67. R. Mojtabai and R. O. Rieder (1998) ‘Limitations of the symptom-orientated approach to psychiatric research’, British Journal of Psychiatry, 173: 198–202.
68. M. J. Muller and H. Wetzel (1998) ‘Improvement of inter-rater reliability of PANSS items and subscales by a standardized rater training’, Acta Psychiatrica Scandinavica, 98: 135–9.
69. D. M. Carter, A. Mackinnon, S. Howard, T. Zeegers and D. L. Copolov (1995) ‘The development and reliability of the Mental Health Research Institute Unusual Perceptions Schedule (MUPS): an instrument to record auditory hallucinatory experiences’, Schizophrenia Research, 16: 157–65.
70. G. Haddock, J. McCarron and N. Tarrier (1999) ‘Scalesto measure dimensions of hallucinations and delusions: the Psychotic Symptom Rating Scale (PSYR-ATS)’, Psychological Medicine, 29: 879–89.
71. N. C. Andreasen (1979) ‘The clinical assessment of thought, language and communication disorders’, Archives of General Psychiatry, 36: 1315–21.
72. N. M. Docherty, J. P. Rhinewine, R. P. Labhart and S. Gordinier (1998) ‘Communication disturbance and family psychiatric history in parents of schizophrenic patients’, Journal of Nervous and Mental Disease, 186: 761–8.
Chapter 7 The Significance of Biology
1. Quoted in A. Hodges (1983) Alan Turing: The Enigma of Intelligence. London: Burnette Books.
2. Quoted in E. Shorter (1997) A History of Psychiatry. New York: Wiley.
3. R. Hunter and I. MacAlpine (1963) Three Hundred Years of Psychiatry. London: Hogarth Press.
4. W. Mayer-Gross, E. Slater and M. Roth (1975) Clinical Psychiatry. London: Cassell.
5. S. Guze (1989) ‘Biological psychiatry: is there any other kind?’, Psychological Medicine, 19: 315–23.
6. T. S. Szasz (1960) ‘The myth of mental illness’, American Psychologist, 15: 564–80.
7. T. S. Szasz (1992) ‘The United States v. drugs’, in J. K. Zeig (ed.), The Evolution of Psychotherapy: The Second Conference. New York: Brunner/Mazel Inc., pp. 300–12.
8. T. S. Szasz (1999) Fatal Freedom: The Ethics and Politics of Suicide. Westport, CT: Praeger.
9. This quote is from Thomas Szasz’s summary statement and manifesto, which can be found on the website of the Thomas S. Szasz MD Cybercenter for Liberty and Responsibility.
10. T. S. Szasz (1979) Schizophrenia: The Sacred Symbol of Psychiatry. Oxford: Oxford University Press.
11. F. G. Glaser (1965) ‘The dichotomy game: a further consideration of the writings of Dr Thomas Szasz’, American Journal of Psychiatry, 121: 1069–74.
12. M. Roth (1973) ‘Psychiatry and its critics’, British Journal of Psychiatry, 122: 374.
13. S. Finger (2000) Minds Behind the Brain: A History of the Pioneers and their Discoveries. Oxford: Oxford University Press.
14. D. Healy (1997) The Anti-Depressant Era. Cambridge, MA: Harvard University Press.
15. E. Kraepelin (1907) Textbook of Psychiatry, 7th edn (trans. A. R. Diefendorf) London: Macmillan.
16. P. J. McKenna (1994) Schizophrenia and Related Syndromes. Oxford: Oxford University Press.
17. G. W. Roberts (1991) ‘Schizophrenia: a neuropathological perspective’, British Journal of Psychiatry, 158: 8–17.
18. P. J. Harrison (1999) ‘The neuropathology of schizophrenia: a critical review of the data and their interpretation’, Brain and Language, 122: 593–624.
