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Schizophrenia and violence
The "Society and Culture" section is interesting, especially the survey that notes that the public thinks of people with this disorder are likely to be violent. I have printed material that states that, to the contrary, people who have schizophrenia are no more likely than the general public to be violent. In fact, they are TWICE as likely to VICTIMS of violence. I can't however, find a good place online for a citation for that. Any help? Jfulbright (talk) 21:30, 15 July 2011 (UTC)
What sort of printed material do you have? The statement does not accord with published reviews such as PMID12042226, PMID19668362, and PMID19454640. It is true that the majority of people with schizophrenia are not violent, but it does not seem to be true that they are no more violent than people without schizophrenia. Looie496 (talk) 22:00, 15 July 2011 (UTC)
Did you read the details of abstracts you mentioned? Note the factor of substance abuse. A few abstracts is not enough to draw a general conclusion from in the first place. — Preceding unsigned comment added by 109.144.242.98 (talk) 06:08, 22 August 2011 (UTC)
Schizophrenia is a heterogenous diagnosis. Jung suggested that schizophrenics were an extreme of a scale and associated compassion with their type.
All the schizophrenics I know are not violent. They're usually quite soft and caring people. I've been punched in the face a few times but it was never by a schizophrenic. It was by a normal human being.
The risk of homicide by a person with a mental illness has been estimated to be close to the chance of being struck by lightning. I believe it was a psychiatrist who said this though I don't have the reference. He was making the point about relative risk or something like that, i.e. there's very very little chance of being killed by a schizophrenic though it may be possible to statistically show that there is a higher chance of certain types of schizophrenics committing homicide.
The truth is schizophrenics are at far higher risk of killing themselves with 10% dying by suicide. it's probably worth expanding on this suicide side with a sense of human understanding and compassion to understand why this group of people kill themselves rather than focusing on the very small minority who harm others. — Preceding unsigned comment added by 78.149.156.237 (talk) 00:43, 20 August 2011 (UTC)
Sorry. This last comment was by me. --Morethanhuman (talk) 01:48, 20 August 2011 (UTC)
Severely Lacking in Alternative Points of View
I was a bit shocked to see that the section regarding Existential, or "anti-psychiatric" viewpoints on Schizophrenia seems to have been removed.
Upon finding this article, the reader is lead, through its entire length, to follow common, established opinions of Schizophrenia. This seems natural, but in a topic as important and as sensitive as "mental health," nothing could be worse than presenting one-track information. It's a bit like being fed propaganda. And while I won't be that guy--the person who calls everything fascist, etc.--I will say that fair and balanced presentation of information here is extremely important.
The commonplace views of schizophrenia by the establishment have been shown to be full of flaws. Thomas Szasz, R.D., Laing, among others are intellectuals with extremely valid points, putting forth shattering questions on the topic of schizophrenia, and questioning the establishment. To simply ignore their reflections on the subject is essentially to "go with the flow" of modern psychiatry. That's all well and dandy for those of you who refuse to question. But if you ask me, science should not always be turned to as an answer for everything, and at the VERY LEAST, one should never stop questioning, especially in the realm of scientific inquiry.
While i support the addition of antipsychiatric info here, as its notable (and may be true, but thats another matter), i also think we should have a section on new research into the MEDICAL origins of the illness, such as the Pathogenic theory of schizophrenia, and its possible relationship with endogenous retroviruses.(mercurywoodrose)76.245.45.179 (talk) 04:29, 16 May 2011 (UTC)
As there are so many conjectures around the cause(s) of schizophrenia, an article has been created to cover them in some detail, which can't be done in this general article. See Causes_of_schizophrenia#Infections. --Anthonyhcole (talk) 06:02, 16 May 2011 (UTC)
We already cover the link to infections in this article here Schizophrenia#Environment and as mentioned above go into greater depth in the subarticle. Doc James (talk · contribs · email) 20:31, 16 May 2011 (UTC)
The IPs are complaining about the major issue of this article- it presents schizophrenia as a mental health issue and not as the neurological issue that is actually is (and supported by mountains of peer-reviewed, secondary sources). I agree with the IPs. Basket of Puppies 21:51, 16 May 2011 (UTC)
Did you read the first comment in this thread? We've been over this. Stop exaggerating. Casliber (talk·contribs) 02:29, 17 May 2011 (UTC)
And you do see how other editors (the IPs) are complaining about the POV nature of this article, yes? You may have been over it but people are complaining and you don't seem to be concerned. Basket of Puppies 03:40, 17 May 2011 (UTC)
Depends how many of them are independent people BoP. One at least isn't. Casliber (talk·contribs) 09:15, 17 May 2011 (UTC)
And now you are in charge of deciding who is a legitimate editor and not? Very sad to see this. Basket of Puppies 13:10, 17 May 2011 (UTC)
I'd like to see a section here summarising the more notable criticisms of the construct schizophrenia, from both within and without mainstream psychiatry. --Anthonyhcole (talk) 04:36, 17 May 2011 (UTC)
Shucks, he's right. This article reads like szhophrenics need to 'get over it' or have a good sit down session with their shrink. it's slanted! —Preceding unsigned comment added by 134.241.58.253 (talk) 17:40, 17 May 2011 (UTC)
As soon as I can refer people with schizophrenia to a neurologist I will accept that it is a neurological conditions. As long as the only people who will accept care are psychiatrist I will consider it mental health. Doc James (talk · contribs · email) 10:13, 3 June 2011 (UTC)
I agree, this article lacks any alternate points of view. There is a good deal of evidence of abnormality in brains of people with truly hallucinogenic schizophrenia, and this is important to note. There is also borderline cases where people are paranoid, and this may or may not be delusional in nature which is out of the direct empirical knowledge of the diagnostician. We could easily class Alex Jones and Art Bell as schizophrenics under the DSM criteria, though this would be unacceptable as they have a right to have paranoid beliefs. That being said, there are people who are most sincerely and obviously deeply troubled by what can be objectively identified as an errant hallucination, such as one individual I met who said he would witness his deceased parents following him around and speaking to him. He was aware of it as a hallucination, but it still brought him great trouble. I know Paul McHugh's (formerly Dean of Psychiatry at John Hopkins) essay "How Psychiatry Lost it's Way" addresses schizophrenia as a legitimate illness, which he is, in all respects, correct to treat as such, but he does express a deep skepticism and despair over purely "appearance-based" diagnostics. This is worthy of investigation and inclusion as I am certain there are others in health fields who share his point of view, and any empirical based scientist would be foolish to disregard the flaws in basing decisions only on presenting symptoms without addressing anything further.
Additionally, should Nash be included, we should qualify that John Nash's actual life story is very very different from the Film "A Beautiful Mind," that he claims to this day to have had no visual hallucinations, and that he expresses a great deal of skepticism regarding psychiatry in general. I believe it is offensive, and perhaps libelous, to refer to him as specifically having a disease which he does not specifically claim to have. If he must be included in the article, it is fair to describe that he was forcibly medicated against his will and that the film is a highly inaccurate portrayal of his life.
Please give some alternate views or a broader discussion of the spectrum exhibited by those classed as schizophrenics.
"The St. Louis scholars were looking into a limited number of well-established disorders. Among them was schizophrenia, an affliction that can manifest itself in diverse ways. What the investigators were striving for was to isolate clear and distinct symptoms that separated indubitable cases of schizophrenia from less certain ones. By creating a set of such "research diagnostic criteria," their hope was to permit study to proceed across and among laboratories, free of the concern that erroneous conclusions might arise from the investigation of different types of patients in different medical centers.
"With these criteria, the St. Louis group did not claim to have found the specific features of schizophrenia-a matter, scientifically speaking, of "validity." Rather, they were identifying certain markers or signs that would enable comparative study of the disease at multiple research sites-a matter of "reliability." But this very useful effort had baleful consequences when, in planning DSM-III (1980), the third edition of its Diagnostic and Statistical Manual, the APA picked up on the need for reliability and out of it forged a bid for scientific validity. In both DSM-III and DSM-IV (1994), what had been developed at St. Louis as a tool of scholarly research into only a few established disorders became subtly transformed, emerging as a clinical method of diagnosis (and, presumably, treatment) of psychiatric states and conditions of all kinds, across the board. The signs and markers-the presenting symptoms-became the official guide to the identification of mental disorders, and the list of such disorders served in turn to certify their existence in categorical form." - Paul McHugh (1999), Former Dean of Psychiatry, John Hopkins Medical - "How Psychiatry Lost Its Way" Bloomingdedalus (talk) 19:25, 19 June 2011 (UTC)
Perhaps we can include a section between History and Society and Culture on various criticisms issued by major persons in the field of psychology? It is important to note that in a disease which is defined and diagnosed exclusively by its appearance and symptoms, not by any blood tests or brain scans or otherwise, there are issues that arise within the philosophy of science, I.E. how do we tell who is Syd Barrett and who is Martha Mitchell? I have found several articles on the bias of diagnosing disorders by this method, as well as many articles which suggest from various psychologists that there is a persistent racist bias in the diagnosis. I most certainly have met people who exhibit very classic schizophrenia, but I also have met people who have been diagnosed schizophrenic who do not seem to agree with the diagnosis, especially as regards diagnosis without visual or auditory hallucination. I understand this is not the place to debate the validity of the subject itself, but it may be important to include that there is some disagreement when it comes to more borderline cases, and these are, fundamentally, philosophical issues arising out of appearance based diagnostics. Bloomingdedalus (talk) 20:09, 19 June 2011 (UTC)
Sandy, I'd like to speak specifically to the edit conflict that you and I just had, concerning the section about brain structure that Bloomingdedalus added, and which I tightened up a bit. Please take a look at #Should we say more about cortical grey matter loss, below. The answer to the question asked there is "yes". The source absolutely satisfies MEDMOS: it's a review of the literature, by one of the most prominent experts in the field. If other editors familiar with the subject matter feel that it's UNDUE, then by all means let's discuss it. Personally, I think it was a bit unbalanced before, treating the neurology as only chemical and not also structural, while the overwhelming balance of the literature suggests that it probably is partly structural, even though all of it is still incompletely understood. --Tryptofish (talk) 23:24, 19 June 2011 (UTC)
The alleged source conflict concerns including controversies regarding unfalsifiable hypothesis like the categorization of schizophrenia based on it's appearance alone. I do not believe she was referring to the Brain Structure stuff I added. Unless she reverted the changes I made regarding brain structure in some people diagnosed as schizophrenic. You can't blame them, Schizophrenia and Autism are the APA's two biggest sellers.
Sandy is unable to distinguish between medical knowledge and blind assertion with loose associations. "The significance of this turn to classifying mental disorders by their appearances cannot be underestimated. In physical medicine, doctors have long been aware that appearances, either as the identifying marks of disorder or as the targets of therapy, are untrustworthy. For one thing, it is sometimes difficult to distinguish symptoms of illness from normal variations in human life. For another, identical symptoms can be the products of totally different causal mechanisms and thus call for quite different treatments. For still another, descriptions of appearances are limitless, as limitless as the number of individuals presenting them; if medical classifications were to be built upon such descriptions, the enumerating of diseases would never end." -Paul McHugh, Dean of Psychiatry, John Hopkins
I thought it would be polite to people who have been misdiagnosed with this as a result of over-zealous DSManiacs to include a section on controversy over the classification of the disorder given that we are no more close to understanding it's physical apparatus than we are to understanding if it is one physical apparatus by which these symptoms emerge. Bloomingdedalus (talk) 01:03, 20 June 2011 (UTC)
TLDR again. OK, so let's just (again) load this article up with every editor's latest pet peeve, rather than relying on high quality secondary reviews to decide what is worthy of inclusion, again end up with a too long article, and again end up at FAR when that inevitably happens. This article is exhausting-- I'm unwatching, and will declare Delist the next time it appears at WP:FAR because it got loaded up with everything and the kitchen sink, as well as MOS issues and inconsistent citations. Bye, SandyGeorgia (Talk) 02:13, 20 June 2011 (UTC)
Guilt trip much? Notice I haven't included anything controversial and I hope the article remains protected. Sure, I have more than a few "pet peeves" with the "scientific" methods involved in the production of the DSM, so I'll admit a conflict of interest in my distrust in all things called scientific subject to relative interpretation. The kind of section I was proposing would include alternate perspectives from people of repute within the scientific community, but, at the same time, would be a matter of opinion given that the premise of diagnosing any mental disorder by symptoms alone is inherently flawed. I most certainly think there are people who should be classified as schizophrenic based on symptoms alone. I don't know how to present you with a study that indicates how many people have been incorrectly diagnosed due to overzealous psychiatrists, because, my guess is, they don't go back to psychiatrists in such a case. I think the article is pretty solid and was struggling to find things to contribute. But, sure, we'll ignore the elephant of subjective diagnosis in the room. There are clearly schizophrenic behaviors and people who need medications and psychiatrists who have done the world for people with hallucinations and delusions, and these are probably the majority. There are also political witch-hunters. I will not add any controversial information because of my CoI skeptic's bias against the APA - as I only have interest in finding a way to bridge the empirical blockade between pathology and psychiatric diagnosis. I do support those who want to include a small section of reputable people within the field who do not necessarily tow the party line regarding this disorder given that it's inherent premise in the form of DSM criteria is subject to debate, unlike something like HPV or Measles.
I'm as interested as anyone in this being a quality article including all points of view in a neutral setting. There are reputable psychiatrists who do express skepticism regarding the diagnostic criteria. It is difficult to find a study regarding the premise of schizophrenia itself as the premise of schizophrenia is simply based on a category for a set of symptoms. Studies of schizophrenic individuals require them to be diagnosed as schizophrenic in the first place, so, when reputable academics within the mental health field express skepticism towards the criteria for diagnosis in and of itself, it may be reasonable to include their hypothesis as well, even if they are just opinions regarding what they view as a faulty premise. That doesn't mean we include what Tom who works at the corner market says, but, within reason, the use of the term produces no inherent underlying pathology, suggesting that many causal mechanisms produce the same symptoms while being different disorders, were it not for this reason, I would not be inclined to include those who had trouble with the classification. Bloomingdedalus (talk) 02:51, 20 June 2011 (UTC)
I have tightened it up further. This is only supposed to be an overview. Doc James (talk · contribs · email) 04:51, 20 June 2011 (UTC)
I like that further tightening. Thanks. There, that wasn't so difficult. --Tryptofish (talk) 17:28, 20 June 2011 (UTC)
I don't have a reference for it but what's the difference between a brain difference and a brain deficit? The retrovirus theory shows there's something in our genome which creates certain types of human beings. These human beings may be different and may be labelled as mentally ill using biomedical evidence - just as homosexuality was, or had you forgotten that this mental lllness is no longer an illness?
"Research has been done on the shape of the callosum in those with gender identity disorder. Researchers were able to demonstrate that the shape of the corpus in men that felt they were female was actually reversed, and that the same held true for women that felt they were men. The publishers of this article argued that the shape of the corpus defined the mental sex of individuals over their physical sex.[18]"
There is a brain difference noted. So what happens to people with gender identity disorder? If they can afford it doctors change their sex after they've ensured the person is certain of who they are.
Even DSM-IV-TR notes there is no definitive neurological test, i,e. no MRI test, can which can definitively diagnose schizophrenia in all patients.
And those of you who consider it a neurological problem perhaps they can answer the question of why black men are overdiagnosed with schizophrenia in the US and UK (I've heard a range of figures but it's something like 3 times more than their white countrparts) but this doesn't happen in the West Indies. (New Horizons mental health strategy consultation document though the problem is noted in several other sources.)
Sorry. This last comment was by me. Still getting used to this.--Morethanhuman (talk) 01:47, 20 August 2011 (UTC)
I notice there is absolutely no reference about countries during the Coldwar period attempting various forms of control (individual and en-mass) and there is absolutely no reference to various crimes against humanity during the second world war conducted on people diagnosed with such conditions and the relevant creation of the Nuremberg Code. (History proves how a subsection of people can be eugenically picked for experimentation.)
It proves the encyclopaedia to be slanted towards the indoctrinated profession rather than actually substantiating that a small percentage of those that get classified as Schizophrenic are actually likely being misused in experimentation. (Until such time as it's discussed professionally and record in such places as encyclopaedia's, Doctors are going to continue to be not as well informed as they might have originally assumed they were.) Stryderunknown (talk) 20:36, 21 August 2011 (UTC)
The use of the diagnosis of schizophrenia for political reasons is noted in Richard Bentall's award winning book Madness Explained. The book also includes a scientific lambasting of the reliability and validity of the science of schizophrenia (which totally breaks down when it comes to clinical practice anyway). The books well worth a read.
