Vol. 25: 409-432 (Volume publication date March 2002) Basket of Puppies 00:26, 29 December 2010 (UTC)

  • Further evidence of my point: "In addition, the pathogenesis of the disease is hypothesized to be neurodevelopmental in nature based on reports of an excess of adverse events during the pre- and perinatal periods, ... " (Also very old, 2002-- we have current highly reputable reviews, yet you don't seem to want to state what they say.) For NPOV, we have to accord due weight to other views, and not state this as fact in the lead. SandyGeorgia (Talk) 00:34, 29 December 2010 (UTC)
  • Does not say it is a neurodevelopmental disorder. Also, apparently not indexed at PubMed, which may speak to the quality of the journal. SandyGeorgia (Talk) 01:25, 29 December 2010 (UTC)
  • Does not say it is a neurodevelopmental disorder. Also, apparently not indexed at PubMed, which may speak to the quality of the journal. SandyGeorgia (Talk) 01:25, 29 December 2010 (UTC)
  • Hypothesis, not fact. Further, this paper contains an entire section devoted to citicism of the hypothesis, including but not limited to:

Critics of the neurodevelopmental model claim that it does not fully account for a number of features of schizophrenia, including the long gap between neurodevelopmental insult and the development of symptoms, the progressive clinical deterioration observed in some patients, and evidence of progressive changes in certain ventricular and cortical brain structures.1,207–209 Longitudinal studies have demonstrated evidence of an increase in ventricular volume over a period of 2–4 years among first-episode patients.143,210 Moreover, a decline in frontal lobe volume and posterior superior temporal gray matter volume over a period of 4 years has been reported in patients with chronic schizophrenia.211

Unless we give due to weight to all theories, including those most prevalent, the article is POV. SandyGeorgia (Talk) 01:17, 29 December 2010 (UTC)
  • Correlation is not causation: " ... syndrome marked by neurodevelopmental abnormalities". All of this is proving my point, and you still haven't indicated what van Os and Picchione say. I'll unwatch for a while, and tag the article POV tomorrow unless you include other mainstream sources as indicated or correct the text as suggested above; this is not a productive use of editor time. SandyGeorgia (Talk) 00:48, 29 December 2010 (UTC)
  • And, "Finally, the field seems to be witnessing a revival of theoretical speculation, with several new syntheses of existing literature pointing to new hypotheses about pathophysiology in a neurodevelopmental context." SandyGeorgia (Talk) 01:12, 29 December 2010 (UTC)
  • Conclusion There is widespread consensus in the literature that SZ is a neurodevelopmental disorder and abundant sources to cite reflect this. Basket of Puppies 00:54, 29 December 2010 (UTC)
  • Here's a quote from Brain and Behavior p219 (ISBN #:0716711877),

    Abnormal brain development can be much subtler than anencephaly. For example, if cells do not migrate to their correct location and these mispositioned cells do not subsequently die, they can disrupt brain function and may lead to disorders ranging from seizures to schizophreniaemphasis mine

    Yet another secondary source that declares SZ to be as a result of abnormal brain development. Basket of Puppies 01:58, 29 December 2010 (UTC)
  • Here is another quote from a textbook Biological Psychology, 10th ed ISBN#0-495-60300-7 p453:

    schizophrenia is based on abnormalities in the prenatal (before birth) or neonatal (newborn) development of the nervous system, which lead to a subtle abnormalities of brain anatomy and major abnormalities in behavior (Weinberger, 1996).

    Yet another secondary text that indicates that SZ is neurodevelopmental/neurodegenerative. Basket of Puppies 02:21, 29 December 2010 (UTC)

POV[edit]

The article is currently POV, stating as fact in the lead the hypothesis that schizophrenia is neurodevelopmental. Contrasted to all of the hypotheticals listed above, here is the most recent high quality, secondary review article (Picchione, 2007, BMJ)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1914490/

which nowhere states that schizophrenia is neurodevelopmental, and clearly labels it as a mental illness, as it is currently classified. Wiki can explore hypotheses in the body of the article, but not state them as fact in the lead. I will check in tomorrow or the next day to see if the article should be tagged POV. SandyGeorgia (Talk) 01:05, 29 December 2010 (UTC)

  • BoP, please READ and stop wasting time. We don't tout hypotheses in the lead of an article, while leaving out mainstream thinking, and we don't "compromise" the integrity of medical articles with misstatements and POV. Mainstream thought is not reflected in this article, it gives undue weight to fringe theories and hypotheses, and it is POV. Schizophrenia is currently viewed as a mental disorder, with genetic and environmental contributing factors. You might start by moving all of this neural stuff to the bottom of the article, placing the mainstream stuff first, and expanding it in the lead so as not to give undue weight to hypotheses (I appreciate that you made the effort to at least work mental disorder back into the lead, but we don't "compromise" if that means we're still not getting it right, according to Wiki's policies on sourcing, due weight, and NPOV). The lead at Causes of schizophrenia might give you some ideas of how to proceed to write a more neutral lead (and article). SandyGeorgia (Talk) 01:50, 29 December 2010 (UTC)
How is it a "misstatement and POV" to indicate that SZ is a neurodevelopmental/neurodegenerative disease? The refs say just that over and over. Also, please don't shout. Ok? Basket of Puppies 01:51, 29 December 2010 (UTC)
I've outlined that very well above, and I'm tired of repeating myself while you answer no questions. You might also consider the proper use of the word "neural" as at Causes of schizophrenia: "Neural correlates do not provide sufficiently useful criteria", which is the missing point in this POV article. Have you read WP:UNDUE? SandyGeorgia (Talk) 01:52, 29 December 2010 (UTC)
SG, at this point I think we are not talking to each other but rather past each other. Let's wait for the third opinion, ok? Basket of Puppies 01:57, 29 December 2010 (UTC)

Comment from an uninvolved editor[edit]

Hi; I just dropped by in response to your post on WP:3O. I'll break this long boring comment down into bullet points. Thanks for remaining civil - do please try not to snipe at each other, that'll just make things worse. (You can snipe at me, if that helps relieve your tension :-)

  • I thought that neurodevelopmental problems would be a subset of mental illnesses in this context. If this is the case (please correct me if I'm wrong!), by keeping that subset in mind it might be possible to sidestep a couple of points of disagreement. Specifically, considering the thread above, I don't think that citing one source which uses the specific (and controversial) term necessarily contradicts another which uses the more general term, so we could find a way to sidestep some arguments about which-source-overrules-which.
  • If research is still ongoing into the mechanisms of schizophrenia, I don't think it's unreasonable to mention current theories in the lede (and I can't think of a specific policy against it), as long as it's phrased carefully, and it's in line with the usual concerns about due weight &c (and, of course, compatible with reliable sources). Consider the Higgs boson; physicists don't yet have a definite agreement on the subject, but rather than stripping content out of the lede to avoid mentioning hypotheses, that article's lede summarises the current stance of researchers on the Higgs boson, and briefly alludes to other possibilities.
  • I don't see how BoP's recent compromise diff "leaves out mainstream thinking" - could somebody explain? It's possible that I've misread sources on the first reading. However, I do think the wording of that diff is a little stilted. Bearing in mind that the lede should be an accurate and representative summary, would you consider a compromise along these lines?
"The mechanisms of schizophrenia are varied, and some research is ongoing. Schizophrenia is a mental illness (or some similar concrete definition). Current research suggests (a few words summarising the main thrust of research)"
  • On primary sources: I feel that a rigid black-and-white distinction would be unhelpful. In line with WP:MEDRS, it should be OK to build a broad framework out of secondary sources and then maybe use primary sources to fill in a couple of details which are gaps in the framework (as long as we exercise due caution; the primary source doesn't contradict the secondary, &c). More generally, the reliability of sources isn't boolean either, so if we're starting from a fairly high level - our sources are peer-reviewed medical research rather than blogposts or pamphlets - it may be necessary to weigh each source in context rather than apply rigid top-down rules in advance.