19. See E. H. Burrows (1996) ‘A brief history of brain imaging’, in S. Lewis and N. Higgins (eds.), Brain Imaging in Psychiatry. Oxford: Blackwell, pp. 1–13.
20. E. C. Johnstone, T. J. Crow, C. D. Frith, J. Husband and L. Kreel (1976) ‘Cerebral ventricular size and cognitive impairment in chronic schizophrenia’, Lancet, ii: 924–6.
21. P. W. R. Woodruff and S. Lewis (1996) ‘Structural brain imaging in schizophrenia’, in Lewis and Higgins (eds.), Brain Imaging in Psychiatry, op. cit., pp. 188–214.
22. See, for example, D. Fannon, X. Chitnis, V. Doku, L. Tennakoon, S. O’Ceallaigh, W. Soni, A. Sumich, J. Lowe, M. Santamaria and T. Sharma (2000) ‘Features of structural brain abnormality detected in first-episode psychosis’, American Journal of Psychiatry, 157: 1829–34.
23. Harrison, ‘The neuropathology of schizophrenia’, op. cit.
24. For systematic reviews of CT and structural MRI studies of schizophrenia, see: S. W. Lewis (1990) ‘Computed tomography in schizophrenia, 15 years on’, British Journal of Psychiatry, 157 (Supplement 9): 16–24 (in this review, significant ventricular enlargement was reported in only nine out of twenty-one studies, and enlargement was marginal in a further three); Woodruff and Lewis, ‘Structural brain imaging in schizophrenia’, op. cit., pp. 188–214 (in this review, it is reported that ventricular enlargement was observed in the majority of studies, although the differences between the schizophrenia patients and the controls was statistically significant in only the minority).
25. R. J. Dolan and G. M. Goodwin (1996) ‘Brain imaging in affective disorders’, in Lewis and Higgins (eds.), Brain Imaging in Psychiatry, op. cit., pp. 227–43.
26. S. Raz and N. Raz (1990) ‘Structural brain abnormalities in the major psychoses: a quantitative review of the evidence’, Psychological Bulletin, 108: 93–108.
For two recent studies which have compared and failed to find a difference between schizophrenia and bipolar patients, one using CT and the other using MRI, see: J. Danckert, D. Velakoulis, P. McGorry, N. Bridle, A. Kelman, A. Hoberton and P. Pantelis (1998) ‘A CT study of ventricular size in first episode psychosis’, Schizophrenia Research, 29: 75; S. C. Schulz, L. Friedman, R. Findling, J. Kenny, T. Swales and A. Wise (1998) ‘Both schizophrenic and bipolar adolescents differ from controls on MRI measures’, Schizophrenia Research, 29: 81.
27. G. N. Smith and W. G. Iacano (1986) ‘Lateral ventricular enlargement in schizophrenia and choice of control group’, Lancet, i: 1450.
28. J. D. van Horn and I. C. McManus (1992) ‘Ventricular enlargement in schizophrenia: a meta-analysis of studies of ventricular:brain ratio’, British Journal of Psychiatry, 160: 687–97; P. J. McKenna (1994) Schizophrenia and Related Syndromes. Oxford: Oxford University Press.
29. Woodruff and Lewis, ‘Structural brain imaging in schizophrenia’, op. cit., pp. 188–214.
30. B. K. Piri, N. Saeed, A. Oatridge, J. V. Hajnal, S. B. Hutton, L.-J. Duncan, M. J. Chapman, T. R. E. Barnes, G. M. Bydder and E. M. Joyce (1998) ‘A longitudinal MRI study of first-episode schizophrenia: assessment of cerebral changes and quantification of ventricular changes’, Schizophrenia Research, 29: 76.
31. For example, in most people the two cerebral hemispheres are not quite symmetrical, and the left frontal and right temporal lobes are slightly larger than their opposing anatomical structures. In a recent study (T. M. Sharma, E. Lancaster, T. Sigmundsson et al. (1999) ‘Lack of cerebral asymmetry in familial schizophrenic patients and their relatives: the Maudsley family study’, Schizophrenia Research, 40: 111–20) it was observed that this skew is less marked or is even absent in some schizophrenia patients.
