Talk:Schizophrenia/Archive 5

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Video Talk:Schizophrenia/Archive 5

Lead sentence

All that Greek doesn't seem necessary up front when the etymology of the term isn't scientifically meaningful but does reinforce inaccurate stereotypes. It could be included a bit later together with clarification that it isn't split personality. But the lead does need to include mention of the "negative" emotional symptoms. Pile-Up (talk) 10:00, 17 February 2010 (UTC)

p.s. the first source, on onset, is from 1991 about a study between 1965-84 in one region of one city; must be a more suitable one. Pile-Up (talk) 11:50, 17 February 2010 (UTC)

I was taught that the name's origin makes sense in terms of the disconnection hypothesis of schizophrenia (see Friston, KJ (1998). The Disconnection Hypothesis. Schizophrenia Research) Seasunsky (talk) 03:35, 18 March 2010 (UTC)

Maps Talk:Schizophrenia/Archive 5

Metacognitive training

I suggest again to add a description of the metacognitive training in the psychological and social intervention section. See Treatment of schizophrenia to look at what I wrote there! Especially because of the possible severeness of the illness I think that the treatment section in the main article should inform about every possibility to increase symptom reduction, particularly when a method is investigated well and can be used as an additional treatment with no side effects. Thanks! --Neuschrank (talk) 11:32, 15 March 2010 (UTC)

You should be able to edit this article too, being also part of the stagnant encyclopedia that supposedly anyone can edit. The references in the treatment article don't include links but I've found The metacognitive training for schizophrenia patients: description of method and experiences from clinical practice (2009) and Metacognitive training for patients with schizophrenia (MCT): Feasibility and preliminary evidence for its efficacy (2010). It looks like it's still in the early feasibility/pilot stages, and also very similar to existing CBT approaches, so not sure it merits more than a sourced sentence saying as much?

Incidentally the existing text about CBT needs some amendment where it says "clearly" effective because there continue to be mixed findings, this seems like a good recent open access summary article of CBT approaches that could be added Cognitive Behavior Therapy for People with Schizophrenia (2009) Tweak279 (talk) 14:51, 15 March 2010 (UTC)

I am a bit confused about editing the articles...you mean I am able to edit the treatment article? Yes, that I am, but I cannot edit the main one, so I did this suggestion here...! You seem to be dissatified with the references of the MCT I added on the treatment article? I just forgot to underlie them with links what I can make up soon. If I understand you right, your main concern is that MCT may not be evaluated enough currently to put it in the main article, am I right? Could you please tell me what conditions have to be fullfilled to highlight the meaningfulness of the MCT? And how can I eventually edit the main article to insert a shortened version of the mct-part of the treatment article, if possible? --Neuschrank (talk) 16:39, 16 March 2010 (UTC)

Sorry for not being clear. I thought you would be able to edit this main article by now if you've made 5 edits or whatever it is & joined a while ago? If you still can't edit this article I think the Wikipedia administration needs to undo the protection on this article, or else make a bit more effort to facilitate the editing of articles rather than just protecting them and ignoring talk page comments, as I see you also raised this issue some time ago. I thought your references were fine, I just wanted to post the links to now-published articles. Do you not agree that this approach is only in the early stages and is kind of a variant of CBT? Tweak279 (talk) 20:19, 16 March 2010 (UTC)

Neuschrank has been around long enough to be autoconfirmed, but doesn't have enough edits -- only 8 total so far; 10 are needed. However I have some doubts: a treatment should not be included unless it is described in at least some broad review articles discussing a variety of treatments, not just in articles devoted to the one specific method. Looie496 (talk) 21:45, 16 March 2010 (UTC)

Hello, thanks for your kind and constructive answers!

@ Tweak279: While I agree that MCT is a variant of CBT it is more devoted to cognitive biases (jumping to conclusions) and less to symptoms ("backdoor approach"). Cognitive biases putatively involved in the formation of psychosis are changed which is thought to improve symptoms. With its many cognitive tasks however it has also been viewed by some as "cognitive remediation"

@ Looie496: I agree with you. The method has been positively mentioned in some independent reviews (e.g. Craig Steel (2008). Cognitive Behaviour Therapy for Psychosis: Current Evidence and Future Directions. Behavioural and Cognitive Psychotherapy, 36 , pp 705-712) and there are now 6 studies showing tentative evidence for its feasibility and effectiveness. Still, at this stage it might be wise to shorten the paragraph a bit. Relative to CBT the approach currently consumes too much space. --Neuschrank (talk) 11:23, 17 March 2010 (UTC)

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Source: Elliot Valenstein and Robert Whitaker

"Increased dopamine activity in the mesolimbic pathway of the brain is consistently found in schizophrenic individuals. The mainstay of treatment is antipsychotic medication; this type of drug primarily works by suppressing dopamine activity. "

According to one accredited neuroscientist and a award winning medical journalist this was established by studying the drugs and not the brain with the belief that the drugs worked based on the observed behavior of the individual. They cite studies that show that drugs like PCP that increase dopamine do not resemble the psychosis seen in Schizophrenics and that autopsy studies of Schizophrenic people show inconsistencies in this matter. They both also cite numerous studies from the National Institute Of Mental Health and The American Psychiatric Association itself that decreasing dopamine in the brain creates a "therapeutic parkinsons" and a "chemical straight jacket". 24.236.234.23 (talk) 22:05, 18 March 2010 (UTC)

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0.4 to 0.6?

So one in 200 people is a schizophrenic? Daniel Christensen (talk) 02:26, 17 April 2010 (UTC)

Something like that yeah. Casliber (talk · contribs) 03:37, 17 April 2010 (UTC)

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Symptoms

One of the classes I'm taking at university right now is a seminar all about schizophrenia. After reading what feels like half the literature on the subject, the symptoms of the disorder are no longer classified into positive and negative symptoms, but rather psychosis, negative symptoms and cognitive impairments. This should be updated. Seasunsky (talk) 03:27, 18 March 2010 (UTC)

The word 'psychosis' is the name referring to a state where one is suffering from psychotic symptoms and contains several disorders, one of which is schizophrenia. It is true, however, that the notion of psychotic symptom does overlap alot with positive symptom. We've noted that in the article too. Casliber (talk · contribs) 20:10, 26 March 2010 (UTC)

Research by: B. Whitmer, 30 April 2010 - Here are the symptoms I've uncovered since I started my research on schizophrenia. The two categories of schizophrenia are positive and negative symptoms. Each person with the disorder is diagnosed according to which category their symptoms match. Positive symptoms include delusions, hallucinations, irregular behavior, and paranoia. In contrary to positive symptoms, negative symptoms are quieter to the naked eye. Negative symptoms include social withdrawal, depression, flat mood, and no motivation. The negative symptoms are harder to detect in an individual because they are not as predominant. Although negative symptoms are less dramatic, they are just as crucial to the brain as positive symptoms. According to Snyder, Gur, and Andrews, authors of the book "Me, Myself, and Them", "it's not uncommon for others to misinterpret negative symptoms as signs of coldness, or laziness."

Please see talk page guidelines at WP:TALK, WP:MEDRS and also please sign your entries by entering four tildes (~~~~) after your post. SandyGeorgia (Talk) 02:45, 1 May 2010 (UTC)

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Why?

I felt the need to put this out there for comment.

Research by Mackay, F.(2006) on mice found that stress on mice had the effect of T cell suppression by NPY (signaling hormone).

Unrelated research by the US National Institute of Drug Administration (NIDA), that a stressed (psychological stress) individual has characteristically low levels of dopamine.

Low levels of dopamine may correspond with lower T cell activity if the above mouse study is accurate.

Given that schizophrenia has high levels of dopamine, is it such a large jump to hypothesise that one reason for a schizophrenic state is so that the dopamine and therefore T cell function is elevated/restored?

Is it therefore also reasonable to hypothesise, that a schizophrenic state may serve as a defense that prevents a prolonged stressed state occurring? In doing so, prevents the negative effect due to the stress suppressing the immune system and leaving the organism/individual vulnerable. Pizone (talk) 03:48, 2 April 2010 (UTC)

Please see talk page guidelines at WP:TALK. SandyGeorgia (Talk) 02:45, 1 May 2010 (UTC)

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Additional suggestions

I suggest to add a movie named "Karthik Calling Karthik" under I conic depictions in the article. It is an Indian movie based completely on a guy suffering from schizophrenia. --Preceding unsigned comment added by Gautam1411 (talk o contribs) 02:51, 22 May 2010 (UTC)

I suggest adding the known qualitative tests for schitzophrenia.

Besides psychiatric diagnosing methods. There are also qualitative tests for schitzophrenia which are useful in uncertain cases.

• Most of the schitzophrenics can see through certain optical illusionslike "the hollow-mask illusion".[1]

• A blood test for schitzophrenia will be available soon.[2]

These tests only apply only for schizophrenia. It is naturally possible to have psychotic symptoms because of other illnesses, drugs or other conditions in environment.

Retroviral cause: Someone needs to read the latest DISCOVER magazine, June 2010. The article on page 58 called The Insanity Virus is about the theory that schizophrenia is caused by a retrovirus that for the most part remains dormant in all of us except those who exhibit signs of the said disease. Could a good wikipedia editor review this article and add the information here? May 9, 2010 --Preceding unsigned comment added by 142.217.214.194 (talk) 13:16, 10 May 2010 (UTC)

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Edit request from Freevers, 21 April 2010

{{editsemiprotected}} put a wiki link to the word Soteria http://en.wikipedia.org/wiki/Soteria

Freevers (talk) 11:09, 21 April 2010 (UTC)

It's already there. ~ Amory (u o t o c) 15:40, 21 April 2010 (UTC)

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Cannabis and schizophrenia information needs update/revision

There has never, ever been a causal link established between cannabis and schizophrenia. Yes, the article does mention this, but then it goes on to offer information only from one side of the debate. If you follow the money on any report that's claimed a link between cannabis and schizophrenia, you'll find they've been sponsored by governments, pharmaceutical corporations and other parties with obvious conflicts-of-interest when it comes to research in cannabis.

When someone truly impartial who doesn't have a buck to make off the prohibition of cannabis does a study, say, Keele University or The Charité, you see much different results. Can someone with an account please include information from the following sources in this article? Also, if possible, any mention of cannabis being in any way responsible for schizophrenia should be removed, or at least included with mention of its criticisms and opposing findings, considering how easy it is to prove the falsehood and duplicity within those "reports".

http://www.ukcia.org/research/keele_study/Assessing-the-impact-of-cannabis-use-on-trend-in-diagnosed-schizophrenia.pdf

https://www.thieme-connect.com/ejournals/abstract/pharmaco/doi/10.1055/s-2005-918628

http://www.erowid.org/plants/cannabis/cannabis_health3.shtml

In the interests of keeping the truth available... 69.196.147.119 (talk) 07:46, 14 May 2010 (UTC) Anandamism

I agree wholeheartedly. There are two HUGE red flags in the abstract cited for the causal relationship between marijuana and psychotic episodes:

1) The first line of the Findings: There was an increased risk of any psychotic outcome in individuals who had ever used cannabis.

That the authors themselves found little evidence of a causal link. Where causal link can't be established, 'risk' can not be assigned. An objective paper would have used the term 'rate'.

2) The Interpretation: we conclude that there is now sufficient evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life.

Although the scientific community is quickly losing sight of this important aspect of its responsibility, it is not the job of objective researchers to recommend actions be taken based on their data. It betrays bias towards a desired outcome and panders to ideologies.

As there is far more data contradicting the claim of these supposed scientists, its use here is relegated to unnecessary. At least until they can bring forth some data showing a definitive causal link.
--K10wnsta (talk) 00:15, 18 June 2010 (UTC)

I reverted your removal, for a couple of reasons. First reason was that the deleted text was compliant with WP:NPOV as it pointed out with another reference that increased rates of cannabis use in several countries was not associated with increased rates of schizophrenia, thus the reader has a balance of two viewpoints. The second reason that I reverted was because wikipedia is not about WP:TRUTH and the recent meta-analysis was compliant with WP:MEDRS.--Literaturegeek | T@1k? 00:43, 18 June 2010 (UTC)

As an aside, one thing I've noticed about the studies that are in favor the causality hypothesis (and I've read several of them) is that the vast majority of them have either Drs. Robin Murray and/or Jim van Os somewhere in the list of authors (though often not the first authors). Anyone else ever notice that? Hmmmmm.Ajax151 (talk) 22:17, 5 July 2010 (UTC)

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Hormone vs. Neurotransmitter

Neurotransmitters including dopamine, serotonin, and glutamate are incorrectly called hormones throughout this article. I don't have the time to correct these mistakes, but I thought I would bring it to the attention of the wikipedia community. --Preceding unsigned comment added by 128.97.1.230 (talk) 22:50, 19 May 2010 (UTC)

Actually I have found different opinions on this subject. Here is the one:

Yes, dopamine is a hormone which, by definition, is released by endocrine cells directly into the bloodstream, to have an effect elsewhere in the body. Dopamine is release by the hypothalamus to inhibit the release of prolactin in the anterior lobe of the pituitary gland. It is also released by the adrenal medulla to constrict blood vessels as part of the 'fight or flight' reaction. Dr Sarah Brewer, author of The Human Body (Quercus).

Main article on dopamine also calls it hormone. But if you decide to change word "hormone" with "neurotransmitter" that if fine with me, I think both are right. :-) Innab (talk) 05:11, 20 May 2010 (UTC)

Dopamine is both a neurotransmitter (in the brain) and a hormone (in other parts of the body). Its role in schizophrenia is related to its action as a neurotransmitter, though, so that is the term that should be used. The same holds for serotonin. Glutamate, to my knowledge, has no hormonal role, since it is a simple amino that is present in high concentrations throughout the body as part of the metabolic system. Looie496 (talk) 00:16, 25 May 2010 (UTC)

Ok. I replaced the word "hormone" with "neurotransmitter". Innab (talk) 01:04, 2 June 2010 (UTC)

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The "Induced Thoughts" Section of the Article

None of the references in this section actually give any information about schizophrenia. So, whoever wrote the section basically made it up as they went along - and the main idea of the section ( that schizophrenia can develop in individuals who "think about feeling euphoria to induce euphoria" ) is completely unfounded. I suggest cleaning up this section, or maybe even just delete it entirely. It is misinformation. Articles on psychological disorders should only consist of general information about the disorder, and technical information -- this is so people don't try to diagnosis themselves, especially when the information isn't even accurate! --Preceding unsigned comment added by 173.16.137.120 (talk) 08:38, 7 June 2010 (UTC)

I'm going to flag the section. It qualifies as being "original research" (which is against wiki guidelines for this type of article), and none of the information is verifiable. --Preceding unsigned comment added by 173.16.137.120 (talk) 08:43, 7 June 2010 (UTC)

I did not write the section, but I find it quite helpful. I'm taking care of a boy sick with schizophrenia. He totally agrees that repetitive thinking can drive you crazy. He also said the article helped him to realize that he himself repeatedly invokes the pleasant memories of his past love. Before he felt like "thoughts got stuck in his head" or got "implanted in his brain". After reading this article he understands that the pleasant thinking releases dopamine and that makes him feel high, like on drugs, and that why he is doing it. He is more willing to take responsibility for his own thoughts and actions now. Yaroslav K (talk) 17:20, 7 June 2010 (UTC)

Hi Yaroslav! It must be quite a job caring for a boy with schizophrenia. However, Wikipedia is not a self-help guide, and more importantly, the information in Wikipedia should be reliable. I get concerned about this boy, because even if it might be helpful for him in the short run not to invoke the pleasant memories, but do you really know what the effect will be in the long run? So, if the section is badly referenced, it should be tagged or removed. Lova Falk talk 17:46, 7 June 2010 (UTC)

I now removed the entire section. The references of this section are about dopamine and/or drugs, but not a single reliable reference that says that there is a connection between schizophrenia and dwelling on happy memories, or creating happy thoughts. Yes, it is pure misinformation. Lova Falk talk 17:57, 7 June 2010 (UTC)

Lova, there is a great deal of difference between normal thinking of happy memories from time to time and a schizophrenic who sits for days and months looking in a corner of his room, totally deep in his world, even forgetting to eat sometime. It is like a difference between drinking a glass of wine once a month and an alcoholic addict who cannot stop drinking every day, losing his job, money and loved ones. Most of the schizophrenics that I know totally realize that the repetitive thoughts are ruining their life and want to get them under control. You can remove the section, but it could really help many of them. Yaroslav K (talk) 19:50, 7 June 2010 (UTC)

Show me a reliable source that there is a connection between schizophrenia and the patients' control over their own thoughts, schizophrenia, pleasant thoughts, dopamine and addiction (new edit) and I put the section back in. But actually, what you write makes me more convinced that it is good that this section is gone. Schizophrenia is a very serious disorder that requires professional treatment. Letting schizophrenic patients read this section and encourage them to deliberately stop certain thoughts, is at best a goodhearted attempt to help them, and at worst something that can hurt them. Lova Falk talk 11:54, 8 June 2010 (UTC)

Cognitive behavioural therapy has benefitial effects in schizophrenics, but it is administered professionally. Anyhow, I would like to add my voice here to say that I agree that the section should have been deleted. It did look dubious to me as well as too original researchy and this article is already quite large, some say too large.--Literaturegeek | T@1k? 12:05, 8 June 2010 (UTC)