Comments / suggestions / complaints? bobrayner (talk) 05:40, 29 December 2010 (UTC)

As an aside, if you have difficulty getting access to the full text of a particular paper, just say so - I have a subscription to most interesting journals & archives. bobrayner (talk) 05:53, 29 December 2010 (UTC)
Bobrayner, I am extremely impressed that you a) summoned up the courage to offer your neutral opinion and b) have such an impressive grasp on the situation. Bravo. I agree with you on about every point. One point that I'll be interested in your reply- I view mental illness as a subset of neurological basis. In the case of SZ, an improper neurodevelopment leads to what we call mental illness, not the other way around. Such as in the case of PTSD, the traumatic events cause degeneration of the amygdale and hippocampus which then leads to symptoms that we call mental illness. I have degrees in psychology (BS) and neurobiology (MS) so I think I've gotten a broad range of education in both fields and in the end I firmly see the neurodevelopmental/neurodegenerative issues being the parent issue of mental illness. That being said, if you think that my compromise text is actually a good compromise (but needs a bit of tweaking) then I would invite this to go forth. I do not see how it leaves out mainstream thinking in the least. In fact I've cited no less than half a dozen secondary sources (and several more primary sources) that indicate SZ is neurodevelopmental/neurodegenerative and firmly think this *is* the mainstream thinking. Realizing that not every paper agrees with me I am very open to this compromise (with additional tweaking) that would satisfy all the sources and all opinions on the issue. Again, thank you so much for coming and offering your neutral and unbiased third opinion. Sincerely, Basket of Puppies 06:33, 29 December 2010 (UTC)

I've been involved, and I too want to thank Bob for his thoughtful and sensible help. In the time since I logged out yesterday, the talk here between BoP and Sandy has been, for me, tl;dr. But I'd suggest to you both to just drop the stick and walk away, instead of escalating this. We can always come back and make more edits later.

It seems to me that much of the heat here has been about editing protocol, rather than about the actual merits of the content, and it may be helpful to recognize that there's a difference. As a matter of fact: it's not true, per the reliable sources, to say that neurodevelopmental models of SZ are just hypotheses. It's the scientific consensus that some kind of neurodevelopmental model is going to be correct. There's still a lack of answers about how much is strictly developmental and how much is some other kind of neural mechanism, and a lack of answers as to which mechanisms are the real ones, but non-organic ideas (like moral failure or bad mothering) have long ago been relegated by mainstream science to the realm of discredited fringe theories. I'm not an RS of course, but I promise you that you'll find review sources to back that up. So chill. --Tryptofish (talk) 15:25, 29 December 2010 (UTC)

Tryptofish, in an attempt to compromise with SG I changed the lede to reflect SZ as a mental illness with leading hypothesis of neurodevelopmental/neurodegenerative process. This seems to accurately reflect the studies and also SGs position. So I am unsure why there is still a conflict. Basket of Puppies 18:33, 29 December 2010 (UTC)
Yes, I'm not sure myself, and I was telling all involved to chill, not singling out either one of you. I want to make it clear that you are, in fact, correct in describing it as neurodevelopmental and neurodegenerative, and it's just a matter of working collaboratively to develop the sourcing. The suggestion that developmental/degenerative is controversial is not supported by the literature. --Tryptofish (talk) 18:43, 29 December 2010 (UTC)
I think the sourcing issue has largely been worked out since I found two secondary sources that go into some depth of SZ. SG still has a problem with the use of any primary source at all, something that isn't supported by policy, but I am diligently working around that. Still unsure what I am doing wrong (if anything), tho SG claims I am POV and FRINGE in how I am presenting this article. Can you help explain it to me? She make the claims but doesn't give specifics. Basket of Puppies 18:48, 29 December 2010 (UTC)
For obvious reasons, I'm not going to put myself in the position of trying to explain what someone else is saying, but it seems to me that you are now doing the right things, and whatever is still not agreed upon will be worked out in time. It kind of looks to me like editors understandably got pissed off over some of the earlier disagreements at FA, and it's taking a little while to let go of that. For now, I'd say follow what bobrayner suggested above (including the use of primary sources, per his fourth bullet point), and that should be fine. --Tryptofish (talk) 18:58, 29 December 2010 (UTC)
Sounds good to me! Basket of Puppies 19:05, 29 December 2010 (UTC)
Well, we can't reach an agreement whilst one person is quiet. SandyGeorgia, how do you feel? What do you think would be the best way forward? And is there anything we can do to bring you back to the bargaining table? :-)
BoP: You might not like me saying this, but if there's entrenched disagreement, it's unhelpful to talk in terms of "The other person is blocking progress...". That can provoke more defensive responses, then you'd react defensively, and we'd keep going round in circles. Given what SG has said already, can you think of any other options to put on the table? bobrayner (talk) 20:24, 29 December 2010 (UTC)
Having looked at Sandy's talk (I have way too much free time today!), I think she just needs to recover from her leaking roof and get a good night's sleep. Bob, you've been immensely helpful here, so big thanks to you. I think things are heading in the right direction now (famous last words). --Tryptofish (talk) 20:33, 29 December 2010 (UTC)
Yes, still catching up, and will be dealing with roof issue for a few more days. There is some feedback on my talk, if that will help advance things in the interim. SandyGeorgia (Talk) 15:54, 30 December 2010 (UTC)

New lead, more to do[edit]

I have attempted to somewhat neutralize the lead (with direct quotes, that someone may want to better paraphrase, my prose stinks) to avoid POV, but content needs to be added to the body of the article, discussing problems with the neurodevelopmental hypothesis, and where needed, updating info to newer (than 2001) reviews. That's all I have time for today. Regards, SandyGeorgia (Talk) 23:34, 30 December 2010 (UTC)

I like the way that this lede reads. It is balanced and takes into account all the opinions. I have a few questions regarding the sourcing for it, however. I see that The Neurodevelopmental Hypothesis of Schizophrenia, Revisited is being used, but I read it and it doesn't appear to be a secondary source. Am I missing something? Basket of Puppies 23:49, 30 December 2010 (UTC)
This dispatch (written incidentally by two of Wiki's finest biomed editors) may help you better understand sourcing and citation formatting in biomedical articles. First, if you will use the convention that is used on most medical articles when discussing citations, it will be time-saving and easier for all. You are referring to PMID 19223657 . When you want to refer to a PubMed indexed article on user talk, you only need enter PMID followed by a space and the PMID number-- then we can all get directly to the abstract. Second, at the PubMed abstract, near the bottom of the page, you will find a drop-down that says "Publication types"; there, you will see it's a review. The Dispatch gives you techniques for locating recent reviews at PubMed. Third, this is the Diberri template filler: you only need plug in a PMID, and it returns a cite journal template. Fourth, Eubulides wrote the vcite template, that uses a slightly different format and is helpful on long articles, as it takes less code (for reasons I can't explain), so after you get the cite journal template from Diberri, you only need switch cite to vcite. SandyGeorgia (Talk) 23:57, 30 December 2010 (UTC)
Huh? I just am wondering if I am mistaken about the article being primary or secondary. Basket of Puppies 00:02, 31 December 2010 (UTC)

Neurological[edit]

Fact: Everyone agrees that schizophrenia is associated with structural abnormalities. What the connection between these abnormalities and thinking the world is out to get you however is debated (dopamine is believed to be involved somewhere). What causes these sturctural abnormailities is also debated but most likely is muitifactorial.Doc James (talk · contribs · email) 18:53, 29 December 2010 (UTC)

I agree 100% with that. And another fact is that neither of us is a reliable source (which you know, and I don't mean that you were implying otherwise), so whoever wants to, go and find the sources that reflect that! --Tryptofish (talk) 19:13, 29 December 2010 (UTC)
These are the conclusions of the Lancet09 review. Uptodate states:

PATHOPHYSIOLOGY — The biological basis of schizophrenia involves a combination of genetic and environmental factors, both of which are required for development of the disorder [96,97]. The wide range of symptoms and subtypes of the illness suggest the possibility of multiple pathways for its development. Eugen Bleuler, who coined the term schizophrenia, was probably close to the mark when he titled his 1911 monograph on psychosis 'Dementia Praecox, or The Group of Schizophrenias' [98].The prevailing model for the pathogenesis of schizophrenia includes a combination of genetic vulnerability, early developmental insults, and later biological and psychosocial stressors as essential factors. The numerous variants of these factors may be responsible for both the heterogeneity of the illness and the lack of consensus in studies of risk factors. It concludes "Genetic and environmental risk factors contribute to the development of schizophrenia. Altered neurotransmitter pathways, including dopamine, are implicated, and enlarged sulci and ventricles are found on brain imaging."