A number of studies have also revealed evidence that the area of the corpus callosum – the large bundle of nerve fibres that connects the two hemispheres – is reduced in schizophrenia patients compared with normal controls (see P. W. R. Woodruff, I. C. McManus and A. S. David (1995) ‘Meta-analysis of corpus callosum size in schizophrenia’, Journal of Neurology, Neurosurgery and Psychiatry, 58: 457–61).
32. See S. Rose (1993) The Making of Memory: From Molecules to Mind. London: Bantam.
33. See J. D. Bremner, P. Randall, T. M. Scott, R. A. Bronen, J. P. Seibyl, S. M. Southwick, R. C. Delaney, G. McCarthy, D. S. Charney and R. D. Innis (1995) ‘MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder’, American Journal of Psychiatry, 152: 973–81; and also M. B. Stein, C. Koverola, C. Hanna, M. G. Torchia and B. McClarty (1997) ‘Hippocampal volume in women victimized by child sexual abuse’, Psychological Medicine, 27: 951–9.
34. M. H. Teicher (2000) ‘Brain ab
normalities common in survivors of childhood abuse’, Cerebrum, 2: 50–67.
35. E. A. Maguire, D. G. Gadian, I. S. Johnsrude, C. D. Good, J. Ashburner, R. S. J. Frackowiak and C. D. Frith (2000) ‘Navigation-related structural changes in the hippocampi of taxi drivers’, Proceedings of the National Academy of Science.
36. My account of the work by Mosso is taken from M. Posner and M. E. Raichle (1994) Images of Mind. New York: Scientific American Library.
37. S. W. Lewis (1996) ‘Functional brain imaging’, in Lewis and Higgins (eds.), Brain Imaging in Psychiatry, op. cit., pp. 108–15.
38. M. S. Keshavan and J. D. Cohen (1996) ‘Magnetic resonance spectroscopy and functional MRI’, in Lewis and Higgins (eds.), Brain Imaging in Psychiatry, op. cit., pp. 116–37.
39. P. Flor-Henry (1969) ‘Psychosis and temporal lobe epilepsy: a controlled investigation’, Epilepsia, 10: 365–95.
40. P. Green (1978) ‘Interhemispheric transfer in schizophrenia: recent developments’, Behavioural Psychotherapy, 6: 105–10.
41. T. Crow (1991) ‘The origins of psychosis and “The descent of man” ’, British Journal of Psychiatry, 159 (Supplement 14):76–82; T. Crow (1995) ‘A Darwinian approach to the origins of psychosis’, British Journal of Psychiatry, 167: 12–25.
42. T. J. Crow (1998) ‘Nuclear schizophrenic symptoms as the key to the evolution of modern homo sapiens’, in S. Rose (ed.), From Brains to Consciousness: Essays on the New Sciences of the Mind. London: Penguin, pp. 137–53.
43. P. Satz and M. F. Green (1999) ‘Atypical handedness in schizophrenia: some methodological and theoretical issues’, Schizophrenia Bulletin, 25: 63–78.
44. Sharma et al., ‘Lack of cerebral asymmetry’, op. cit.
45. R. E. Gur (1999) ‘Is schizophrenia a lateralized brain disorder?: Editor’s introduction’, Schizophrenia Bulletin, 25: 7–9.
46. J. H. Gruzelier (1999) ‘Functional neuropsychological asymmetry in schizophrenia: a review and reorientation’, Schizophrenia Bulletin, 25: 91–120.
47. D. H. Ingvar and G. Franzen (1974) ‘Abnormalities of cerebral blood flow distribution in patients with chronic schizophrenia’, Acta Psychiatrica Scandinavica, 50: 425–62.