The overdiagnosis rate of schizophrenia in black people in the UK is 9 times higher than their white counterparts. This may be partially explained by migration associations with schizophrenia (about 2 times - sorry. No reference) but there may also be an association between the characteristics of people with schizophrenia (wander lust, seeking new or thrilling experiences) and migration so the association may not be casual.
The important thing to note is the rate of diagnosis between black and white people in equal in the West Indies. I'm afraid I don't have the reference for that other than the New Horizons mental healthcare strategy consultation document.
Metzl's work and the observation that the diagnosis has changed since Bleuler's initial concept may partially explain it. What may also explain it is the conditioning of doctors who become psychiatrists and the teaching they're given in the early stages of psuychiatry. The former is my idea and is based on the idea that mental health/psychiatry is a way to enforce social norms. The latter part of the idea is based on a study which looked into the variance of diagnosis amongst American psychiatrists. It wasn't age or gender or race. It was where the psychiatrists learned psychiatry. I'm afraid I don't have the reference. Read the paper a few years ago. It was a study conducted at a psychiatric conference and actors were used with pre-written scripts to assess the factor most responsible in the different diagnoses which might be given to the same patient. (I really wish I could remember what the study was.) --Morethanhuman (talk) 16:27, 24 August 2011 (UTC)
It is also worth noting that the UK's National Institute for Clinical Excellence - the body which writes national clinical guidance - accepts the biopsychosocial model rather than the biomedical model of cause.
http://www.nice.org.uk/nicemedia/live/11786/43607/43607.pdf
(P22 has the info.)
--Morethanhuman (talk) 16:33, 24 August 2011 (UTC)
Excellent source. Which part of it do you think is not reflected here? Doc James (talk · contribs · email) 16:37, 24 August 2011 (UTC)
The reference to higher rates of schizophrenia among BEM in Britain is easily verifiable: pmid:16938150 & doi:10.1017/S0033291700033845 . It's already in the article though, if in highly abbreviated form, in the Causes#Environment section. It could probably go in epidemiology which is one of the few areas of the text that could do with extension. FiachraByrne (talk) 17:39, 24 August 2011 (UTC)
Also there's an excellent discussion on the validity of schizophrenia, the absence of biomarkers, and the clinical utility of category/dimensional approaches, validity of kraepelinian dichotomy etc, in the Feb 2011 issue of World Psychiatry. It's also open access. http://www.ncbi.nlm.nih.gov/pmc/issues/194727/
Somebody who comes to Wikipedia looking for information about paranoid schizophrenia should not be fobbed off to a short unreferenced low-quality fork article, which I discovered because apparently editing it was somebody's community-college class project. That term should re-direct to this much more informative article. As an alternative, people could improve the article Paranoid schizophrenia so that reading it is more informative than reading this one. Sharktopustalk 11:39, 2 August 2011 (UTC)
I support this proposal. I've just looked at DSM IV TR for this and it says very little. What it says is pretty well covered in the few sentences this article has on paranoid type. My local med library has one student thesis from 2002 and one textbook from 1980 covering paranoid schizophrenia. So, unless someone is prepared to fill out Paranoid schizophrenia with content from some other reliable sources, the sooner it is redirected here, the better. --Anthonyhcole (talk) 12:31, 2 August 2011 (UTC)
It's fine with me too. --Tryptofish (talk) 21:29, 2 August 2011 (UTC)
Hearing no objection, and since the other article continues to be worthless, I will re-direct it to this one. Sharktopustalk 01:01, 22 August 2011 (UTC)
Thank you Sharktopus. --Anthonyhcole (talk) 01:16, 22 August 2011 (UTC)
Symptoms vs. Signs
Physicians distinguish between symptoms (which are subjective complaints) and signs (which are objective and can be verified using medical tests). There are no signs of schizophrenia. — Preceding unsigned comment added by 130.49.145.135 (talk) 21:29, 14 September 2011 (UTC)
Thanks. I'm a PhD, and thus unencumbered by an understanding of clinical practice, but I changed the header to be just "Symptoms". Even if some of our MD editors are going to argue that some, um, patient characteristics can be objectively identified, I think it's a good idea to shorten the header, because "Signs and symptoms" sounds rather wonky to me, and we're writing for the general public. No one will be confused or misled by just saying "Symptoms". --Tryptofish (talk) 21:53, 14 September 2011 (UTC)
There are signs such as affect / atonia / ect. thus restored.--Doc James (talk · contribs · email) 04:06, 15 September 2011 (UTC)
Be that as it may, it still sounds very wonky to me. Whatever. --Tryptofish (talk) 20:10, 15 September 2011 (UTC)
The signs include what the doctor observes (as opposed to that the patient experiences or reports) - disorganised speech, thought blocking and agitated behaviour. "Signs and Symptoms" is a pretty standard heading and I don't think it is that cumbersome. Casliber (talk·contribs) 20:35, 15 September 2011 (UTC)
It's (the edit) no big deal to me either way. I'm sure it's significant to physicians. I just think that the general public thinks of all that stuff as being "symptoms". I'll wager that when you talk to a patient, you might say something like "you have the symptoms of such-and-such", rather than than "you have the signs and symptoms of such-and-such". --Tryptofish (talk) 20:58, 15 September 2011 (UTC)
No, this is an important distiniction, and one that is often overlooked. A sign, by definition, is objective. Disorganized speech, thought blocking, and agitated behavior are symptoms; they cannot be verified. A physician's clinical interpretation is only interpretation. — Preceding unsigned comment added by 130.49.147.31 (talk) 22:05, 15 September 2011 (UTC)
Casliber or Doc James: how would you distinguish (in the context of this discussion) between what you are calling "signs", and what the page (as well as all the literature that I have read) calls "positive symptoms"? I don't think that the text of the section ever uses the words "sign" or "signs". --Tryptofish (talk) 22:31, 15 September 2011 (UTC)
It becomes tricky when one considers page layout - technically speaking, signs are what the doctor observes and symptoms are what the patient reports, however, the lay-concept is to use "symptoms" as a broader more encompassing concept (including what might be strictly called "signs"). You can see when we use the term "negative symptoms" for phenomena such as affective flattening, poverty of speech and social withdrawal which are all almost always observed rather than reported. Ditto with how we lay out the page, trying to divide the page into "symptoms" and "signs" would cut across some phenomena which can be either or both (e.g. a health professional can observe a patient talking to auditory hallucinations). Anyway, you're right on the abbreviation. @130.49.147.31 - witnessing agitated behaviour, disorganized behaviour, or several other symptoms is objective - I am not sure what point you are getting at above. Casliber (talk·contribs) 00:12, 16 September 2011 (UTC)
The term sign refers to a biological lesion, an objective indication of some medical fact. In order for a measurement to be objective it must be tested independent of the physician or scientist who proposes the measurement. Examples of medical signs include abnormal heart rhythm (measured using electrocardiography) and fever (measured using a thermometer). Behavior is not a sign, and observing behavior is certainly not objective. The presence or absence of signs in schizophrenia is determined entirely by the clinician's subjective interpretation; there are simply no objective scientific tests used to confirm any of the manifestations of schizophrenia. — Preceding unsigned comment added by 130.49.147.30 (talk) 02:17, 16 September 2011 (UTC)
I said earlier in this talk thread that I regarded the issue as no big deal insofar as how we edit the page, but seeing now that 130. feels more strongly about it, I'm going to discuss the issue a bit more instead of dropping it. Casliber, I completely agree with you that we should not have separate sections of this page for Signs and for Symptoms. Instead, I'm leaning towards saying that we should change the header name back to, simply, "Symptoms". Given that the text never identifies any signs as such, I think the only text-based justification for keeping the word "signs" in the header would be if someone edits the section so as to refer to some of the things in it as signs rather than as symptoms. Otherwise, we have a title that promises "signs" and then never delivers them. (For what it's worth, I also notice that Symptom#Positive and negative symptoms actually uses this page as an example of things that are symptoms, and Symptom#Symptom versus sign makes the point that there can be overlaps such that the areas where you and 130. disagree can be matters of how one chooses one's definition.) --Tryptofish (talk) 18:23, 16 September 2011 (UTC)
(unindent) I agree with Tryptofish. Nonexpert readers, the primary target of this article, are only going to be confused by the word "signs". Take the statement above: "There are no signs of schizophrenia". That's going to look like sheer gibberish to a nonexpert reader. Looie496 (talk) 19:11, 16 September 2011 (UTC)
Erm, that's because it's not true - makes a bit of a mockery of any researcher or clinician who observes behaviour. I can't really discuss things with the IP further but concede that leaving "signs" out for clarity/lay meaning is fine. Casliber (talk·contribs) 20:44, 16 September 2011 (UTC)
Thanks. --Tryptofish (talk) 20:54, 16 September 2011 (UTC)
References 32 does not support the claims made in the article
The following sentence from the "Environment" section cites references 32 and 33:
Childhood experiences of abuse or trauma are risk factors for a diagnosis of schizophrenia later in life.[32][33]
Reference 32 only states that childhood trauma is a risk factor for psychopathology, not necessarily schizophrenia. Page 1879 of the print edition states that only five major categories of psychopathology were considered: anxiety disorders, major
depressive disorder, alcohol abuse or dependence, illicit drug abuse or dependence, and antisocial behavior.
The results table also includes a category for "any psychiatric disorder," but the article text shows this category is only used for "Presence of a disorder from one or more of these five categories." — Preceding unsigned comment added by 152.132.12.128 (talk) 22:50, 22 September 2011 (UTC)
I've removed that ref, and the other one as well since it is a primary source, and replaced them with a MEDRS-compatible review paper. Looie496 (talk) 23:49, 22 September 2011 (UTC)
Edit request from , 12 November 2011
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because of an extra "and."
Timotheus1 (talk) 03:56, 12 November 2011 (UTC)
Because "processes" is modified by both "psychological" and "social", the second "and" is necessary. --Anthonyhcole (talk) 04:04, 12 November 2011 (UTC)
Edit request on 9 December 2011
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Causes of Schizophrenia:Diet
The lack of omega three fatty acids in the modern western diet is increasingly implicated as a causal factor for a number of diseases, including schizophrenia. Fish oil is a dietary source of long chain omega three poly unsaturated fatty acids. In a 2010 study, fish oil supplementation was found to prevent development of schizophrenia in high risk teens and young adults, age 13-25. The study demonstrated that 1.2 grams of fish oil (the equivalent of two small capsules) per day for three months significantly reduced the likelihood of transitioning to psychiatric disorder, and also indicated that the protective effect extended beyond the supplemental period: 10 months after the daily supplementation regiment, 2 of the 41 individuals had developed schizophrenia. In the control group which did not receive fish oil supplementation, 11 of the 40 individuals had developed schizophrenia. Although the sample size was small, the results were statistically valid. Larger studies are currently underway. (G. Paul Amminger, MD; Miriam R. Schäfer, MD; Konstantinos Papageorgiou, MD; Claudia M. Klier, MD; Sue M. Cotton, PhD; Susan M. Harrigan, MSc; Andrew Mackinnon, PhD; Patrick D. McGorry, MD, PhD; Gregor E. Berger, MD. (2010) "Long-Chain -3 Fatty Acids for Indicated Prevention of Psychotic Disorders-A Randomized, Placebo-Controlled Trial", Arch. Gen. Psychiatry, 67(2):146-154.
We use recent review articles rather than primary research. Thus the ref in question is not appropriate. Thanks Doc James (talk · contribs · email) 20:19, 9 December 2011 (UTC)
Great that the Wikipedia articles have been compared positively to some other resources (except on complexity of language maybe, as in reading level required). For the record, they extracted the information between May and August 2010 - and this is how the article was at the start of May last year. They only extracted information from this article on five topics:
the relationship between cannabis and psychosis/schizophrenia
childhood onset of psychosis
schizophrenia and violence
side-effects of antipsychotics
stigma and schizophrenia
I notice that since August the subsection on violence which I recall creating is no longer in the article, having been moved. And some of the content on stigma was in Controversies and Recovery subsections that I recall working on has also since been moved/deleted (apparently without notification here, as noted above). EverSince (talk) 01:51, 20 December 2011 (UTC)
Really? "Although several biological abnormalities have been reproduced...they are not sensitive enough (usually seen only in 40–50% of patients)" - in turn sourced to 112Eversense (talk) 03:31, 23 December 2011 (UTC)
Is there a better way to write "is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness." as supported by ""Schizophrenia" Concise Medical Dictionary. Oxford University Press, 2010. Oxford Reference Online.". I do not have access to this.Doc James (talk · contribs · email) 12:48, 23 December 2011 (UTC)
Neutrality and Facts Missing
The facts are that a great number of psychologists have asked schizophrenia to be declassified as a disease and call it a junk drawer diagnosis. That this fact is missing from your article, as well as the research that backs up these facts, shows that this article was written from the point of view of psychologists who are biased and stand to make money from this sickness as a disease. Also, this diagnosis is most often and American diagnosis. Neutrality is clearly missing. — Preceding unsigned comment added by 68.49.33.150 (talk) 13:06, 21 October 2011 (UTC)
I think there is tentative agreement among editors watching this article that it could do with more information about scholarly criticism of the syndrome. What we're waiting for is someone to write the section. Adding to Wikipedia medical articles is arduous because everything has to be attributed to a reliable source, so it's a question of hoping someone with the requisite motivation, intelligence, writing skill and access to sources turns up. --Anthonyhcole (talk) 21:15, 12 November 2011 (UTC)
Historically there was a lower threshold of diagnosis and broader concept in the US. Not sure if it still holds true now. Regarding junk diagnosis, point out a Review Article and we can digest. Casliber (talk·contribs) 21:35, 12 November 2011 (UTC)
Wow this is really absurd and wrong. There was a section in this article on exactly what is being raised here, for a long time. Perhaps Casliber has forgotten or never noticed it going. I just checked and it was moved in its entirety to a subarticle (Diagnosis of schizophrenia) in January 2011. The edit comment? 'moved to subpage'. Talk page comment there or here? NONE that i can see.
Now looking back at the archive I see that this exact same complaint was subsequently raised in May 2011 by several editors, under the title "Severely Lacking in Alternative Points of View". A discussion in which I noticed Casliber commented at one stage. Yet toward the end of that discussion several secondary sources were listed when requested (apparently in addition to and in ignorance of all the sourced material by then on the diagnosis subpage) including (from editor Morethanhuman I think):
"Also there's an excellent discussion on the validity of schizophrenia, the absence of biomarkers, and the clinical utility of category/dimensional approaches, validity of kraepelinian dichotomy etc, in the Feb 2011 issue of World Psychiatry. It's also open access. http://www.ncbi.nlm.nih.gov/pmc/issues/194727/ "
I have to say the current article here is really nicely and cleanly structured and everything, but it kinda represents a failure of Wikipedia because it blatantly doesn't achieve NPOV and due weight of notable views, even though it's a Featured Article. I am prepared to work on reintroducing bits or a section on these issues but not if it's going to just be removed at some point due to medic bias or issues with the length of the article or whatever. EverSince (talk) 23:45, 16 December 2011 (UTC)
I have not looked through all the articles but many of them appear to be primary research. We use review article or major textbooks per WP:MEDRS to provide overviews of topics. The content in question was removed as it was primarily based on primary sources and this article was about to fail FAR due to sourcing issues. If there are viewed supported by review articles we can add them with appropriate weight. Doc James (talk · contribs · email) 00:16, 17 December 2011 (UTC)
As per our core policy wp:verify "It has always been good practice to try to find and cite supporting sources yourself" rather than just removing material, let alone without edit comment or discussion on the article's talk page before or after. Especially if material already has peer-reviewed secondary sources including reviews of the literature. Especially if other editors then as in the past apparently proposed replacement sources but then got no reply. The absurd thing about trying to disown this whole area is that even general reviews routinely cover or make some of the points, including the van Os paper already used throughout. And that's not even mentioning WP:NOTTEXTBOOK. Eversense (talk) 18:47, 23 December 2011 (UTC)
The article discusses the glutaminergic theory of schiz. but I have found evidence of endocannabinoid systems impacting the glu systems which in turn could lead to excess dopamine. Since this article discusses cannabis as a linke to psychosis I think this also should be an added fact. Unfortunately, I still have to wait a few days to become confirmed. I'd like to hear opinions in the mean time. Zzaffuto118 (talk) 22:49, 26 December 2011 (UTC)
If I understand you correctly (and please set me straight if I'm wrong), you are talking about your own laboratory data. If so, it would be very premature to include it in this article at Wikipedia. Generally, we do not add information here until it has not only been published in a peer-reviewed journal, but it has also been cited as significant in a peer-reviewed review article. Otherwise, there would simply be too much stuff here, much of it changing frequently. --Tryptofish (talk) 15:19, 27 December 2011 (UTC) But congratulations on your research! It sounds like you are doing very interesting work. --Tryptofish (talk) 15:22, 27 December 2011 (UTC)
I think there is a bit of published literature on the topic, but it isn't clear to me that there is coverage at a level that would justify including a discussion in this top-level article. Looie496 (talk) 16:10, 27 December 2011 (UTC)
The article also claims schizophrenia can be caused by drugs, while the outcome of research shows it's hard to tell if that's the case (see Causes_of_schizophrenia and mentioned sources). This does not help the article's neutrality. At this point the article still lacks a neutral point of view. ViezeRick (talk) 17:27, 3 January 2012 (UTC)
Prevention / Edit Request/ Discussion
I was thinking that a mention such as "Children of schizophrenics might try to avoid substance abuse so as not to increase their chances of developing schizophrenia" in the Prevention section might be warranted. Based on: "Thus, it seems that cannabis can be conceptualized as a cumulative causal factor in some individuals, acting in concert with other vulnerability factors to promote the manifestation of the illness in some individuals who might otherwise have remained schizophrenia free." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659306/ and other references.