Doc James (talk · contribs · email) 19:30, 29 December 2010 (UTC)

More reviews[edit]

This article currently heavily cites Shenton, which is 2001 (much too old for such a widely studied condition). Here are other recent reviews for consideration:

  1. Fatemi SH, Folsom TD. The neurodevelopmental hypothesis of schizophrenia, revisited. Schizophr Bull. 2009;35(3):528–48. doi:10.1093/schbul/sbn187. PMID 19223657.
    Discusses the hypothesis, 2009, full text freely available (valuable for our readers) and has an entire section devoted to problems with the hypothesis.
  2. Wood SJ, Pantelis C, Yung AR, Velakoulis D, McGorry PD. Brain changes during the onset of schizophrenia: implications for neurodevelopmental theories. Med. J. Aust.. 2009;190(4 Suppl):S10–3. PMID 19220166.
    Review, 2009, " ... they challenge the conventional neurodevelopmental model of schizophrenia".
  3. Murray RM, Lappin J, Di Forti M. Schizophrenia: from developmental deviance to dopamine dysregulation. Eur Neuropsychopharmacol. 2008;18 Suppl 3:S129–34. doi:10.1016/j.euroneuro.2008.04.002. PMID 18499406.
    Free text not available, but 2008 and abstract sounds interesting.

Also noting that free full text is available for Steen, which is currently cited in the article, but using the wrong citation format (citation style was altered in the article, against WP:CITE, not only producing inconsistent citations, but the {{pmid}} template does not provide for full-text when it's available. Please restore the citations to here to the vcite fformat for consistency, and use the Diberri format filler to yield free full text when it's available (or manually supply the URL if Diberri doesn't return it).

  1. Steen RG, Mull C, McClure R, Hamer RM, Lieberman JA. Brain volume in first-episode schizophrenia: systematic review and meta-analysis of magnetic resonance imaging studies. Br J Psychiatry. 2006;188:510–8. doi:10.1192/bjp.188.6.510. PMID 16738340.

This is just a sampling of newer reviews, and there are scores more, so we may need to use newer sources here. These reviews specific to the mechanisms may be useful for this article; however, broader-based, newer, and highest quality reviews such as Doc James linked above still do not call the condition neurodevelopmental, so the hypothesis should be explored fully in this daugher article from both sides. SandyGeorgia (Talk) 23:10, 30 December 2010 (UTC)

Adding, in case it's still not clear, these are reviews specific to the topic of this article, not rising to the level of reviews needed in the main Schizophrenia article, as they don't cover the topic broadly, and are only looking at specific hypotheses. SandyGeorgia (Talk) 00:06, 31 December 2010 (UTC)
I don't mean to be rude, but how have you decided that a secondary source review article is not allowed to be used? I see you say it doesn't raise to a level, but how did you come to that and where is the consensus for it? Just seems confusing to me. Basket of Puppies 00:15, 31 December 2010 (UTC)

Edit warring again[edit]

In the interests of moving on, I'm boldly collapsing this. Now let's work on improving the page. --Tryptofish (talk) 19:03, 31 December 2010 (UTC)

This series of edits once again changed the citation style of the article, even after pages of discussion of this problem with BoP, against Wikipedia:CITE#Citation styles and consistency. This is how the article looked before BoP's first edit; it does not use the PMID template, it uses vcite with the Diberri format. Please revert. BoP, before reverting a change which has already been discussed, you should discuss it on talk, and gain consensus if you want to change the citation style. I am dismayed that you continue to edit war after our discussion; please see WP:BRD. SandyGeorgia (Talk) 23:45, 30 December 2010 (UTC)

Huh? SG, why are you accusing me of edit warring so quickly? I was just making the lede refs to have the same format as the rest of the article. Basket of Puppies 23:57, 30 December 2010 (UTC)
Frustration growing, that at this stage, you don't know what edit warring is. You have already been reverted on changing citation style, it has been explained to you, our talk page discussion led me to believe you understood, and yet you again changed citation style. Any time you revert changes against BRD, which have already been discussed and where you've reverted those before, you are edit warring. Three reverts are not required for edit warring (hence the admin who didn't block you for your edit warring on 27 December allowed you apparently to remain confused about what constitutes edit warring). We had talked about you changing citation style, yet you did it again, with no discussion. Do you not seee the differences in formatting between your style and the style used in the article? SandyGeorgia (Talk) 00:02, 31 December 2010 (UTC)
Whatever are you talking about, SG? I noticed an inconsistency in the refs so I fixed them. I really don't understand why you are accusing me on edit warring when I am just following the suggestion to keep references consistent. Basket of Puppies 00:04, 31 December 2010 (UTC)
Then please try to reread; I have explained it all above as well as I'm able. Perhaps someone else can get you to understand. Edit warring is a bright line you should not cross, and whenever you are changing citation style, and reverting more than once, you are edit warring. You introduced the citation inconsistency; the style was consistent before you started. I'm unwatching again, I find this waste of time incredibly frustrating, and I hope someone else can help you understand. SandyGeorgia (Talk) 00:08, 31 December 2010 (UTC)
SG, I had a read of the policy page and it says

Citations in Wikipedia articles should be internally consistent. You should follow the style already established in an article if it has one; where there is disagreement, the style used by the first editor to use one should be respected.

When this article was created it used *both* vcite AND cite pmid. I took the time to standardize them to cite pmid and every ref is in that format. It appears that changing them to vcite would be breaking the guideline. I am not trying to edit war and only trying to keep things consistent. I hope you realize I am doing this entire in good faith and not trying to push any buttons or make anyone upset. Basket of Puppies 00:13, 31 December 2010 (UTC)

It seems I can't log out for the night and then come back without finding more drama here. I've reviewed the edits, and I have to largely agree with BoP here. There is nothing resembling edit warring, and BoP appears entirely to be acting in good faith. As best I can tell, Sandy gave a useful but confusing explanation of citation styles in #New lead, more to do, above. BoP's "huh?" question at the end of that section is entirely reasonable, and I think it's a bit much to get out the pitchforks because BoP didn't follow what Sandy was saying, and made a good faith edit based on another part of the guidelines. --Tryptofish (talk) 15:02, 31 December 2010 (UTC)

Thank you, Tryptofish. I swear I am editing in good faith and not trying to make any drama. I appreciate your assessment of the situation and it's good to know I am not unintentionally messing things up. Basket of Puppies 16:12, 31 December 2010 (UTC)
Various patronising comments such as "you don't know what edit warring is" are unhelpful too. Please, let's not provoke any more drama - that's not going to improve the article. bobrayner (talk) 17:40, 31 December 2010 (UTC)
I agree, Bobrayner. I hope SG will be kind and not say those sort of things from now on. Basket of Puppies 18:16, 31 December 2010 (UTC)
Good, I'm happy to hear this! I recognize that Sandy has had a few stressful days in real life, due to a leaking roof, so hopefully this is an understandable situation all around. And I would support formatting the references as Sandy has advised. But let me make it real clear here that the consensus is that BoP has come around from whatever was a matter of conflict before, and now, it's time to put that behind us. --Tryptofish (talk) 18:32, 31 December 2010 (UTC)