48. P. F. Liddle (1996) ‘Functional imaging in schizophrenia’, in Lewis and Higgins (eds.), Brain Imaging in Psychiatry, op. cit., pp. 215–26.
49. D. R. Weinberger, K. F. Berman and R. F. Zec (1986) ‘Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia: I. Regional blood flow evidence’, Archives of General Psychiatry, 45: 609–15.
50. R. Erkwoh, O. Sabri, K. Willmes, E. M. Steinmeyer, U. Buell and H. Sass (1999) ‘Active and remitted schizophrenia: psychopathological and regional cerebral blood flow findings’, Psychiatry Research: Neuroimaging, 90: 17–30; S. A. Spence, S. R. Hirsch, D. J. Brooks and P. M. Grasby (1998) ‘Prefrontal cortex activity in people with schizophrenia and control subjects: evidence from positron emission tomography for remission of “hypofrontality” with recovery from acute schizophrenia’, British Journal of Psychiatry, 172: 316–23.
51. G. D. Pearlson (1999) ‘Structural and functional brain changes in bipolar disorder: a selective review’, Schizophrenia Research, 39: 133–40.
52. R. Penades, T. Boget, F. Lomena, M. Bernardo, J. J. Mateos, C. Laterza, J. Pavia and M. Salamero (2000) ‘Brain perfusion and neuropsychological changes in schizophrenia patients after cognitive rehabilitation’, Psychiatry Research: Neuroimaging, 98: 127–32.
53. M. H. Teicher (2000) ‘Brain abnormalities common in survivors of childhood abuse’, Cerebrum, 2: 50–67.
54. M. Trimble (1996) Biological Psychiatry (2nd edn). Chichester: Wiley.
55. Quoted in R. M. Julien (1975) A Primer of Drug Action. San Francisco, CA: Freeman.
56. D. E. Wooley and E. Shaw (1954) ‘A biochemical and pharmacological suggestion about certain mental disorders’, Proceedings of the National Academy of Sciences USA, 40: 228–31.
57. A. Friedhoff and E. van Winkle (1962) ‘The characteristics of an amine found in the urine of schizophrenic patients’, Journal of Nervous and Mental Disease, 135: 550.
58. G. S. Claridge (1978) ‘Animal models of schizophrenia: the case for LSD-25’, Schizophrenia Bulletin, 4: 186–209. Interestingly, there has recently been a revival of interest in the role of serotonin in the symptoms of schizophrenia, probably because of persisting lack of evidence in favour of the dopamine hypothesis. For example, it has been reported that there is an unusual distribution of serotonin receptors in the frontal cortex of some psychotic patients (see F. Owen and M. D. C. Simpson (1995) ‘The neurochemistry of schizophrenia’, in S. R. Hirsch and D. R. Weinberger (eds.), Schizophrenia. Oxford: Blackwell, pp. 358–78).
59. R. K. Siegel and M. E. Jarvick (1975) ‘Drug-induced hallucinations in animals and man’, in R. K. Siegel and L. J. West (eds.), Hallucinations: Behavior, Experience and Theory. New York: Wiley.
60. A. Carlsson and M. Lindqvist (1963) ‘Effect of chlorpromazine or haloperidol on formation of 3-methoxytyramine and normetanephrine in mouse brain’, Acta Pharmacologica et Toxicologica, 20: 140–4.
61. For details of these and other milestones in the development of the dopamine hypothesis, see P. J. McKenna (1994) Schizophrenia and Related Syndromes. Oxford: Oxford University Press.
62. P. Connell (1958) Amphetamine Psychosis. London: Chapman & Hall. For a recent study which has reported similar observations, see D. Harris and S. L. Bakti (2000) ‘Stimulant psychosis: symptom profile and acute clinical course’, American Journal of Addictions, 9: 28–37.
63. B. M. Angrist and S. Gershon (1970) ‘The phenomenology of experimentally induced amphetamine psychosis: preliminary observations’, Biological Psychiatry, 2: 95–107.