The prevention section is bleak. Might we not suggest in the prevention section that environmental risks not be added to genetic risks as a method of prevention? Glennconti (talk) 20:41, 1 January 2012 (UTC)
We already state that cannabis is a risk factor under causes. As the ref in question does not say stopping is useful for prevention I am hesitant to state it here. But happy to hear others thoughts.Doc James (talk · contribs · email) 20:48, 1 January 2012 (UTC)
My gut reaction is that we should not say that anything is preventative without considerable sourcing saying explicitly that it is preventative. The quote from the source, above, says that it's a causal factor, but doesn't explicitly speak to prevention. (Making the inference could be WP:SYNTH.) --Tryptofish (talk) 20:52, 1 January 2012 (UTC)
It might or might not pass WP:RS, but for our purposes here, it falls short of WP:MEDRS. But it links to the studies on which it is based. (I haven't clicked through to those links.) If there are peer-reviewed studies, and preferably review articles or medical textbooks, that specifically address prevention, then I'd say that those fit the bill. --Tryptofish (talk) 21:36, 1 January 2012 (UTC)
Melbourne University's Professor David Castle stated in a February, 2005 interview that heavy drug use during formative times of life, such as the years at school, could affect the way a teenager or young adult thought, impairing cognitive ability and having a long-term impact on job prospects....
Professor Castle, author of the book Marijuana and Madness, has said that those people with this "psychotic proneness" were those who had a family history of mental illness or who had had a bad response on their first use of cannabis or to a tiny amount. Others at risk included those who had experienced a psychotic episode where they had paranoid thinking or heard a voice calling their name. Professor Castle said experiencing such a one-off episode was far more common than people thought.
"People with such a vulnerability should avoid cannabis like the plague," he said.
Without the effects of the drug, such a person might live their whole life without ever experiencing mental health problems. It has been estimated, for example, that between 8% and 13% of people that have schizophrenia today would never have developed the illness without exposure to cannabis.
Apparently there is a body of thought which supports my contention that there is a preventative aspect to schizophrenia not covered by our article. Is there anyone that can review the MEDRS to see if there should be an update to the Prevention section of this article? I am not qualified. Glennconti (talk) 21:47, 1 January 2012 (UTC)
If I understand correctly (again, I haven't looked at the sources, and I'm about to log off for the day), that's all from an interview, so it really isn't peer reviewed (yet). By the way, I see from your user page that we went to the same high school, but doubtless at different times. --Tryptofish (talk) 22:00, 1 January 2012 (UTC)
"Go Tigers!!!"Glennconti (talk) 22:57, 1 January 2012 (UTC)
That Lancet review seems more than enough for you to include a point on this view. The full text says "The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis"..."The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness."
I agree with the broader point about views on prevention. This World Health Org review is a few years old but includes a section on possibilities for 'primary prevention' (a term this article could maybe use, to distinguish from the work on relapse prevention). This ia a more recent review on prevention, not as international, I've only scanned through it but seems to address both early intervention (identified high-risk individuals) and population-wide public health strategies, stating that there's lots of uncertainties & reasons why some approaches probably wouldn't be effective, but also outlining apparently notable work on how various causes could be prevented on a socio-economic and community level. Eversense (talk) 10:47, 2 January 2012 (UTC)
Yeah, I like the last few paras of this article as it makes a lot more sense - there being stronger associations between early developmental adversity and a host of subsequent problems, so taking a more holistic approach (remembering also Rutter's work on the Isle of Wight showing early adversity predisposing to any adult pathology), but I found the rest of the article a bit frustrating in that it ponders alot but stops short of firmly suggesting anything. Do others feel the suggestions of the last few paras are solid enough to summarise? Casliber (talk·contribs) 13:55, 2 January 2012 (UTC)
The lancet one I think we can use, and this one discusses the problems and barriers succinctly. Do we think we can add a bit from both? Our prevention section is pretty slim..... Casliber (talk·contribs) 13:55, 2 January 2012 (UTC)
Yes, I agree with Eversense and Casliber. Those are definitely appropriate sources, and it's a subject appropriate to address here. Just stick to where they explicitly make recommendations. Stuff where they ponder things but don't actually say "here is a recommendation for preventing or delaying schizophrenia" should instead be left for Causes of schizophrenia. --Tryptofish (talk) 16:09, 2 January 2012 (UTC)
My familiarity with this literature is very limited, so this is basically OR, but I think one should be alert to an important distinction. It seems unlikely to me that substance abuse could cause schizophrenia per se, but I have seen cases that gave a very strong impression that substance use can induce a psychotic break. I believe there is literature to support such an acute effect, but I wouldn't be able to point to specific articles. Looie496 (talk) 16:34, 2 January 2012 (UTC)
Apparently the medical literature does support the statement that cannabis use does cause schizophrenia in some people. Further it appears that the literature goes even further and suggests that schizophrenia can be prevented in some people if cannabis is not used. At least that's my take on it. Glennconti (talk) 17:09, 2 January 2012 (UTC)
That Lancet review seems quite clear in concluding that it "lends weight to the view that cannabis use precipitates schizophrenia and other psychotic disorders". And that avoidance could delay onset, and improve outcomes even if it did develop. It seems to leave open whether that could prevent these things altogether. Personally I don't see why you shouldn't be able to add/start a point on this in the prevention section. Eversense (talk) 12:29, 3 January 2012 (UTC)
The Moore/Lancet Review was highly recommended to me today at work and I am reading the fulltext now, to figure out what to add. Casliber (talk·contribs) 12:53, 3 January 2012 (UTC)
I don't have access to the full text of the Moore/Lancet review and therefore will defer to others to please make the desired edit to the prevention section. Thank you. Glennconti (talk) 13:50, 3 January 2012 (UTC)
However, it was my hope, among other things, that we might be able to provide a clear warning to children of schizophrenics that they are not powerless and that they can do something to avoid onset of the problem. If we can craft an edit that does this, I will be 100% satisfied. Glennconti (talk) 14:38, 3 January 2012 (UTC)
The Moore et al. full text can be found here btw (& i noticed some informal criticisms of it in reply just as a sidenote). Seems to suggest there's enough connection, at least on a population-wide level, to raise it as an issue despite the uncertainty. Only just realised the other one was another more recent Large et al. one. Eversense (talk) 16:30, 3 January 2012 (UTC)
I am still reading the Moore/Lancet Review. This http://bjp.rcpsych.org/content/184/2/110.full specifically states in the conclusion that "Cases of psychotic disorder could be prevented by discouraging cannabis use among vulnerable youths." I am going to use this to start a change to the prevention section as per EverSince's suggestion. Please revert if I am being too bold. Glennconti (talk) 14:51, 4 January 2012 (UTC)
Only thing not sure on unfortunately is the source seems to only say "An analysis of the Edinburgh High Risk Study found that both individuals at high genetic risk of schizophrenia (by virtue of two affected relatives) and individuals with no family history of schizophrenia were at increased risk of psychotic symptoms after cannabis use". Though it does identify younger people in general as at particular risk... Eversense (talk) 15:36, 4 January 2012 (UTC)
My take on this [3] is that familial risk is associated with an increased sensitivity to cannabis induced psychosis ie patients with a family history of psychosis should not use cannabis. Can we use this to establish this point in the prevention section?? Glennconti (talk) 16:51, 4 January 2012 (UTC)
Article seems to make a good point but it might be problematic in coming more from their primary study than a review, and not explictly linking it to prevention that I could see (it does say that while "relative effect sizes of differential sensitivity were high, absolute effect sizes, for example, of cannabis on schizotypy in unaffected siblings, were small."). There does seem to be a general mental health review that cites it (google scholar, open access) which does also mention prevention, not sure if that would be considered to fit the bill... Eversense (talk) 17:47, 4 January 2012 (UTC)
NPOV tag
Per comment
Quote ViezeRick: "The article also claims schizophrenia can be caused by drugs, while the outcome of research shows it's hard to tell if that's the case (see Causes_of_schizophrenia and mentioned sources). This does not help the article's neutrality. At this point the article still lacks a neutral point of view."
User in question has also made changes to the text of the lead without consensus.Doc James (talk · contribs · email) 18:01, 3 January 2012 (UTC)
I am not sure what NPOV issue is? "Causes of schizophrenia" is not as well written or sources as this article and I agree is in need of improvement. Tagging here though is not appropriate without sufficient justification.Doc James (talk · contribs · email) 18:26, 3 January 2012 (UTC)
I disagree with the use of the NPOV tag. It is an overly heavy-handed approach to the issue. Please remove the tag and resolve on the Talk page. Glennconti (talk) 18:42, 3 January 2012 (UTC)
A dispute about the neutrality of the article should be enough justification. Besides that, I am not the only person disputing parts of the article's neutrality. Disputes about the neutrality have started in October 2011 and where still ongoing last week. I see no reason why we can't edit the article to become more NPOV, or work out a solution on this talk-page. The rules do not allow removal of the tag until the dispute is resolved, so the less time we talk about the tag, the faster we can resolve the dispute. I've already asked some questions (below) which, when answered, might help me make an edit proposal. ViezeRick (talk) 19:35, 3 January 2012 (UTC)
You are only disputing the neutrality of a very small part of the article. Basically whether or not to say "may cause" versus "appears to cause". Do you really want to flag a FA for that for a week or so? Glennconti (talk) 19:41, 3 January 2012 (UTC)
No, I was hoping to solve the issue as soon as possible.
In my opinion the lead is not a small part of the article, on the contrary... The lead sets the further tone of the article, so the lead should be as neutral as possible. It does not have a neutral tone at the moment, I don't understand why we cannot use the information from Causes_of_schizophrenia (which has a npov) to change the tone of the lead.ViezeRick (talk) 19:48, 3 January 2012 (UTC)
As no description of the neutrality "issue" has been presented along with reliable sources and there is no consensus for said tag will be removing the it shortly.Doc James (talk · contribs · email) 17:23, 4 January 2012 (UTC)
Lead text
I removed the edits I made to the lead text. Could you please explain why you disagree with my attempt to make the lead take more neutral? ViezeRick (talk) 18:16, 3 January 2012 (UTC)
The lead is just a summary with " some recreational and prescription drugs appear to cause or worsen symptoms." summarizing "A number of drugs have been associated with the development of schizophrenia, including cannabis, cocaine, and amphetamines.[3] About half of those with schizophrenia use drugs and/or alcohol excessively.[33] The role of cannabis could be causal,[34] but other drugs may be used only as coping mechanisms to deal with depression, anxiety, boredom, and loneliness.[33][35] Cannabis is associated with a dose-dependent increase in the risk of developing a psychotic disorder.[36] Frequent use has been correlated with twice the risk of psychosis and schizophrenia;[35] however, the causality of this link has been questioned, and it remains controversial.[25][37][38] Amphetamine, cocaine, and to a lesser extent alcohol, can result in psychosis that presents very similarly to schizophrenia.[3][39] Although not generally believed to be a cause of the illness, people with schizophrenia use nicotine at much greater rates than the general population.[40]" Doc James (talk · contribs · email) 18:19, 3 January 2012 (UTC)
But isn't that summary about drug abuse, instead of prescribed use? And even if it is not, doesn't my edit make the lead more neutral? What alternatives to my edit would you suggest? ViezeRick (talk) 18:26, 3 January 2012 (UTC)
Amphetamines are prescription drugs and they may worsen schizophrenia. The term "recreational drug use" is preferred over "drug abuse" as it is more neutral.Doc James (talk · contribs · email) 18:31, 3 January 2012 (UTC)
Ah, they may worsen schizophrenia. That sounds more neutral than "appear to cause or worsen" to me. I'm still confused though... The summary is clearly titled: "Substance abuse". And I still don't understand why you believe that my edit would not have made the lead more neutral, it is taken literally from Causes_of_schizophrenia (section: substance use) ViezeRick (talk) 19:01, 3 January 2012 (UTC)
Thanks and fixed. I think the majority of reviews support "appear to cause or worsen" but am happy to hear what others think.Doc James (talk · contribs · email) 19:45, 3 January 2012 (UTC)
In the "appear to cause" VS "may cause" debate, I feel the ever so slight "appear to cause" version is more appropriate in that if there is some uncertainty in a health issue we should err on the side that promotes a healthier outcome. Glennconti (talk) 19:56, 3 January 2012 (UTC)
But Wikipedia does not give medical advice. When even scientist have not reached consent, we must be careful not to push our views. ViezeRick (talk) 20:07, 3 January 2012 (UTC)
This is not POV pushing. If the majority say "appear to cause" and few say "may cause" why are we bound to say "may cause"? Glennconti (talk) 20:10, 3 January 2012 (UTC)
I did not say anyone was pov pushing, I just said we should be careful not to. I don't think promoting a healthier outcome over neutrality is the right thing to do here, since wikipedia does not give medical advice, but aims to be a neutral encyclopedia. When there is not enough evidence for (any) claims, it's better to remain neutral (when editing wikipedia). ViezeRick (talk) 20:18, 3 January 2012 (UTC)
If I drop the dispute, will you help improve the lead text? ViezeRick (talk) 20:20, 3 January 2012 (UTC)
If you wish to suggest an edit, please do so. I feel the "appear to cause" language is NPOV in that it tempers the certainty of the direct cause position with some uncertainty. So I am not currently in favor of any change to the lead. Glennconti (talk) 21:01, 3 January 2012 (UTC)
"some studies show that recreational and prescription drugs appear to cause or worsen symptoms. The relationship between schizophrenia and drug use is complex, meaning that a clear causal connection between drug use and schizophrenia has been difficult to tease apart."