Ok, then you all carry on here, and I'll focus on other dispute resolution when and if I have time. I placed a very clear link above, which shows as clearly as possible that there were no {{cite pmid}} templates in the article before BoP started altering the citation style, the citation style used in the article is the vcite template and has been since the article started, and from his other post above, it's now apparent that he perhaps until now, and even now, doesn't yet know how to determine what a primary source is and how to distinguish them from secondary sources, in spite of my lengthy efforts to help him understand and post helpful links to him. I suggest the best way forward now, and to avoid other editor's misspending their time and effort on this, is for BoP to seek a mentor who has time to help him understand these basic concepts of Wiki editing, and to encourage him to read pages and links posted to him. As long as this doesn't spill over into the main featured article, I don't have time to engage and am not finding this at all productive. AGF is fine and good, but someone else needs to help BoP understand these fundamentals, as it's very time consuming, and as long as they don't affect the integrity of the main article and its featured article review, I give up. I appreciate that BoP is trying to improve, and do AGF, but someone else needs to help in the fact that the issues continue, and amount to IDIDNTHEARTHAT, which the rest of you are now enabling. SandyGeorgia (Talk) 18:36, 31 December 2010 (UTC)

No, this is not enabling. I understand full well that AGF isn't the proverbial suicide pact, but I also point out that refusing to drop the stick is a kind of didn'thearthat too. --Tryptofish (talk) 18:46, 31 December 2010 (UTC)
As I said, as long as the continued misunderstanding of fundamentals of Wiki editing doesn't spill over into the main article, and affect its WP:FAR, the stick is dropped, primarily because I don't have time to continue to try to make long posts including links to help BoP understand these fundamentals. You are welcome to discuss BoP's behaviors with me on my talk if you still have concerns, and I will respond as I get some sleep. Inconsistent citations are a minor matter here, but they are part of WP:WIAFA and will affect the FAR if they are introduced at the main article, and primary sources in the main article will cause it to be defeatured, which is why it would be helpful if BoP would understand these concepts. SandyGeorgia (Talk) 18:59, 31 December 2010 (UTC)

Citation style[edit]

As an example:

cite pmid
Cite journal using Diberri format
Vcite journal using Diberri format (the style used in the schizophrenia articles, which per WP:CITE should not be changed without consensus)

Note the differences (not to mention that for some reason, cite pmid returns the WRONG information, which is now in the article). The formatting differences are a minor (but irritating) factor on non-featured articles, but a matter that affects featured articles, which must have a consistent citation style. And, if citations from this article are eventually transported to the main article, they need to use vcite. SandyGeorgia (Talk) 19:27, 31 December 2010 (UTC)

  • Does someone else have time to figure out 1) why cite pmid returns wrong info, and 2) why vcite is generating two periods after the et al? Both of these need to be addressed in those templates, but they are protected and I can't read the syntax there, and don't have time to engage yet another issue. I only discovered this when making this post. SandyGeorgia (Talk) 19:40, 31 December 2010 (UTC)
  • The only thing I can find that could be contributing somehow to the error is that van Dyck CH is an author on both; I can't find the Magnus Barelegs' article at PubMed to see what it's PMID actually is. Weird stuff. SandyGeorgia (Talk) 19:48, 31 December 2010 (UTC)
Template:Cite pmid/8799184 was added by User:Citation bot 2 on 28 December. See User:Citation bot 2#False positives; issues should be reported to the bot talk page. ---— Gadget850 (Ed) talk 20:00, 31 December 2010 (UTC)
Ok, I see this link has gone red, which means the bot (or someone) is working to fix it now ... So, another problem is that the cite pmid template is filled in by bot, and subject to error, which means I'll never use it anywhere. SandyGeorgia (Talk) 20:12, 31 December 2010 (UTC)
This is a frequent problem with this bot. I was battling it some time ago with {{cite doi}} template. See here. Ruslik_Zero 20:13, 31 December 2010 (UTC)
Thanks, Ruslik0-- so this is something I should watch for at FAC, and I suggest that, per guideline anyway, that template should be removed from this article now. It was employed here against the WP:CITE guideline anyway. SandyGeorgia (Talk) 20:15, 31 December 2010 (UTC)
What is interesting is that in both case the bot inserted the same article: 'Magnus Barelegs' Expeditions to the West'—it seems to like history. I manually forced the bot to refill the citation. Ruslik_Zero 20:20, 31 December 2010 (UTC)
I almost deleted that page to see if it would repopulate properly, but I was searching for a precedent. Good to know. ---— Gadget850 (Ed) talk 20:53, 31 December 2010 (UTC)
Magnus Barelegs: learn something new every day! I rather doubt that he published anything on the frontal cortex, though. --Tryptofish (talk) 20:25, 31 December 2010 (UTC)
Now fixed by the bot; thanks all. So, now the (correct) example shows how insanely long the cite pmid citations are, increasing the page length. Eubulides designed vcite for two reasons: 1) something about the citation style being more common in medicine (I can't recall where to find that post), and 2) because it takes less time to load, so is more useful on long articles. SandyGeorgia (Talk) 20:28, 31 December 2010 (UTC)

I am not married to one format or another. Each is broken and needs to be fixed. If someone wants to go through and change every single ref to vcite then be my guest, but until the technical problems are fixed in each I suggest no action. Basket of Puppies 19:55, 31 December 2010 (UTC)

With all due respect, that ignores the fundamental problem which is that your change of citation style, against guideline,[6] has now resulted in a blatant citation error currently standing in the article, which should be fixed now. The only "error" in vcite is two periods, which is quite insignificant, and may not even be an error, as it may be part of that citation style. I'd ask Eubulides, who designed that template and was one of Wiki's finest medical editors, but he gave up on dealing with tenditious medical editors and left. He wasn't prone to mistakes, so I'm inclined to believe that the citation style employed actually uses two periods, intentionally. SandyGeorgia (Talk) 20:14, 31 December 2010 (UTC)
Hey BoP, hint, when you have a few minutes, please consider changing those cites to the vcite format. We'll work out those bugs in the various templates in due time. --Tryptofish (talk) 20:16, 31 December 2010 (UTC)
Until they're restored to the state they were in before BoP altered citations here, we don't know how many of them are wrong :/ SandyGeorgia (Talk) 20:38, 31 December 2010 (UTC)
Like I said elsewhere, when this article was copied over there were both vcite and cite pmid. I have a lot of experience with cite pmid so I standardized the article on cite pmid. Shabbat is starting in a few minutes so I'll be signing off until Saturday night. Basket of Puppies 20:42, 31 December 2010 (UTC)
Perhaps you will see why this is frustrating for me now? Did you read the section above, now collapsed, and the diff above[7] where I show when you altered the style? This is the article before you edited it; it consistently used vcite. There was *one* wayward cite pmid: you altered the citation style, so if there are errors now ... SandyGeorgia (Talk) 20:45, 31 December 2010 (UTC)
Correction, it more consistently used cite journal rather than vcite journal, but it still had only one cite pmid template. I suggest we standardize to vcite rather than cite so that citations here will be consistent with the main article. They're both based on the Diberri PMID filler (which is used on most medical articles), but vcite loads faster and produces a shorter citation. SandyGeorgia (Talk) 20:58, 31 December 2010 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────BoP, when you get back here after Shabbat, please just do it. Happy New Year, everyone! --Tryptofish (talk) 21:02, 31 December 2010 (UTC)