You're quite right, I should have explained myself much better. I have edited a bit above. Lova Falk talk 14:57, 8 June 2010 (UTC)

Dopamine definitely plays role in addiction. Please read the article or google yourself "addiction dopamine" there are about 7 millions results. Dopamine is released (particularly in areas such as the nucleus accumbens and prefrontal cortex) by rewarding experiences such as food, sex, drugs (like Amphetamine), neutral stimuli that become associated with them. Even thinking about reward like sex, drugs, alcohol, food, can increase the dopamine levels. Researches prove it is what placebo effect is all about. If you ever been deeply in love you probably know that thoughts about desired object can make you feel "high", like on drugs. However, over-stimulation of reward system with anything be it drugs, alcohol, or repetitive thinking of the same thought - is addiction and it is not good for brain. Innab (talk) 18:55, 8 June 2010 (UTC)

For me it is all about people with schizophrenia, not about money or self-promotion, so if something is helping them, then IMHO it is worth to research. But I agree that section can be written better to promote professional help with Cognitive behavioral therapy which helps patients to get their intrusive thoughts under control. Innab (talk) 18:55, 8 June 2010 (UTC)

I never contested that dopamine plays a role in addiction, but please, find a source that is acceptable according to WP:MEDRS that connects dopamine, addiction, happy thoughts and schizophrenia (all four of them and not just dopamine and addiction, or dopamine and pleasant thoughts), and I would love to assist in writing a section about it. Also, I understand your motivation is very good, but Wikipedia is an encyclopedia and not a self-help guide, so that restricts what should be included. But I would certainly not object to a section about cognitive behavioural therapy and schizophrenia. Lova Falk talk 19:20, 8 June 2010 (UTC)

(edit conflict) Innab, I don't mean to be disrespectful but I think that you are chasing chemicals around too much. The brain is extremely complex, yes there is persuasive evidence that dopamine is involved in schizophrenia but schizophrenia is not seen as an addictive disorder. What you are trying to do in my view is promote a novel medical hypotheses and this would violate WP:NOR, in particular WP:SYN. Original research is not allowed in articles, especially not an entire section of it in a featured article. I am sceptical but who knows you may be on to something but wikipedia is not about truth; your theory would more suit a blog or a letter to the editor of a medical hypothesis based journal, but not an encyclopedia. We do already have a section in this article with regard to psychological interventions for schizophrenia, including CBT. I understand that your motives are in WP:GOODFAITH and to help people, but you need a recent reliable secondary source which specifically backs up your theory before it could be added to this article.--Literaturegeek | T@1k? 19:23, 8 June 2010 (UTC)

Lova, if there evidences that: "A" is connected to "B", "B" is connected to "C", "C" is connected to "D", then it makes sense to me that "A" is connected to "D". It is reliable secondary sources that thinking about reward release dopamine (see my links above). You already agreed that excessive release of "feel-good" neurotransmitters like dopamine play a role in addiction (i.e. desire to repeat the experience). Current article states: "Increased dopamine activity in the mesolimbic pathway of the brain is consistently found in schizophrenic individuals. The mainstay of treatment is antipsychotic medication; this type of drug primarily works by suppressing dopamine activity". Innab (talk) 21:15, 8 June 2010 (UTC)

Pleasant thinking is perfectly normal, necessary and beneficial when it is not turning into addiction. Depression is what lowering dopamine level and makes people seek ways to bring their dopamine level back to normal. Reasons for depression need to be removed, IMHO. Instead, some people turn into dangerous ways of drugs, alcohol, gambling and excessive repetitive thinking. All this releases "feel-good" neurotransmitters. It is very hard to tell when casual drinking become a "substance abuse", or when "pleasant thinking" become a dopamine addiction. But any of the addictions can eventually ruin these people lives. Innab (talk) 21:15, 8 June 2010 (UTC)

"if there evidences that: "A" is connected to "B", "B" is connected to "C", "C" is connected to "D", then it makes sense to me that "A" is connected to "D"."

Innab, the above quote from your post is a classic example of synthesis and is not allowed in wikipedia articles. Did you read the WP:SYN, link that I gave you? No reliable source that I have seen says schizophrenia is due to "addictive" repetative thinking. Repetative thinking is more likely to be classed as an obessive disorder, anyway. Schizophrenia is not addiction, it is a chronic psychosis.--Literaturegeek | T@1k? 23:21, 8 June 2010 (UTC)

Unfortunately, doctors does not make any money telling patients they can be in charge of their own thoughts. My own experience has been that docs would rather medicate than look for the cause. Nobody wants to treat schizophrenics as normal human beans with addictions, and this idea will not find support. Yaroslav K (talk) 01:44, 9 June 2010 (UTC)

The article discusses ruling out medical causes eg adverse drug reactions, medical disorders/diseases etc, substance induced causes (acute intoxication or withdrawal related) etc before a diagnosis can be made. As the theory that schizophrenics are "addicted to their own thought patterns" will not likely ever receive support in academic literature then it cannot be added to this article.--Literaturegeek | T@1k? 17:57, 9 June 2010 (UTC)

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Increased dopamine 'consistently found' alteration

I've just altered a sentence in the introductory paragraph which said "Increased dopamine activity in the mesolimbic pathway of the brain is consistently found in schizophrenic individuals". This is not the case, as increased dopamine activity is only inconsistently found in people with schizophrenia, although, on average it is more commonly present (see the recent review by Howes and Kapur). This claim doesn't appear in the main text. Hence I've altered it to "Increased dopamine activity in the mesolimbic pathway of the brain is commonly found in people with schizophrenia". - Vaughan (talk) 22:06, 1 July 2010 (UTC)

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schizophrenia not to be confused with ...

I have removed the previous content of this section. Wikipedia talk pages are intended to be used for discussions related to improving the article, and any changes to an article must be based on reputable published sources. Other information, even if true, is not usable unless there are published sources to back it up. If we let this page turn into an argument about whether mind control really exists based on personal experiences, it will turn into total chaos and won't lead to any improvements in the article. Looie496 (talk) 18:51, 7 July 2010 (UTC)

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Refrences please

This article is well written and all but it seems to be majorly lacking in sources and cross refrencing in many sections.Please someone fix it. --Preceding unsigned comment added by Wikimakesmart (talk o contribs) 21:01, 26 August 2010 (UTC)

This is a featured article, with hundreds of sources listed. Can you be more specific about where you see a problem? Looie496 (talk) 16:25, 27 August 2010 (UTC)

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Crespi on autism/schizophrenia link

Please see the discussion at Talk:Autism#Crespi on autism/shizophrenia link for the new text added here and at autism. Also, this article still needs a review for overreliance on primary sources. SandyGeorgia (Talk) 14:57, 1 September 2010 (UTC)

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Biographies of People With Schizophrenia

• Nasar, Sylvia (2001). A Beautiful Mind: The Life of Mathematical Genius and Nobel Laureate John Nash. New York: Touchstone. ISBN 0-743-22457-4. 
• Jiang, William (2010). A Schizophrenic Will: A Story of Madness, A Story of Hope. New York: Createspace. ISBN 1-451-501224-4 . 
• Neugenboren, Robert (2003). Imagining Robert:My Brother, Madness, and Survival, a Memoir. New Jersey: Rutgers University Press. ISBN 0-813-53296-5. 
• Saks, Elyn (2008). The Center Cannot Hold. New York: Hyperion. ISBN 1-401-30944-5. 
• Steele, Ken (2001). The Day the Voices Stopped. New York: Basic Books. ISBN 0-465-08226-2. 
• Schiller, Lori (1996). The Quiet Room: A Journey out of the Torment of Madness. New York: Grand Central Publishing. ISBN 0-446-67133-9. 

Kd3qc (talk) 20:38, 2 September 2010 (UTC)

Um, it isn't clear what you are asking. Insert a whole new section?

By the way, if you reply here, you will then have logged 10 edits, making you eligible to edit the article yourself. ~Amatuli? (talk) 20:49, 2 September 2010 (UTC)

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semiprotection (again)

I think the pending changes trial was unsuccessful in this case - the trickle of unsuitable info increased. Anyway, I've swtiched it back to semiprot to give us a breather in pruning...Casliber (talk · contribs) 02:45, 2 September 2010 (UTC)

I agree, good move.--Literaturegeek | T@1k? 12:39, 8 September 2010 (UTC)

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Cite journal replaced with vcite journal

This article has too many primary sources, resulting in slow load time and difficult editing; I've replaced cite journal with {{vcite journal}}.[3]

With cite

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SandyGeorgia (Talk) 03:37, 10 September 2010 (UTC)

This source is incorrectly formatted (and why is it used here at all, anyway)?

• Department of Public Health, GUIDELINES FOR THE USE OF ATYPICAL ANTIPSYCHOTICS IN ADULTS

SandyGeorgia (Talk) 04:30, 10 September 2010 (UTC)

Segment removed now. Contradicted by other more recent material anyway. Casliber (talk · contribs) 05:21, 10 September 2010 (UTC)

No laboratory test for schizophrenia exists. ref name "DSM-IV-TR"

re this edit ...every mental health condition has no laboratory test - why the mention of this in the introduction? the addition implies the POV that schizophrenia is a biological disease... Earlypsychosis (talk) 09:19, 14 September 2010 (UTC)

See I'd take it to mean the opposite (i.e. de-biologise it) by stating there was no lab test. I hadn't thought about other conditions, but is worth mentioning on several other pages I'd suspect. Casliber (talk · contribs) 10:14, 14 September 2010 (UTC)

VeriPsych(TM) in the first paragraph?

Smacks a bit of advertisement to me. Is Biomarker Insights a reputable journal or mainly an industry-sponsored one? Looking at the paper here, it seems to be more of the latter. I see they don't sell the test to anyone else, only perform it in their lab, so they don't need (or avoid) FDA approval for the test itself that way. [4] Tijfo098 (talk) 11:59, 12 October 2010 (UTC)

Agree completely and removed. We need to base this on review articles. Doc James (talk · contribs · email) 12:46, 12 October 2010 (UTC)

Ok, thanks. By the way, the publisher of that journal only has a so-so reputation [5] Tijfo098 (talk) 12:56, 12 October 2010 (UTC)

Rename this article

I would like to propose that this article is renamed 'Dysfunctional Perception Syndrome' with a redirect from 'Schizophrenia' to it. 'Schizophrenia' has always been a meaningless bucket-term and a junk diagnosis only favoured by lazy psychiatrists.. The condition has nothing whatever to do with a split-brain so the derivation of the word has always been wrong. The Japanese have already renamed this condition. There are many health professionals and mental survivor's groups who agree that the condition is mis-named. See http://www.intervoiceonline.org/2010/2/7/renaming-schizophrenia for one example. You can find many more. I will so tag the article and the debate may be held.

SmokeyTheCat 12:45, 24 September 2010 (UTC)

I cannot find the relevant tag. Because I am not an administrator? Perhaps some other editor could tag this article as I have proposed please? Thanks in advance.

SmokeyTheCat 12:53, 24 September 2010 (UTC)

Please don't tag it, the chances of this happening are zero. Until DSM changes the name there is really nothing to talk about. I personally wouldn't have any objection to a redirect of Dysfunctional Perception Syndrome to this article, though. Looie496 (talk) 16:40, 24 September 2010 (UTC)

Agree with Looie, but would like to point Smokey to this page, WP:COMMONNAME. An article topic is not renamed based on an editor's reasoning of what is the best name but rather on what it is commonly known as, so like Looie said there is no chance of the name of this article being renamed to what you propose even if you convinced everyone here that your novel choice of a name is the best one.--Literaturegeek | T@1k? 16:06, 2 October 2010 (UTC)

Umm...yeah The others put it well. The name is inaccurate as there is alot more going on besides auditory hallucinations and delusions of reference. The name steers away from the frontal lobe/issues with planning and complex task performing. But in a way that is beside the point. Main issue is common name, which is schizophrenia. Casliber (talk · contribs) 17:06, 3 October 2010 (UTC)

Okay, I am clearly in a minority of one here so will not tag the page, even if I could. The arguments above are sound enough. For the record tho, this wasn't some manic personal idea of mine. I heard a discussion of renaming this condition by reputable psychiatrists on the BBC's Radio Four. It seems inevitable that the condition will be renamed as the more progressive psychiatrists become more senior in the profession as it's really in no-one's interest to have this condition misnamed as it presently is. Wiki and I can wait until then. SmokeyTheCat 14:08, 13 October 2010 (UTC)

You may want to join the discussion page (http://en.wikipedia.org/wiki/Talk:Social_construction_of_schizophrenia) for Social construction of schizophrenia for more on that debate , or indeed to improve and edit the current article , currently rated as C class by someone from the wikidisability project. (Darwinerasmus (talk) 22:56, 20 October 2010 (UTC))

Small Spelling Error

Under the Section "Economic Burden" unemployment is spelled "unenployment'

Fixed -- thanks for pointing it out. Looie496 (talk) 03:07, 18 October 2010 (UTC)

Schizophrenics sensitive to gluten and dairy.

http://www.celiac.com/articles/22317/1/Hippies-Werent-the-Only-Ones-Tripping-in-the-Sixties/Page1.html --Preceding unsigned comment added by 96.224.74.146 (talk) 04:13, 18 October 2010 (UTC)

Need a review article. Doc James (talk · contribs · email) 23:22, 20 October 2010 (UTC)

Cannabis

Newer review from the authors of the 2007 Lancet article: http://bjp.rcpsych.org/cgi/content/full/193/5/357 (2008); this one is about outcomes. Robin Murray seems to think the danger of causing psychosis is greater (see his bio); I'm not sure if that's wroth mentioning here though. Also a 2010 meta-analysis http://schizophreniabulletin.oxfordjournals.org/content/36/6/1115.abstract finds that 1/4 of the schizophrenia patients could be diagnosed with CUD (cannabis use disorder). Also a 2010 10-year longitudinal study http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/987 (not a review though) found that cannabis worsens the outcomes. That seems to agree with a 2009 study on long-term outcomes of discontinuing cannabis after a first episode http://schizophreniabulletin.oxfordjournals.org/content/early/2009/11/13/schbul.sbp126.full Tijfo098 (talk) 10:57, 25 October 2010 (UTC)

Article issues

I think that this is a little shaky in the FA department. Here are some concerns I found:

• First paragraph of "signs and symptoms" is entirely unsourced.
• "Research suggests" weasel-wording in "positive and negative symptoms" section.
• [Citation needed] under Diagnosis header.
• "In a recent study" under Substance Abuse header -- how recent? Don't use recent.
• Medication header has a couple one sentence paragraphs and another unqualified "recent."
• Second paragraph of "iconic cultural depictions" is unsourced.
• Many references are lacking page numbers and/or have broken DOIs.

Ten Pound Hammer, his otters and a clue-bat o ^{(Otters want attention)} 22:42, 6 November 2010 (UTC)

Thanks for mentioning this. I'll take a look. -- WeijiBaikeBianji (talk, how I edit) 00:41, 7 November 2010 (UTC)

Good points...and should be straighforward to fix. Casliber (talk · contribs) 02:30, 8 November 2010 (UTC)

Encephalitis lethargica

Regarding this edit: The NEJM review of that book specifically questioned that assertion: "How can he be so certain that persons with Kraepelin's schizophrenia in fact suffered from encephalitis lethargica and that therefore today the outcome of the disease is seen in an unnecessarily gloomy light?". You may want to read the rest: Van Gijn, J. (2002). "Book Review Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill by Robert Whitaker. 334 pp. New York, Perseus, 2002. $27. 0-7382-0385-8". New England Journal of Medicine. 346 (26): 2096. doi:10.1056/NEJM200206273462620. . Tijfo098 (talk) 02:16, 8 November 2010 (UTC)

Susan has also pointed out that the same (or similar) information is covered here which is a good start. Now what would be better is the same information from the PMID article was covered elsewhere in one or more Review Articles - the sheer enormity of material published on schizophrenia means we have to limit the page to material which has gained broad acceptance. Casliber (talk · contribs) 02:23, 8 November 2010 (UTC)

PS: It does get cited in 19 articles, with some interesting places to look. Casliber (talk · contribs) 02:26, 8 November 2010 (UTC)

Yes, certainly I agree about the need to limit this page. I thought it was interesting enough to try out (Google gives at least 12,000 hits for "encephalitis lethargica schizophrenia" and over a million if you drop the "lethargica"). Regarding the review and comments from Tijfo098, I have about four days to go on a DYK. Thank you. -SusanLesch (talk) 02:30, 8 November 2010 (UTC)

To Casliber: hopefully in a better known journal (need not be a psychiatric one) than J Hist Behav Sci., which seems rather obscure [6]; impact factor not much better than Psychological Reports. [7] Tijfo098 (talk) 02:56, 8 November 2010 (UTC)

I've looked at some of the articles citing Boyle. Insofar I did not ones in mainstream sources, but there's no shortage of articles like Simon, L. (2006). "Abnormal Psychology Textbooks: Valid Science or Political Propaganda". Ethical Human Psychology and Psychiatry. 8: 101. doi:10.1891/ehpp.8.2.101.  which cite him. Not very reassuring. Tijfo098 (talk) 03:21, 8 November 2010 (UTC)

I wouldn't expect you to be reassured. M Boyle is Mary Boyle, author of "Schizophrenia: A Scientific Delusion?". -SusanLesch (talk) 03:26, 8 November 2010 (UTC)