Just wondering, what would be wrong or nonfactual about the above change? ViezeRick (talk) 23:21, 3 January 2012 (UTC)
What's wrong about the above is a clear causal connection between drug use and schizophrenia has NOT been difficult to tease apart. A review as of 2010 [4] states "Existing reviews generally conclude that these cohort studies show cannabis has a causal relationship to psychosis". The contention is whether cannabis use can cause serious psychotic disorders that would not otherwise have occurred cannot be answered from the existing data so therefore more studies with different methodologies are being called for. Glennconti (talk) 00:48, 4 January 2012 (UTC)
This is just one review? Causes_of_schizophrenia mentions several other sources, but those claim the opposite. Sweden and Japan, where self-reported marijuana use is very low, do not have lower rates of psychosis than the U.S. and Canada do. ViezeRick (talk) 01:28, 4 January 2012 (UTC)
The 2010 review looked at at least 10 other studies all of which concluded a causal relationship or the lack of ability to exclude one. This certainly does not imply a causal link has been difficult to find. Can the similar rates in Sweden and Japan be currently explained? No; but, Japanese do a lot of urban living which has also be identified as a risk factor which could be an explanation. More questions can always be asked and more studies proposed. Glennconti (talk) 03:04, 4 January 2012 (UTC)
"Thus, cannabis use is now widely accepted as a modest contributory cause of schizophrenia and similar illnesses" [5]Glennconti (talk) 16:18, 4 January 2012 (UTC)
Concerns regarding recent refs
A couple of recent refs are of questionable quality IMO. This summary of a presentation to congress in 1998 is a little old and not peer reviewed http://www.loc.gov/loc/brain/brkfast.html
Sources that where not of the highest quality per WP:MEDRS or most recent (last 3-5 years) was what brought this article to FAR. Wish to avoid going in that direction again.Doc James (talk · contribs · email) 01:45, 6 January 2012 (UTC)
Of course, so shall we delete the section on the biomedical viewpoint on prevention, or consider the source either not necessary for an obvious point, or easily replaceable i.e. via the NIMH webpage on schizophrenia? Not sure re. that description of last FAR, it seems to have been described as initiated 'improperly' by someone wanting to dipute the content, though tied up with primary sourcing issues both ways. Eversense (talk) 03:21, 6 January 2012 (UTC)
Do not have any problem with the content just the references thus left it for discussion. Will see if I can dig up better refs unless someone beats me to it. Doc James (talk · contribs · email) 04:00, 6 January 2012 (UTC)
ok i'll keep looking as and when too, tho seems to be covered by just the latter refs for now anyway. Eversense (talk) 04:29, 6 January 2012 (UTC)
Substance misuse / Edit request / Discussion
Can we beef up the substance misuse section as far as causality and cannabis is concerned using Moore/Lancet? Apparently there is a misunderstanding of the current position on causality as evidenced by the recent NPOV tag discussion. Can we add "cannabis use is now widely accepted as a modest contributory cause of schizophrenia" as does this article [6] using Moore/Lancet or others? Glennconti (talk) 18:54, 4 January 2012 (UTC)
I just came across this paper Do patients think cannabis causes schizophrenia? which couldn't be used as a source for its specific results as it's only one small study, though in its discussion & conclusion it reviews findings, and well anyway it seems to give another point of view/caution on this... Eversense (talk) 01:44, 7 January 2012 (UTC)
A section on violence under "Signs and symptoms"
I think I may have removed content regarding violence a while ago as it was not previously supported by reviews. As I look there appears to be a number of reviews available. What do people think of the following?
While schizophrenia is associated with violence and homicide these behaviors are primarily attributed to the higher rates of drug misuse within this population.[1] Rates of homicide also parallel those within the population as a whole.[2] What role schizophrenia has on violence independent of drug misuse is controversial.[3] Those with severe mental illness including schizophrenia are at a significant greater risk of being victims of both violent and non violent crime.[4]
^Fazel, S (2009 Aug). "Schizophrenia and violence: systematic review and meta-analysis". PLoS medicine. 6 (8): e1000120. PMID19668362. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Large, M (2009 Jul). "The relationship between the rate of homicide by those with schizophrenia and the overall homicide rate: a systematic review and meta-analysis". Schizophrenia research. 112 (1–3): 123–9. PMID19457644. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Bo, S (2011 Jul). "Risk factors for violence among patients with schizophrenia". Clinical psychology review. 31 (5): 711–26. PMID21497585. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Maniglio, R (2009 Mar). "Severe mental illness and criminal victimization: a systematic review". Acta psychiatrica Scandinavica. 119 (3): 180–91. PMID19016668. {{cite journal}}: Check date values in: |date= (help)
Well that simply isn't true regarding the prior content that's now in the prognosis subarticle... it was sourced to reviews and national surveys, while some very specific studies on the rarer homicide issue had been in there since someone started the section. It wasn't saying anything much different to the above, although these are all more recent now which is progress. Personally I think extra caution against misinterpretation is justified in this area so - since it's not itself a sign or symptom, I suggest it goes in the society section, which already addresses the issue from one side; I would object to any statement simply saying its associated with schizophrenia - only in a very specific sense is it in a minority; the independence point is down also to other key factors incl. socioeconomic; a key issue re the more severe acts is what specific individual histories or mental states they may be related to, as well as the fact that random stranger homicides are even rarer despite that being (understandably) a stand-out fear. Eversense (talk) 11:12, 6 January 2012 (UTC)
Yes you are correct I moved it rather than removed it. I think only one of the refs is described as a review by pubmed. Have added to the section on society and culture.Doc James (talk · contribs · email) 19:01, 6 January 2012 (UTC)
Several were reviewing the evidence - tagged as review or meta-analysis, or titled an overview in journal of world psychiatry, US national govt-funded surveys, a seminal paper on relationship to neighbourhood. Pubmed & biomedical indexing doesn't dicate reliable secondary sourcing on wikipedia anyway, esp. in social contexts or on other points of view. Eversense (talk) 20:24, 6 January 2012 (UTC)
Either way I hope what we have now wrt violence makes everyone sufficiently happy. Eversense changes has definitely improved on what I wrote. Doc James (talk · contribs · email) 02:34, 7 January 2012 (UTC)
I thought what you put together was great and I hope others are ok with what's there or to edit it too. Eversense (talk) 03:33, 7 January 2012 (UTC)
Doc James what you have put together is excellent. Thank you. Topgunn9 (talk) 00:01, 8 January 2012 (UTC)
The term schizophrenia is commonly misunderstood to mean that affected persons have a "split personality". Although some people diagnosed with schizophrenia may hear voices and may experience the voices as distinct personalities, schizophrenia does not involve a person changing among distinct multiple personalities. The confusion arises in part due to the literal interpretation of Bleuler's term schizophrenia. The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933.[124]
to:
The term schizophrenia is commonly misunderstood to mean that affected persons have a "split personality". Although some people diagnosed with schizophrenia may hear voices and may experience the voices as distinct personalities, schizophrenia does not involve a person changing among distinct multiple personalities. The confusion arises in part due to the literal interpretation of Bleuler's term schizophrenia (Bleuler originally associated Schizophrenia with dissociation and included split personality in his category of Schizophrenia[1][2]). Dissociative identity disorder (having a "split personality") was also often misdiagnosed as Schizophrenia based on the loose criteria in the DSM-II [3][4]. The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933.[124]
because:
I looked up "split personality" on Wikipedia and read the same information on the Dissociative Identity Disorder page and after some googling I found some more sources to back this up. The last source (Putnam, Frank W. (1989)) is also referred to on the DID page.
There's a lot of information to be found on Schizophrenia being misdiagnosed as DID (or visa versa - but that's a topic of debate) because of vague criteria in the DSM-II and DSM-III (being explained as delusions of control, thought insertion, hearing of voices or atypical psychosis) but I don't think all of that belongs on this page, so I tried to keep the addition as simple and unbiased as I could.
I hope this will be a useful contribution but I am human, so please check for mistakes and such...
sources:
[1] Stotz-Ingenlath G: Epistemological aspects of Eugen Bleuler’s conception of schizophrenia in 1911. Med Health Care Philos 2000; 3:153—159
[2,3] Hayes, J. A., & Mitchell, J. C. (1994). Mental health professionals' skepticism about multiple personality disorder. Professional Psychology: Research and Practice, 25, 410-415
[4] Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press. pp. 351. ISBN0-89862-177-1
I would like to suggest that the first paragraph of this article describe schizophrenia as a neurodevelopmental disease, possibly in addition to being a mental illness. I am reading the book The Origins of Schizophrenia, published 2012 by Columbia University Press, and chapter 1 (page 25) says:
In recent years, evidence has accumulated in support of a role for neurodevelopmental insults in the etiopathogenesis of schizophrenia (Brown, 2011). The dramatic changes in brain structure and function from conception to birth underscore the particular vulnerability to insults during this stage of development with regard to both short- and long-term disease outcomes (Tau & Peterson, 2010). Hence, the determinants of detal brain development- both genes and environmental factors- deserve consideration as potential risk factors for schizophrenia.
This scholarly book is summarizing the most recent scientific consensus on this terrible disease and it is pointing to schizophrenia as a neurological issue more than it is a mental health issue. Thank you. 140.247.141.165 (talk) 22:41, 29 January 2012 (UTC)
Oh, and another thing, this book discredits/updates a lot of information that is presented in this article. I would suggest that this article be demoted from being a FEATURED ARTICLE until such time that this article can be sufficiently updated with the most recent scientific findings. Thank you. 140.247.141.165 (talk) 22:57, 29 January 2012 (UTC)
I think you are misreading the book. "Evidence has accumulated in support of a role of neurodevelopmental insults" is by no means the same thing as "evidence conclusively demonstrates that neurodevelopmental insults are the main cause". Given the current distribution of scientific opinion, that would be a massive overstatement. Looie496 (talk) 03:19, 30 January 2012 (UTC)
Um hi. I agree that this article should reflect the leading theories of scientists and agree that this book represents a very reliable secondary source, and is also the most recent secondary source. The quote seems to be saying that there is a lot of evidence to show that schizophrenia is a disease caused by a neurodevelopmental problem. Surely there is no statement saying that it is 100% certain (I don't know if scientists ever say something if 100% certain) but they are saying that the evidence has "accumulated", which I think might significant for scientist-speak. I also think that this article should reflect the opinion that schizophrenia is much more than just a mental disorder but is also an actual neurological problem. 76.118.180.210 (talk) 04:00, 30 January 2012 (UTC)
Thanks for presenting a potential new reliable source for the article. I'd like to highlight that it says neurodevelopmental insults "deserve consideration as potential risk factors for schizophrenia" (my emphasis). That is weak in my opinion. As such, if this kind of statement is significant enough for inclusion, it would first go to Causes of schizophrenia or maybe mechanisms. Posting this on the talk page there might be a good next step. Thanks. Biosthmors (talk) 17:47, 30 January 2012 (UTC)
PreNatal Estrogen
Excessive prenatal estrogen exposure may play a role in gene expression for schizophrenia.(see study) In addition, a 2009 animal study determined that in utero and inordinate estrogen exposure may disrupts specialized brain cells and their ability to regulate brain chemistry in the left hemisphere, specifically altering the way cells release and reabsorb dopamine. (see study)
It is thought that excessive prenatal testosterone exposure plays a role in autism and may cause damage to the right pre-frontal cortex (see study), which may evince the flip side to schizophrenia.....(see study)Witch Hazell (talk) 21:16, 4 February 2012 (UTC)
Interesting, but those are not sources that would be usable in an article like this. Per WP:MEDRS, there is a strong preference for using review papers as sources rather than primary research studies. The reason for that policy is that when it comes to topics with a very extensive literature, it is generally possible to find individual studies that support pretty much any idea one can imagine. We as Wikipedia editors are not in a good position to judge which studies stand the test of time and which don't -- it's much better to leave that judgement to the authors of high-quality review papers. Looie496 (talk) 00:33, 5 February 2012 (UTC)
Image query
I was interested in the image at the top "Cloth embroidered by a patient diagnosed with schizophrenia" but the diagnostic claim seems to only go to a Flickr user who took the photo. Seems the cloth is exhibited at the Glore Psychiatric Museum and may be this one in their brochure. But that's only described as "an embroidered sheet that was this patient’s only form of communication." (not sure what to make of that claim either...)
Maybe in the actual museum it says patient diagnosed with schizophrenia, but then what was their name so they can be credited. S/he may have given rights to the museum to exhibit it but their says privacy statement says "Copyright 2009 All Rights Reserved, St. Joseph Museums, Inc. Reproduction in whole or in part of any photographs, maps, and illustrations without prior written permission from the copyright holders is strictly prohibited."
I know these things are a real pain but it would also be better if image was specifically claimed to be a representation of symptoms associated with schizophrenia, as it can't really be assumed that everything someone with a diagnosis does is just a manifestation of that condition. Eversense (talk) 01:53, 24 December 2011 (UTC)
Possible source of an alternative in case the above is problematic or to use anyway - Altered spatial frequency content in paintings by artists with schizophrenia (2011) - Page 5 "Portions of the paintings by artists with schizophrenia analyzed in this study, shown with calculated amplitude spectrum slopes." The paper is open access published under Creative Commons license and in it they thank NARSAD Artworks for the original full images. Not totally sure if that means they can be used here or who would be credited. Eversense (talk) 06:33, 24 December 2011 (UTC)
I think we discussed the current one before (?) - I don't think I was especially keen on it and am happy to consider alternatives - that one you've linked to looks interesting on first impression. I'll try and read article later. Casliber (talk·contribs) 06:46, 24 December 2011 (UTC)
I also agree that this issue is well worth looking into. Thanks. --Tryptofish (talk) 16:57, 24 December 2011 (UTC)
Seems photos taken of the museum permitted, but the personal Flickr caption can't be relied on (which is the case anyway of course) - told was 'a patient who was mute and possibly schizophrenic'. Eversync (talk) 11:13, 11 February 2012 (UTC)
See no discussion in the article of T. gondii 's possible involvement in the rise or development of schizophrenia. The Atlantic 's "How Your Cat is Making You Crazy" is off-puttingly titled, but fairly thorough on the research being done on the subject. If medical journal cites are necessary for the article, someone with access to a database could use the researchers' names to find their papers and the corroboration/disputes so far. 101.229.79.243 (talk) 00:31, 11 February 2012 (UTC)
Edit request on 24 February 2012
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Patients involved in violence or the refusal to use violence often complain of immediate talking and remote viewing by people who communicate in the mind through the use of hypnogogic mental language acoustics and claim to organize violence and violent crime syndication within or beyond the community. Easily Scared Persons report the condition is similar to being viewed or sensed by persons unseen, in places unknown, for deceptive or hostile purposes, while talking or listening to a host audience, not within the perception of the individual, or otherwise being threatened or intimidated without the support or assistance of lawful community.
Make-believe emotional information and fake working solutions are often considered options by those coping and dealing with chronic confusion or other acute pressures of the mind that accompany the cognitive disability. Most sufferers of schizophrenia report being able to modify the antagonism of 'voices' by performing constructive forms of counter-confrontation, without the use of violence, however, all 'voices' evidence an intention to exploit the perception and risk of being remotely viewed and immediately sensed by others for purposes of creating fear and poverty. The mental abuse and emotional torment experienced by the sufferer may or may not cause extreme states of agitation or confusion (delusion) that result in the condition of violence. Much of the illness of provoked emotion or hearing voices can be remedied by strategies that remove conditions that cause fear and poverty, whether the cognitive disability of 'hearing of voices of people in the mind,' is considered people or not.
Not done: please be more specific about what needs to be changed.--Ankit MaityTalkContribs 11:43, 24 February 2012 (UTC)
Thanks for your suggestions. It makes sense to me that relieving poverty and fear would reduce the intensity of emotional symptoms and auditory hallucinations. The social pain inflicted on the mentally ill is something I'd like to learn more about. As for the remainder of your comment, I know next to nothing about auditory hallucinations. Hearing Voices Movement looks interesting and I intend reading that one day. But we can only add information to medical articles that has already been published in a reliable source. Our own analysis, if it's not backed up by a reliable source, can't be included in Wikipedia articles. --Anthonyhcole (talk) 15:47, 24 February 2012 (UTC)
I think the above edit request refers in large part to a symptom I know in the UK as 'ideas of reference' when the mind wrongly attributes an outside agency (e.g. a television,government body, VIP) is referring to the patient. This is a common component of paranoid schizophrenia and is common in chronic schizophrenia, yet I see no mention of this term.
Another symptom I frequently see in the more advanced forms of schizophrenia, and for some reason related to the chronic 'simple schizophrenic' and old style hebephrenic class (also not described fully) is obsessional compulsive type symptoms - checking of keys and switches would be an example. "Command voices" are often a feature which is linked to obsessive behaviour in schizophrenia. I feel this feature does not get enough attention - but this (I think) is purely my subjective view, from 40 years of observing the illness in thousands of different clients. — Preceding unsigned comment added by 82.19.6.67 (talk) 21:46, 2 March 2012 (UTC)
Edit request on 5 March 2012
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I would like to submit a request to add information on the history of schizophrenia with citation. It will be a verbatim addition and the source is Vol. 4, No. 1 of the 1978 from Schizophrenia Bulletin.
Not done for now: Please be more precise what should be change to what. (say: "X to Y") mabdul 21:31, 5 March 2012 (UTC)
Edit request 25 March 2012 Substance misuse - cannabis
I am a bit new here so forgive if I get this one wrong; this is a protected section,, so I need to submit a "talk" suggestion?