Don't hat it until the techno people are done beating up the bot (or whatever they do in these cases), and the source checkers at FAC know to watch out for these templates at FAC! Does one say Happy Shabbat? Or whatever the equivalent is ... SandyGeorgia (Talk) 21:05, 31 December 2010 (UTC)

In the interim, another editor has gone through all the refs, and, with a bit of time passed, this issue strikes me as a tempest in a wiki-teapot. Not worth spending time on. --Tryptofish (talk) 14:48, 3 January 2011 (UTC) I should have my head examined for having bothered to have said that. --Tryptofish (talk) 14:57, 3 January 2011 (UTC)

And, I have discussed with that bot operator in the past many times to stop using bot edits to change ref style, yet he continues to do it, introducing now a fourth style to this article, so I'll be dealing with that. Also, I don't think an IDIDNTHEARTHAT pattern of behavior is a "tempest in a wiki-teapot". SandyGeorgia (Talk) 14:50, 3 January 2011 (UTC)
As an FYI to those involved here I've attempted to format the remaining refs to render the authors in the Diberri format, and added various extra DOI and PMID entries, but haven't made any attempt to resolve the use of cite pmid vs cite journal vs vcite journal, so the citation style remains in a mixed state. I expect a conversion to vcite journal will be the resolution, but I don't use vcite journal, so will leave that to others. Rjwilmsi 15:23, 3 January 2011 (UTC)
No you haven't, and we've had this discussion before; please read up on the Diberri format, specifically when and how to truncate how many authors to et al and how to handle page numbers. Also read up on vcite vs cite for load time on articles with many citations; it uses a different style and doesn't impede load time. Since it doesn't appear that DoB is going to restore the info he removed with the cite pmid template, I'll do those sometime later, using the Diberri format. I do, however, appreciate that you added the PMIDs and DOIs, as that meant less work for me, but as we've discussed before, you need to gain consensus before using a bot to alter citation style. Putting a note on talk would be nice. SandyGeorgia (Talk) 15:43, 3 January 2011 (UTC)
Much better; I'll catch up later, and fix the cite pmids if warranted. SandyGeorgia (Talk) 15:54, 3 January 2011 (UTC)
I've noted the '> 6 authors == 3 authors et al' convention at Wikipedia:Manual_of_Style_(medicine-related_articles)#Citing_medical_sources so will follow that. I am not clear on any issues over page number/range formatting, can you clarify that one? Rjwilmsi 16:10, 3 January 2011 (UTC)
Thanks, that really helps-- that bot is chunking up the text with gobs of authors in a terrible format, that makes editing hard. I'll go find the link to page number stuff and come back. SandyGeorgia (Talk) 16:12, 3 January 2011 (UTC)
Well ... I can't find it ... MOS gets fiddled with so often it's impossible to keep up with. The gist is that we don't write something like page 14535–14539; we write 14535–9, or is it 39, I can't recall ... plug in some PMID with awful-long page numbers to the Diberri PMID filler (link on my user page), and you'll see what I mean. Since I use Diberri when filling in templates, I don't recall the exact convention. SandyGeorgia (Talk) 16:20, 3 January 2011 (UTC)
Fine on that one, when editing by script that's what I do (i.e. shortest format). When editing manually I will probably paste it from the journal page as is (and convert dash), but I'll try to keep the convention in mind. Rjwilmsi 16:27, 3 January 2011 (UTC)
Thanks, that helps! I found User:Diberri/Template filler, but it doesn't explain page number truncation, so I can never remember if it's to two digits or one-- need to test one to see. SandyGeorgia (Talk) 16:30, 3 January 2011 (UTC)
Found a sample for you, it's one digit:
SandyGeorgia (Talk) 16:48, 3 January 2011 (UTC)
Fixed all the page numbers, will do more later. SandyGeorgia (Talk) 16:57, 3 January 2011 (UTC)

Not quite finished repairing the cite pmid templates to vcite, but I need to take a break for a bit, in case anyone else wants to dig in anywhere. SandyGeorgia (Talk) 19:41, 3 January 2011 (UTC)

Dopamine copyedits[edit]

I'm happy to see the copyedits Sandy has been doing to the Dopamine section that was imported from Causes of schizophrenia. I have an additional pointer to make, which is that the text relies overly much (as in WP:UNDUE) on reports from a single investigator (the one whose name appears repeatedly, previously as "Dr. ..."). It would be good to get more balance in that regard. I arguably have a bit of a WP:COI, which is one of the reasons I'm not doing that myself. --Tryptofish (talk) 18:58, 3 January 2011 (UTC)

Yep, it's a mess; I'm only picking up the obvious, but it needs a full rewrite. I'm not up to the task :) But did we really have that text in a featured article? SandyGeorgia (Talk) 19:45, 3 January 2011 (UTC)
I don't think the Causes page was ever FA. (?) I mentioned some things about its history recently on your user talk. --Tryptofish (talk) 20:09, 3 January 2011 (UTC)
Ah, sorry, I thought this text had come from the main article. Back to work now. SandyGeorgia (Talk) 20:15, 3 January 2011 (UTC)

To do[edit]

I think I'm done restoring the citations to a consistent style, except for the raw URLs that I can't chase down in PubMed. I'd like to get back to the main article now, but much work remains to be done on this article, which is Unbalanced at best, POV at worst. It gives undue weight to old research, individual researchers, and primary sources, while neglecting to expand on current thinking according to reviews, and criticism of the various hypotheses. At least the following (maybe more) remains to be done:

  1. Eliminate primary sources as warranted, particularly the older ones.
  2. Rewrite to avoid undue to one author, overrepresented now in the article.
  3. Rewrite to include mainstream thinking and criticism/controversy about some of these hypotheses.
  4. Rewrite to incorporate secondary reviews. Some are listed above at Talk:Mechanisms of schizophrenia#More reviews; more can be found in the main article as it evolves. In an area as well researched as SZ, there is little reason to rely so much on old, primary sources, or even a ten-year-old review (Shenton).
  5. Copyedit.
  6. Wikilink.

I will not tag the article POV now, because replacing primary sources is the first order of business, but I will come back in a few weeks to see if work is underway to balance this article. Best, SandyGeorgia (Talk) 20:37, 3 January 2011 (UTC)

Following up on that last point, in my opinion the problem is primarily in this Dopamine section, more so than for the page as a whole. As POV is generally understood by most editors, I think this is less a matter of POV generally, than of WP:UNDUE emphasis on too narrow a selection of primary sources. I have put a tag on the section, with that in mind. --Tryptofish (talk) 15:05, 4 January 2011 (UTC)
I have access to the most recent textbooks on neurobio and neurodevelopmental diseases. I can post copyright-allowed sections regarding dopamine here so we can develop that section better. Basket of Puppies 20:46, 4 January 2011 (UTC)
Books are less likely to be as uptodate as recent journal-published and peer-reviewed reviews, of which there are plenty. SandyGeorgia (Talk) 21:59, 4 January 2011 (UTC)
Also have access to all of those. Any articles in particular? Basket of Puppies 22:25, 4 January 2011 (UTC)
If you do PubMed searches based on the subjects now covered in that section of the page, you'll find plenty. Look for review articles, and work by authors other than those who are heavily emphasized in the current version. --Tryptofish (talk) 23:07, 4 January 2011 (UTC)

Reason for including Philip Seeman's research[edit]

When I first read the section on dopamine a couple of years ago, it sounded very pessimistic toward the dopamine hypothesis. I inserted Dr Seeman's opinion inbetween the paragraphs to present another point of view on the proofs the other author had used. That way the article was a bit more balanced.Notpayingthepsychiatrist (talk) 23:02, 29 January 2011 (UTC) However, enthusiasm for the dopamine hypothesis has waned, despite Anissa Abi-Dargham's research; yet dopamine antagonism is still the treatment for schizophrenia http://www.ncbi.nlm.nih.gov/pubmed/14972078.Notpayingthepsychiatrist (talk) 02:18, 30 January 2011 (UTC)