She seems entirely committed to the notion that schizophrenia is nothing but a social construction: "Just as ideological biological psychiatrists reduce all explanations to neurochemistry, Boyle seems unwilling to entertain anything other than a social explanation for madness." Hardly a reliable source for examining the historical record. Tijfo098 (talk) 03:36, 8 November 2010 (UTC)

I'm happy to see you've upgraded her to a female this time. But I don't like your source mentalhelp.net ("Ask a Psychiatrist" we have "12 online" right now). Pardon me if I return to my project. -SusanLesch (talk) 04:15, 8 November 2010 (UTC)

+----------------------------------------------------------------------------------------------------+ Metapsychology online reviews is a reasonably good source of book reviews in my experience. There's probably a review in PsycCRITIQUES as well, but I did not check. And MOR is free to access, so they have Google ads. I normally have them blocked, so I don't normally see what you say they advertise, and on a spot check, I don't get the one you say you see, but you can probably get one like that on occasion. Google probably doesn't think I need a psychiatrist. :-D Tijfo098 (talk) 04:24, 8 November 2010 (UTC)

Oh dear. My fault entirely for not noticing that that was an ad. Sorry. -SusanLesch (talk) 05:45, 8 November 2010 (UTC)

There are more reviews on Talk:Mary Boyle. One even said "But we like to remind that biology is not a right-wing plot." Tijfo098 (talk) 06:02, 8 November 2010 (UTC)

Side note

E. Fuller Torrey's hypothesis on Toxoplasma gondii is not mentioned in this article either, and there's a good reason for that too: it's not mainstream. Ironically, Boyle and Torrey are at opposite ideological poles on mental illness causes, and particularly treatment. Tijfo098 (talk) 04:08, 8 November 2010 (UTC)

By the way

Searching for citations of Boyle's book, I found this 2010 BJP paper of some relevance here: Craddock, N.; Owen, M. J. (2010). "The Kraepelinian dichotomy - going, going... But still not gone". The British Journal of Psychiatry. 196: 92-95. doi:10.1192/bjp.bp.109.073429. PMC 2815936 . PMID 20118450. . Boyle was cited in one of the five letters to the editor this paper triggered: [8]. Tijfo098 (talk) 06:12, 8 November 2010 (UTC)

Other research

Zuardi et al., 2006, Cannabidiol, a Cannabis sativa constituent, as an antipsychotic drug, Brazilian Journal of Medical and Biological Research (2006) 39: 421-429 http://www.scielo.br/pdf/bjmbr/v39n4/6164.pdf

A snip from the abstract says it all but the paper is worth a read. "In addition, open case reports of schizophrenic patients treated with CBD and a preliminary report of a controlled clinical trial comparing CBD with an atypical antipsychotic drug have confirmed that this cannabinoid can be a safe and well-tolerated alternative treatment for schizophrenia."

I am unaware of the psychiatric research into the levels of THC versus CBD in street cannabis. It is noteworthy that the drug does induce something that looks psychosis-like, i.e. it scores on PANSS and other scales of psychosis as looking like psychosis in lab conditions however if users are sat in front of a TV watching Cheech and Chong it is clearly a pleasant experience whereas pathological psychosis for many is an intensely distressing experience.

Cannabis in one of many entheogen and can be used for purposes other than recreational highs. There are non-pathological interpretations of psychosis and schizophrenia advocated by organisations such as Intervoice and the Hearing Voices Network which seek to apply meaning to the experiences pathologised by psychiatry as schizophrenia. Rufus May is an advocate of an approach to deal with voice hearing, delusions and hallucinations as real

Morethanhuman (talk) 10:42, 5 December 2010 (UTC)

Concerning this article, that paper would count as a primary source per WP:MEDRS and therefore not really suitable. In any case the paper is clearly not favorable to giving cannabis itself to people with schizophrenia, which would be a remarkably bad idea. Looie496 (talk) 18:07, 5 December 2010 (UTC)

Contradiction about lifetime prevalence

There is a contradiction in the article about the lifetime prevalence: in the introduction it is given as "a global lifetime prevalence of around 1.5%", in the section Epidemiology it is given as "The lifetime prevalence of schizophreni [...] is commonly given at 1%. However, a 2002 systematic review of many studies found a lifetime prevalence of 0.55%." 87.212.160.173 (talk) 14:59, 8 December 2010 (UTC)

probably time to update with another more recent review and also time to challenge the myth that incidence is fixed McGrath, J.; Saha, S.; Chant, D.; Welham, J. (2008). "Schizophrenia: a concise overview of incidence, prevalence, and mortality". Epedemiol. Review. 30: 67-76. doi:10.1093/epirev/mxn001. PMID 18480098. . Earlypsychosis (talk) 20:37, 8 December 2010 (UTC)

Heh -- that came out citing an article with title Magnus Bareleg's Journey to the West. I fixed the cite pmid template. Looie496 (talk) 22:53, 8 December 2010 (UTC)

Journalism about schizophrenia

Perhaps that topic deserves a few sentences by itself: [9] [10] Tijfo098 (talk) 07:09, 8 November 2010 (UTC)

Also, I see we cover [11], but not the other two papers from the fabled press release (all in the same issue of Nature), so we're doing slightly worse journalism. ;-) The best write-up seems this one (but, hey it came a day later, so it doesn't count.) Tijfo098 (talk) 07:29, 8 November 2010 (UTC)

Edit regarding poor use of words

The sentence under 'Postive and Negative Symptoms': "Negative symptoms are things that are not present in schizophrenic persons but are normally found in healthy persons, that is, symptoms that reflect the loss or absence of normal traits or abilities." can be written better to avoid use of "things" . I would suggest "Negative symptoms are a result of traits or abilities that are not present in schizophrenic persons, but are normally found in healthy persons." 76.175.239.170 (talk) 21:35, 28 November 2010 (UTC)

I take your point, but the article needs to say what negative symptoms are, not what they are the result of. Looie496 (talk) 17:47, 29 November 2010 (UTC)

I have to somewhat agree on the comments of the unnamed poster. I might only be in the process of getting my Masters in Psychology, and thus not a true 'expert', but the section on 'Positive and Negative Symptoms' just seems off. The way negative symptoms are portrayed (i.e. only called that because they are difficult to treat, as opposed to positive symptoms, which according to the article are easier and more responsive to treatment and thus called 'positive') is inaccurate - it has more to do with the LACK of symptoms that are usually expected, such as an inexpressive face. I would like to have a discussion on this section, and a forum of ideas and sources, otherwise I feel this section needs to be reviewed by someone higher in the science/medical field. People use Wiki as an important source of information, and if we are giving them something inaccurate, we need to discuss ways to fix it, because mis-information is worse than no information at all. Thank you! Barbiegurl676 (talk) 10:13, 21 December 2010 (UTC)

A spelling bug

It's in "These symptoms gererally respond well to medication." Replace "gererally" with "generally". Good article, by the way. Alexander.gotmanov (talk) 11:42, 20 December 2010 (UTC)

Iconic cultural depictions

Add reference to the movie Clean Shaven http://en.wikipedia.org/wiki/Clean,_Shaven which tries to objectively view schizophrenia and those who are affected by it. Linuxsims (talk) 14:41, 22 December 2010 (UTC)

Neuroanatomical and neurophysiological pathologies

Schizophrenia is a neurological disorder and after reading the very meager section on the neuroanatomical and neurophysiological pathologies I have a few papers to suggest for expanding this section and for making it much more inclusive of the data. The following are PMIDs:

• 11343862 A review of MRI findings in schizophrenia.
• 20954428 Structural neuroimaging in schizophrenia: from methods to insights to treatments.
• 20237131 Diffusion tensor tractography findings in schizophrenia across the adult lifespan.

Until this section is vastly improved I really don't see how it can continue to be an FA. It's just missing lots of very important information. Basket of Puppies 00:21, 24 December 2010 (UTC)

The first two are reviews; the third is a comparative study (primary source). SandyGeorgia (Talk) 16:40, 26 December 2010 (UTC)

That's a very biological viewpoint. Thankyou for restricting the results to review articles- ultimately, these have very little impact on how the condition is treated and managed. Yes some aspect of neuroimaging should be included. I'll have a read though. Casliber (talk · contribs) 02:10, 24 December 2010 (UTC)

Can you please explain what you mean by a very biological viewpoint? I ask as I am confused as to what else schizophrenia might be. It's a brain disease that effects every aspect of a person's life. The review articles are valid secondary sources, especially Shenton's MRI review article, which is the authoritative paper as to MRI findings of the schizophrenic brain. Still, I cannot see how this article can continue to be a Featured Article when it is lacking in extremely basic information as to the underlying pathologies. Basket of Puppies 03:45, 24 December 2010 (UTC)

It means that we have what we call very clear-cut neurological disorders such as epilepsy, parkinsons' disease, multiple sclerosis etc. Then we have several psychotic disorders such as schizophrenia, bipolar disorder and some forms of depression, where the hard evidence is not so clear cut. There is a huge range on how people view these latter disorders, from very biological psychiatrists - who focus on investigations, genetics, subtypes etc. all the way through to the other extreme of folks in the antipsychiatry and similar who see them as sociological constructs. Consensus I'd take an educated guess (working in the field) as lying about a third the way along from the former to the latter. There are other odd discrepancies, such as the fact that the concordance is somewhere between 40 and 50% for monozygotic twins (biologically focussed investigators tout this as firm evidence for the biological nature of the illness...but in which case why is this not much higher?) and several others.

Anyway, I digress a little - in medicine we generally reserve the term "neurological" for the more medical bunch of conditions I outlined initially - the second bunch are still generally called "psychiatric", "functional" (older term now) etc. There is a nuance here in common parlance that veers from what one would concretely expect. I will read the Reviews sometime soon as I am juggling a bit. Getting fulltext should be pretty straightforward. Casliber (talk · contribs) 03:59, 24 December 2010 (UTC)

I have in front of me (PDF form) "Adams and Victors Principles of Neurology 8th Ed" which lists schizophrenia and goes into depth of the CT and MRI findings and labels it a genetic problem in at least 80% of the cases. Thus I am very confused how you can declare schizophrenia not to be neurological. Basket of Puppies 04:11, 24 December 2010 (UTC)

As I said, it is in the nuance. Of course it is neurological, but there are some funny ways that doctors use words....anyway, I am actually busy wrapping presents ATM - BoP, I don't own this article, you are more than welcome to summarise and add the three review articles. I am up to my armpits in wrapping paper and have a few other priorities on-wiki as well. If you can't get fulltext let me know and I will try to ferret some. Casliber (talk · contribs) 13:19, 24 December 2010 (UTC)

You very much act like you own this article. Basket of Puppies 18:24, 24 December 2010 (UTC)

(undent) Classically, "neurological" disorders pertains to disorders that can be linked to pathologies of specific regions of the nervous system. For example, Gerstmann syndrome is considered a neurological disorder because it can be linked with pathologies in left parietal cortex, as is dyscalculia. Conversely, disorders that are due to widespread differences in neurotransmitters or brain communication are considered "psychiatric" or "mental", and generally linked to disorders of overall thought or emotion (depression, OCD, schizophrenia, etc). This is the point that Casliber has been arguing (correctly in my opinion). The problem here is that mental disorder, which the psychiatric disorder page redirects to, seems to carry the implication that it's just "all in your head", while it is indeed clear that there is a genetic and biological basis for schizophrenia, as Basket of Puppies rightly argues. So, "neurological" doesn't apply in this case, since sz is not linked to just one brain region, but "mental" alone also feels inappropriate. Simply insisting on adding neurological also doesn't address the deeper issues, but neither does leaving "mental" alone. Perhaps "neuropsychiatric" in parallel with neuropsychiatry would be more appropriate than purely "neurological" or "mental." Edhubbard (talk) 21:37, 24 December 2010 (UTC)

neuropsychiatry has its own connotation too, which I'll dig up. Big problem is, wikipedia has to reflect current usage, even if idiosyncratic :/ Casliber (talk · contribs) 22:16, 24 December 2010 (UTC)

For instance, the WHO distinguishes neurological and mental health disorders, reserving the former for epilepsy and MS, and discussing schizophrenia separately. Casliber (talk · contribs) 00:28, 25 December 2010 (UTC)

I never suggested even for a minute that mental disorders be removed from the lead of this article but rather have twice tried to add neurological disorders. Each time this has been reverted with an edit summary of "see talk". I am here seeing talk but I do not see the rationale for removing neurological. I am only suggesting that each point be presented. So why constantly remove valid, sourced information? You say you do not WP:OWN the article but it sure seems like you do. Basket of Puppies 22:50, 25 December 2010 (UTC)

BoP - (1) I didn't revert you the second time. (2) find me a summary where it is called a neurological disorder. (3) I hope your intentions are to improve the article rather than just the lead. Casliber (talk · contribs) 00:31, 26 December 2010 (UTC)

Casliber, 1)I know, your tag-team buddy did, 2) I cited it above in the neurology textbook, 3) I hope you've read the FAR. Basket of Puppies 15:43, 26 December 2010 (UTC)

Basket of Puppies, please inform yourself of WP:MEDRS and the use of secondary reviews in medical articles, WP:OWN#Featured articles, and avoid personalizing issues. The article needs work, but not of the kind you are proposing, and accusations of ownership are unhelpful. SandyGeorgia (Talk) 16:39, 26 December 2010 (UTC)

I am very well informed of WP:MEDRS, I am fully aware of WP:OWN, which is why I opened this talkpage and FAR discussion before making any changed and I never personalize the issues. The article is in desperate need of work as it is literally 10 years behind the literature and my accusations of ownership are accurate. Basket of Puppies 16:56, 26 December 2010 (UTC)

I have nominated Schizophrenia for a featured article review here. Please join the discussion on whether this article meets featured article criteria. Articles are typically reviewed for two weeks. If substantial concerns are not addressed during the review period, the article will be moved to the Featured Article Removal Candidates list for a further period, where editors may declare "Keep" or "Delist" the article's featured status. The instructions for the review process are here. Basket of Puppies 23:35, 25 December 2010 (UTC)

Reviews

A few reviews as it is time to get down to work:

• van Os J, Kapur S (2009). "Schizophrenia". Lancet. 374 (9690): 635-45. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006. 
• Schultz SH, North SW, Shields CG (2007). "Schizophrenia: a review". Am Fam Physician. 75 (12): 1821-9. PMID 17619525.  CS1 maint: Multiple names: authors list (link)
• Rigby P, Alexander J (2008). "Understanding schizophrenia". Nurs Stand. 22 (28): 49-56; quiz 58, 60. PMID 18429458. 
• Picchioni MM, Murray RM (2007). "Schizophrenia". BMJ. 335 (7610): 91-5. doi:10.1136/bmj.39227.616447.BE. PMC 1914490 . PMID 17626963. 
• Kane JM, Correll CU (2010). "Pharmacologic treatment of schizophrenia". Dialogues Clin Neurosci. 12 (3): 345-57. PMID 20954430. 
• Lybrand J, Caroff S (2009). "Management of schizophrenia with substance use disorders". Psychiatr. Clin. North Am. 32 (4): 821-33. doi:10.1016/j.psc.2009.09.002. PMID 19944886. 

Doc James (talk · contribs · email) 16:59, 26 December 2010 (UTC)

Citation style

BoP, please do not alter the established citation style on this article, per WP:CITE. [12] This (and most medical articles) follows the Diberri template filler style, with vcite, and FAs must have a consistent citation style. You can find the Diberri template filler on my user page, you plug in the PMID and it returns a cite journal, and then replace that with vcite. Please gain consensus for your changes on talk; besides the change in citation style, I do not see consensus for your other changes above, so I have reverted. Productive work is underway; please discuss your edits on talk and follow consensus. SandyGeorgia (Talk) 02:51, 27 December 2010 (UTC)

WP:BOLD means nothing here? I have to ask before I edit? Really? Basket of Puppies 02:54, 27 December 2010 (UTC)

You have been warned: [13]. WP:OWN#Featured articles is clear; you are editing against consensus. SandyGeorgia (Talk) 02:59, 27 December 2010 (UTC)

This is against guideline, and will not get through FAR. SandyGeorgia (Talk) 03:34, 27 December 2010 (UTC)

Changes to text do not match the ref

The ref says "The diagnosis of schizophrenia is associated with demonstrable alterations in brain structure and changes in dopamine neurotransmission, the latter being directly related to hallucinations and delusions." Lancet09. This edit [14] changed it to "Those with a diagnosis of schizophrenia have both changes in brain structure and brain chemistry." from "Those with a diagnosis of schizophrenia have both changes in brain structure and neurotransmission of dopamine." and I am unable to find where the ref following it supports this wording.Doc James (talk · contribs · email) 03:00, 27 December 2010 (UTC)

Perhaps BoP would like to take an opportunity to revert himself before I have to file the 3RR report. I will wait five minutes. SandyGeorgia (Talk) 03:02, 27 December 2010 (UTC)

SG, it is under construction as the template says. Please hold on just a few minutes while I get it all sorted out. Ok? Basket of Puppies 03:03, 27 December 2010 (UTC)

Under construction does not allow you to edit war a change that has been repeatedly disputed here, and such editing is disrespectful of the amount of work Doc James and others have done to preserve the article's featured status; you had a chance to revert so productive work could continue here, and you have been repeatedly asked to gain consensus on talk for changes. AN3 report. You have edit warred over this issue for three days, in spite of no one supporting your changes. SandyGeorgia (Talk) 03:28, 27 December 2010 (UTC)

BoP, it would be helpful if you would follow the article talk page and answer queries here rather than in edit summary. SandyGeorgia (Talk) 07:16, 27 December 2010 (UTC)

Formating

One does not discuss mechanism based on imaging modality. I have moved these section to the subpage. It needs to be presented better. Doc James (talk · contribs · email) 07:24, 27 December 2010 (UTC)

What would be helpful is if you wished to summarize the mechanism section in 12,000 bite of text and in non technical language in maybe 3 section (psychological, neurological, and molecular ) or others. Remember this is a main general overview. More detail and technical language can be used in the subarticle.Doc James (talk · contribs · email) 07:41, 27 December 2010 (UTC)

Agree with the move (the text was overburdened with detail), but the images should come back, pretty please? SandyGeorgia (Talk) 07:48, 27 December 2010 (UTC)

Agree just going over things. Doc James (talk · contribs · email) 07:51, 27 December 2010 (UTC)

Problem!