I think this section is very interesting;
one comment re the Substance misuse subheading
I would suggest to separate this into two:
1. Substance misuse - cannabis
2. Substance misuse - other drugs.
you will see the reason for this. There is simply so much more evidence re cannabis and schizophrenia that it would be better to separate the two
the current section is as follows:
Substance misuse
A number of drugs have been associated with the development of schizophrenia, including cannabis, cocaine, and amphetamines.[3] About half of those with schizophrenia use drugs and/or alcohol excessively.[33] The role of cannabis could be causal,[34] but other drugs may be used only as coping mechanisms to deal with depression, anxiety, boredom, and loneliness.[33][35]
Cannabis is associated with a dose-dependent increase in the risk of developing a psychotic disorder[36] with frequent use being correlated with twice the risk of psychosis and schizophrenia.[35][37] While cannabis use is accepted as a contributory cause of schizophrenia by many,[38] it remains controversial.[25][39] Amphetamine, cocaine, and to a lesser extent alcohol, can result in psychosis that presents very similarly to schizophrenia.[3][40] Although not generally believed to be a cause of the illness, people with schizophrenia use nicotine at much greater rates than the general population.[41]
I suggest to separate this - as mentioned above. We now get a new subheading
Substance misuse - cannabis
Cannabis is associated with a dose-dependent increase in the risk of developing a psychotic disorder[36] with frequent use being correlated with twice the risk of psychosis and schizophrenia.[35][37] While cannabis use is accepted as a contributory cause of schizophrenia by many,[38] it remains controversial.[25][39]
suggested addition with subheadings:
A recent review looked at this issue in greater detail
[source: Deepak Cyril D’Souza, Richard Andrew Sewell and Mohini Ranganathan.
Cannabis and psychosis/schizophrenia: human studies
Eur Arch Psychiatry Clin Neurosci. 2009 October ; 259(7): 413–431
link http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864503/ ; please note footnotes as per this paper; can be inserted if editors feel appropriate]
Cannabinoids, psychosis, and causality
Does exposure to cannabinoids “cause” psychosis where none would have otherwise existed?
The commonly applied criteria to establish disease causality include temporality, strength and
direction of the association, biological gradient (dose), consistency, specificity, coherence,
experimental evidence, and biologic plausibility.
Dose
Several studies reviewed here provide evidence of a dose–response relationship between
exposure to cannabinoids and the risk of both psychotic symptoms and disorder.
Temporality
Experimental evidence from laboratory studies clearly demonstrates a robust temporal
relationship between exposure to cannabinoids and psychotic symptoms. The onset of cannabis
use may precede, follow, or co-occur with the onset of schizophrenia. Allebeck et al. [9]
reported that in 69% of a schizophrenic patient sample from a Swedish case registry (n = 112),
cannabis abuse preceded the onset of psychotic symptoms by at least 1 year. Further, in only
11% did the onset of psychotic symptoms precede the onset of cannabis abuse. Similarly,
Linszen et al. [133] found that cannabis abuse preceded the onset of psychotic symptoms by
at least 1 year in 23 of 24 cannabis-abusing recent-onset schizophrenic patients. Hambrecht
and Hafner, [83,84] in their study of first-episode schizophrenic patients, found that 14.2% of
the sample had a lifetime history of drug abuse, with cannabis being the most frequently abused
drug (88%). Furthermore, drug abuse preceded the first sign of schizophrenia by more than 1
year but typically by more than 5 years in 27.5% of patients. In 37.9% of individuals, drug
abuse followed the first sign of schizophrenia, and in 34.6% of individuals the first sign of
schizophrenia and drug abuse started within the same month. Related to the above, some studies
suggest that cannabis and other substance use is associated with an earlier age of and more
abrupt onset of psychotic symptoms in schizophrenic patients [4,8,11,12,37,76,84,133,149,
224,226].
However, schizophrenia begins insidiously, and evolves through several identifiable stages,
with the emergence of psychotic symptoms as the final step in the evolution of the disorder.
As a result, while it may be easy to pinpoint the emergence of positive psychotic symptoms in
retrospective studies, pinpointing the onset of the less obvious prodromal symptoms is
extremely challenging.
Strength
Cannabis exposure increases the odds of developing schizophrenia modestly (40%) even after
controlling for many potential confounding variables [160].
Direction
The case of reverse causality has been proposed whereby risk for schizophrenia predisposes
to cannabis use, rendering the association between cannabis and psychotic illness merely an
epiphenomenon of a shared vulnerability for both psychosis and cannabis [38,137]. Since
several longitudinal studies excluded people with psychosis at baseline, or adjusted for
psychotic symptoms in the analysis, the observed association between cannabis and psychosis
is unlikely to reflect reverse causation [160].
Specificity
While there is a strong association between cigarette smoking and schizophrenia, there is little
evidence to support the notion that cigarette smoking “causes” schizophrenia. Further, the
association between cannabis use is weaker for anxiety or affective disorders [160].
Biologic plausibility
The effects of cannabinoids on key neurotransmitters and known to be implicated in psychosis,
and also neurodevelopmental processes provide biological plausibility for
the association.
I think this would be useful as addition to clarify the current research evidence.
This is lifted from the d'Souza review paper (see link above), which in itself is freely available on the internet. does this infringe copyright regulations here?
I certainly can tidy this up a bit more and clarify, but before I spend more time on this I was asking for assessment from the "editor(s)".
thanks Rosengarten2020 (talk) 21:06, 25 March 2012 (UTC)
This article is a general overview. We have a specific article that deals with the causes of schizophrenia here [7] that makes the distinction you suggest and needs further work. Feel free to make improvements there as it is not protected.Doc James (talk · contribs · email) 22:21, 25 March 2012 (UTC)
Sourcing question
I have a question about this edit [8], about what appears to have been a sourcing problem for the sentence "Difficulties in working and long-term memory, attention, executive functioning, and speed of processing also commonly occur.(ref name=Lancet09)" My impression is that those various "difficulties" are indeed widespread in the disease. I realize from other edit summaries that there were some serious issues with some of the other material that was removed (and I feel guilty for not having checked those things myself, when they were first added to the page!), but the edit summary isn't clear in this case. Please understand that I am not objecting to the edit, but just seeking to understand what the situation is. Thanks. --Tryptofish (talk) 17:16, 17 April 2012 (UTC)
hmmm ... I don't believe I intended to remove that part ... I was doing a lot of work on accumulated cruft, but that one sentence isn't in my memory, so it may have been a mistake. If the source is good, please do reinstate! SandyGeorgia (Talk) 19:54, 17 April 2012 (UTC)
Thanks! (Hey, you could have said you did it on purpose, and I would have believed you!) I re-checked the source (a very high-quality Lancet review), and there is a passage that backs up the sentence in question, but the sentence is not copied from the source. I'll put it back. --Tryptofish (talk) 22:42, 17 April 2012 (UTC)
Thank you, and my apologies for the extra work! SandyGeorgia (Talk) 22:47, 17 April 2012 (UTC)
Poorly worded, but not undue
I think the sentence that was removed here[9] is poorly worded but not undue considering we already have two sentences discussing the possibility of less cannabis preventing the condition. If anything it suggests that the article needs to update (with doi:10.1177/0269881111414751, perhaps) its cannabis related sentences. I recommend something like this: "While it has been suggested that less cannabis use might prevent the condition, in young adults, it has been estimated that several thousand heavy users would have to refrain from cannabis in order to prevent one case." That way we would have less prose but more updated info. Biosthmors (talk) 22:47, 16 May 2012 (UTC)
I was the editor who made the edit you linked, and maybe I didn't make myself clear enough in my edit summary. Although we both agree about the poor wording, my concern about UNDUE was based on the previous series of edits. This page is a summary page about the main topic of schizophrenia. Overall, cannabis as a causative factor just isn't that prominent a part of the literature, and it doesn't require that lengthy a back-and-forth on this page. If there are concerns that what is there now is one-sided, then I would prefer to scale that back, rather than to extend the point-counterpoint. --Tryptofish (talk) 15:15, 17 May 2012 (UTC)
I see now that my edit has been reverted on the grounds that there was no discussion here in talk. I wonder, then, what this talk thread was about. --Tryptofish (talk) 18:56, 17 May 2012 (UTC)
I agree with Tryptofish, as noted in previous edit summary, there is way too much discussion about cannabis here. If we have to re-write it to include said information in a more compact manner I would probably be fine with that, but addition like this editor wants is unwarranted and I will revert. Yobol (talk) 18:57, 17 May 2012 (UTC)
I reverted the latest edit since I was unaware that you had recently discussed it on the talk page. (Sorry about that) I think the best thing would be to remove all of the cannabis-related stuff from the prevention section (remember that cannabis is already mentioned a great deal in the causes section) rather than to only remove the stuff I added. I added that last study to maintain NPOV by balancing out what appeared to be a biased section full of mostly speculative information. One must also remember that overall, there really is no worldwide scientific consensus that cannabis actually causes cases of schizophrenia that would not otherwise have occurred, regardless of what the (mostly British and Australian) media or folks like Robin Murray or Jim van Os like to claim. For example, it is very difficult to explain away the fact that psychosis/schizophrenia rates remained relatively constant over the past few decades despite massive increases in cannabis use in most Western nations.Ajax151 (talk) 19:14, 17 May 2012 (UTC)
I think that may be a good suggestion, about removing all of it from the prevention section, while leaving what is in the causes section. What do other editors think about that? --Tryptofish (talk) 19:21, 17 May 2012 (UTC)
The causes section can also use a few "tweaks" (pun intended), but that's a topic for another thread.Ajax151 (talk) 19:35, 17 May 2012 (UTC)
I went ahead and removed all of the cannabis-related stuff from the Prevention section, as no one seems to object to removing it for now.Ajax151 (talk) 20:20, 20 May 2012 (UTC)
Good, thanks. --Tryptofish (talk) 21:58, 20 May 2012 (UTC)
Sorry, folks, but cannabis-related research is notoriously poor with other conditions-- please find a secondary review compliant with WP:MEDRS, and do not add info based on primary sources. SandyGeorgia (Talk) 21:14, 17 May 2012 (UTC)
So let me get this straight. Avoiding cannabis will prevent onset of psychosis just not in significant enough numbers to offset the "benefit" of heavy cannabis use in young people or in people with a family history of psychosis, so we're just not going to mention it at all. I'm sorry but I have to disagree. We should mention abstention of cannabis will prevent onset of psychosis in some cases as supported by the literature. Glennconti (talk) 21:15, 5 June 2012 (UTC)
What text do you propose? I don't mind stating, "In young adults, it has been estimated that several thousand heavy users would have to refrain from cannabis in order to prevent one case." doi:10.1177/0269881111414751Biosthmors (talk) 21:29, 5 June 2012 (UTC)
I am proposing that we say "Research indicates that cannabis abstention by some vulnerable portions of the population will prevent onset of psychosis in some cases." I think people with a family history of psychosis are also more vulnerable to cannabis-induced psychosis. Glennconti (talk) 21:48, 5 June 2012 (UTC)
I am sympathetic to the impulse to want to provide medically helpful information to the public, but Wikipedia:Medical disclaimer means that we must not do that. As explained above, we really have to be guided here by secondary review sources. --Tryptofish (talk) 23:10, 5 June 2012 (UTC)
I think what was stated about cannabis in the prevention section prior to the recent revisions was all properly sourced. The issue arose with how to add information from a newer study.doi:10.1177/0269881111414751 People thought it was too diffucult so they expunged all info about cannabis and prevention. This is not appropriate in my opinion. Glennconti (talk) 23:19, 5 June 2012 (UTC)
Although you may disagree, the issues were actually about the newer study not supporting a major role for cannabis, and about WP:UNDUE. --Tryptofish (talk) 23:25, 5 June 2012 (UTC)
Exactly. So the bone of contention is the amount of cases which would be prevented. Not that a prevention effect would indeed occur. There is a prevention effect. We should state this. Glennconti (talk) 23:37, 5 June 2012 (UTC)
But not when the effect would be so small as to be UNDUE, since we are not giving medical advice. --Tryptofish (talk) 23:39, 5 June 2012 (UTC)
Who makes the decision that the effect is too small to mention? My understanding is that the newer study is based on young people not people with a family history of psychosis. The effect is much greater in people with a family history. Part of the material that was expunged said, if I remember properly, half of the people with a family history of psychosis that experienced cannabis induced psychosis developed chronic psychotic symptoms. Glennconti (talk) 23:50, 5 June 2012 (UTC)
"There is scientific evidence that in rare cases immunizations can cause adverse events, such as oral polio vaccine causing paralysis." This was taken from a wiki article. Is this UNDUE? Glennconti (talk) 00:16, 6 June 2012 (UTC)
I think you misunderstand the meaning of UNDUE. It has to do with the % of people that believe a statement is true. So for example in the statement above most people would say it is true so it is not UNDUE. It has nothing to do with the "rareity" of the cases. Just as most studies will agree that "some cases of schizophrenia could be prevented". Even the new study that you cite agrees to this. Glennconti (talk) 01:10, 6 June 2012 (UTC)
This is what was there before the new study was to be added:
However, some cases of schizophrenia could be delayed or possibly prevented by discouraging cannabis use, particularly among youths.[5] Individuals with a family history of schizophrenia may be more vulnerable to cannabis induced psychosis.[6] And, one study found that cannabis induced psychotic disorders are followed by development of persistent psychotic conditions in approximately half of the cases.[7]
How about this?:
However, some small number of cases of schizophrenia could be delayed or possibly prevented by discouraging cannabis use, particularly among youths.[5][8][9] Individuals with a family history of schizophrenia may be more vulnerable to cannabis induced psychosis.[6] And, one study found that cannabis induced psychotic disorders are followed by development of persistent psychotic conditions in approximately half of the cases.[10]
In the causes/substance abuse section, I recently added a study about methamphetamine (crank, tweak, speed, crystal meth) being a possible cause of schizophrenia, only to have it repeatedly reverted. I understand that we should use secondary sources instead of primary ones whenever possible, and that news reports of primary studies apparently don't count as WP:MEDRS. However, while that study appeared to be the first of its kind in the Western world, the original study cites older Japanese studies that suggest similar conclusions. Thus, it can function as both a primary and a secondary source as long as those Japanese studies are also mentioned.Ajax151 (talk) 19:28, 17 May 2012 (UTC)
"Recently read", "first of its kind", "news reports" ... see WP:RECENTISM, WP:NOTNEWS, WP:UNDUE, and WP:MEDRS. This is a broad overview article, we aren't a news source, we don't mention everything ever studied. SandyGeorgia (Talk) 21:16, 17 May 2012 (UTC)
Agree with Sandy. We are not in the breaking news business. Doc James (talk · contribs · email) 06:10, 18 May 2012 (UTC)
Edit request on 30 May 2012
This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.
Under schizophrenia > Management > Medication
Newer antipsychotics (lurasidone, asenipine) have been developed to cause less of the side effects associated with earlier atypical antipsychotics, such as extreme weight gain, high risk of diabetes, or cardiac problems due to elevated cholesterol.
I think the phrase self-limited psychosis is very vague. I cannot find any scholarly articles explaining this phrase, even after checking the source material. Could someone either remove it or edit it to be more clear? I don't have a wikipedia account, so I can't. — Preceding unsigned comment added by 24.186.30.227 (talk) 09:52, 24 June 2012 (UTC)
No strong feelings, but I can't see any value in the phrase in any case, so I went ahead and removed it. Looie496 (talk) 15:44, 24 June 2012 (UTC)
Schizophrenia symptoms using remote neural monitoring technology
It is important to note that the Schizophrenia Symptoms can also be produced using Remote Neural Monitoring Technology
It is important to put this in the article. — Preceding unsigned comment added by 115.111.223.43 (talk) 09:11, 3 August 2012 (UTC)
The source you provided is a blog, and we generally do not use those as source material for this article. --Tryptofish (talk) 20:27, 3 August 2012 (UTC)
Please see WP:MEDRS for sourcing guidance. Thks Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:01, 4 August 2012 (UTC)
Use of word in genetics section "theoretical" and theory
I don't think that the words theoretical should be used here in this paragraph. Unless they are actually theories. This is adds to the conflation of the scientific term theoretical, which is very significant thing, and the layman theoretical which is to say that it is speculative which I think would be a better word here.