Linked paper is dated 2004. --Tryptofish (talk) 19:26, 30 January 2011 (UTC)

Just for whoever rewrites this section, last year this paper was published which showed sz actually have an excess of dimers, not monomers as previously expected by Philip Seeman: http://www.molecularbrain.com/content/3/1/25Notpayingthepsychiatrist (talk) 22:56, 2 February 2011 (UTC) Yet Seeman et al earlier expected methylspiperone to detect dimers?!http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B73F6-48065CD-3G&_user=10&_coverDate=10%2F01%2F1992&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1628651273&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=47db147ed05804c07c9d7fc61e7349e3&searchtype=a Notpayingthepsychiatrist (talk) 03:01, 3 February 2011 (UTC)

Cognitive Dysmetria[edit]

Could someone do a section on cognitive dysmetria please?Notpayingthepsychiatrist (talk) 02:26, 28 January 2011 (UTC)

Now that you've done so, I'd like to make an observation, not as a criticism, but to try to reflect the recent talk above, that grows out of recent discussions at Talk:Schizophrenia. I'd really like us to try to get away from this pattern of saying "now, a particular investigator has put forth another hypothesis (which has not yet become well-accepted in secondary sources), and here is a primary source for it". --Tryptofish (talk) 21:06, 28 January 2011 (UTC)
Yes, but the only problem with that is, for example, the dopamine hypothesis has been around for decades, yet even it is not 'well-accepted'; infact just prior to Abi Dargham's work it was almost dismissed I feel...Darryl Eyles, a scientist at my local university, has been quoted as saying - with schizophrenia you don't have much to hang your hat on...http://www.abc.net.au/catalyst/stories/s1872656.htm
I see what you mean, http://en.wikipedia.org/wiki/Wikipedia:Third-party_sources provides a big problem for schizophrenia research reporting... Notpayingthepsychiatrist (talk) 03:24, 29 January 2011 (UTC)
Could we call the page 'Mechanism theories of schizophrenia'. There should be plenty of cross verification that X theory is this, and behaves this way, rather than trying to find the cause of schizophrenia?Notpayingthepsychiatrist (talk) 03:37, 29 January 2011 (UTC)
It is not needed that it is fully accepted, only that it has been considered important enough by other researchers to be reviewed in a secondary source. Nevertheless the article by Andreasen is considered a review in pubmed, so it is a secondary sourece and there are also newer reviews on it. PMID 12081302, PMID 17562694--Garrondo (talk) 08:56, 29 January 2011 (UTC)
OKNotpayingthepsychiatrist (talk) 10:16, 29 January 2011 (UTC)
I feel that my point was not well-understood, so let me try to clarify a bit. As I said, this wasn't a criticism. Nor was I arguing for deletion of this particular material, necessarily. What I'm getting at is that too much material on these pages has been sourced to primary sources, and too often it has been of a form that reads less like an encyclopedia than as a sort of scientific soap opera: "Dr. X wrote a paper about so-and-so, then wrote another paper to explain why the first paper wasn't wrong, and then wrote a third paper about why the second paper can actually be explained..." and on like that. It tends to make the writing too lengthy, too technical, and with a WP:UNDUE emphasis on some investigators over others (particularly problematic in the Dopamine section of this page). Considering the most recent discussions at Talk:Schizophrenia and also just above, we should be trying harder to present the material sourced to recent reviews, and to minimize the narrative style of "Dr. X said", when that person is a primary source (admittedly a useful way to avoid WP:OR in many cases, but here, used beyond the point of being helpful). Again, just friendly advice, not a criticism. --Tryptofish (talk) 19:08, 29 January 2011 (UTC)
Thanks for the advice Tryptofish. I have schizophrenia and a lot of my writing has been without regard for the format of an encyclopaedia, so I'm glad there are a team of us.Notpayingthepsychiatrist (talk) 21:39, 29 January 2011 (UTC)

The reason I report on Dr Seeman more than others of the same opinion is because he is a leader in the field; which is why PNAS chose him to introduce Abi Dahgam's work with dopamine.Notpayingthepsychiatrist (talk) 02:27, 30 January 2011 (UTC)

And thank you, in turn, for taking my comments in the spirit in which they were intended. We should be careful to base judgments about leadership in the field on a carefully-balanced review of the scholarly literature, which is why secondary sources are better guides than are individual observations by editors. I'm itching to respond more to your last point, but WP:BLP and WP:COI compel me to hope that other editors following this talk will examine this instead. --Tryptofish (talk) 19:24, 30 January 2011 (UTC)

Sorry about the conflict of interest. I read somewhere that editors, instead of voting, should voice themselves by editing. I didn't mean to misconstue your comments and will stay away from editing this site. Sorry again.Notpayingthepsychiatrist (talk) 04:45, 31 January 2011 (UTC). But in reading Philip Seeman's contributions, and why I said he was a leader: "In 2001, he was made an Officer of the Order of Canada "for his research on dopamine receptors and their involvement in diseases such as schizophrenia, Parkinson's and Huntington's".[3] In 1985, he was made a Fellow of the Royal Society of Canada.[4]". But over to you.Notpayingthepsychiatrist (talk) 04:57, 31 January 2011 (UTC) I had honestly never heard of third party sources, or conflict of interest till now, sorry about that; which means a lot of the section on dopamine and a lot of the article on schizophrenia is not edited properly, really sorryNotpayingthepsychiatrist (talk) 20:55, 31 January 2011 (UTC)

Oh my goodness, there's no need for you to apologize, and I feel bad that you felt that you had to apologize over this, so let me apologize to you! It sounds like you think that I was saying that you have a WP:COI editing this page, but that's not what I meant! The COI applies to me, not you, so please feel free to continue editing here.
OK, I guess I better explain more clearly what I was trying to say obliquely. In real life, I'm an academic researcher who has, broadly speaking, done research in this area. Many years ago, I spoke at a Society for Neuroscience meeting, in the course of which I criticized (on some very technical grounds) some of the methodology used in the data reported in the Dopamine section of this page. At the end of my talk, some sharp words were exchanged between me and the scientist who is widely cited in that section of this page. So I think that I would have a COI if I were to take it on myself to delete that material. (And if I really allowed myself to say here what I really think, I would be violating WP:BLP, 'nuff said!) I know enough about the literature in the field to know that the description on this page is WP:UNDUE. Fixing that would not involve citing any papers that I wrote, but it would require citing work by people with whom I've collaborated.
End of full-disclosure digression. Please, please, let me make it absolutely clear that there is nothing COI about people who have SZ editing this page, and that the "third party" language at WP:MEDRS refers to sources, not to editors! Please feel free to continue editing, and please understand that I wasn't finding fault with you, just trying (badly, it now seems!) to provide guidance about how to edit going forward. What should be the take-home message here is that secondary sources such a review articles should guide what we do or do not emphasize on this page (and not what Tryptofish thinks!). --Tryptofish (talk) 22:34, 31 January 2011 (UTC)

I see, thanks very much, I could never have imagined that - glad to be part of the teamNotpayingthepsychiatrist (talk) 00:12, 1 February 2011 (UTC)

Secondary source in the last 5-10 years are needed. --Doc James (talk · contribs · email) 14:23, 8 February 2011 (UTC)
I posted above at least two.--Garrondo (talk) 14:48, 8 February 2011 (UTC)
Great so it can be readded with those as sources. Doc James (talk · contribs · email) 14:54, 8 February 2011 (UTC)
I did not read them, so I do not know if they fully support the deleted paragraph. Moreover the aim of one was clearly to refute the theory of cognitive dysmetria. --Garrondo (talk) 07:14, 9 February 2011 (UTC)

