14 June 2006

Trauma The Major Cause of Schizophrenia?

by Kate Melville

Two psychiatric conferences in Europe have been told that child abuse can cause schizophrenia. The man behind the contentious theory, University of Manchester researcher Paul Hammersley, described his theory as "an earthquake" that will radically change the psychiatric profession. Working in conjunction with New Zealand clinical psychologist Dr John Read, Hammersley gathered evidence from 40 studies which revealed childhood or adulthood sexual or physical abuse in the history of the majority of psychiatric patients. Additionally, their review of 13 studies of schizophrenics found abuse rates from a low of 51 percent to a high of 97 percent.

"We are not returning to the 1960s and making the mistake of blaming families, but professionals have to realize that child abuse was a reality for large numbers of adult sufferers of psychosis," explained Hammersley. Hammersley and Read argue that two-thirds of people diagnosed as schizophrenic have suffered physical or sexual abuse, which they claim shows it to be a major - if not the major - cause of the illness. With a proven connection between the symptoms of post-traumatic stress disorder and schizophrenia, they say, many schizophrenic symptoms are actually caused by trauma.

They admit not all schizophrenics suffered trauma and not all abused people develop the illness, but they believe the level of actual abuse may be an important difference. In their review of the 33,648 studies conducted into the causes of schizophrenia between 1961 and 2000, they found that less than 1 percent of research budgets was spent on examining the impact of parental care.

The researchers concede that genes may still have a role to play, but other evidence shows that genes alone do not cause the illness. A recent study compared 56 adoptees born to schizophrenic mothers with 96 adoptees whose biological parents did not have the illness. The families were observed extensively when the children were small and all the adoptees were assessed for psychiatric illness in adulthood. It was found that a high genetic risk combined with deficient care during upbringing increased the likelihood of developing schizophrenia. The researchers say this shows that genes alone do not cause the illness.

Hammersley and Read point out that if patients believe their illness is an unchangeable genetic destiny requiring a physical solution, they will readily accept a drug prescribed to them when in fact they require quite different treatment. Worse, say the researchers, those who buy the genetic fairytale are less likely to recover. "I hope we soon see a more balanced and evidence-based approach to schizophrenia and people using mental health services being asked what has happened to them and being given help instead of stigmatizing labels and mood-altering drugs," said Read.

Source: University of Manchester