We know the hallmark symptoms: hallucinations, delusions and hearing 鈥渧oices鈥�. But the causes of schizophrenia are more obscure. Is it mostly linked to inheritance or, as controversially claimed this week, the result of child abuse?
鈥淓nvironmental influence has been underplayed,鈥� says Paul Hammersley of the University of Manchester, UK. He and John Read of the University of Auckland in New Zealand argued in a debate at London鈥檚 Institute of Psychiatry that two-thirds of people with schizophrenia have been physically or sexually abused as children.
After analysing 40 studies of people with schizophrenia, Hammersley and Read suggest that abuse might trigger permanent changes in brain structure or chemistry leading to hallucinatory flashback-like symptoms not unlike those seen in patients with post-traumatic stress disorder. They also argue that much of the evidence linking genes to schizophrenia is flawed.
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Mainstream psychiatrists are not impressed. 鈥淭here are no methodologically robust studies showing that schizophrenia is caused by childhood abuse,鈥� says Robin Murray of the Institute of Psychiatry. 鈥淭he strongest predictor of schizophrenia is a family history of the disorder.鈥�
Peter McGuffin, also at the institute, warns that refocusing on abuse risks a return to the 1960s 鈥渨hen it was fashionable to blame the parents for 鈥榗ausing鈥� schizophrenia鈥�. 鈥淎 hazard is that it demonises the family,鈥� he says.