"One idea implicates genes involved in the evolution of language and human nature, but to date such ideas remain little more than speculative in nature.[28][29]" Fathernicolow (talk) 04:58, 18 August 2012 (UTC)fathernicolow
In my opinion, you raise a good point. I've made an edit along those lines, although I used slightly different wording. --Tryptofish (talk) 14:28, 18 August 2012 (UTC)
Abnormalities of volatile organic compounds produced in patients with schizophrenia
I am curious as to whether the concept of the "back ward odour" in a subset of schizophrenic patients is considered notable for inclusion in the article. Perhaps the implications of the blood borne presence of volatiles on the etiology of a subset of schizophrenia is too controversial for wikipedia.tepi (talk) 14:16, 25 August 2012 (UTC)
Since the 19th century, authors have suggested that their is a peculiar smell associated with Schizophrenia. [11] The branched chain fatty acid trans-3-methyl-2-hexenoic acid (TMHA) was uniquely detected in the sweat of patients with Schizophrenia by one study, [12] although a later study found that this chemical was ubiquitously present in controls, and concluded that there is no relationship with Schizophrenia. [13] An earlier study failed to identify this chemical at all in the sweat of Schizophrenics. [14]
It was then reported that the volatile profile of the breath was abnormal compared to controls. Both carbon disulfide, (a neurotoxin said to possess an ether-like odor), and pentane, (a marker of peroxidation of lipids), were found to be significantly elevated. [15]
A recent research paper analysing the body odor of Schitzoprehnia patients with gas chromatography and sensors confirmed that there is indeed an alteration of body odor, but its nature is complex and cannot be explained by a single compound, but rather to a general changes in the odor. [16]
See also blood borne halitosis:
A minority of medications can also cause halitosis directly, usually by the blood borne halitosis mechanism.
Disulfiram (antabuse) can give a garlic or metallic taste in the mouth, [17] and lead to halitosis via formation of one of its metabolites, carbon disulfide. [18] Carbon disulfide has been detected in plasma, urine and breath after disulfiram administration, [19][20][21] but it is mainly subject to pulmonary excretion, [22][23][24] meaning that this is a type of blood borne halitosis. It is not produced endogenously, [25] although it has been implicated as contributing to the so called "odor of schizophrenia".
Are there recent reviews? Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:38, 25 August 2012 (UTC)
I think this was the latest (2005) [26] otherwise...seems to have received interest in the 70's. If I find any I will update this thread. Here are some more older papers on the topic, but I either can't access them or they aren't in english: [27][28][29][30][31]tepi (talk) 16:14, 25 August 2012 (UTC)
Interesting - I've never seen any literature on this so it hasn't hit clinical psychiatry in a big way...when I first worked in psych wards the pervasive smells were from chlorpromazine syrup and cigarettes, now both much less evident..Casliber (talk·contribs) 22:12, 25 August 2012 (UTC)
refs
^Stotz-Ingenlath G: Epistemological aspects of Eugen Bleuler’s conception of schizophrenia in 1911. Med Health Care Philos 2000; 3:153—159
^Hayes, J. A., & Mitchell, J. C. (1994). Mental health professionals' skepticism about multiple personality disorder. Professional Psychology: Research and Practice, 25, 410-415
^Hayes, J. A., & Mitchell, J. C. (1994). Mental health professionals' skepticism about multiple personality disorder. Professional Psychology: Research and Practice, 25, 410-415
^Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press. pp. 351. ISBN0-89862-177-1
^ abCite error: The named reference Henquet2008 was invoked but never defined (see the help page).
^Arendt, M (2005 Dec). "Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases". The British journal of psychiatry : the journal of mental science. 187 (6): 510–5. doi:10.1192/bjp.187.6.510. PMID16319402. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^{{cite journal |author=Hickman M, Vickerman P, Macleod J, Lewis G, Zammit S, Kirkbride J, Jones P.|title=If cannabis caused schizophrenia--how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations. |journal=Addiction |volume=104 |issue=11 |pages=1856–61 |year=2009 |month=Nov |pmid=19832786 |doi=
^{{cite journal |author=Weissenborn R; Nutt, D.|title=Popular intoxicants: what lessons can be learned from the last 40 years of alcohol and cannabis regulation?|journal=Journal of Psychopharmacology |volume=26 |issue=2 |pages=213–220 |year=2012 |month=Feb |pmid= |doi=10.1177/0269881111414751 |url=http://jop.sagepub.com/content/26/2/213.abstract
^Arendt, M (2005 Dec). "Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases". The British journal of psychiatry : the journal of mental science. 187 (6): 510–5. doi:10.1192/bjp.187.6.510. PMID16319402. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Shirasu, M. (NaN undefined NaN). "The scent of disease: volatile organic compounds of the human body related to disease and disorder". Journal of Biochemistry. 150 (3): 257–266. doi:10.1093/jb/mvr090. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Smith, K. (NaN undefined NaN). "Sweat in Schizophrenic Patients: Identification of the Odorous Substance". Science. 166 (3903): 398–399. doi:10.1126/science.166.3903.398. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Gordon, SG (1973 Jul). "Studies of trans-3-methyl-2-hexenoic acid in normal and schizophrenic humans". Journal of lipid research. 14 (4): 495–503. PMID4715330. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Perry, TL (1970 Dec). "Failure to detect trans-3-methyl-2-hexenoic acid in the sweat of schizophrenic patients". Clinica chimica acta; international journal of clinical chemistry. 30 (3): 721–5. PMID5493894. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Phillips, M (1993 Sep). "Increased pentane and carbon disulfide in the breath of patients with schizophrenia". Journal of clinical pathology. 46 (9): 861–4. PMID8227439. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Di Natale, C (2005 Aug). "Identification of schizophrenic patients by examination of body odor using gas chromatography-mass spectrometry and a cross-selective gas sensor array". Medical science monitor : international medical journal of experimental and clinical research. 11 (8): CR366-75. PMID16049378. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^O'Reilly, RA (1977 Dec 12). "Breath odor after disulfiram". JAMA : the journal of the American Medical Association. 238 (24): 2600. PMID579195. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Faiman, MD (1984 Oct). "Elimination kinetics of disulfiram in alcoholics after single and repeated doses". Clinical pharmacology and therapeutics. 36 (4): 520–6. PMID6090051. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Jensen, JC (1982 Dec). "Elimination characteristics of disulfiram over time in five alcoholic volunteers: a preliminary study". The American journal of psychiatry. 139 (12): 1596–8. PMID6293320. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Jensen, JC (1980 Mar 14). "Determination of disulfiram and metabolites from biological fluids by high-performance liquid chromatography". Journal of chromatography. 181 (3–4): 407–16. PMID6248572. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Bloor, RN (2006 Jun). "Quantification of breath carbon disulphide and acetone following a single dose of disulfiram (Antabuse) using selected ion flow tube mass spectrometry (SIFT-MS)". Addiction biology. 11 (2): 163–9. PMID16800830. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Wells, J (1974 May 22). "Detection of carbon disulphide (a disulfiram metabolite) in expired air by gas chromatography". Journal of chromatography. 92 (2): 442–4. PMID4836244. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Phillips, M (1986 Aug 22). "Measurement of breath carbon disulfide during disulfiram therapy by gas chromatography with flame photometric detection". Journal of chromatography. 381 (1): 164–7. PMID3771714. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^van den Velde, S (2007 Jun 15). "Halitosis associated volatiles in breath of healthy subjects". Journal of chromatography. B, Analytical technologies in the biomedical and life sciences. 853 (1–2): 54–61. PMID17416556. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Di Natale, C (2005 Aug). "Identification of schizophrenic patients by examination of body odor using gas chromatography-mass spectrometry and a cross-selective gas sensor array". Medical science monitor : international medical journal of experimental and clinical research. 11 (8): CR366-75. PMID16049378. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^SMITH, K (1960 Feb). "Demonstration of a peculiar odor in the sweat of schizophrenic patients". A.M.A. archives of general psychiatry. 2: 184–8. PMID13832051. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Melançon, SB (1970 Aug). "[The peculiar odor of schizophrenics]". L'union medicale du Canada. 99 (8): 1445–6. PMID5486801. {{cite journal}}: Check date values in: |date= (help)
^Smith, RV (1972 Feb). "Methods for the preparation of trans-3-methyl-2-hexenoic acid, the malodorous component of schizophrenics' sweat". Journal of pharmaceutical sciences. 61 (2): 316–7. PMID5062104. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
^Grant, FW (1973 Jul). "Comments on a proposed mechanism of formation of the "schizophrenic odor factor"". Research communications in chemical pathology and pharmacology. 6 (1): 335–6. PMID4734009. {{cite journal}}: Check date values in: |date= (help)
^Perry, TL (1971). "[Organic acids in biological fluids in chronic schizophrenia]". Vestnik Akademii meditsinskikh nauk SSSR. 26 (5): 71–2. PMID5172972.
Schizophasia & word salad
I thought it was rather odd that the text word salad in the article was actually linked to schizophasia, even though an article on word salad actually exists.--Coin945 (talk) 16:12, 26 August 2012 (UTC)
Perhaps those two pages ought to be merged? --Tryptofish (talk) 21:10, 26 August 2012 (UTC)
See also addition
A great addition to the see also list would be the list of people who have had schizophrenia! — Preceding unsigned comment added by 120.148.99.217 (talk) 12:50, 11 September 2012 (UTC)
That's an interesting idea! As far as I can tell, we don't have List of notable schizophrenics. I suspect it would become a problem, however, to establish sourcing for every person on the list. --Tryptofish (talk) 21:46, 11 September 2012 (UTC)
I foresee that turning into a can of worms. The list would end up having a few people famous for their accomplishments, such as John Nash, and a bunch of mass murderers. And given the difficulty of distinguishing psychosis caused by mania from psychosis caused by schizophrenia, there would be lots of people with uncertain diagnoses, such as Jean-Jacques Rousseau. Looie496 (talk) 22:00, 11 September 2012 (UTC)
We have lots of similar pages listing notable cases of diseases. I am not a fan of them but we could at a link to the society and culture section if someone was to create one. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:50, 12 September 2012 (UTC)
Thanks for the link. I'll put it in the see also section. I've also tagged its talk page to be covered by WP:BLP. --Tryptofish (talk) 23:19, 24 September 2012 (UTC)
I'm sure it won't be difficult to find sources to support the contention but I object on principle to the use of retrospective diagnosis for historical figures such as Michelangelo etc. I think it's methodologically unsound and, personally, I'd be disinclined to include anyone on such a list who hasn't received an actual clinical diagnosis. I accept that no WP policy will support me here. FiachraByrne (talk) 10:11, 24 October 2012 (UTC)
I'm not watchlisting the list page, but I suppose that you could raise the issue on the talk page there. Alternatively, you might be able to add something, with a source, to the list page that would point out that such criticism exists. --Tryptofish (talk) 22:46, 24 October 2012 (UTC)
IQ as a risk factor
Under the 'Prognosis' section, it is claimed that high IQ is a risk factor for schizophrenia. In actuality, low IQ, and general neuropsychological/cognitive/executive impairment are risk factors (Aylward, E., Walker, E. & Bettes, B., 1984. Intelligence in schizophrenia: meta-analysis of the research. Schizophrenia Bulletin, 10(3), p.430-459; Kremen, W.S. et al., 2001. Intelligence quotient and neuropsychological profiles in patients with schizophrenia and in normal volunteers. Biological Psychiatry, 50(6), p.453-462.) Also, the reference given in the text makes no reference to Schizophrenics having higher IQs. — Preceding unsigned comment added by 86.163.47.100 (talk) 20:50, 22 October 2012 (UTC)
That sounds to me like a good point, and I'd like to hear what other editors think about it. --Tryptofish (talk) 23:01, 22 October 2012 (UTC)
convincing evidence, suggest change article to reflect this. Here is another recent study, concluding " Lower IQ was associated with increased risk of schizophrenia, severe depression, and other nonaffective psychoses. Risk of schizophrenia was increased in subjects with average IQ compared with those with high scores, indicating that risk is spread across the whole IQ range." Zammit S, Allebeck P, David AS, Dalman C, Hemmingsson T, Lundberg I, Lewis G. A longitudinal study of premorbid IQ Score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Arch Gen Psychiatry. 2004 Apr;61(4):354-60. PubMed PMID: 15066893. — Preceding unsigned comment added by Tepi (talk • contribs) 23:22, October 22, 2012
It seems to me that this would be a very good image for this page, but alass when I tried to add it, the page was locked. Notconfusing (talk) 23:45, 22 October 2012 (UTC)
I guess it depends on how good the evidence is that it really captures what it feels like. Myself, I don't have schizophrenia, and I don't feel like I really understand it any better after looking at the image. I'm aware of audio representations that are very compelling, so I wonder whether a sound file might be a possibility. --Tryptofish (talk) 23:03, 23 October 2012 (UTC)
No doubt if it went up there would be objections but if it's really a self-portrait by someone who has received the diagnosis I think it should be used. It's certainly a more interesting image than the current one, particularly in its depiction of embodiment. FiachraByrne (talk) 23:10, 23 October 2012 (UTC)
I agree with FiachraByrne. If it is a self-portrait it would be good to use it. Lova Falktalk 08:39, 24 October 2012 (UTC)
At long last! I thought I was the only one who felt like Radiohead makes my own head explode! Anyway... About images, I see some value in replacing the handwriting sample with a self-portrait. I think what we need to do, though, is to place a higher priority on how the image "captures" the experience of schizophrenia, as opposed to how aesthetically pleasing the image is (and I'm not sure how to accomplish that). About audio files, I have a distant memory that someone created some to imitate auditory hallucinations, as a training tool for physicians. I remember hearing some of it quite a few years ago, and finding it very compelling. After all, schizophrenia is typified more by auditory hallucinations than visual ones. However, I don't know whether the audio I heard is freely licensed, and I don't remember where to find it. It's probably worth doing some search engine searches, so if any of you find something before I get around to it, that would be great. --Tryptofish (talk) 22:59, 24 October 2012 (UTC)
Here's a quick search link, and there's clearly audio stuff out there: [10]. The trick is to get something that is properly licensed. --Tryptofish (talk) 23:04, 24 October 2012 (UTC)
Thanks for the search link Tryptofish. I'll rummage through when I have a little time. In regard to the image, personally I'm not advocating this particular image because it is visually pleasing but nor do I see that as a deficit. I'm advocating it as representation of the experience of schizophrenia by someone who has received the diagnosis. Also, I think it's an interesting perspective in terms of some of the accounts of the body/embodiment that some people report. It is used in teaching, so I guess others must feel it has some kind of didactic value as well. I certainly think it's superior to the current image. FiachraByrne (talk) 00:24, 25 October 2012 (UTC)
Mild
Is there such a thing as mild schizophrenia? if so, is there a seperate wikipedia article for this? Pass a Methodtalk 21:02, 28 October 2012 (UTC)
Schizoid doesn't strike me as a personality disorder, more like an introvert. But those two links are not what i was looking for. Pass a Methodtalk 23:06, 28 October 2012 (UTC)
Not that this is an appropriate line of inquiry for an article talk page nor that I'm medically qualified but you'd have to define mild. Maybe something like the Hearing Voices Movement? Certainly, there's a substantial sub-clinical population (i.e. a population without clinically significant symptoms or "mild") with some, generally mild, psychotic symptoms (e.g. [11] & [12]. No wikipedia article on that as far as I know but could be a good idea. FiachraByrne (talk) 02:51, 29 October 2012 (UTC)
Rename Request
I propose that this article be renamed 'False Perception Syndrome' with a redirect. I am a Mental Health Survivor who has been labelled with this condition in the past so feel better acquainted with this ailment than most editors of this page who seem to coming from the psychiatrists position not the survivors. The argument may be read here :- http://www.asylumonline.net/resources/campaign-for-the-abolition-of-schizophrenia-label/ so I will not repeat it. I hope that other editors will be sympathetic to this proposed rename and look forward to a constructive debate. SmokeyTheCat 17:01, 31 October 2012 (UTC)
Wikipedia is not the place to fight that battle, and in any case the idea of renaming the article to a term that you have invented is a non-starter. Looie496 (talk) 17:12, 31 October 2012 (UTC)
Hi Smokey. I'm afraid it does not matter if we are sympathetic to your cause or not. As long as this mental illness is called schizophrenia in the dsm or icd, we will have an article called schizophrenia. I am sorry, but I cannot see us have any kind of debate about this. However, I wish you good luck with your campaign! With friendly regards, Lova Falktalk 18:03, 31 October 2012 (UTC)
You might have more luck writing an article about the campaign itself or a related topic if sufficiently notable. FiachraByrne (talk) 20:20, 31 October 2012 (UTC)
Bénédict Morel
I changed the history section so that it more accurately summarises the History of schizophrenia article (in fact I also changed that article so that it more accurately reflects the dementia praecox article which I also changed some time ago). Basically, while the claim is still frequently made, generally in psychiatric textbooks, that Morel's use of the term démence précoce is linked or even somehow equivalent to dementia praecox as used by Pick or Kraepelin reliable sources (i.e. those that know the primary sources and intellectual context) do not endorse this reading. However, I think my addition might break up the flow of this section and was wondering if it might be better relegated to an explanatory note? FiachraByrne (talk) 23:33, 31 October 2012 (UTC)
I like your addition. Before seeing your talk comment here, I had already re-ordered the paragraph, and I think that takes care of the flow issue. I think it's useful to keep the information in the main text. --Tryptofish (talk) 23:37, 31 October 2012 (UTC)
Ah, that's a much more coherent sequence. Thanks Tryptofish! FiachraByrne (talk) 23:56, 31 October 2012 (UTC)
My pleasure! --Tryptofish (talk) 23:59, 31 October 2012 (UTC)
News coverage of schizophrenia
News coverage of schizophrenia on November 14 2012 suggested that people with schizophrenia are not being given adequate care. If any one knows about this issue it could be incorporated into the article. ACEOREVIVED (talk) 14:35, 14 November 2012 (UTC)
Is this a world wide problem? In that case, if there are good sources, it would be good to mention it in the article. However, if this is a local issue, it is more doubtful... Lova Falktalk 15:18, 14 November 2012 (UTC)
Well, it's a worldwide problem, but for different reasons in different places. In the U.S., the biggest contributing factor is that very few people with schizophrenia are institutionalized long-term nowadays, but many of them end up homeless. I definitely agree that the article should deal with this issue, but appropriate material would take some work to write. Looie496 (talk) 03:58, 15 November 2012 (UTC)
You are right. Now that I come to think of it, I have heard that there are many schizophrenics among the homeless people, not getting any medical treatment at all. We should find sources about that also. Lova Falktalk 09:19, 15 November 2012 (UTC)
One indication, from one source, of the progress of schizophrenic genetic research.
found through
NIMH > NIF > Schizophrenia Research Forum > News
Seems that this information might be reviewed by someone competent for inclusion into this article, considering what seems to be a lack of dissemination to the general public of the progress of research (subjective, unproven evaluation).
specifically the indications that genetics is not the 'best' course to follow.