I am confused. BoP had concerns that this article was based on old primary research and it needed to be fixed. He than goes and adds:

Computed Tomography scans of schiznoprenic brains show several pathologies. The brain ventricles are enlarged as compared to normal brains. The ventricles hold Cerebrospinal Fluid(CSF) and enlarged ventricles indicate a loss of brain volume. Additionally, schizophrenic brains are widened sulci as compared to normal brains, also with increased CSF volumes and reduced brain volume.Jernigan TL, Zatz LM, Moses JA, Berger PA. Computed tomography in schizophrenics and normal volunteers. I. Fluid volume. Arch. Gen. Psychiatry. 1982;39(7):765-70. PMID [//www.ncbi.nlm.nih.gov/pubmed/7165476 7165476.]

Electroencephalograms (EEG) measure the electrical impulses on the surface of the brain. EEGs have demonstrated abnormalities in the schizophrenic brain, including nerve conduction in the temporal lobe depending on handedness of the patient.Holinger DP, Faux SF, Shenton ME, et al.. Reversed temporal region asymmetries of P300 topography in left- and right-handed schizophrenic subjects. Electroencephalogr Clin Neurophysiol. 1992;84(6):532-7. PMID [//www.ncbi.nlm.nih.gov/pubmed/1280199 1280199.]

Both old primary research studies???Doc James (talk · contribs · email) 07:51, 27 December 2010 (UTC)

If this article is to make it through FAR (hopefully with a minimum of agida for all in a productive and collegial editing environment), it would be most helpful if BoP would understand that WP:OWN#Featured articles is policy for a reason. Not guideline, not a suggestion, a policy; collaboration would be most appreciated and avoid a lot of trouble and misspent time for all of us; we do all have the same aim, to improve the article, right? SandyGeorgia (Talk) 07:58, 27 December 2010 (UTC)

PS, the article is finally loading more quickly for me; I've been beefing about that for years. There are still some raw URLs in the article citations; I can work on those once the article is more stable, if those links are retained. SandyGeorgia (Talk) 08:07, 27 December 2010 (UTC)

Pathophysiology needs paragraphs, but since the text may change, I won't do that yet. SandyGeorgia (Talk) 08:09, 27 December 2010 (UTC)

If someone wishes to take on the section on "history" and "society and culture" that would be great. Will continue to work on "management" and "epidemiology" moving on to "signs and symptoms" and "diagnosis". The history and society pages often need to be based on google books refs as journals do not always cover in detail.Doc James (talk · contribs · email) 16:37, 27 December 2010 (UTC)

Pathophysiology

I've removed this

ErbB4 protein abnormalities are also associated with neuropathophysiology of the schizophrenic brain.

because the ErbB4 association is only suggested for Han Chinese schizophrenics. I think this is too new, speculative and detailed for a general article on schizophrenia. Anthony (talk) 10:57, 27 December 2010 (UTC)

Good-- recentism and primary source. Even after scores of edits and improvements by Doc James, the article is still replete with pet theories, recentism and primary sources, although several reviews have now been added to the article that can be used to rewrite. I removed and self-reverted an entire section of primary sources (and see that Pathophysiology is the same), pending review by the docs, but I'm wondering how I can help or how we can divide up the work ... I could start chopping primary sources, but I'm not sure that's the best way to go here. How can we divide up the work, would it be helpful if I just started chopping primary-source text so the article can be rewritten? Where should I focus my efforts to be of most help? A good deal of pathophysiology needs to go, but I haven't read further yet. SandyGeorgia (Talk) 14:50, 27 December 2010 (UTC)

OWN and probably leaving

No one owns any articles on Wikipedia. That is policy. Not a guideline, not an essay. It is clear that a group of editors feels otherwise and is willing to keep this article with vast stretches of inaccurate information rather than entertain for a moment that someone outside should be allowed to edit. I came to this article because I am a graduate student who researches schizophrenia among other neurodegenerative brain diseases. What I saw absolutely horrified me. In an attempt to improve the article I formed a talkpage discussion which got nowhere. I then opened a featured article review which helped and I agreed to improve the neural/neurological section. I spent 3 straight hours on it, changing it from what literally looked like vomit on the screen to discreet sections divided by neuroimaging and electrophysiology using (mostly) secondary review articles (which fully qualify as secondary sources) where our readership could learn about each approach to the schizophrenic brain. Again came along the OWNers of this article and not only reverted my edits but also reverted the several secondary sources. This is a major net less for the article. I have been discussing this with colleagues at university and they all agree this article is a major embarrassment for Wikipedia. My good faith attempts at improving the article have been met with resistance the likes of which is truly horrifying. 15,000 people a day view this article and are reading completely inaccurate information. I likely will return here only to show friends at school just how poor this article is and then explain how it's rated as a "Featured Article". Until then I will go off to work collaboratively with other editors who do not feel they OWN anything. Basket of Puppies 16:22, 27 December 2010 (UTC)

Your comments do not provide examples of problems you describe. You have refed a 1982 and 1992 primary research study above and have not commented. One these a study of 30 schizophrenics and the other about half that. I have never seen a paper that discusses the mechanism of an injury based on imaging modality and mentioned that on your talk page that this is not the way to go. Your edits were not deleted they were moved until the formatting and referencing could be improved. I agree that the page has problems. Other than that I will WP:AGF. Doc James (talk · contribs · email) 16:34, 27 December 2010 (UTC)

The page has long had massive problems, but unfortunately, BoP's "corrections" have not been in the direction of correcting those problems, rather exacerbating them. The way medical articles are written in an encyclopedia is not the same way research papers are written; this is an overview article in an encyclopedia, and was already excessively detailed, overrelied on primary sources, and did not summarize adequately to daughter articles. Your editing has exacerbated those trends, which is not to say that the article is by any means in good shape; thanks to multiple medical editors working here, though, it is most certainly improving, and working in a collegial environment will produce better results. BoP, your edit warring, hyperbole, and failure to digest WP:MEDRS and WP:OWN#Featured articles, and work collaboratively with qualified medical colleagues here, is not the way to advance the necessary article improvements. The FAR can succeed in improving the article if you will stop the sorts of editing issues that have led to your post above, and allow others to work collaboratively, in an orderly fashion, to restore the article to standard. The first issue at hand is to rewrite the article to secondary reviews, eliminating primary sources, yet you advocate and have edited in more primary sources and recentism. SandyGeorgia (Talk) 16:41, 27 December 2010 (UTC)

BoP has returns these two studies here [15]. I have nothing else to say... Doc James (talk · contribs · email) 16:43, 27 December 2010 (UTC)

Well, apparently some admins are inclined towards letting him continue to edit war against consensus, and to accuse me of same behaviors; someone else is welcome to add that to the AN3 report I filed, or ask the admin (or another admin) to revisit. BoP, I share your concerns about the state of this article, but your attitude, approach, and willingness to edit war rather than work collegially with qualified professionals towards improvement is not the best approach and is unlikely to yield the result we all desire-- an improved article, which takes time, patience, and collaboration rather than edit warring to install your own preferences. Your actions will only result in chasing off all of the editors on Wiki who are willing and able to improve this article, and are likely to result in a much detiorated final result, as tagging your incorrect insertions will mar the article further. Please collaborate and refrain from edit warring; there is a good deal of experience represented here in the editors who were willing to help, and it would be sad if your behaviors chased them all off and left the article in much worse shape. Please note that you initiated a FAR improperly, FAR is not dispute resolution, and the FAR was because you wanted to install changes based on primary sources; the FAR was allowed to continue only because I have long noted here on talk that the article needed to improve, but your approach is not likely to yield results that will benefit the readers that will continue to come to this page whether or not the article retains featured status. Please don't work in such a way that will cause further deterioration. SandyGeorgia (Talk) 16:55, 27 December 2010 (UTC)

In essence what Sandy said, BoP I can really do without the exaggerations. Casliber (talk · contribs) 20:31, 27 December 2010 (UTC)

Progress on size

This version, before Doc James began the substantial rewrite to incorporate updated secondary reviews, had 229 citations and

File size: 325 kB

Prose size (including all HTML code): 83 kB

References (including all HTML code): 16 kB

Prose size (text only): 49 kB (7233 words) "readable prose size"

References (text only): 1102 B

Images: 123 kB

This version, with probably a bit more than half of the article reworked so far, has 171 citations, is much more readable, and now at least I can load the article to work on it:

File size: 274 kB

Prose size (including all HTML code): 64 kB

References (including all HTML code): 14 kB

Wiki text: 98 kB

Prose size (text only): 35 kB (5210 words) "readable prose size"

References (text only): 890 B

Images: 119 kB

As the text stabilizes, it will need a full WP:MOSLINK and WP:OVERLINK review, but it's probably too soon to do that now. I'm still concerned about the very long paragraph in the "Neurological" section (which I believe should be "Neural"), and don't know if it's been checked yet for primary sources and accuracy. SandyGeorgia (Talk) 01:35, 30 December 2010 (UTC)

Have not gone through the "neurological section yet". Will take a look after finishing the treatment stuff. Doc James (talk · contribs · email) 01:47, 30 December 2010 (UTC)

Many thanks Doc James - I have been feeling quite burnt out after fiddling around with this article for the past three years or so, so felt independent eyes at this point are a good thing. I'll try and double check as we go (but currently have several pots on the wiki-stove as we speak). Casliber (talk · contribs) 02:34, 30 December 2010 (UTC)

It is such a huge research base so more the merrier.Doc James (talk · contribs · email) 02:48, 30 December 2010 (UTC)

Comorbidity review

A review to be added yet. Buckley PF, Miller BJ, Lehrer DS, Castle DJ (2009). "Psychiatric comorbidities and schizophrenia". Schizophr Bull. 35 (2): 383-402. doi:10.1093/schbul/sbn135. PMC 2659306 . PMID 19011234.  CS1 maint: Multiple names: authors list (link) Doc James (talk · contribs · email) 02:56, 30 December 2010 (UTC)

Glad it's online and we've got several months. Do any of the reviews above, at Talk:Schizophrenia#Cannabis, need to be used to replace sources currently in the article? SandyGeorgia (Talk) 03:23, 30 December 2010 (UTC)

Neurological disorder

Really? We would need a review article for this. I somehow do not think my colleges in neurology would be impressed if I called them for someone I had diagnosed with schizophrenia.Doc James (talk · contribs · email) 04:57, 26 December 2010 (UTC)

This 2010 Nature article is interested:

How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This 'rethinking' of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.

Insel TR (2010). "Rethinking schizophrenia". Nature. 468 (7321): 187-93. doi:10.1038/nature09552. PMID 21068826. 

It is suggesting we think of it as a neurological disorder by is currently a mental disorder. The cause is unknown. Doc James (talk · contribs · email) 05:02, 26 December 2010 (UTC)

I completely agree with the article. Schizophrenia must be viewed as a neurological disorder, not a mental health disorder. Basket of Puppies 06:49, 26 December 2010 (UTC)

Nothing new here. Ignores the fact that there has been alot of focus on receptors and psychopharmacology. It is an opinion piece. Find me a consensus statement that says "neurological" BoP. Casliber (talk · contribs) 09:20, 26 December 2010 (UTC)

This refs say today schizophrenia is viewed as a mental disorder. We think it should be view as a neurodevelopmental disorder. So one could add to the body of the text that some wish schizophrenia where viewed as a neurodevelopmental disorder but it currently is not. Second just because someone is affiliated with the NIH does not mean they speak on behalf of the NIH.Doc James (talk · contribs · email) 10:34, 26 December 2010 (UTC)

About terminology

I got interested in this discussion by way of my previous editing at Causes of schizophrenia and Mechanisms of schizophrenia. I've read the talk here, and something jumped out at me. Perhaps, by my pointing it out as a previously uninvolved editor, I can offer something that will be helpful to those of you who are involved.

I just realized that some of the disagreement here arises from how editors with different kinds of academic and professional backgrounds use language differently. These differences appear to me to be causing editors, who are actually not that much in disagreement, to misunderstand one another, and to perceive more disagreement than really exists. I totally understand what Doc James said about psychiatrists, not neurologists, treating patients who have schizophrenia. And I'm further very aware of, within psychiatry, the disagreements over biological/pharmacological versus analytical/behavioral/cognitive schools of thought and practice. (I'm a neuroscientist with a PhD in biochemistry, by the way, if anyone wonders.)

So it strikes me that someone with my background, and, I believe, the general reading public, would understand "neurological" to refer in a general way to something that has to do with stuff going wrong, biologically, in the brain, in contrast to, for example, the old discredited assertion that the disease is caused by a bad mother. Now that might just sound wrong, oh so wrong, to someone to whom "neurology" connotes a particular medical consult, and may further rankle someone who thinks professionally about how to counsel patients and who doesn't want to just send someone packing with a bottle of pills. But research studies referring to "neurodevelopmental" components are looking at something different--things that might, perhaps, be the underlying basic mechanisms of the disease--than are studies examining, for example, the co-occurrence of cannabis use--no credible source claims that if you smoke a joint you will wake up the next morning with schizophrenia.

So, in discussing here how best to characterize what the sources are saying about "neural", "neurological", "neurodevelopmental", or "neurodegenerative", please consider how one's accustomed reaction to those words may be different from how most readers may understand them. A source may talk about, for example, ventricular or sulcal enlargement, without in any way discounting the effects of social environment on the expression of the disease. With that, some of the perception in this talk of controversy may smooth over.

Oh, and by the way, Thomas R. Insel isn't just affiliated with the NIH; he is the Director of the US National Institute on Mental Health. Cheers! --Tryptofish (talk) 21:34, 30 December 2010 (UTC)

That makes me feel soooo much better about Insel; kinda like Swedo and her PANDAS work, but I digress. SandyGeorgia (Talk) 21:53, 30 December 2010 (UTC)

Good, I'm glad you feel better. That's what I'm here for, it appears. But I was talking about Insel, not Emil Kraepelin. And anyway, that was a digression of my own, at the end of a post primarily about bigger things. --Tryptofish (talk) 22:30, 30 December 2010 (UTC)

Recentism and primary studies

I've removed two edits that fail to conform to WP:MEDRS and reflect WP:RECENTISM-- one a rat study. This is a broad overview article, and we shouldn't use these kinds of recent primary studies that haven't been subjected to secondary review; in fact, we're working to remove such sourcing from this article so it can survive WP:FAR. SandyGeorgia (Talk) 16:11, 31 December 2010 (UTC)

Fair enough. Anthony (talk) 16:21, 31 December 2010 (UTC)

Emotion in negative symptoms

I'm having trouble understanding this from Schizophrenia#Positive and negative symptoms

Negative symptoms are symptoms that are altered or defect emotional responses that respond less successfully to medication.