Moved graph here[edit]

Dopamine D2-Like Sites in Schizophrenia, But Not in Alzheimer’s, Huntington’s, or Control Brains for [3H]Benzquinoline The authors say the d2-like sites detected in this diagram could represent the d4-like sites in other replicated experiments. Antipsychotics were found to increase binding sites two fold. SYNAPSE 25:137–146 (1997)PHILIP SEEMAN, HONG-CHANG GUAN, JOSE NOBREGA, DILSHAD JIWA,RUDOLPH MARKSTEIN, JA-HYUN BALK, ROBERTO PICETTI, EMILIANA BORRELLI, AND HUBERT H.M. VAN TOLPermission (Reusing this file)John Wiley & Sons, Inc. has no objections to your proposed reuse of this material.Credit to our Work must appear on every copy using the Material as follows: Title, volume number, issue number, year (e.g. Vol. 1, No. 1, 1996), page numbers. Copyright (year and owner); and the statement “Reprinted with permission of John Wiley & Sons, Inc.”
This needs a better explanation before being added. Clear and short please. --Doc James (talk · contribs · email) 14:08, 8 February 2011 (UTC)

Please don't bother re-writing the caption. The image itself is not representative. --Tryptofish (talk) 15:17, 8 February 2011 (UTC)


Hey Tryptofish, the image interpretation was described as doperminergic at best guess and it is characteristic of schizophrenics.Notpayingthepsychiatrist (talk) 19:46, 15 February 2011 (UTC) As the caption says, the results of the experiment were confirmed by Seeman's 1993 Nature report, which was replicated many times and also used the subtraction technique. The same drug was tried on living schizophrenics but without accounting for non specific binding which was crutial. The diagram is a good example of the section of the article which mentions success in postmortem experiments not confirmed by invivo experiments. Notpayingthepsychiatrist (talk) 21:06, 15 February 2011 (UTC)

I do not think this image adds anything. It is not based on a review... Doc James (talk · contribs · email) 22:34, 15 February 2011 (UTC)

But many images in Wikipedia don't add anything per se, except to illustrate a point more clearly. Isn't it ok to use a primary source, so long as it is introduced by third party material - there is a quote concerning monomers and dimers in the article which I believe is third party.Notpayingthepsychiatrist (talk) 23:47, 15 February 2011 (UTC)

You might find it useful to read WP:MEDRS. These really are primary sources, not review articles. The monomer-dimer thing is not widely accepted in the field as explaining binding results, and the results shown in the image are qualitatively well-accepted as correct, but quantitatively poorly-accepted, and conflict with WP:UNDUE. --Tryptofish (talk) 23:59, 15 February 2011 (UTC)

Hi Tryptofish, I read the recommended policy; it says: "Peer-reviewed medical journals are a natural choice as a source for up-to-date medical information in Wikipedia articles. They contain a mixture of primary and secondary sources, as well as less technical material such as biographies. Although almost all such material will count as a reliable source for at least some purposes, not all the material is equally useful, and some, such as a letter from a non-expert, should be avoided. Journal articles come in many types: original research, reviews, case reports, editorials and op-ed pieces, advocacy pieces, speculation, book reviews, letters to the editor and other forms of commentary or correspondence, biographies and eulogies."

As this is a peer reviewed journal from experts, does it comply?

I think a picture is useful, especially to people not familiar to the topic. It brings home immediately that there is some difference.Notpayingthepsychiatrist (talk) 05:46, 16 February 2011 (UTC)

Well, in MEDRS, I guess I would point more specifically to the "Basic advice" section, especially what it says about secondary sources and being up to date. No one disagrees that the source here is from a peer reviewed journal. The distinction is between primary and secondary sources. In general, images certainly can be useful, but the concern that both I and Doc James are trying to express here is that this particular image is unrepresentative and misleading. (Yes, the scientific consensus is that dopamine receptors are elevated in people with SZ, but not by that much.) --Tryptofish (talk) 20:03, 16 February 2011 (UTC)

Hi again guys, I think I see the problem. For example Doc James said the image added no new material; and Tryptofish says it is unrepresentative - are you guys aware that the figure is not that of the d2 receptor per se (so it is not saying there are seven times the d2 receptors in schizophrenia); but perhaps monomers of it [I too don't understand how a monomer differs from a normal], or dimers of it (d2-like), which is why the results are so pronounced. In Nature in 1993 Seeman found the same thing using Raclopride and Nemonapride. So saying that we can see that the image is representative and that it does add something. See further down in the Wikipedia article where Seeman says such a difference in the monomer or dimer balance in schizophrenia is the reason for methylspiperone's exagerated results too. This comment comes from a monograph source that Wikipedia recommended: http://www.ovid.com/site/catalog/Book/1752.jsp?top=2&mid=3&bottom=7&subsection=11 Notpayingthepsychiatrist (talk) 00:07, 17 February 2011 (UTC)

The present day scientific consensus is that the monomer/dimer thing has absolutely nothing to do with the number of binding sites. Ditto what I already said about sources. --Tryptofish (talk) 00:28, 17 February 2011 (UTC)

Hi again, I think there would be scientists who are still interested - and should have their findings represented http://www.ncbi.nlm.nih.gov/pubmed/20813060 I've learned a lot about what Wikipedia encyclopaedia is and isn't; it would be good to have these policies presented to you when you first edit (or maybe they were)...Notpayingthepsychiatrist (talk) 23:14, 17 February 2011 (UTC)

About your first point, that link is authored by the same investigators, exactly the issue about primary sources. --Tryptofish (talk) 00:13, 18 February 2011 (UTC)

Actually only one of the authors was the same in the graph and 2010 report (Seeman). The report was by: Min Wang, Lin Pei, Paul Fletcher, Shitij Kapur, Philip Seeman, Fang Liu. Notpayingthepsychiatrist (talk) 07:37, 18 February 2011 (UTC)

Isn't http://www.ovid.com/site/catalog/Book/1752.jsp?top=2&mid=3&bottom=7&subsection=11 a review?

I found this review of drug use in dimers which says there are implications for schizophrenia http://www.ncbi.nlm.nih.gov/pubmed/18824244...[[User:Notpayingthepsychiatrist|Notpayingthepsychiatrist]] ([[User talk:Notpayingthepsychiatrist|talk]]) 08:16, 18 February 2011 (UTC) - sorry about that - refers to the halucinagenic receptors.Notpayingthepsychiatrist (talk) 08:53, 18 February 2011 (UTC)

One book says: "However, the result appears to have been due to a D4-like site (perhaps related to the D2 monomer/oligomer issue), not the true D4 receptor, and the status of the latter in schizophrenia is unknown.63" p352 The chapter is: "Postmortem studies in schizophrenia Paul J. Harrison, MA, BM, DM, MRCPsych" The book is "Diaglogues in clinical neuroscience. Schizophrenia general findings" http://www.dialogues-cns.org/brochures/07/pdf/07.pdf Notpayingthepsychiatrist (talk) 09:26, 18 February 2011 (UTC)

This is not actually a book, but a journal that was only indexed in medline since 2005 - it looks like a review. Tryptofish, I think we should include this as a significant minority point of view MEDRES says those points of view are welcome in Wikipedia so long as it is clear what they are; on this basis I have reincluded it.Notpayingthepsychiatrist (talk) 13:32, 18 February 2011 (UTC)

I'm going to leave this for other editors to sort out. It seems to me that we are going from bad to worse, and I'm failing to explain myself well enough, so maybe other editors can explain this better than I have. --Tryptofish (talk) 21:41, 18 February 2011 (UTC)

Mechanisms mentioned in a MIT lecture[edit]

I've been watching this MIT lecture by Edward Scolnick (video). He discusses some mechanisms that don't seem to be currently mentioned at all in this article, so I wanted to point them out so editors who are more knowledgeable in this area could add them if they're not already there somewhere. I've paraphrased and I'm not an expert, so watch the video if you want the horse's mouth:

  • Interaction of excitatory pyramidal cell and inhibitory parvalbumin inhibitory interneurons: It has been postulated that the system is malfunctioning in patients with sz. (around 16:00 in vid) -- apparently the most consistent pathology observed, and has compelling experiments done in mice, showing some relationship to gamma waves.
  • The Wnt signaling pathway (26:00) is a bio-chemical pathway emerging as important in the pathogenesis of psychiatric illness. It's where lithium is known to work, and three genes found in association with mental illness are related to different steps in the pathway.