What was clear from those studies was that, with thousands of patients recruited and billions of SNPs genotyped, no single gene or allele was likely to contribute a great deal to the risk of disease in a large number of people. “If there was a truly common variant, the technique would have found it,” said David Porteous, of the University of Edinburgh in the United Kingdom. He added, “If you were looking for a single, defining marker in the general population of individuals with schizophrenia, there isn’t one. That is for certain now.”
Instead, the evidence points to many genes—hundreds and perhaps even thousands—that each contributes a small amount to the cause of schizophrenia. The data to date suggest that common variants account for just a fraction of the risk of schizophrenia in a population. Estimates of that fraction range from a low of 4 percent (Purcell et al., 2009) to a generous 30 percent, says Porteous; there is no wide agreement on the number. Writing about the GWAS published in Nature in 2009, Kevin Mitchell, Trinity College, Dublin, opined on SRF that, “Based on the meager haul of common variants dredged up by these three studies and their forerunners, this [common variants] hypothesis should clearly now be resoundingly rejected” (see full text of Mitchell’s comment on SRF related news story).--
comment by,
flagrant disregard of wikiformatting guidelines~~
It's already in the article: "It is likely that many genes are involved, each of small effect and unknown transmission and expression." FiachraByrne (talk) 05:35, 18 November 2012 (UTC)
I see that, now, although the disparity between
--
"Estimates of heritability vary because of the difficulty in separating the effects of genetics and the environment.[24] The greatest risk for developing schizophrenia is having a first-degree relative with the disease (risk is 6.5%)"
6.5%!
And
"Living in an urban environment during childhood or as an adult has consistently been found to increase the risk of schizophrenia by a factor of two,[2][3]"
by Two!
--
is Significant.
I guess that the encyclopedic nature of wikipedia lends itself to dry presentation.
well... maybe there should be a research section , or a law section
"Target identification
The NIMH spends the majority of its resources on discovery and translational neuroscience, but most of this work has yet to produce new novel druggable targets. According to March, however, epigenetic changes, brain circuit activation, intracellular signaling pathways modifications, structural brain changes, neuroplasticity, changes in RNA expression, and proteomic and metabolomic markers all hold great promise for understanding early disease processes and, by extension, may reveal novel treatment targets.
For that reason, the report recommends that more money be spent both on the preclinical side and on the early-phase clinical pharmacology side. The hope is that this investment in translational neuroscience can be moved rapidly into interventions that are better for patients, said March, a professor of psychiatry and behavioral sciences at Duke."
flagrant disregard of wikiformatting guidlines~~ — Preceding unsigned comment added by 70.44.113.171 (talk) 06:15, 18 November 2012 (UTC)
Well, I'm no expert on these issues and stats and odds ratios are not something I'm educated in but assuming the above figures are correct and that about 1% or less of the population receives a diagnosis of schizophrenia. Therefore, according to your figures above, if I have first-degree relative with a diagnosis of schizophrenia my odds of receiving the same increase by six and half times relative to the general population whereas living in an urban environment may double it. This doesn't make schizophrenia primarily a genetic condition but there's certainly a strong genetic component to it (leaving aside, of course, the question of what the hell schizophrenia actually is and if it corresponds to some putative natural kind or is a disease concept that incorporates a range of conditions perhaps with different aetiologies). FiachraByrne (talk) 09:56, 18 November 2012 (UTC)
I apologize if I am misinformed, but I took this to mean that genetics plays a 6% role while urban living plays a 200% role.
This is what I am talking about, that is a very large difference.
flagrant disregard of wikiformatting guidlines~~ — Preceding unsigned comment added by 70.44.113.171 (talk) 21:05, 18 November 2012 (UTC)
Edit request on 7 December 2012
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Occurrences
Schizophrenia is one of the most common psychoses. It occurs worldwide and affects all social classes, though not equally. It is more common in lower socioeconomic classes than upper and middle socioeconomic classes. A possible explanation of this is downward social mobility, which many people experience as they develop this disorder.[1]
In addition, schizophrenia occurs in both men and women. Men, however, mostly develop it at an earlier age. Symptoms usually appear first in late adolescence or early adulthood, but they can also appear in later years. A few cases of childhood schizophrenia have been reported as well; it is comparatively rare.[2]Habibyum (talk) 01:55, 7 December 2012 (UTC)
This seems to largely duplicate information that is already in the article. Also an encyclopedia is not a good source, as it has the same status as Wikipedia itself. Looie496 (talk) 02:47, 7 December 2012 (UTC)
Use of mental disorder in the lead
Any neurological disorder of the brain can be called a "mental disorder". In other words, it is too broad. Autism is a featured article and doesn't call it a "mental disorder" but a "disorder of neural development". It would be more accurate to say: "Schizophrenia is a form of psychosis..." or "Schizophrenia is a psychotic disorder...". This is a featured article so I felt as if it would be more appropriate to put this on the talk page before making any changes to the lead. Is it okay if I change it? ATC.Talk 05:00, 9 January 2013 (UTC)
The problem though is that schizophrenia is not a form of psychosis. Schizophrenia is one of the primary psychiatric causes of psychosis. So, no, I don't agree. Lova Falktalk 07:21, 9 January 2013 (UTC)
Okay. I did more research on it. They have a "split (schizo) mind (phrenia)". So wouldn't it be better to call it a thought disorder? ATC.Talk 17:46, 9 January 2013 (UTC)
It however is a "mental disorder" which is synonymous with "psychiatric disorder" and is in fact the most famous off all such disorders. I do not under the issue? Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:49, 9 January 2013 (UTC)
I think it's better to say in the lead: "Schizophrenia is a thought disorder characterized by..." ATC.Talk 18:01, 9 January 2013 (UTC)
The way it is now in the lead is better. It is a mental disorder (the more general term) characterized by a breakdown of thought processes (here comes the thought disorder part) and by poor emotional responsiveness (and here is the other part).Lova Falktalk 18:11, 9 January 2013 (UTC)
I too would prefer to keep the "mental disorder" terminology. A mental disorder is not the same thing as a neurological disorder of the brain, which is what I think the opening post of this talk section is getting at. A neurological disorder such as essential tremor is clearly distinct from what one would consider a mental disorder, and schizophrenia is clearly the latter. --Tryptofish (talk) 01:55, 10 January 2013 (UTC)
I believe that "mental disorder" is the best descriptor. In DSM it is classified as one of the psychoses but realistically they are all a bit more complex than just psychotic symptoms (e.g. frontal lobe dysfunction etc.). "Thought disorder" is a name for a type of symptom/sign of disorganized thinking so is not used to classify illnesses. Casliber (talk·contribs) 23:23, 10 January 2013 (UTC)
Connect with other Schizophernian
any idea where i can connect with other Schizophernian via facebook Ab8 (talk) 02:41, 5 February 2013 (UTC)
Sorry, but this is an encyclopedia, and this talk page should only be used for issues related to improving the article. Looie496 (talk) 03:40, 5 February 2013 (UTC)
Research
While there is no cure for schizophrenia, research to learn more about the causes, progression, and treatment of the disease is ongoing. In the last two decades, more than 50,000 studies on schizophrenia have been published.[3] In 2005, 12 schizophrenia researchers from the University of Minnesota and the Minneapolis Veteran's Administration compiled the findings from these articles to determine what fundamental facts were discovered from which scientific theories can be built today. Their work, published in the Schizophrenia Bulletin, summarizes what we now know about schizophrenia from research, and where more thought and data could have the greatest impact in our future understanding the disease.[4]
The U.S. National Institutes of Health is currently recruiting for many human clinical trials involving patients with schizophrenia.[5] Additionally, large organizations like the Brain & Behavior Research Foundation, the National Alliance on Mental Illness (NAMI), and the Schizophrenia International Research Society (SIRS) are working with both government and private institutions to recruit and fund talented researchers studying schizophrenia and related mental illnesses. Each year the Brain & Behavior Research Foundation awards two large NARSAD Grants for schizophrenia research: the Lieber Prize for Schizophrenia Research ($50,000) and the Sidney R. Baer, Jr. Prize for Schizophrenia Research ($40,000).[6]
Some of this is primary research supported by links to a forum. Research sections should generally be a summary of ongoing research based on recent review articles. It also needs independent sources to support the content. Yes the BBRF has funds available but why is this notable and it should not be supported by a link to the BBRF itself. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:00, 27 February 2013 (UTC)
This PMID:19329559 could be a good ref just not in the way it is used. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:02, 27 February 2013 (UTC)
Would the following revision address the issues you raised?
While there is no cure for schizophrenia, research to learn more about the causes, progression, and treatment of the disease is ongoing. Current research directions include genetic association studies, discoveries of new animal models of the disease, and new drug development to treat the disease. The U.S. National Institutes of Health is currently recruiting for many human clinical trials involving patients with schizophrenia.[7] Additionally, large organizations like the Brain & Behavior Research Foundation, the National Alliance on Mental Illness (NAMI), and the Schizophrenia International Research Society (SIRS) are working with both government and private institutions to recruit and fund talented researchers studying schizophrenia and related mental illnesses.
In the last two decades, more than 50,000 studies on schizophrenia have been published.[8] In 2005, 12 schizophrenia researchers from the University of Minnesota and the Minneapolis Veteran's Administration compiled the findings from these articles to determine what fundamental facts were discovered from which scientific theories can be built today. Their work, published in the Schizophrenia Bulletin, summarizes what we now know about schizophrenia from research, and where more thought and data could have the greatest impact in our future understanding the disease.[9]Rmlewinson (talk) 02:26, 6 March 2013 (UTC)
Please use secondary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:31, 8 March 2013 (UTC)
Add genetics links between five major psychiatric disorders, from wikinews?
Hi 99.109.125.252! I hope you don't mind I removed the reflist and instead showed your link. It is too new - that is, not confirmed by other studies and described in a review. With friendly regards, Lova Falktalk 09:20, 2 March 2013 (UTC)
Epidemiology section
There's an odd and contradictory patch in the epidemiology section:
Despite the received wisdom that schizophrenia occurs at similar rates worldwide, its prevalence varies across the world (PMID1565705), within countries (PMID16520429), and at the local and neighborhood level (PMID17473901)...In 2000, the World Health Organization found the prevalence and incidence of schizophrenia to be roughly similar around the world, with age-standardized prevalence per 100,000 ranging from 343 in Africa to 544 in Japan and Oceania for men and from 378 in Africa to 527 in Southeastern Europe for women.[13]
First off, the whole "received wisdom" phrasing seems odd. Second, the sources are also odd - PMID1565705 is from 1992, PMID16520429 is a primary study that only covered three counties in England, and PMID17473901 is another primary source that again is only about one neighbourhood in London, England. The latter two are from the same researcher. Epidemiology of schizophrenia repeats this phrase verbatim in the lead (brought over in the very first edit to that page by Doc James [14]). It was added here by Vaughan back in 2007, and appears to have remained largely unchanged and unchallenged since. Am I the only one that thinks this is odd? Was this discussed somewhere in the archives? WLU(t)(c) Wikipedia's rules:simple/complex 13:38, 14 March 2013 (UTC)
I've just read Chapter 2 of The American Psychiatric Publishing Textbook of Schizophrenia (2006). Its on Google books. The authors acknowledge the contradiction between the WHO's more homogenous results and the large-ish variation between the individual studies that they review, and put it down to "presumably a result of the standardization of method" (in the WHO study). The studies they are using are of similar vintage to those we cite before the WHO report, from the last thirty years, basically. I think our language could be clearer. And perhaps we could use that 2006 chapter as the source, rather than the primary sources we're presently using (per the medical sources guideline). --Anthonyhcole (talk · contribs · email) 14:13, 18 March 2013 (UTC)
bravo!
I've done so much complaining and nit-picking in these talk pages that I just wanted to say that this article really stands out to me as excellent. The thesis gives a good grasp of the thing for the layman (a thesis that talks over the head of a novice is a very common error in Wiki articles), fleshed out well in a logical pattern in the body, and solid references throughout. I was just looking for a general overview and got sucked into the meat of the article because of the way it flows. Many of the articles I've commented on with "helpful advice" could look at this one as an example of how to do it right.
Pb8bije6a7b6a3w (talk) 23:53, 17 March 2013 (UTC)
Thank you! Very nice to read. But instead of giving helpful advice, why don't you be bold and start improving articles, with this one in mind? Lova Falktalk 09:44, 18 March 2013 (UTC)
Thanks and agree we do need more editors. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:34, 18 March 2013 (UTC)
Yep. Have a go, if it interests you. It's fun and satisfying, and very good karma. --Anthonyhcole (talk · contribs · email) 17:02, 20 March 2013 (UTC)
Axis-1 disorder
Not sure how many clinicians have contributed to this page. But a bit more on how the shrinks classify schizophrenia (axis-1 disorder, etc. ) might be in order. Firebird9 (talk) 20:21, 1 April 2013 (UTC)
Sent in lead unclear
"hospital stays are now shorter and less frequent than they once were"
Is this meaning that less people with schizophrenia will need to go to hospital than historically, or that people with schizophrenia will need to go to hospital less often than historically? Lesion (talk) 18:18, 18 April 2013 (UTC)
To me, it's not confusing, but that may just be me. "Shorter" means that people with sch. who have to be hospitalized now need to spend less time there than previously. "Less frequent" means both that a smaller percentage of people need to be hospitalized, and that those that do, need to be hospitalized fewer times repeatedly. --Tryptofish (talk) 00:27, 19 April 2013 (UTC)
Edit request on 9 April 2013
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The word 'and' in the first line of the article should be removed.