I can't access the text, have just read a couple of chapters about negative symptoms from 2 other texts and still can't see what this sentence is trying to say. Can someone with access please clarify? Anthony (talk) 03:21, 1 January 2011 (UTC)

Yes, that sentence was awful. I'm familiar with what that sentence was trying to say, and I've taken a stab at fixing it. Please check whether my change was OK. The broad idea is that positive symptoms are the presence of abnormal thought processes, whereas negative symptoms are the absence of normal thought processes. But there should be much better sources for that, than the nursing text that was cited, so I would strongly suggest replacing that source instead of trying to find out what exactly it said. I'm traveling now, but if memory serves, Goodman & Gilman would be a good source for positive/negative and the differences in medication response, and there are certainly other sources too. --Tryptofish (talk) 15:30, 1 January 2011 (UTC)

why is a good 2008 meta analysis removed CBT is an effetive treatment

so there are two review articles about CBT. surely a 2008 meta analysis (in a good journal) stating that CBT is benefical cant be trumped by a article in 2010. CBT is a recommended treatment. Cheers earlypsychosis (on holiday) --Preceding unsigned comment added by 121.73.183.15 (talk) 06:07, 6 January 2011 (UTC)

The synopsis of the text was wrong. It stated "CBT is now considered a recommended treatment for schizophrenia" while the ref says "CBT is a promising but under evaluated intervention. Currently, trial-based data supporting the wide use of CBT for people with schizophrenia or other psychotic illnesses are far from conclusive. More trials are justified, especially in comparison with a lower grade supportive approach. These trials should be designed to be both clinically meaningful and widely applicable.". The are two completely different things. Also the edit was not WP:DUE.Doc James (talk · contribs · email) 16:43, 6 January 2011 (UTC)

Additional Reading or New Fictional Accounts in Literature Section

Having never dealt with Schizophrenia on a personal level, it remained a topic of mystery for a long time. As with any type of issue, people still treat mental illness as if it is some disease that can be caught like a virus or common cold. I know tolerance has progressed, but society still proves to be intolerant of those they deem to be different. I propose that in the additional reading section or a new section related to fictional representations in literature, that Wally Lamb's wonderful and heartbreaking book "I Know This Much is True" be included for those who want to witness the effects that Schizophrenia has on families. Although this book is fictional it takes a clinical approach in showing how, if untreated, it can cause the individual to slip further away from reality. Wally Lamb shows Schizophrenia from its onset and he pulls no punches. It is my belief that this book could shed some light on an important subject ... Especially for family members who might be searching for any depiction of Schizophrenia related to a patient choosing not to take medication. Please include this very important fictional account of Schizophrenia.Tstrothe (talk) 13:34, 6 January 2011 (UTC)

I don't know if Wikipedia policies will allow what you suggest; more experienced editors will no doubt comment on that. But thank you for the reference. I'm going to get me a copy. --Anthonyhcole (talk) 17:10, 6 January 2011 (UTC)

If and when we have a subarticle on Schizophrenia in society and culture or however else we wish to summarize this section, it would be good there. Doc James (talk · contribs · email) 17:21, 6 January 2011 (UTC)

My feeling is that if there were reputable scholarly sources that described the book as an accurate and useful portrayal of schizophrenia, then a mention of it might be warranted. The same applies to a few other well-known fictional accounts. Looie496 (talk) 17:22, 6 January 2011 (UTC)

Reviews on prognosis

Intend to add these:

• Jobe TH, Harrow M (2005). "Long-term outcome of patients with schizophrenia: a review". Can J Psychiatry. 50 (14): 892-900. PMID 16494258. 
• Menezes NM, Arenovich T, Zipursky RB (2006). "A systematic review of longitudinal outcome studies of first-episode psychosis". Psychol Med. 36 (10): 1349-62. doi:10.1017/S0033291706007951. PMID 16756689.  CS1 maint: Multiple names: authors list (link)
• Warner R (2009). "Recovery from schizophrenia and the recovery model". Curr Opin Psychiatry. 22 (4): 374-80. doi:10.1097/YCO.0b013e32832c920b. PMID 19417668. 

Doc James (talk · contribs · email) 00:35, 7 January 2011 (UTC)

Done this section for now. --Doc James (talk · contribs · email) 06:44, 8 January 2011 (UTC)

Images

There are some interesting images in other languages that might be good in the signs and symptoms section if we could get a translation... Doc James (talk · contribs · email) 06:59, 8 January 2011 (UTC)

Problem

I am unable to find where in this ref this text is supported "The use of psychological treatments and medication has been found effective in reducing the chances of people who fulfill the high-risk criteria from developing full-blown schizophrenia."Doc James (talk · contribs · email) 07:31, 8 January 2011 (UTC)

It's not there. In fact, it says "the evidence base for so-called phase-specific treatments at this time remains very limited, offering little guidance." (p.63)
Van Os J, Delespaul P. (2005) "Toward a world consensus on prevention of schizophrenia." Dialogues Clin Neurosci. 7(1):53-67. PMID 16060596.
Anthonyhcole (talk) 08:38, 8 January 2011 (UTC)

Research section

I am the first to admit that I know very little about schizophrenia--most of what I know is limited to the UpToDate articles I have read over the past few days. But I still wonder whether the research section is appropriate for this article. Mayn of the sources seem to be dated (c. 2000) and/or are primary sources. UpToDate hardly mentions current research controversies. Why that is I am not sure, but I think we should consider following what they do. NW (Talk) 21:07, 15 January 2011 (UTC)

Short answer-- no (see WP:MEDMOS); long answer, I'm planning to work on that section, but got distracted with Wakefield. SandyGeorgia (Talk) 21:33, 15 January 2011 (UTC)

Agree with Sandy - there are so many trials into all sorts of research aspects which have no impact on how the condition is managed etc. that we have to leave them out. There is so much stuff which needs to get left out that has a higher weighting. Luckily we have daughter articles...Casliber (talk · contribs) 21:51, 15 January 2011 (UTC)

Move that content to the research section will deciding what to do with it. Maybe put it in a subarticle on the diagnosis of schizophrenia? Doc James (talk · contribs · email) 22:06, 15 January 2011 (UTC)

MEDMOS says: "Research directions: Include only if addressed by significant sources. See Trivia, and avoid useless statements like "More research is needed". Wikipedia is not a directory of clinical trials or researchers." BTW, Malleus is working on a copyedit, see questions on his talk. SandyGeorgia (Talk) 22:09, 15 January 2011 (UTC)

Exactly. Doc James (talk · contribs · email) 22:14, 15 January 2011 (UTC)

Okay, just looking at research controversies - Andreasen is a pretty key figure as she's the one who really crystallised many of the terms in the mental state examination that we all use today. In some ways I like this bit, in others it just seems like alot of discussion about fuzziness in diagnosis. There is a message I guess that is good to impress upon the reader that DSM is a research tool (hahaha, said with a straight face as it is used as a bible) which classifies on symptom clusters not neurobiology, and there is ongoing investigation into how we classify it. If this is suggested elsewhere I think the 'bottom subsection can be discarded, but otherwise I am musing on it...Casliber (talk · contribs)

It fits nicely in an article on the Diagnosis of schizophrenia. Doc James (talk · contribs · email) 22:22, 15 January 2011 (UTC)

Excellent suggestion - move at thy leisure, I am off to make breakfast..Casliber (talk · contribs) 22:26, 15 January 2011 (UTC)

HERV

I came across this interesting article suggesting schizophrenia is caused by an endogenous retrovirus and thought it would be appropriate to mention here, along with the well-known correlation between schizophrenia and toxoplasmosis. Rather than propose a specific edit (since the article is protected and I'm not at all knowledgeable about the subject), I'll just leave the suggestion here. 67.122.209.190 (talk) 05:21, 25 January 2011 (UTC)

Added: My innate cynicism now wonders (after looking at Geneuro's website) to what extent that Discover article might be a marketing vehicle for geneuro.com. I'd already added links to some virology articles that I'll leave in place, but maybe those could use some review or independent corroboration. 67.122.209.190 (talk) 05:43, 25 January 2011 (UTC)

The cause is still unknown but here is a review that comments on this association Christensen, T (2010 Sep). "HERVs in neuropathogenesis". Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology. 5 (3): 326-35. PMID 20422298.  Will look further when I have time... And another Yolken, RH (2008 May). "Are some cases of psychosis caused by microbial agents? A review of the evidence". Molecular psychiatry. 13 (5): 470-9. PMID 18268502.  . We of course already comment on the association of viral infections during pregnancy. Doc James (talk · contribs · email) 05:58, 25 January 2011 (UTC)

Thanks. There's a lot more abstracts here. I'd heard of the toxoplasma association before, but I had previously never heard of HERV's, which are not microbes in the usual sense (they are part of human DNA). 67.122.209.190 (talk) 07:58, 25 January 2011 (UTC)

We discuss infections and schizophrenia here Causes_of_schizophrenia#Infections. I would be happy to give you and hand improving this section and than maybe moving a summary to the main article. Let me know if you need access to journals. Doc James (talk · contribs · email) 18:34, 25 January 2011 (UTC)

Cannibis

These text is in the subarticle and IMO is not sufficiently well reffed to belong here:

Despite increases in cannabis consumption in the 1960s and 1970s in western society, rates of psychotic disorders such as schizophrenia remained relatively stable.

The issue is that local data from the UK is being presented not as a single local study. Doc James (talk · contribs · email) 18:09, 25 January 2011 (UTC)

Schizophrenics sensitive to gluten

http://www.celiac.com/articles/22317/1/Hippies-Werent-the-Only-Ones-Tripping-in-the-Sixties/Page1.html "Having learned about this connection between celiac disease and schizophrenia, Dr. Dohan then undertook a study in which he examined hospital admission rates for schizophrenia both during periods of plenty and during World War II grain shortages. He found that there was, indeed, a reduction in admissions during grain shortages, which normalized when ample grains became available again.

Dohan's next step, along with several colleagues, was to design and conduct a single-blind cross-over study of schizophrenic patients in a locked ward. They found that symptoms of schizophrenia abated on a gluten-free, dairy-free diet. These same patients relapsed on re-introduction of these foods. " --Preceding unsigned comment added by 71.167.67.87 (talk) 08:56, 17 January 2011 (UTC)

Thank you for the suggestion of adding this information to the article. Sadly, we cannot accept it as the source you cited isn't considered a reliable source for purposes of this encyclopedia. Basket of Puppies 18:09, 17 January 2011 (UTC)

I beleive this to be a study he was reffering too --Preceding unsigned comment added by 71.167.67.87 (talk) 06:05, 18 January 2011 (UTC)

It's a very interesting study, albeit a bit old, from 1988. If it can be found cited or discussed in a more recent review article then it can surely be included in this article. Basket of Puppies 06:44, 18 January 2011 (UTC)

"He estimates that 3% of schizophrenic people could potentially benefit from such a diet." http://www.webmd.com/schizophrenia/news/20040219/gluten-intolerance-linked-to-schizophrenia

http://www.healthyfellow.com/219/gluten-intolerance-and-schizophrenia/

The more intoductury research trials are free. A more recent study being number eight. http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&term=%22Schizophrenia%2Fdiet%20therapy%22%5BMeSH%20Terms%5D

--Preceding unsigned comment added by 71.167.67.87 (talk) 22:29, 18 January 2011 (UTC)

I reviewed each of those links. The one in Schizophrenia Bulletin includes links to subsequent papers that cited it. The only such paper in the last decade is a genetic linkage review of the Danish National Registers, that, at most, treats gluten sensitivity as just one of numerous autoimmune association factors. WebMD and Healthy Fellow are not reliable medical sources for our purposes here. The PubMed search results yield mostly primary research studies in recent years. The one review that shows up is this: [16], which concludes that the association with gluten sensitivity for most people with schizophrenia is not supported by existing data, and would require much larger studies to determine any reliable association. Therefore, this relatively marginal theory really does not belong on this page. --Tryptofish (talk) 22:44, 18 January 2011 (UTC)

The review article cited says

RESULTS: A drastic reduction, if not full remission, of schizophrenic symptoms after initiation of gluten withdrawal has been noted in a variety of studies. However, this occurs only in a subset of schizophrenic patients.

This is interesting but it's only for a very specific subset of SZ patients. I'd have to pull the full article and read exactly which subset. Once that info is known (and there aren't any other studied directly contradicting it) I don't see why it can't be included in the article. Basket of Puppies 23:23, 18 January 2011 (UTC)

The WebMD link indicates that this is true for only 3% of people with schizophrenia, so I'd be very cautious about over-selling the point, if we include it at all. The review came out five years ago, and absent anything in the way of subsequent reports that it is impacting health care, this may not be anything other than WP:UNDUE. It may be an interesting lead for a grant application, but not helpful information for an encyclopedia article. --Tryptofish (talk) 23:33, 18 January 2011 (UTC)

I wouldn't use the WebMD link but the review article is a reliable secondary source and it is still pretty recent. WP:UNDUE says

Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint.

As such it would seem a violation of UNDUE not to at least make mention of a gluten and SZ subset link. Basket of Puppies 23:47, 18 January 2011 (UTC)

(Sigh) I wasn't saying to use WebMD as a source, and you might want to be careful about cherry-picking how you quote UNDUE. --Tryptofish (talk) 23:52, 18 January 2011 (UTC)

Accusing me of cherry picking isn't approriate nor is it collegial. I'll ignore you said it and focus on the issue. Is the use of this secondary reliable source for linking gluten and a SZ subset a violation of UNDUE? No. In fact, UNDUE would require that a brief mention be made of this specific SZ subset and gluten relationship in order to maintain balance. I am keen to hearing your on-topic reply to this issue. Basket of Puppies 00:03, 19 January 2011 (UTC)

That 2006 review doesn't identify the subset. It seems to be using the term "subset" to mean "some". Its "summation" reads:

• The current literature suggests that a certain subset of schizophrenic patients may benefit from a gluten-free diet.

• Shared immunlogic abnormalities and genetic associations suggest a common underlying vulnerability between celiac disease and schizophrenia.

It warns:

• A large portion of the literature on the effectiveness of gluten withdrawal on schizophrenic symptoms has come from one research team.

• Large randomized clinical trials are necessary to verify these claims of an association between schizophrenia and celiac disease.

(Emphasis mine.) Without the support of other WP:MEDRSs, it may be WP:UNDUE and too early, but this association has been suggested for decades, so ought to be mentioned somewhere. Perhaps Causes of schizophrenia? (Provided the uncertainty and need for much more - and more rigorous - investigation is mentioned). --Anthonyhcole (talk) 06:21, 19 January 2011 (UTC)

Would support its addition on the subpage Causes of schizophrenia but not here at this point. Doc James (talk · contribs · email) 06:26, 19 January 2011 (UTC)

Again, WP:UNDUE says

Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint.

Because this is a secondary reliable source that it would be most appropriate to make a brief mention of the finding of this study, either on this or the subpage. Basket of Puppies 06:32, 19 January 2011 (UTC)

How about something like this on Causes of schizophrenia: "There may be an association between celiac disease (gluten intolerance) and schizophrenia in a small proportion of patients, though large randomized controlled trials and epidemiological studies will be needed before such an association can be confirmed. Withdrawal of gluten from the diet is an inexpensive measure which may improve the symptoms in a small (<=3%) number of schizophrenic patients." --Anthonyhcole (talk) 06:50, 19 January 2011 (UTC)

We are not required to mention all reviews (there are at least 11 thousand BTW). --Doc James (talk · contribs · email) 06:52, 19 January 2011 (UTC)

@Anthony: That sounds just fine. It's brief, accurately sums up the review article and is appropriately worded.

@Doc James, all 11k reviews likely say the same things over and over with not a whole lot of new or novel information. However, to say that we can arbitrarily decide not to use a secondary reliable source would be cause this article to fall below the standards of an FA and violate WP:UNDUE. I am sure nobody wants that to happen. Basket of Puppies 06:59, 19 January 2011 (UTC)

I have never said we should not us it. I am saying that it is published in a less well known journal. The conclusions are tentative at best. This wiki article is for a overview. I am saying that this topic is best in the subarticle. Doc James (talk · contribs · email) 07:02, 19 January 2011 (UTC)

WP:MEDRS says nothing about the stature of the individual journals, but it does say to respect secondary sources over all overs. If you think MEDRS should be updated to include a comprehensive list of journals in order of important, then I look forward to such a list. Until then I am unable to distinguish level of journal importance when dealing with peer-reviewed, published and reliable journals. Basket of Puppies 07:06, 19 January 2011 (UTC)

Impact factor is something of a guide, though it's not infallible. --Anthonyhcole (talk) 07:41, 19 January 2011 (UTC)

Done Thank you to the OP for bringing this up, and everybody for the lively and informative discussion. --Anthonyhcole (talk) 07:22, 19 January 2011 (UTC)

I agree with having it in secondary article but not in main article: independently of it being a review precisely as we have 11.000 reviews on the disease and only one supports the link it seems that it is giving it undue weight to have it in the main article. --Garrondo (talk) 07:30, 19 January 2011 (UTC)

So do I - doesn't come up in clinical practice at all to date. If it were only this simple...Casliber (talk · contribs) 07:35, 19 January 2011 (UTC)

There seems to be some confusion as to what WP:UNDUE says and means. Quite simply, it says to present opinions in articles based upon their prevalence in the reliable sources. If only one article says there is a gluten-SZ subset link then it needs to be mentioned briefly and certainly not extensively. To eliminate it, however, would be a violation of UNDUE, not to mention bordering close on WP:OR. I kindly suggest we keep this in mind when dealing with peer-reviewed, published, secondary sources in reliable journals. Basket of Puppies 17:44, 19 January 2011 (UTC)

Well, actually it can be interpreted the other way also: to not give undue weight to an article that only appears in one review article out of a thousand we could say that a line on it should be commented roughly every 1000 lines. Since articles are much shorter the place is NOT the main article but the more specific subarticles that dig into more into subsections. OK, I know I am over-over simplyfing, but to say that appearance in a single source is reason enough for inclusion is also an over simplification.--Garrondo (talk) 07:25, 20 January 2011 (UTC)

I agree in principal with this but not in fact. Not every review article reviews SZ entirely. Some stick to the specific areas, such as MR neuroimaging (Shenton's article, for example), and others will stick just to the dopamine hypothesis. Others will simply review older electrophysiological aspects, such as Holinger's article. What I am saying is not every review article is a review of SZ but rather a review of an aspect of SZ. Thus, it can only be expected that there may be a review article that has reviewed something that none of the others have touched on. Thoughts? Basket of Puppies 16:04, 20 January 2011 (UTC)

For weight I usually use the following test: I find the best general reviews of the disease in general and also good "subsectional reviews" (in this case would be diagnosis in SC, treatment of SC...). If a fact does not appear in the first level or the second level of reviews it is way to specific to be in the main articles, even if it appears in a secondary source.--Garrondo (talk) 20:28, 20 January 2011 (UTC)

