Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Standard view
Full view
of .
Look up keyword
Like this
0 of .
Results for:
No results containing your search query
P. 1
75078955 Psychiatric Persecution the Pitfalls Associated With a Schizophrenia Diagnosis

75078955 Psychiatric Persecution the Pitfalls Associated With a Schizophrenia Diagnosis

Ratings: (0)|Views: 5|Likes:
Published by Simon Benjamin

More info:

Published by: Simon Benjamin on Dec 21, 2011
Copyright:Attribution Non-commercial


Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less





Webster, R. December 8, 20111
Psychiatric Persecution: The Pitfalls Associated with a SchizophreniaDiagnosis
 By Robin Webster 
I am not a medical professional.
Schizophrenia Prevalence
Researchers have come a long way in recent years uncovering how prevalentschizophrenia is, its causes, and how the disease progresses. Contrary to official estimates of schizophrenia prevalence in the United States (National Institutes of Mental Health, 1993) andCanada (Health Canada, 2002), which suggest a prevalence of about 1%, recent best estimatessuggest the actual median prevalence rate globally is 0.453% (Saha et al., 2005). The chance thatan average person will develop schizophrenia is estimated to be 1 in 250 or 0.4%. Using currentestimates of the U.S. population, which was just under 313 million on December 7, 2011 (U.S.Census Bureau, 2011), this translates into 1.25 million Americans who can expect to developschizophrenia during their lifetime.
Schizophrenia Causes/Etiology
A number of environmental factors can increase the risk of schizophrenia, includingliving in a city, migrating to a new home, and participating in a western economy. For example,the risk of schizophrenia would be higher for an American citizen who has moved away fromhome to find a job in an urban environment. In England, the risk of schizophrenia increases from0.4% to 1.0% by virtue of living in London (Kirkbride, 2006). A similar rural-urban risk gradientwould also be expected to exist in the United States.Scientist attempting to discover whether schizophrenia runs in families have found thatclose to 80% of all cases can be explained by hereditary factors (Kvajo, McKellar, and Gogos,2011). This represents 1 million of the 1.25 million Americans who are predicted to develop thisdisease in their lifetime. The remaining 250,000 Americans, or 0.08% of the current population,will develop schizophrenia despite the absence of a family history.Identical twin studies have shown that a family history of schizophrenia is not an absolutedeterminant of whether a person will develop schizophrenia. If one twin develops schizophreniathen the identical sibling has a 50% average chance of being schizophrenic (Kvajo, McKellar,and Gogos, 2011). The average risk of developing schizophrenia for anyone with a familyhistory of this disease is therefore going to be below 50%.So, why do the remaining 250,000 Americans develop schizophrenia? A percentage willhave experienced a sporadic genetic mutation affecting fetal and/or childhood braindevelopment. Others may have been exposed to bacterial or viral pathogens during fetaldevelopment, which can cause brain inflammation and therefore negatively affect fetal braindevelopment (Meyer, 2011).These diverse causes appear to result in the same outcome: dysregulation of earlychildhood brain development and function. A substantial body of genetic evidence using animal
Webster, R. December 8, 20112models and human genetic association studies has found that the dopamine, glutamate, and
-amino butyric acid (GABA) neurotransmitter pathways do not function appropriately in personswith schizophrenia. In particular, the interneurons in the prefrontal cortex, which are critical tomemory and higher executive functions, are incapable of properly suppressing cortical neuronactivity, which is essential for normal adult cognitive performance
(O’Donnell, 2011)
. This mayexplain why a full manifestation of symptoms typically does not appear until late adolescence.There is also a characteristic age of onset for schizophrenia. First diagnosis incidencepeaks around 15 years of age for both males and females, and declines gradually to almost zeroby late middle age (Abel, Drake, and Goldstein, 2010). This does not preclude the possibility of schizophrenia emerging late in life, but the chances are reduced by one third after the age of 55(Narrow, Rae, Robins, and Regier, 2002). Growing older is therefore a protective factor againstschizophrenia. Late onset disease due to hereditary factors is also protective, since members of these families have a lower risk of developing symptoms (Svensson et al, 2011). In addition, if symptoms do manifest late in life they are typically less severe.
Mechanism of Schizophrenia
A large number of research studies over the past two decades have shown that braindevelopment in children who eventually develop schizophrenia is altered early in life
(O’Donnell, 2011).
Imaging studies have revealed delayed anatomical maturation and corticalthinning consistent with below average intellectual abilities. Psychiatric symptoms consistentwith a diagnosis of schizophrenia, such severe attention deficit disorder, hallucinations, andsuicidal or homicidal tendencies, can appear as early as 6 years of age (Freedman, 2003, p.1747). These findings are all consistent with schizophrenia being caused by altered braindevelopment early in life, whether due to genetic or inflammatory causes.
The main risk factors for schizophrenia is a family history, a spontaneous geneticmutation during early fetal development or earlier, or exposure to an infectious agent duringgestation. About 80% of all schizophrenia cases can be explained by a family history of thedisease. The remaining 20% are due to spontaneous genetic mutations, infection-inducedinflammation, and other unknown causes.Current estimates suggest approximately 1.25 million Americans can expect to developschizophrenia in their lifetime. Of these, 1 million will have a family history of the disease. Theremaining 0.25 million represents 0.08% of the U.S. population, therefore the lifetime risk of schizophrenia in the absence of a disease family history is 1 in 1250.These risks are reduced by a number of factors, including a family history of late onsetschizophrenia, growing older, an absence of psychiatric symptoms during childhood, living in arural setting, staying close to the
place of birth, or living in a developing or third worldeconomy.The advances that have been made over the past two decades in our understanding of schizophrenia make the use of a schizophrenia diagnosis during state-run persecution campaignsproblematic, especially in countries where its citizenry have access to high quality medical care.
Webster, R. December 8, 20113A diagnosis of schizophrenia in the absence of a family history, or severe childhood psychiatricconditions, should be considered suspect and trigger an independent assessment. A late onsetdiagnosis in the absence of a family history of late onset disease, is so rare that it shouldautomatically be validated an independent party (or two).Schizophrenia is also not a disease associated with aging and in fact growing old protectseveryone from the disease, regardless of whether they have a family history or not. Statedanother way, the older a person gets the less likely they will develop schizophrenia. A diagnosisof schizophrenia for an older adult should therefore also be suspect, especially if the symptomsare described as severe. Late onset schizophrenia, when it does occur, tends to be less severe andlimited in scope.

You're Reading a Free Preview

/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->