76.170.254.88 (talk) 02:49, 9 April 2013 (UTC)
Well, we obviously can't just remove it, since that would make the sentence ungrammatical. Do you mean that it should be replaced by "or"? Looie496 (talk) 04:02, 9 April 2013 (UTC)
It seems to me that "or" would be factually wrong, and the existing "and" is correct. --Tryptofish (talk) 22:19, 9 April 2013 (UTC)
That's not 100% clear. It may be possible to have negative symptoms without positive symptoms (especially in people undergoing drug treatment), or vice versa. But "and" certainly describes the typical presentation, and I would be in favor of keeping it. Looie496 (talk) 02:08, 10 April 2013 (UTC)
it's possible to have negative symptoms without postitive ones, it's called simple schizophrenia
F20.6 ICD 10, 295.00 to 295.05 ICD 9
source, wikiepedia :) — Preceding unsigned comment added by 94.197.127.18 (talk) 23:50, 8 May 2013 (UTC)
The following discussion has been closed. Please do not modify it.
Shamanism probably evolved with the earliest form of H. sapiens some 30000 years ago (see the Cro-Magnon burials of presumed shamans in Sungir and Arene Candide). Shamanism is the only “religion” that is genetically determined and cannot be learned – unlike recent agrarian (“hypersocial”) religions like Judaism and its followers (Christianism, Islam, Protestantism, Capitalism, Marxism-Communism, Nazism, Hollywood). In fact, shamans become schizophrenic by the age of 10, but then are able to heal themselves completely by some still unknown epigenetic neurological mechanism. In this way, they become deliberate wanderers between two worlds – the empirical world of their own social group, and the “other world”.
Shamans are not only extremely stable and strong beings, but they also have astonishing map-making skills (“aerial view during flight”, drawing skills, strategical hunt planning skills) and theory-of-mind skills, i.e., they perfectly know the maps of their surrounding animals (including other group members) and are able to play with them and even to “tame”, teach and heal them as “magicians” and therapeutic “psychopompoi”.
Although Julian Jaynes mused about some “schizophrenia” or “bicameral mind” still extending to recent periods (until ancient Greece), there may be a big epigenetic difference between shamans, i.e., schizophrenics who have been able to heal themselves and may then even be able to play with their genes epigenetically by some astonishing mind techniques (with or without the use of hallucinogenics), and the much more common adult schizophrenics in modern (pathological) times – the latter being not able to heal themselves nor being healable by contemporary medicine.
Hence, studying the paleogenetic, genetic, and epigenetic mechanisms involved with shamans (prehistoric or recent ones) may be of crucial importance not only for the understanding of the “evolution of our modern mind” per se, but also for the clinical investigation of modern schizophrenia. — Preceding unsigned comment added by 85.1.151.22 (talk) 11:05, 20 April 2013 (UTC)
If you read the first line at the top of this page "This is the talk page for discussing improvements to the Schizophrenia article". Wikipedia talk pages are not a forum or your personal blog to ramble on with unreferenced content. If you have a suggestion about how to improve this article, please clearly state it and provide references, see wp:MEDRS. Lesion (talk) 11:45, 20 April 2013 (UTC)
This unusable material has been spammed across several talk pages, and a couple of weeks ago was put in Talk:DISC1 by a different IP. Henceforth I'm going to be removing it on sight whenever it pops up. Looie496 (talk) 16:13, 20 April 2013 (UTC)
Would the history of treatment for Schizophrenia be something that may be added to this article? (I felt way silly writing that title, so probably not. But, history is history.) I'm sure that sillier things have been added to articles. Though, this is a featured article, and I'm unsure of if there's a higher standard for stuff added to featured articles.Kude90 (talk) 22:39, 16 April 2013 (UTC)
I'm not sure how to comment directly appart from editing but, I can add
opaites and insuline (to depleat glucose stores in the body) as historical treatments.. there are others such as bleeding or ice water etc... but I don't know if they where for schizophrenia or not.
opiates where stopped 'apparently' because they where addictive, not because they didn't work.. There is evidence that antipsychorics are dependency forming at least, since they cause withdrawl and dopamine supersensitivity / upregulation (which requires dosage to be increased if nothing else)
If this is usefull informatio to add I'll find the appropriate citations, though 'historical' treatments most probably wont have freely avaialbe citations from recent journals... if it's better to put else where I'll do that. — Preceding unsigned comment added by 94.197.127.18 (talk) 23:25, 8 May 2013 (UTC)
This article could definitely use a section on history of treatment History of schizophrenia and you should be able to edit it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:10, 13 May 2013 (UTC)
This write up is a little short on detail and links
Here's my list of things that need updating, a few at a time.
1: Criteria says not if PDD symptoms unless delusions are bizzare etc.... PDDs (autistic spectrum) aren't mentioned in differential diagnosis, even though it's a common misdiagnosis and autism was known as childhood schizophrenia and PDD is preposed as being removed from DSM V and just getting changed to autistic spectrum and genetics (CCV) are different and so is neurology... This is a very important differential diagnosis often not spotted (in my experiance, it's certainly not screened for in the UK).
2: Heridicity should take into account the difference between identicle and non identicle twins (this is good for things that aren't mitocondrial), there is no mention of this though I expect the reseach is readily avaiable. (e.g. 40% is mentioned for identicle twins who have 100% the same DNA, if it's 20% for non identicle twins with 50% of the same DNA then that's 100% inhreitable... even though it may not develop into 'full blown' schizophrenia, the genes will get passed on. crudly speaking.)
3: Criteria for ASPD (anti social personality disorder) mentions that it must not be due to psychosis or words to that effect, there is no mention of this on the schizophrenia page (differential diagnosis), even though it's mentioned on the ASPD page on wikipedia and in the DSM diagnosis criteria.
That's 3 for now... more to follow.
Here's another 3, then that's all for tonight.
1: May be worth mentioning (against dopamine hypothisis etc..) that abilify has 90% affinity with dopamine receptors and the only anti-psychotic that is shown independently to be better than any other (clorazapine) has less effect on dopaime receptors than other anti-psychotics (though required regular blood tests due to white blood cell depletion being a side effect)
2: Other well documented risk factors
a: being born in the winter
b: Cats, though this association is most probably due to a paracite in cat fecies that causes symptoms that are almost indistinguishable from schizophrenia.
ttfn — Preceding unsigned comment added by 94.197.127.18 (talk) 00:08, 9 May 2013 (UTC)
At least per this trial published in the lancet [15]Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:04, 13 May 2013 (UTC)
Harrow 2013
Doc James correctly reverted my removal of text cited to Harrow, noting that it is, in fact, a review although PubMed does not indicate so. However, IMO the text in the article is too strong for what the source supports.
conclusions from PMID23512950, Harrow 2013-- Overall, the longitudinal studies cited do not provide conclusive proof of a causal relationship between being off medications and being psychosis free. They do clearly indicate that not all schizophrenia patients need continuous antipsychotics for a prolonged period, providing extensive evidence of samples of medication-free schizophrenia patients with favorable outcomes.6,12,22 Is it at least a moderate-sized number of schizophrenia patients who do well, longitudinally, without medications? This important issue needs longitudinal research for more precise answers. The longitudinal studies indicate the importance of further research on how many schizophrenia patients profit from continuous administration of antipsychotics over a prolonged period, what factors identify and separate schizophrenia patients who do not need prolonged antipsychotic treatment, and whether or not prolonged use of antipsychotics is harmful for some or many patients.
The above-cited longitudinal results from many different countries and different types of schizophrenia patients provide data bearing on issues about long-term treatment. Discussions by Whitaker, Moncrieff, and others question long-term antipsychotic treatment.25–27 These disparate views, research by WHO and DOSMED in developing countries,12 and our own longitudinal studies5–7 should be considered as prompts for further long-term outcome research on this important issue.
This is not a strongly worded conclusion, where our article presents as fact what this article appears to be raising as an important question in need of further study. I continue to believe this is not a strong enough source for the cited text. Clearly, further research on this controversial matter is needed. Can we either eliminate this source or reword the text to better match? The strongest conclusion of this paper is that further study is needed. Regards, SandyGeorgia (Talk) 18:00, 22 June 2013 (UTC)
"There is little evidence regarding benefits from anitpsychotic use beyond two or three years" In fact if you look at many of the Cochrane reviews of specific agents the evidence at any point in time is not very good. "One study (n=599) compared risperidone against placebo but the attrition rate was 60% over a period of six weeks rendering most of the efficacy and global improvement data unusable. " [16] "Despite the fact that 3443 people were randomised in 12 quetiapine studies, there are almost no data on service utilisation, economic outcomes, social functioning and quality of life. Over half of those within the quetiapine versus placebo comparison were lost to follow up (53% quetiapine vs 61% placebo, n=716, 4RCTs, RR 0.84 CI 0.7 to 0.9, NNT 11 CI 7 to 55) so it is impossible to interpret any ratings of global or mental state within this comparison with confidence." [17]
We have stated "The American Psychiatric Association recommends considering stopping antipsychotics if there are no symptoms for more than a year". The ref states "American Psychiatric Association (APA) guidelines3 suggest clinicians to consider antipsychotic discontinuation for schizophrenia patients who have been symptom free for a year or more" We could look at reffing another source such as PMID: 15000267 Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:27, 22 June 2013 (UTC)
My impression is that this is a topic that is controversial in the recent literature, and we need to work to present a balanced view of the distribution of opinions in the field rather than relying too heavily on any one review. I understand how difficult this can be when our own experiences clearly support one side of a debate, but I think this is a situation where we all need to bend over backward to be neutral rather than just relying on MEDRS. Looie496 (talk) 18:41, 22 June 2013 (UTC)
I don't think our text is entirely in line with the quotes Doc James provided above from the source ... we've made a blanket statement that there is little evidence, when the paper states there is no data on ... other issues ... or problems with attrition in studies ... could we make our wording more in line with the precise wording in the source? We've also used "recommend" for APA when the paper uses the word "suggest" ... subtle but important difference ... sorry to hammer on this, but considering public cases of people who ended up dead when medications were discontinued w/schizophrenia, I believe we need to hold very close to the sources here. SandyGeorgia (Talk) 19:08, 22 June 2013 (UTC)
Am happy if you wish to adjust it. We just need to make sure we paraphrase. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:18, 22 June 2013 (UTC)
I'm between appointments on a very busy day of hard work, so best not to suggest wording now ... we could put it in quotes if necessary? Also, if we are to use this source, can we work in the strongest conclusion, which is really that a closer look is needed ... lest we leave the impression this conclusion is "a done deal"? It doesn't seem that firm ... will leave it in your capable hands because I'm so swamped today. Best, SandyGeorgia (Talk) 19:22, 22 June 2013 (UTC)
I've tried to look carefully at the source and at our current wording, and I agree with Sandy that we need to tone our wording down a bit. As I read it, the source is saying that, for some patients, it's worth evaluating discontinuation, but the source is not arguing that the meds should be discontinued for all patients, which is what the current wording sounds like. I think that may be the key thing to get across in an edit: that, after considering discontinuation in the subset of patients who have been symptom-free for more than a year, the decision should be discontinuation for some of them, but not all. Also, instead of framing it as what the APA recommends, we might want to frame it as what Harrow et al. recommend. --Tryptofish (talk) 19:51, 22 June 2013 (UTC)
The ref specifically states it is from the APA. We already qualify it with " if there are no symptoms for more than a year". Have replaced the recommends with suggests. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:57, 22 June 2013 (UTC)
I made a further edit, and I hope that it makes it clearer to those readers who are less sophisticated with the source material. --Tryptofish (talk) 14:15, 23 June 2013 (UTC)
Happy with the changes, altered patient to person per WP:MEDMOSDoc James (talk · contribs · email) (if I write on your page reply on mine) 15:31, 23 June 2013 (UTC)
Thanks, and good catch on that. (I'm tempted to thank you for your patience.) --Tryptofish (talk) 20:49, 23 June 2013 (UTC)
Research Organizations
Can I add a section on organizations researching treatment/cures for schizophrenia (and other mental illnesses)? I'm thinking just a bulleted list in alpha order.
Rmlewinson (talk) 18:06, 15 May 2013 (UTC)
Probably not a good idea. In most other articles this usually ends in a secondary article if not deleted. I would only add those organizations that are mentioned in secondary sources as highly influential (see for example the mention of the Hereditary Disease Foundation as a paradigmatic example of this in the huntington's disease article). --Garrondo (talk) 19:54, 15 May 2013 (UTC)
I followed the models on the huntington's disease and parkinson's disease pages to create a Support Organizations section, rather than Research Organizations. Thank you for your help. Rmlewinson (talk) 23:18, 21 June 2013 (UTC)
I have also just noticed that you have repeatedly added this and similar information many times over several months (February, March, and twice in June), and other editors have removed it ... please review WP:3RR and please do not continue adding this info against talk page consensus and guidelines (WP:MEDMOS and WP:MEDRS). I see also that this has been pointed out to you before: Talk:Schizophrenia/Archive_6#Research. Please discuss your edits and gain consensus before making them. SandyGeorgia (Talk) 03:44, 22 June 2013 (UTC)
I appreciate that many experienced editors have done a lot of good work on this article, and that it is now an FA. And I largely agree with Sandy's comments immediately above. But there are readers/ editors who are looking for more discussion of broader issues in this article. Such issues may include support organizations, the thorny issue of recovery, and debates/uncertainties. In some cases, the issues are discussed in linked sub-articles, but more of this broader discussion needs to be brought into this main article, in order to improve the balance. I'm not sure exactly how this would be best done, given length constraints and the need for quality sources. But offer this suggestion for your consideration. Thank you. Johnfos (talk) 07:07, 23 June 2013 (UTC)
Further discussion on my talk: [18]. Important support orgs and research *are* covered in secondary reviews-- including primary sources breaches WP:UNDUE, WP:MEDMOS and WP:NOT. Many similar articles on Wikipedia contain such text that is mentioned in secondary reviews; please locate and use them. SandyGeorgia (Talk) 13:47, 23 June 2013 (UTC)
Please let me know if the following references make this an acceptable submission for this page under Society & Culture: Support organizations
In 1979, the National Alliance on Mental Illness (NAMI) was established in the United States to organize grassroots efforts to raise awareness about mental illness including schizophrenia, address the stigma associated with mental illnesses, and advocate for access to services, treatment, support, and research for those in need.[10]
Two years later in 1981, the American Schizophrenia Foundation (now the Brain & Behavior Research Foundation) was formed by a small group of friends and family for the purpose of providing support and funding research for people with schizophrenia and other mental illnesses. In 1985, the organization was renamed the National Alliance for Research on Schizophrenia and Depression (NARSAD). Since its first grant in 1987, the organization has awarded NARSAD Grants to fund research in every major area of brain and behavior research for all mental illness, distributing close to $300 million to date to scientists worldwide.[11] In 2011, the organization rebranded itself, becoming the Brain & Behavior Research Foundation.
A number of other support and research organizations have formed in many countries around the world and have helped to increase public awareness of schizophrenia and other mental illnesses. In Canada, May 24th is recognized as National Schizophrenia & Psychosis Awareness Day.[12]Rmlewinson (talk) 02:20, 30 June 2013 (UTC)
The general subject matter strikes me as potentially useful, but I'd like to hear some opinions from other editors about the quality of those sources. Also, there should not be external links within the text (only links to other Wikipedia pages), so those links might be better used as references instead. But I'd like to hear from more editors about this. --Tryptofish (talk) 20:40, 30 June 2013 (UTC)
Agree regarding the concerns about external links. To much detail IMO for the main article. Maybe as a subarticle? We could either create a subarticle called "Society and cultural aspects of schizophrenia" or create an article for this content and link it from a single sentence in this article. The refs could be better. Concerns that some are a little old and others are popular press. Is the National Schizophrenia & Psychosis Awareness Day notable? I have never heard of it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:22, 7 July 2013 (UTC)
Done
Not done: please be more specific about what needs to be changed.--Ankit MaityTalkContribs 11:43, 24 February 2012 (UTC)
Not done for now: Please be more precise what should be change to what. (say: "X to Y") mabdul 21:31, 5 March 2012 (UTC)
Anyway... About images, I see some value in replacing the handwriting sample with a self-portrait. I think what we need to do, though, is to place a higher priority on how the image "captures" the experience of schizophrenia, as opposed to how aesthetically pleasing the image is (and I'm not sure how to accomplish that). About audio files, I have a distant memory that someone created some to imitate auditory hallucinations, as a training tool for physicians. I remember hearing some of it quite a few years ago, and finding it very compelling. After all, schizophrenia is typified more by auditory hallucinations than visual ones. However, I don't know whether the audio I heard is freely licensed, and I don't remember where to find it. It's probably worth doing some search engine searches, so if any of you find something before I get around to it, that would be great. --Tryptofish (talk) 22:59, 24 October 2012 (UTC)