Thanks Anthony for adding it that way to the Causes page. I'm kicking myself for not suggesting that from the outset. And agreeing as well with DocJames, Garrondo, and Casliber, I can point out that it actually has been a problem at the Causes page that adding every pet theory that has come down the pike made that page into rather a mess. I think it's good that current attention to these pages growing out of the FAR is cleaning this stuff up, and it's all the more important to attend to that on this main page. --Tryptofish (talk) 18:02, 19 January 2011 (UTC)

It shouldn't be there either-- we're just shuffling chairs on the Titanic by moving every pet theory based on primary research to sub-articles, and if they aren't in reviews, they don't belong there. There's a very long list of disorders and diseases claiming links to gluten intolerance; unless we have a secondary review that considers it important, let's stop shuffling fringe theories off to sub-articles. SandyGeorgia (Talk) 23:09, 20 January 2011 (UTC)

It is discussed briefly in a review which is why it meets subpage significance. I agree that primary research should be in neither place. Doc James (talk · contribs · email) 23:27, 20 January 2011 (UTC)

I'm a dork :) SandyGeorgia (Talk) 23:38, 20 January 2011 (UTC)

That's caused by eating too much gluten. And I have documents to prove it. --Tryptofish (talk) 23:40, 20 January 2011 (UTC)

Guilty as charged! SandyGeorgia (Talk) 23:50, 20 January 2011 (UTC)

It is actually quite a thorough review of the subject (though it completely ignores the effect of gluten or dorkishness), the theory has been around for 50 years or so with some, little, currency, and the evidence for a causal association in a small percentage of schizophrenics (<=3%) is moderate. It deserves a brief mention in an article addressing etiology. --Anthonyhcole (talk) 23:49, 20 January 2011 (UTC)

Agree with Anthony. It is not a "pet theory" but it is a thorough secondary review article so it deserves a brief mention. Basket of Puppies 00:00, 21 January 2011 (UTC)

In the Causes article, not here. --Tryptofish (talk) 00:02, 21 January 2011 (UTC)

Agree, not significant enough for a broad overview, belongs in sub-article. SandyGeorgia (Talk) 00:24, 21 January 2011 (UTC)

What is the point at which something becomes significant enough? I would assume that would be a thorough secondary review article on the topic being published in a reliable medical journal. If I am mistaken then please enlighten me. Basket of Puppies 04:55, 21 January 2011 (UTC)

Not black or white answer: as I said I would vote to have it in the main page when a recent review in the whole disease or its causes (as opposed to a review in this specific theory) mentioned it.--Garrondo (talk) 07:14, 21 January 2011 (UTC)

Agree with Garrondo we need to use editorial judgment. If it was in a recent review that dealt with schizophrenia in general than it would belong here... Doc James (talk · contribs · email) 07:33, 21 January 2011 (UTC)

Agree with both; specialty reviews of individual topics are more suited for sub-articles, unless mentioned in broad reviews. If it were a very new issue, perhaps not yet covered by broad reviews, it might belong here, but that's not the case. If broad, recent reviews don't cover it, it's more approprite in sub-articles. SandyGeorgia (Talk) 13:10, 21 January 2011 (UTC)

Understood. Let me just suggest, however, to cease referring to the daughter articles as places where "pet theories" are placed. That's entirely untrue and pretty insulting. Basket of Puppies 16:08, 21 January 2011 (UTC)

Sorry BoP, I realize in hindsight that it sounded like I was directing that at you, which wasn't my intention. I was referring to the longer history at the Causes page, but that wasn't at all clear the way I wrote it. --Tryptofish (talk) 21:43, 21 January 2011 (UTC)

If Cannibus contributed to a neurological 'disease' in 1% of people, then why is a cure in 3% of a people not something to be mentioned? --Preceding unsigned comment added by 71.167.61.28 (talk) 03:23, 11 February 2011 (UTC)

Because it would violate WP:OR for editors to use that line of reasoning. Instead, we rely on secondary sources to determine whether the reports about 1% of people, and the reports about 3% of people, are notable, for our purposes. --Tryptofish (talk) 20:18, 11 February 2011 (UTC)

The evidence for an association between celiac disease and schizophrenia in <= 3% of patients is only moderate. Perhaps the evidence for the association between cannabis and schizophrenia in 1% of patients is stronger. I haven't looked at it. --Anthonyhcole (talk) 23:07, 11 February 2011 (UTC)

Lede

The lede isn't supposed to have any referenced statements in it; those are supposed to go in the body. I suggest that an editor or editors fix the lede. I would but I am actively avoiding editing this article until consensus is achieved for every change. Basket of Puppies 00:26, 28 February 2011 (UTC)

I have removed some tags and new text that doesn't conform with WP:MEDRS and can be better explored in daughter articles if secondary reviews are found (this is an overview article, already too long). The WP:LEAD may have citations for data, quotes, surprising facts, but they are not required for info summarized elsewhere in the article. I'm not clear if we've finished the lead yet? SandyGeorgia (Talk) 00:31, 28 February 2011 (UTC)

Homelessness

New section time. I'd like to add a sentence about schizophrenia and homelessness. Lots out there for mental health leading to homelessness or as risk factor or as high incidence in homeless populations. It's harder however to get it specifically on schizophrenia and not psychosis or affective disorder. The US's NIMH took a stab at it, where they cite this source - 20% of people diagnosed with schizophrenia were homeless a year later (San Diego, CA and N = 10,040, yr. 1999-2000). Doc James asked for some global data on this - sadly WHO's mojo is ooooold, how old are we allowed to go? The stuff I've found use older definitions of schizophrenia from the DSM-III. Nothing newer than about 15 years. JoeSmack ^Talk 02:41, 1 March 2011 (UTC)

Oh, and I found this review of literature [17] - out of 8 countries reviewed (several European nations, Australia, Canada, Brazil) and 10 with sturdy methodology: the prevalence range was 4-16% and the weighted average prevalence was 11%. JoeSmack ^Talk 03:03, 1 March 2011 (UTC)

Nash

I fixed the caption because it was really misleading. Nash did all his award winning work before developing significant symptoms. (Nobels take decades to be awarded sometimes, and game theory took a long time to be found useful by economists.) Also, I did not kill or cure him when I wrote "suffered", but according to himself he had no significant symptoms for many years now, even though he is unmedicated since the 70s. Some of this is mentioned in the article here on the movie, but it's covered at length in the book. Tijfo098 (talk) 22:45, 3 April 2011 (UTC)

Further reading

As stated in the FAR this section is very subjective: there are thousands of possible "further reading" books in a disease such as schizophrenia (As a fast tests more than 600000 books in google books when searching for schizophrenia.) Unless there is some very good reason to have one of this in the article they do not really add that much info. I have moved section here so it can be integrated in article as sources as recommended in WP:MEDMOS if considered a good option. --Garrondo (talk) 07:04, 4 April 2011 (UTC)

Japanese script

Do Japanese letter in the society section really add any value to the section? Not really sure...--Garrondo (talk) 07:07, 4 April 2011 (UTC)

Irrespective of what the MOS might say (didn't check), they take little space there and a Japanese-speaking person can probably benefit from the extra context they provide. Tijfo098 (talk) 07:52, 4 April 2011 (UTC)

nl-wiki; useful information

May I draw your attention to the information that is on the Dutch wikipedia site (translation by google). It might be an idea to add some of this information in the english wiki.

The research literature is at present the most clear the following picture about the cause of schizophrenia: Meiosis is the process of dividing cells in humans. In meiosis the chromosome pairs split in such a way that a representative of each pair goes to one daughter. This, per cell, the number of chromosomes halved, while each attribute (gene) still remains. As the information for each attribute is attached, solely by chance. Besides the random process in terms of characteristics, there is a second random process taking place. In this second random process in the DNA segments of DNA randomly omitted (deletion), added (duplication), moving (translocation) and inverted (inversion). This process occurs more genetic differences between people to apply. This process explains why even identical twins are not genetically 100% identical.

Problem of the second random process is that genetic mistakes can occur around the time of conception. In particular by the deletion and duplication chromosomes can be shorter or longer or there may occur a complete extra chromosome. The result of a spontaneous change in the structure of DNA is a so-called copy number variation. The emergence of a copy number variations can chromosomes of unequal size and unequal number are grouped together into a new cell. If this occurs around conception, is created from this first cell, a man with a genetic variation. This can be either positive or negative. In positive cases arises from a man who is capable of a special skill that is evaluated positively, such as sports or science. In negative cases, you have to deal with a syndrome or a severe disability.

Nature seems to choose for this spontaneous process, because in the long term genetic level leads to a "better kind of man", when it comes to adapting the organism to its environment. Positive results will breed, making positive adjustment is going to spread, while for negative results will be forthcoming.

Based on the meiosis process can probably schizophrenia in two ways.

   * 1. a spontaneous deviation (a 'novo' the situation): here there are two chromosomes together with a copy number variation as a result of the meiosis process.     * 2. a parent is unknowingly a carrier of a chromosome with a copy number variation and gives it to the conception through to the child what the child has other consequences than to the parent.  

So there are too many pieces to meiotic or too few bits in the DNA occur at a specific location. This is the basis for a syndrome.

Then you may experience problems in the development of the embryo in the first months of pregnancy. Approximately 20 to 40 days after fertilization is wrong on both disorders in the construction of the body parts and brains, which triggers a chain reaction that both autism and schizophrenia may yield. Autism and schizophrenia are also part of a continuum in which both the autism spectrum as the spectrum of schizoid valt.Dit explains why in families with autism often find people with schizophrenia.

Autism and schizophrenia are no exceptions stand alone, but a consequence of a spontaneous genetic change that results in a syndrome. Depending on the severity of the genetic change, the degree of autism spectrum disorder or schizoid spectrum disorders differ. In all lesions are a number of similar characteristics to see:

   * Reduced emotion recognition     * Problems with the theory of mind (ability to form a picture from the perspective of one another and indirectly of itself);     * Problems with the central coherence [4] (the world is composed of fragments without direct connection to each other and must be puzzled);     * Catatonia (immobility or typical stereotyped movements with or without sound);     * Problems with executive functions (higher control functions of the brains);     * The exceptions are more common in men than in women;     * Echolalia.  

There have now discovered a nine locations on the DNA where the syndromes are given, which are related to autism or schizophrenia, the so-called 'hotspots': 1q21.1 (chromosome 1, long arm, band 21.1), 3q29, 15q13 .3, 16p11.2 (chromosome 16, short arm, band 11.2), 16p13.1, 16q21, 17p12, 21q11.2 and 21q13.3. In a number of hotspots is both autism and schizophrenia was observed at that location. In other cases the observed one form to another and even sought. Statistically it is found that a deletion of 1q21.1 (1q21.1-deficiency syndrome) was significantly higher in schizophrenia and prevents a duplication of 1q21.1 (1q21.1-duplication syndrome) was significantly more autistic persons. Similar observations were made of chromosome 16 at 16p11.2 (deficiency, autism / duplication: schizophrenia), chromosome 22 at 22q11.21 (deficiency (Velo-cardio-facial syndrome): schizophrenia / duplication: autism) and 22q13.3 (deficiency (Phelan-McDermid syndrome): schizophrenia / duplication: autism). Research on autism / schizophrenia relationships coupled with deficiencies / duplications of chromosome 15 (15q13.3), chromosome 16 (16p13.1) and chromosome 17 (17p12) are not yet clear. [5].

SpelgroepPhoenix (talk) 20:37, 29 January 2011 (UTC)

We could get in an in depth discussion on why the above is premature, but essentially there is not a global consensus on this - the paper I'll take a look at...Casliber (talk · contribs) 20:47, 29 January 2011 (UTC)

There are now confirmations availbale on the earlier reports:

• Copy Number Variants in Schizophrenia: Confirmation of Five Previous Findings and New Evidence for 3q29 Microdeletions and VIPR2 Duplications at http://ajp.psychiatryonline.org/cgi/content/abstract/168/3/302
• Common Variants in the BCL9 Gene Conferring Risk of Schizophrenia at http://archpsyc.ama-assn.org/cgi/content/short/68/3/232?rss=1

Is there still no reason to make a reference to the research? SpelgroepPhoenix (talk) 10:22, 10 April 2011 (UTC)

Edit request from 98.14.224.84, 6 April 2011

Please note that Mark Vonnegut's diagnosis of schizophrenia is no longer accepted by most professionals, and he has noted it was improper. His psychiatric illness is bipolar disorder. He has discussed this in his 2010 book, JUST LIKE SOMEONE WITHOUT MENTAL ILLNESS, ONLY MORE SO.

I suggest adding the parenthesis at the end of the relevant sentence "(although he now believes a more appropriate diagnosis of his illness is bipolar disorder)."

98.14.224.84 (talk) 04:11, 6 April 2011 (UTC)

I wonder, would it make better sense to remove mention of him from this page? Also, the linked page about his book might need to be updated accordingly. --Tryptofish (talk) 22:50, 6 April 2011 (UTC)

Regardless of his current diagnosis, the book is still about schizophrenia and is therefore germane to the section. No change in the sentence is required. -- Bility (talk) 23:58, 6 April 2011 (UTC)

Bility, you are reading this as though Vonnegut had schizophrenia when he wrote The Eden Express and bipolar disorder later, when he wrote Just Like Someone Without Mental Illness Only More So. Is that how Just Like describes it? I haven't read either book but was assuming he was simply misdiagnosed early on and received a more accurate diagnosis later. I have removed the sentence for now since there is still a question over its accuracy but have no problem returning it once this question is cleared up, if it turns out the earlier condition was, indeed, schizophrenia. --Anthonyhcole (talk) 03:32, 14 April 2011 (UTC)

Smoking and schizophrenia

I do not think anyone would say that smoking causes schizophrenia just that the two are associated. This may be best in the section on prognosis. Doc James (talk · contribs · email) 20:57, 27 February 2011 (UTC)

Apologies, I should look where I'm going a bit better. I'm looking forward to contributing more, both in clarity (something about psychotic disorders always sounds like it was written for a psychiatrist rather than a general person) as well as expanding the epidemiology. Also, this article is remiss not to touch more on homelessness/family impact, so I'll give that a swing too. JoeSmack ^Talk 22:35, 27 February 2011 (UTC)

The article is already too long, and summary style to daughter articles should be used. Also, text should conform to WP:MEDRS-- they are numerous high quality secondary reviews of schizophrenia available to guide as to how much information to include in this overview article, and several sub-articles available for expansion of text cited to secondary reviews. An overview article cannot explore everything about the condition, hence the need for summary style and mentioning here info raised in the highest quality reviews, which are plentiful. SandyGeorgia (Talk) 00:34, 28 February 2011 (UTC)

Ok, whoop, sorry, this is a highly ensconced FA. Lemme just throw out some commentary and see what you all think:

• The 'see also' in the Schizophrenia#Differential section goes to dual diagnosis, yet no substance abuse / dependence disorder is mentioned in the section. If the dual diagnosis article pointed to one more like the modern definition of a co-occurring disorder (a redlink i've been waiting for someone to do something about), it might be a little closer to what you want, but it still misses it's mark. Perhaps a see also to psychotic disorder?

• Are you perhaps thinking of comorbidity? SandyGeorgia (Talk) 02:01, 28 February 2011 (UTC)

I am, but co-occurring disorders tends to be reserved for mental health only, not medical. There's some overlap there, but co-occurring is common parlance as far as my experience in the field and research. Anyways, back to the see also leading to dual diagnosis - it's clearly in error to me. It should either be nixed to changed to see also psychotic disorder. JoeSmack ^Talk 04:12, 28 February 2011 (UTC)

• Speaking of this, there is no mention of co-morbid substance use disorders. It's prominent in the lead, doesn't that mean it gets a sentence somewhere in the article (does it, I'm not sure...)? There's a bit in the causes section under Schizophrenia#Environment, but nothing about co-morbidity. If it were me I'd stick it in prognosis. Prognosis of schizophrenia, its daughter article doesn't mention it, which is also bizare to me, but it's an unassessed article and this is an FA.

• The lead should be a summary of the article, but checking it for completeness has been put off until last. (I haven't caught up.) Some aspects of comorbidity may belong in dignosis, others in prognosis to the extent they affect it. SandyGeorgia (Talk) 02:01, 28 February 2011 (UTC)

Gotcha. Anyone mind if I take a crack at it? I think I'd keep the differential subsection and add a 'co-occurrence' section (or comorbidity, but then I'd sound like a doctor instead of a social worker, ha). JoeSmack ^Talk 04:12, 28 February 2011 (UTC)

• Has having more info on homelessness been discussed on this talk page or is it more expanded in a daughter article? I haven't come across it.