Do these need to be added? —Pengo 03:34, 30 August 2011 (UTC)

I'm familiar with this literature, and it's still a bit in the primary literature stage (including the proposed actions of lithium, by the way). It's probably best for Wikipedia to wait until this moves more into the secondary sources, ie review articles, stage. --Tryptofish (talk) 20:17, 30 August 2011 (UTC)
No worries. Thanks very much for the reply and letting me know what stage it's at. —Pengo 05:43, 31 August 2011 (UTC)

NPOV as regards types of causes/mechanism?[edit]

I just noticed that in the Causes of Schizophrenia article, all the neural processes stuff had gone. And yet all the clinical psychology stuff (cognitive-affective mechanisms) was still there - but stuffed in an 'Other proposed etiologies' section at the end, after a bunch of stuff about Laing & shamans etc.

Yet ironically the intro paragraph here talks about psychosis being attributed "to the mind's faulty interpretation of the misfiring of dopaminergic neurons", which is a nice mixing up of the psychological with the neurological level of explanation.

Even an article on the Neuroscience of schizophrenia couldn't disentangle itself from cognitive and affective neuroscience. 'Neurology of schizophrenia' would seem to most reflect the current content of this article, seriously.

Is any other prinicipled distinction being offered for the current structuring of the content across these articles? EverSince (talk) 15:33, 15 December 2011 (UTC)

Do not understand your issue? Yes agree that this page is not that good. Doc James (talk · contribs · email) 21:41, 15 December 2011 (UTC)
Actually I realise a similar point about NPOV has kinda been discussed above already (I only scanned the talk before & didn't expect that tbh). The article clearly contains a lot of excellent material but I am also questioning the balance. It seems the neural section that was in the Causes article, has been moved here, and then expanded with new content. Especially on the neurotransmitter angle and especially the dopamine section, which is understandable but then there's already a whole article related to that.
So my point is that the psychological mechanisms content from the Causes article should have been moved here also, and expanded also, with due weight. Here's a recent article that uses exactly that exact phrase in case any doubt. EverSince (talk) 22:55, 16 December 2011 (UTC)
Excellent idea. Doc James (talk · contribs · email) 23:06, 16 December 2011 (UTC)

two things on dompmine etc...[edit]

1: abilify has a 90% (wow) afinity, but the only antipsychotic that performams better than the rest in indipendent studies (clorazapine) has less effect on dopamine. 2: There is an article, neurotransmiters team up, or something to that effect that says that whaever ketamine blocks (can't remember the propper name for it, though it's in this page) causes release of dopamine in schizophrenics but not in people without the condition. 3: it may be worth while mentioning things like upregulation, dompaine supersensitivity etc.... that are known as a side effect of antipsychotics as a specfic reason why there may be greater D2 receptors etc.... esp since the rest of the page is quite technical it seems fitting to put the correct technical reasons in the page not just mention that it may be due to antipsychotics. — Preceding unsigned comment added by 94.197.127.18 (talk) 00:50, 9 May 2013 (UTC)

if you feel like being brave[edit]

The defaut network (associated with a sense of self) is more active in people with schizophrenia (source wikipedia, though I'm currently cross referencing) It is known that antidepressants can cause this to become less active and also are associated with schizoaffective disorder symptoms. it is also known that the default network is more active in people with depression, a common co-morbitity with schizophreia. positive symptoms of schizophrenia are also often/always? 'personal' by defintion.

schizophrenics (and possibly other people) experiancing psychosis have over activity in the mirror neuron network ( a sense of other selfs), this relates to the sevrity of positive symproms and also occures even though antipsychotic medication is given.

People with post traumatic stress disorder have less activity in the default network, that is when an 'external' stressor has been applied, often an 'other self'

Ketamine is also a highly effective treatment for depression, even otherwise untreatable depression, this blocks the (can't remember )receptors associated with schizophenia, the default network is also associated with depression. (that is being more self consious)

Meditation is also associated with the development of psychosis, though I don't know which specific type of meditation this may be some form of thinking about things other than ones self in a way, more cross referencing needed.

It should be noted that mirror neurons, although being a sense of 'other' selfs fire in the part of the brain that fires when ones own self performs an activity and so are also in a way a sence of 'self and other similar selfs'

Personally ketamie causes me to spot patterns in things from time to time (something some schizophrenic friends have also mentioned and i experiane when I had a psychosis and also a lot like clanging thought disorder), though it also has other effects... as yet I have no research to back this up in other people. — Preceding unsigned comment added by 94.197.127.18 (talk) 01:08, 9 May 2013 (UTC)

The kynurenic hypothesis[edit]

Hi,

Recently it have been hypothesis that the kynurene pathway is over expressed, rising the concentration of kynurenic acid, however as kynurenic acid is an antagonist of NMDA receptor, it seems that it's possible that the raise in the kynurenic pathway is responsible for the schizophrenic symptoms.

beside, a recent work shows that decreasing kynurenic acid permits to decrease some psychiatric symptoms.

I'd like to add these result on this page, is someone interested on helping myself?

--Nicobzz (talk) 13:20, 12 August 2014 (UTC)


I wonder if this 'hypothesis' is a hypothesis at all. The number of reviews written on this topic is extremely small compared to for example dopamine, glutamate, inflammation, interneurons and oxidative stress (the latter being also relatively new). I suggest we remove the kynurenic part entirely. - MAMWhistler (talk) 23:16, 26 July 2015 (UTC)

dissapearing graph on d2 -like receptors and sz[edit]

this graph was important it revealed by accident that d2 receptors in sz are in a permanent state of compression or being turned on or what Seeman would describe as d2high. In them was found an 'additional fragment' this occurs when receptors are incubated in the agonist for a long time and they are near degradation.

When you look at the striatum of Cerebral Palsy sufferers they show no d2 activitiy and that illness is caused by hypoxia.

The graph showed sz were on the way to that - which is why the 2 never occur together.

It's a disgrace and backward step that it wasn't saved.

58.108.246.194 (talk) 04:10, 25 February 2016 (UTC)

As the results of this graph are simple competition and all d2 receptors had been exposed to antipsychotics in most cases why did some only respond to the ligand and this was repeated in another experiment using GLC756 and it wasn't d4 receptors as a clone for this receptor was later developed. Could it be a set of highly activated compressed receptors with additional fragments as found in FABES. Macropharges hadn't removed them because they were still active but in CP that is where they do.

58.108.246.194 (talk) 05:13, 28 February 2016 (UTC)

Here is the graph's link

https://en.wikipedia.org/w/index.php?title=Mechanisms_of_schizophrenia&diff=667942623&oldid=667758993#/media/File:Synapse.jpg

would someone first diagnosed like to see it? 58.108.246.194 (talk) 05:20, 28 February 2016 (UTC)


-- Perhaps the graph and a large part of the dopamine theory should be moved to the page of the same name. Right now the dopamine theory is very heavily represented, and other theories (e.g. oxidative stress) are underrepresented. Perhaps make the dopamine section smaller and more to the point? — Preceding unsigned comment added by ThVanderHeijden (talkcontribs) 20:02, 13 March 2017 (UTC)