64. A. Carlsson (1995) ‘The dopamine theory revisited’, in Hirsch and Weinberger (eds.), Schizophrenia, op. cit.
65. Trimble, Biological Psychiatry, op. cit.
66. W. A. Brown and L. R. Herz (1989) ‘Response to neuroleptic drugs as a device for classifying schizophrenia’, Schizophrenia Bulletin, 15: 123–8.
67. H. J. Coppens, C. J. Sloof, A. M. J. Paans, T. Wiegman, W. Vaalburg and J. Korf (1991) ‘High central D2-dopamine receptor occupancy as assessed with positron emission tomography in medicated but therapy-resistant patients’, Biological Psychiatry, 29: 629–34.
68. The first and most extensively researched of these is clozapine, which is thought to have a low affinity for the DA2 receptor. Whether or not it has sufficient affinity to account for its anti-psychotic effects is a matter of controversy, and is discussed in McKenna, Schizophrenia and Related Syndromes, op. cit.
For a recent study demonstrating low DA2 receptor affinity of another atypical neuroleptic, quetiapine, see S. Kapur, R. Zipursky, C. Jones, C. S. Shammi, G. Remington and P. Seeman (2000) ‘A positron emission tomography study of quetiapine in schizophrenia: a preliminary finding of an antipsychotic effect with only transiently high dopamine D-sub-2 receptor occupancy’, Archives of General Psychiatry, 57: 553–9.
69. McKenna, Schizophrenia and Related Syndromes, op. cit.
70. A. Clow, P. Jenner, A. Theodorou and C. D. Marsden (1979) ‘Neuroleptic drugs and the dopamine hypothesis’, Lancet, i: 934.
71. McKenna, Schizophrenia and Related Syndromes, op. cit.
72. D. F. Wong, H. N. Wagner, L. E. Tune, R. F. Dannals, G. D. Pearlson and J. M. Links (1986) ‘Positron emission tomography reveals elevated D2 dopamine receptors in drug-naive schizophrenics’, Science, 234: 1558–63.
73. L. Fadre, F. A. Wiesel, H. Hall, C. Halldin, S. Stone-Elander and G. Sedvall (1987) ‘No D2 receptor increase in PET study of schizophrenia’, Archives of General Psychiatry, 44: 671–2.
74. G. D. Pearlson, D. F. Wong, L. E. Tune, C. A. Ross, G. A. Chase, J. M. Links, R. F. Dannals, A. A. Wilson, H. Ravert, H. N. Wagner and J. R. DePaulo (1995) ‘In vivo D-sub-2 dopamine receptor density in psychotic and nonpsychotic patients with bipolar disorder’, Archives of General Psychiatry, 52: 471–7.
75. E.
K. G. Syvaelahti, V. Raekkoelaeinen, J. Aaltonen, V. Lehtinen and J. Hietala (2000) ‘Striatal D-sub-2 dopamine receptor density and psychotic symptoms in schizophrenia: a longitudinal study’, Schizophrenia Research, 43: 159–61.
76. Trimble, Biological Psychiatry, op. cit.
77. S. Rose (1984) ‘Disordered molecules and diseased minds’, Journal of Psychiatric Research, 18: 351–60.
78. M. Laruelle and A. Abi-Dargham (1999) ‘Dopamine as the wind in the psychotic fire: new evidence from brain imaging studies’, Journal of Psychopharmacology, 13: 358–71; M. Laruelle, A. Abi-Dargham, R. Gil, L. Kegeles and R. Innis (1999) ‘Increased dopamine transmission in schizophrenia: relationship to illness phases’, Biological Psychiatry, 46: 56–72.
79. M. B. Hamner and P. B. Gold (1998) ‘Plasma dopamine beta-hydroxylase activity in psychotic and non-psychotic post-traumatic stress disorder’, Psychiatry Research, 77: 175–81.
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