• Do you have a high-quality, secondary journal review that mentions it? If so, we can figure out where to work it in-- if not, sub-articles. SandyGeorgia (Talk) 02:01, 28 February 2011 (UTC)

I'll find something in the next couple of days, the homelessness article's ref doesn't follow WP:MEDRS content guidelines. Mental illness is a major factor in homelessness, and psychotic disorders are probably the majority of that mentally ill population. I'll find something off NIMH or something. JoeSmack ^Talk 04:12, 28 February 2011 (UTC)

How's this? NIMH, they cite this large US study - 20% of people diagnosed with schizophrenia were homeless a year later (San Diego, CA and N = 10,040). Although not mentioned in the NIMH page, the cited study puts schizophrenia at 54% of homeless with mental illness, making it the leading mental illness to be correlated with homelessness by a pretty large margin. JoeSmack ^Talk 04:28, 28 February 2011 (UTC)

• "The rate of schizophrenia varies up to threefold depending on how it is defined." - is this phrased as to avoid the word 'overdiagnosed'? If this is meant to be summary length or what have you, there's secondary sources that state the tendency to overdiagnose so I'd vote to change the wording. I'd do more digging into the ref that's provided but i don't have access to it and my internet connection isn't sturdy enough to dig on google scholar.
• There are sex differences that might merit a sentence or two more, namely the bimodal age-at-onset for women and the difference in experience of positive and negative symptoms. I haven't seen it discussed much in daughter articles.

• If it's discussed in reviews, it should be in Epidemiology. SandyGeorgia (Talk) 02:01, 28 February 2011 (UTC)

Does the DSM count as a secondary or tertiary source? It's in there if the former, if the later I'll find something. JoeSmack ^Talk 04:12, 28 February 2011 (UTC)

• I feel like the word Haldol should be somewhere in Schizophrenia#Medication. Every other medication is, and it's not fair. ;-) Also, anyone mind if I put how long a typical depot shot of antipsychotics last? To my knowledge there's only Haldol and Risperidone, (I forget their super special marketing names/dosages/durations, but I can find it).

• Haloperidol and risperdal, I think. We don't typically give dosage information. SandyGeorgia (Talk) 02:01, 28 February 2011 (UTC)

Yep, that's it. Haloperidol decanoate is the depot injection. Others are risperdal consta and zuclopenthixol decanoate. I would just put one could also take some antipsychotics by depot shot, such as XXXX that would last 2 to 4 weeks for those who demonstrate poor daily medication compliance. JoeSmack ^Talk 04:12, 28 February 2011 (UTC)

Any feedback would be appreciated. JoeSmack ^Talk 01:51, 28 February 2011 (UTC)

If anyone wants to attack this stuff more indepth just make a new section for the topic, I'm overthreaded on this conversation already. JoeSmack ^Talk 04:12, 28 February 2011 (UTC)

Yes rates of homelessness in different parts of the world should be discussed in the section on prognosis. Does the WHO mention this?Doc James (talk · contribs · email) 06:57, 28 February 2011 (UTC)

Cannabis is associated with a dose-dependent increase in the risk of developing a psychotic disorder.[36] Frequent use has been found to double the risk of psychosis and schizophrenia.[35] Some research has however questioned the causality of this link.[24] Amphetamine, cocaine, and to a lesser extent alcohol, can result in psychosis that presents very similarly to schizophrenia.[3][37]

Yes, frequent use has been found to double the risk of psychosis, but what is the absolute risk? Without a denominator, there is absolutely no grasp on the actual likelihood. For instance, if there is a 0.05% chance of psychosis without the use of cannabis, then double the risk would only equate to 0.10%. Hardly a real concern. Yet we have no idea what the real risk is.

The even bigger link is Schizophrenia, Cannabis, and Conspiracy theories. If you dig deep into the Cannabis Legalization scene, you will find that an alarming majority of them indeed suffer from undiagnosed schizophrenia. Each and every one of them will also follow conspiracy theorists such as Jesse Ventura and Alex Jones as if they are the infallible word of God. I cannot believe this link is not mentioned anywhere in this article, almost every schizophrenic patient is into conspiracy theories and smoking cannabis. --Preceding unsigned comment added by 24.187.8.149 (talk) 22:48, 15 April 2011 (UTC)

Study: Modelling schizophrenia using human induced pluripotent stem cells

Nature (journal) published an interesting study about schizophrenia: Modelling schizophrenia using human induced pluripotent stem cells. Well this should revolutionize diagnosis before this breaks out. Maybe even Gene therapy in the long term... --Cyrus Grisham (talk) 15:59, 18 April 2011 (UTC)

I have seen many stories over the years about breakthroughs in schizophrenia. I guess for everyone's sake I do hope there is progress in this one, but I will believe it when I see it. This article (which is huge) has to be restricted to common practice and core secondary source material. We have set up daughter articles on cause and treatment of schizophrenia where it is good t o highlight more research-related developments or experimental therapies. Cheers, Casliber (talk · contribs) 22:38, 18 April 2011 (UTC)

Change title picture for the topic

Change the title picture for the topic, the stitched blanket seems irrelevant.

I'm sure there are much better pictures to use to describe it. 76.98.250.164 (talk) 19:21, 29 April 2011 (UTC)

Could you propose some of this better pictures for us to consider?--Doc James (talk · contribs · email) 23:02, 29 April 2011 (UTC)

@IP, this has been a difficult topic to find illustrations for indeed. Casliber (talk · contribs) 00:08, 30 April 2011 (UTC)

Refs in the lede

The lede section is supposed to summarize the article, not introduce new information. Thus, the lede section should not include refs. I suggest removing them and ensuring there is no information in the lede that does not exist in the main article. Basket of Puppies 03:19, 1 May 2011 (UTC)

I agree with your point that everything in the lead should be covered in the body of the article. As for citations in the lede, opinions differ. Personally, as a reader, I prefer footnote markers^[23] in the lede, because it saves me having to scour the body for supporting sources. But, as I said, opinions differ. Let's see what the general feeling on this page is. --Anthonyhcole (talk) 04:43, 1 May 2011 (UTC)

Personally, I find inline citations in leads to be helpful. What, specifically, is in the lead that is not also in the main text? --Tryptofish (talk) 17:08, 1 May 2011 (UTC)

My personal preference is to minimize refs in the lead, but I feel that numerical data, and similar types of specific empirical statements, require references regardless of where they occur. Most of the refs in the lead are associated with numerical figures. Looie496 (talk) 17:53, 1 May 2011 (UTC)

A ref after a statement implies it's new information. The lede is supposed to summarize the article, not introduce new information. The lede needs to be rewritten to ensure this is happens as it is currently not the case. Basket of Puppies 00:37, 2 May 2011 (UTC)

Since I had asked above whether anything was in the lead that is not also in the main text, I think I can see that the answer is "nothing", but instead, that specific figures are introduced in the lead and then further expanded upon below. In my opinion, there's nothing wrong with that. In that way, the lead is summarizing what follows, but also providing reliable sourcing for the information that it presents. Since the lead must come at the top of the page, of course, anything in the lead will be "new" from the perspective of reading the page from beginning to end. --Tryptofish (talk) 20:06, 2 May 2011 (UTC)

Please read WP:LEADCITE. Looie496 (talk) 01:24, 2 May 2011 (UTC)

Which says

The necessity for citations in a lead should be determined on a case-by-case basis by editorial consensus.

I say no citations in the lede, but rather only in the body of the article. Rewrite the lede to summarize the article. Basket of Puppies 01:31, 2 May 2011 (UTC)

We are both free to disagree, but let's be clear that this is a matter of preference, not of fundamental policy. Looie496 (talk) 01:51, 2 May 2011 (UTC)

Fully realize this. In fact it's why I posted that very sentence that says it's a matter of local consensus. Basket of Puppies 01:56, 2 May 2011 (UTC)

It's clear how the four of us feel. Let's see what others have to say. --Anthonyhcole (talk) 02:51, 2 May 2011 (UTC)

I like citations in the lead and recommend we continue using them expecially in controversial topics such as this.--Doc James (talk · contribs · email) 14:36, 5 May 2011 (UTC)

Poor article

Was told about this article by a friend who also studies the neurological aspects of schizophrenia. I have to agree with my friend's assessment this article in that it's really terrible! This article presents schizophrenia as a mental illness when it is in fact a neurological disorder of developmental and degenerative subsets thereof. I hope this can be updated and fixed ASAP. 140.247.141.137 (talk) 22:14, 4 May 2011 (UTC)

It's not appropriate to come to this article with general complaints. Specifics back by reliable sources count.OrangeMarlin ^{Talko Contributions} 22:19, 4 May 2011 (UTC)

He was right. You are all a bunch of bullies. I am brand new here and the first thing you tell me is I am acting inappropriately. Wikipedia reliability just suffered another loss. --Preceding unsigned comment added by 140.247.141.165 (talk) 23:31, 4 May 2011 (UTC)

I think this suggests a sockpuppet investigation is in order, especially this edit. Casliber (talk · contribs) 03:30, 5 May 2011 (UTC)

Wikipedia is not here to push a subgroups idea of what schizophrenia is. If your views are not reflected by main stream scientific publications get them accepted there first. If in a few years they are accepted there, Wikipedia will be altered to reflect them. --Doc James (talk · contribs · email) 14:35, 5 May 2011 (UTC)

Edit request from Pdaly12

I am a student at Central College in Pella, IA in a Medical Anthropology class and I am doing a research paper on schizophrenia and part of our project is to make an edit to the Wikipedia page of our subject. I was wondering if you could give me access to make some small edits on the page. I would help add to the society and culture subsection and add some examples of different cases of each subtype of schizophrenia in the subtypes subsection. It would be really appreciated if you gave me access for today. Thanks, Pat --Preceding unsigned comment added by Pdaly12 (talk o contribs)

Hi, welcome to Wikipedia and thank you for offering to help with this article. This article has been semi-protected so that unregistered and new users cannot edit it. You may want to look up an Ambassador who can help you with coordinate between your school and Wikipedia. You can also request confirmed status if you can't wait for the autoconfirmed criteria. Alternatively, you can post your changes here and someone will put them in for you. If your professor will be checking the edit history to see your changes, you should also request that whoever edits the article for you put your username in their edit summaries. Hope that helps! -- Bility (talk) 23:24, 5 May 2011 (UTC)

Eggs in one basket.

I have removed the material from this section because hardly any of it related to the purpose of this page, which is to discuss ways of improving the article, not to discuss the topic itself or tell personal stories. Anything that goes here should be specifically framed in terms of issues regarding the article text and should be supportable on the basis of reputable published literature. Looie496 (talk) 17:41, 6 May 2011 (UTC)

What can be discussed on article talk pages is very tightly constrained by the policy WP:TALK, in order to keep the discussions focussed and keep the page from turning into a massive wall of text. The different major subtypes of schizophrenia are touched on in the article at Schizophrenia#Subtypes. --Anthonyhcole (talk) 00:17, 7 May 2011 (UTC)

Pronunciations

It might be worth having non-American pronunciations featured on the page, viz. that with a "Z" sound as opposed to the "TS". 91.85.188.73 (talk) 13:43, 8 May 2011 (UTC)

In Australia we say TS. Where is it pronounced Z? --Anthonyhcole (talk) 04:41, 17 May 2011 (UTC)

Age of onset

Realising the restricted and highly rigorous nature of changes to the page, this is just to draw editors attention to a study rather than specifically to disgree, im sure theres good reasons for whats said on this page. Gorwood et al (1995) found that average ages of onset were 27.8 in men, and 32.5 in woman, which seems to agree with what is said under the Epidemiology heading, but not in the introduction where it says "The onset of symptoms typically occurs in young adulthood". The study is found here http://ajp.psychiatryonline.org/cgi/content/abstract/152/2/208 Lewisly (talk) 17:50, 16 May 2011 (UTC)

Hmm, that study is at the older end but not disagree with the range per se. Describing its onset as in young adulthood is common, and I think most would agree that people in their third decade are young adults, but agree it is a somewhat and possibly subjective lead sentence...anyone reckon we need to make it more exact for the lead? Casliber (talk · contribs) 20:16, 16 May 2011 (UTC)

Averages here may not be very useful.

Whilst the rate ratio curve for incidence is normally distributed, the curves for age at onset are not. Men show a modal incidence in their early twenties and perhaps a second peak around middle age. Women also show modal onset in their early twenties, but this is a lower frequency, somewhat broader mode and is followed by a more pronounced peak in middle age than men (Drake, Addington, Viswanathan, Lewis, & Abel in submission; Häfner, Maurer, Loffler, & Riecher-Rössler, 1993; Hambrecht, Maurer, Häfner, & Sartorius, 1992; Leung & Chue, 2000.) Thus, there is a switch from male predominance in incidence during the early twenties to female predominance in incidence at older ages. Using admixture analysis of a relatively small case register sample of non-incident cases, Castle et al. (1993) suggested that the early modal onset of non-affective psychosis lies at 21-22 years in both women and men, whereas there are secondary underlying curves with modes at 36 years in men and 39 years in women; and women alone have a third mode of onset in their early 60s.

Abel, Drake & Goldstein (2010), page 418.

This could be shrunk to something like

Although schizophrenia can emerge at any age, onset occurs most often in the early twenties and during middle age.

I'm tempted to replace "middle age" with "the later thirties" but that might be relying too heavily on the last reference (Castle et al.) which is a primary study. --Anthonyhcole (talk) 09:40, 17 May 2011 (UTC) Struck comment 09:55, 17 May 2011 (UTC)

The late onset phenomenon is a somewhat different kettle of fish. Need to read up again to figure out best way of framing it. Casliber (talk · contribs) 09:49, 17 May 2011 (UTC)

Excellent. --Anthonyhcole (talk) 09:55, 17 May 2011 (UTC)

While you're at it :) I noticed something about "early onset" (13+) and "very early onset" (<13). If you could shed some light on that, it might complete the picture. I can search for it if you don't want to go there. --Anthonyhcole (talk) 13:31, 17 May 2011 (UTC)

• Regarding the age of the study, that is entirely irrelevant to it being authoritative. Notice that there are other, newer studies that are still referencing this one as an authoritative source. The journals that those studies were published in are all mainstream and authoritative in and of themselves. Age isn't the issue as much as authority and relevance. Basket of Puppies 13:14, 17 May 2011 (UTC)

Errrm, I was talking about the age of the people in the study...Casliber (talk · contribs) 13:25, 17 May 2011 (UTC)

treatment and onset

I happen to be a schizophrenic who has extensive knowledge, first hand, of the treatment and the onset of schizophrenia, which in this case is in a male subject. I saw no mention in the treatment section of the antipsychotic drug Abilify. However, there is an extensive wikipedia page on the drug itself. I would like to see a link to that page, which does relate itself in the treatment of schizophrenia. I have a real problem with the onset time frame for schizophrenia as it seems a bit skewed. Again, this is only one person speaking, however it is from personal first hand experience as my onset was at age seventeen (17 years old). As far as I know, it is very rare to develop schizophrenia after adulthood has set in. It happens typically in the developing brain when adolescents are becoming fully developed, not after the fact. Basichumanbeing (talk) 08:22, 23 May 2011 (UTC)BasicHumanBeing (monday may 23 - 1:21 am pst)

"Abilify" is a brand name for aripiprazole, one of the atypical antipsychotics, and the article, "Atypical antipsychotic," is linked to in this article. The article, Management of schizophrenia, also linked to in this article, briefly discusses atypical antipsychotics. With regard to age of onset, an experienced editor is researching the current medical consensus on this: see the section above this one #Age of onset. --Anthonyhcole (talk) 09:30, 23 May 2011 (UTC)

Brain changes from schizophrenia is currently not verified

Ho 2011 (http://dx.doi.org/10.1001/archgenpsychiatry.2010.199) found brain volume loss from antipsychotic treatment. Part of the loss can not be attributed to other things than antipsychotic treatment (and there is no evidence that not all the loss can be attributed to antipsychotic usage). Therefore the arguments in Os 2009 can no longer be used to tell that there are ongoing brain changes from schizophrenia itself. As far as I know none of the studies referenced by Os have controlled for antipsychotics treatment in such a way that you can say that the brain tissue loss was not caused by antipsychotic treatment.

So I suggest replacing Os 2009 in this area with something more specific and possibly explain why the conclusions may not be valid. And I also suggest adding a link to Ho 2011. Nopedia (talk) 17:22, 28 May 2011 (UTC)

We generally use review articles rather than primary research. Doc James (talk · contribs · email) 17:59, 28 May 2011 (UTC)

I can see the reason for using review articles, but it is misleading on controversial matters since the review articles usually points to old articles. And in a case like this there are strong reasons to believe that the old articles are not valid since they do not take into account the new facts from Ho 2011. In other words: Using Os 2009 here seems plain wrong now.

This is of course a main type of problem with old research, especially in controversial areas, something Ioannidis has written about, see John_P._A._Ioannidis. Nopedia (talk) 18:46, 28 May 2011 (UTC)

The reason we use reviews is to prevent placing undue weight to any single primary source. If and when the primary article is reviewed by the wider medical community in the form of secondary reviews, we can then place its findings in context. Until then, it is likely too soon to be used. Yobol (talk) 19:27, 28 May 2011 (UTC)

Yes, I understand the reason for using reviews. And I appreciate it. It might seem like I wanted the review article to go away from here, but that is just my clumsiness. Of course not. But it must be counteracted by the new research. BTW there is a review in the same issue of Arch Gen Psychiatry that puts Ho 2011 into context: http://dx.doi.org/10.1001/archgenpsychiatry.2010.187

Reading this (and some other reports) I can't see that it is very controversial to have the opinion that antipsychotic treatment gives brain loss. The controversy is rather about how to tell this and maybe about the amount of damage. When it comes to the amount of damage it looks clear that the monkey studies (Dorph-Petersen, Konopaske) gives a rather good estimation of it (if you compensate for that things happens faster in the monkeys shorter life). Many researchers still believe that antipsychotics may have a protecting effect on psychotic brains. There is however no direct evidence of this that I am aware of, only indications. All this is is reflected in the review I mentioned. And I think that should be integrated into this article. (With the addition that the research has nowhere shown that not all the brain loss is from antipsychotic treatment. Or a research article showing that not all is from antipsychotic treatment, but I am not aware of any such article actually.) Nopedia (talk) 20:15, 28 May 2011 (UTC)

The article you point to is an editorial, not a review, and therefore would face the same restrictions per MEDRS as a primary article. As I am not familiar with the literature, are there any review articles that discuss this (and since this is on the schizophrenia talk page, the review would have to specifically discuss in context of treatment of schizophrenia, otherwise this discussion would be better suited for the antipsychotics page)? Yobol (talk)

I believe that editorials in top medical journals should count as reliable secondary sources -- they are very thoroughly reviewed, and aren't simply the opinion of the author. Also David Lewis is a very reputable authority. So I don't think there should be any rule against using this. (I can't access more than the first 150 words at the moment, so I don't actually know what it says.) Looie496 (talk) 01:36, 29 May 2011 (UTC)

Thanks to Doc James for emailing me a copy. Here is my take on the situation: It seems pretty well established that antipsychotic drugs can produce brain volume reductions. However this has been suspected, if not known, for years, and many reviews have taken it into account. In particular PMID 21312403 is a review from 2010 that concludes that widespread volume reductions are seen even in first-episode schizophrenics (who obviously had not been exposed to drugs for any substantial time). Looie496 (talk) 16:41, 29 May 2011 (UTC)

Looie496, Thanks for the pointer to PMID 21312403, but unfortunately I can't get that article for some reason. The abstract says absolutely nothing useful as far as I can see. -- Preceding unsigned comment added by Nopedia (talk o contribs) 17:17, 29 May 2011 (UTC) Nopedia (talk) 17:20, 29 May 2011 (UTC)

The abstract says, "The reductions were seen in both FE and chronic schizophrenia. . . . That these reductions were found in both FE and chronic subjects supports that brain abnormalities are present at the onset of illness, and are not simply a consequence of chronicity.". Looie496 (talk) 17:40, 29 May 2011 (UTC)

Here is the reply I tried to post yesterday, but I had some trouble:

Yes, it is an editorial, sorry (but with a kind of review, but not a review article). There are not many references to these articles yet and my experience is that there will not be many for a long time. It is my impression that it takes considerably longer time for articles that mentions possible adverse effects of antipsychotic treatment to be referenced. (Compare for example Tiihonen 2009, 101 references right now according to Google Scholar, and Konopaske 2008, 37. And part of Tiihonen is good and part is wrong in the conclusion. There is nothing wrong with Konopaske that I am aware of.)

There are yet only two references in English to Ho 2011, Goff (which seem to have misread the article) and Krishnadas (which I can't see much of yet, but it does not look important). However according to WP:MEDRS the reliability and consensus over the quality of the sources are the important thing.

The principal author behind Ho 2011 is Nancy Coover Andreasen on of the most respected researchers in this area, receiver of National Medal of Science year 2000. And the researched writing the editorial is David A Lewis, another well-respected neuroscientist (see http://www.tnp.pitt.edu/pages/employee/lewis/lewis_da.html).

So even if there is no review yet I think the sources are good enough to include. (And I do have some more material that are important here, but I do not have time to add it in a readable way at the moment.) Nopedia (talk) 17:26, 29 May 2011 (UTC)

Reviews are exceedingly important. I have the review mentioned above but would need an email. Doc James (talk · contribs · email) 17:49, 29 May 2011 (UTC)Doc James (talk · contribs · email) 17:42, 29 May 2011 (UTC)

Sorry for responding late. Thanks for the review, Doc James. I can't find that the review says anything about brain tissue loss from schizophrenia. It might be this part that is misleading, pg 258 in the review: "A number of important further issues emerged in our review of the prefrontal cortex studies, including some involving brain-behavior relationships. Nakamura et al. (2007) assessed what they called neocortical GM. They reported a reduction in neocortical GM in FE schizophrenia compared to healthy controls.". They use the word "reduction" here to just mean "smaller at the beginning". They did not check reduction from the illness before antipsychotic treatment and could not do that in their research setup. So my conclusion is still that using Os 2009 here to say something about brain tissue loss now is not good. Nopedia (talk) 23:49, 30 May 2011 (UTC)

Excellent article: couple of points

First, I'd just like to say that, in my opinion, this is a very well written and balanced article. Well done to all who have contributed to it and I hope that it succeeds in its FA review.

I'm not suggesting that anyone attempt any of the following until after the FA process but, personally, I would be interested in a treatment of the validity of schizophrenia as a diagnostic category. Is it a valid construct and to what degree and in what sense? Perhaps distinguishing between its utility as a clinical construct and the absence of a definitive understanding of its aetiology?

The other point relates to the history section. I've previously written part of the the history section of the dementia praecox article (largely written by Richard Knoll) dealing with the first use of the term dementia praecox. The reading I provide there differs considerably from that in this article in relation to the contribution of Benedict Morel and his purportedly early description of the condition. Note 10, note 11 and note 13 from that article are also relevant to this point. FiachraByrne (talk) 23:49, 6 April 2011 (UTC)

I have schizophrenia and I,m using the natural thing for this post. I believe this miracle is unfair and very stupid...etc. I call it a blackball miracle.

Rafael Gonzalez --Preceding unsigned comment added by 75.12.169.22 (talk) 23:28, 10 April 2011 (UTC)

"Blackball miracle": that's an interesting and evocative term Rafael.

I'm going to proceed with editing the page History of schizophrenia in a like but not identical manner to that section of the dementia praecox article which I linked to above. I'm also going to contextualise those studies which claim first recorded appearance of the condition which are very problematic to say the least. I may revisit this article after that FiachraByrne (talk) 01:09, 11 April 2011 (UTC)

Fiachra, I think you've hit the nail on the head when you mention the diagnosis's utility as a clinical construct rather than a reproducible manifestation of certain aetiology. Is this due to the limited treatment options? By this I mean that, to my knowledge, all the various forms of schizophrenia that are described all get treated by rather non-specfic D2 blockade with varying psychological therapies. There seems to be a lot of overlap between diagnoses depending upon what signs are most prominent at the time of examination (schizophrenia, schizophrenia with co-morbid up or down mood, morbid mood with psychotic features, schizoaffetive disorder etc.) and I've seen patients with frequently changing diagnoses on each admission. They all get similar treatment, however, so from a utility point of view, it almost doesn't matter what you call it. I'm coming at this from a basic level, as a med student revising for finals (so so finding the wiki talk page much more interesting than learning prevalence figures...), but generally it seems to me that a lot of psychiatry is 'say-what-you-see' resulting in somewhat arbitrary consensus definitions. I'm also immediately suspicious of the validity of any definition of a condition which employs set time frames such as for a month.

I find the entirety of psychiatry both depressing and exciting in equal measure owing to just how little we know regarding aetiology and therefore the treatments that we have developed. I hope and suspect that the next major advances in medicine are due from psychiatry, allowing us to more fully understand the interdependence of the body, brain and mind and indeed what the mind and conciousness really are. This is clearly exciting but the current outcomes for patients, particualrly people with schizophrenia, are deeply unsatisfactory. I suspect that you're coming at this from a much more mature view point than I so apologies if I'm not contributing. It would be interesting to know what qualified people and patients have to say about it. Jimbobolaffsson (talk) 23:13, 13 April 2011 (UTC)

I would like to remind everybody commenting here that this page is not for general discussion of the topic, it is for discussion of how best to make use of reliable sources in order to improve the article. Any discussion should focus on problems with the article and how they can be fixed. Regards, Looie496 (talk) 23:43, 13 April 2011 (UTC)

I agree with all of the above. Fiachra, do you have any particular authors in mind, upon whose work we could base the new section? I mean an authoritative overview of the question, so we can avoid breaching Wikipedia:No original research, especially Wikipedia:Synthesis. Jimbob, might one of your tutors be able to recommend something? --Anthonyhcole (talk) 02:53, 14 April 2011 (UTC)

Jeffrey Poland has written an interesting chapter touching on some of these points entitled 'How to move beyond the concept of schizophrenia'. The book is part of an excellent series on psychiatry. (Poland also has another chapter of potential interest, here). Berrios, I guess, is best for the history of the disease concept:'Schizophrenia: a conceptual history'. He can be a painful read. The clinical psychologists Richard Bentall (Reconstructing Schizophrenia) and Mary Boyle (http://books.google.ie/books?id=5iRH0v093OgC&pg=PA364&dq=mary+boyles+schizophrenia+a+scientific+delusion&hl=en&ei=cKmnTaqlNM7tOfqYifAJ&sa=X&oi=book_result&ct=result&resnum=5&ved=0CD0Q6AEwBA#v=onepage&q&f=false Schizophrenia: a scientific delusion?] both have fairly polemical books attacking the validity of scientific schizophrenia. -- Preceding unsigned comment added by FiachraByrne (talk o contribs) 02:16, 15 April 2011 (UTC)

I'm slowly working through these, thanks Fiachra. --Anthonyhcole (talk) 15:31, 19 April 2011 (UTC)

One library in Western Australia has one of the books with a chapter by Poland, due back mid-May. Don't wait for me (I'm not buying it at $60 plus postage). --Anthonyhcole (talk) 09:27, 30 April 2011 (UTC)

I did not read anything Poland [18] wrote, but there are some reviews of Mary Boyle's book listed on Talk:Mary Boyle (psychologist). Tijfo098 (talk) 19:55, 29 April 2011 (UTC)

To address the original comment, the "validity of schizophrenia as a diagnostic category" is covered at length in "Social construction of schizophrenia". I don't know why the article isn't summarized and linked from this one. --Pengo 08:07, 20 June 2011 (UTC)

Evolutionary explanations

An alternative explanation for the persistence of schizophrenia: http://ffrf.org/legacy/fttoday/2003/april/index.php?ft=sapolsky. Probably worth mentioning this in the article. Adaba (talk) 09:34, 3 June 2011 (UTC)

Review articles would be need. Feel free to write something and we can look at adding it. Doc James (talk · contribs · email) 09:52, 3 June 2011 (UTC)

Subtypes of schizophrenia

Why does the subtype section not refer to hebephrenic schizophrenia or simple schizophrenia?ACEOREVIVED (talk) 20:12, 20 July 2011 (UTC)

Well, I have now looked and seen it does refer to simple schizophrenia, but I have a feeling that this is in DSM as well as ICD.If you type "hebephrenic schizophrenia" into the box on the left, you get redirected to "disorganized schizophrenia", but this is not mentioned in the article,either. ACEOREVIVED (talk) 20:21, 20 July 2011 (UTC)

I might not understand what you are saying, but the Subtypes sections does mention Disorganized type: Named hebephrenic schizophrenia in the ICD. Did you not notice this, or are you suggesting it is insufficient? Looie496 (talk) 22:12, 20 July 2011 (UTC)

Mary Boyle's work

One thing that could go here is Mary Boyle's arguments that schizophrenia does not exist, but I am aware that this is controversial. ACEOREVIVED (talk) 20:24, 20 July 2011 (UTC)

I think it would take a lot of knowledge to discuss this in an appropriate way. As I understand it her argument is not that people we call schizophrenic are not ill and in need of treatment, but rather that there is no single "disease" they all have in common. Her book has certainly drawn enough attention to be worth a mention, but to write about it usefully I think one would have to have a good feel for how other investigators have treated it. Looie496 (talk) 22:06, 20 July 2011 (UTC)

Sub-section 'Differential'

In the sub-section Differential, under the proper section Diagnosis, it states, "Schizophrenia is complicated with obsessive-compulsive disorder (OCD) considerably more often..." Is this the proper use of the word complicated? Is it in the sense to twist or become twisted together? I double checked in Wiktionary and there didn't seem to be any definition that would cause that statement to make sense. So either Wiktionary doesn't have the full meanings or somebody is using that word wrong. Could someone please let me know. Thanks. Lighthead ^þ 19:56, 28 July 2011 (UTC)

That's a good question. I'd like to know from the MD editors: does this mean that OCD is a complication, or that the diagnosis is often mistaken? As written, it is indeed unclear. --Tryptofish (talk) 21:55, 28 July 2011 (UTC)

Without tracking down the editor responsible it's more than likely meant to be comorbid. The article referenced, the title is actually about Schizophrenia being comorbid with OCD. That must be it. But anyway, thanks for responding Tryptofish. Lighthead ^þ 23:59, 28 July 2011 (UTC)

I agree, that makes entirely good sense. --Tryptofish (talk) 00:41, 29 July 2011 (UTC)

As a side note, somebody must not be doing their job in clearing an article for featured status. That is unless that's a recent entry; I haven't checked. Lighthead ^þ 01:49, 30 July 2011 (UTC)

Cause of schizophrenia

Today's papers have a study from Nature Genetics that needs to be in the article. It's called Exome sequencing supports a de novo mutational paradigm for schizophrenia by Bin Xu, Maria Karayiorgou and several others. It costs $18. Can anybody who is actively working on this article afford to buy it? There are high level summaries in WebMD, Ars Technica and elsewhere. Thanks. -SusanLesch (talk) 02:28, 9 August 2011 (UTC) P.S. I crossposted this to Talk:Causes of schizophrenia and hope that doesn't confuse anything.

Per WP:MEDRS we try to base all references on review articles especially for a topic with as much research as this one. Doc James (talk · contribs · email) 04:54, 9 August 2011 (UTC)

That means nobody can include this study, until somebody decides to write a review? I apologize for being impatient but the findings seemed rather important. -SusanLesch (talk) 16:54, 9 August 2011 (UTC)

Not necessarily a review, but some sort of evaluative discussion in a top-level source, for example a "perspective" piece in Nature or Science. Let me note that although this seems to me as well to be very interesting, the fact that it appeared in Nature Genetics rather than Nature suggests that there may be a few issues with it. The number of subjects, for example, does not seem huge given the statistical levels of difference being reported. We should really allow some sort of expert evaluation to take place before we try to include the study here. Looie496 (talk) 17:18, 9 August 2011 (UTC)

Okay. Thanks very much to you both for your replies. Then all I can do is point this out and trust that it will show up here when the time is right. Best wishes. -SusanLesch (talk) 18:37, 9 August 2011 (UTC)

I do not see a problem with including recent research in subarticles but per WP:DUE we need evidence that this has gained acceptance before including it here in an overview article. Doc James (talk · contribs · email) 19:05, 9 August 2011 (UTC)

I agree with the other comments here. A lot of studies like this (mining for gene correlations) have been coming out, and we here need to be careful about not singling any one of them out, especially when they each point in different directions and may all turn out to be temporary steps towards wherever the story will end up. --Tryptofish (talk) 20:07, 9 August 2011 (UTC)

Should we say more about cortical grey matter loss

I started a new section because I'm not addressing Nopedia's suggestion about Ho 2011
The article doesn't seem to mention grey matter loss, except for "Those with a diagnosis of schizophrenia have changes in both brain structure and chemistry." Should it have more detail; i.e., that the structural change is GM loss, and the regions of loss? (Don't know if it's too early to mention the "subtle but measurable" GM loss due to antipsychotics found in Ho 2011.) --Anthonyhcole (talk) 18:10, 29 May 2011 (UTC)

Responding belatedly, I'd say "yes". It's been added now by another editor; please see the latter part of #Severely Lacking in Alternative Points of View, above. --Tryptofish (talk) 23:26, 19 June 2011 (UTC)

Thanks all. [19]; especially Bloomingdedalus for kicking this off. --Anthonyhcole (talk) 17:58, 20 June 2011 (UTC)

Yes, I think this is doable.... Casliber (talk · contribs) 20:45, 20 June 2011 (UTC)

• I tried to add this in a while back. It was summarily rejected and removed by the WP:OWNers of the article despite having nearly a dozen secondary sources to back it up. Basket of Puppies 01:08, 21 June 2011 (UTC)

The grey matter loss may be caused by medication as some research has suggested. http://archpsyc.ama-assn.org/cgi/content/short/68/2/128

It may also be caused by a special sort of virus. http://www.pnas.org/content/98/8/4293.full

Or it may be a function of what happens to the person in life. Exclusion, isolation, unemployment etc. These may lead certain parts of the brain to be used less or more and cause atrophy.

It is also possible for the brain to function with damaged matter. The effect is called neuroplasticity. It was discovered in the mid-20 century back when stroke patients were written off rather than rehabilitated. A carer decided to rehabilitate his father rather than leave him to die and today modern medical practice is all about recovery. This guys father regained a high degree of function. (If i remember right he died half way up a mountain of a heart attack but I can't confirm that). When he was autopsied they found a large number of the connections between his brain and body had been cut the the brain and nervous system had adapted to the problem with training.

I don't have a reference for that story. I saw it on a BBC docuemntary,. I would suggest it might be worth checking with a doctor to see if the story is true and finding a reference for it. It is important when providing information about schizophrenia that the info is accurate but you also need to give patients and carers a bit of hope. -- Preceding unsigned comment added by 78.149.156.237 (talk) 00:33, 20 August 2011 (UTC)

Sorry. This last comment was by me. --Morethanhuman (talk) 01:48, 20 August 2011 (UTC)

Source of the article : Wikipedia