Ernest Dempsey — Some interesting news for all those who have serious interest in psychology, or broadly in mental health: political anarchy can cause schizophrenia. This claim, mind-boggling as it sounds, was made earlier this month, as reported in a news post on Express Tribune. Difficult to deal with, this revelation has not only put psychology research in Pakistan to question but also the seriousness of media in knowing what they are publishing. The claim in question was made in some workshop in Peshawar, the same city that has been in headlines for a major plagiarism issue this year, and it says political anarchy, terrorism, and social and economic disorders have resulted in an increased number of schizophrenia patients in the country. Very difficult to swallow indeed! Coming to the main claim later, it’s a pain to see words flung around without verifying their very existence. We know about ‘social circumstances’ and ‘economic crisis’, and of course ‘psychological disorders’ or ‘personality disorders’ etc; but social and/or economic disorders? A disorder is, in terms of health, a disease or problematic health condition. What possibly can ‘social and economic disorders’ mean? Maybe these terms will become meaningful in future unforeseen, but not as we know language today. Now to the cause of schizophrenia, well, before the appearance of this bombastic ‘finding’, political anarchy/terrorism and socio-economic were never scientifically related to schizophrenia in causal context. Schizophrenia is a neurobiological condition affecting the thinking faculty of patients, who gradually lose sensing reality as it appears to what are considered ‘normal’ people. Such conditions as schizophrenia fall in the category of ‘psychosis’. Depression commonly accompanies schizophrenia, but not always. And the two are different by nature as professor of psychiatry Elyn R. Saks notes in her book The Center Cannot Hold, “Depression, even psychotic depression, was primarily a disorder of feelings… schizophrenia was a thought disorder, a disorder that was psychotic at its core.” (p. 221.) With genes involved in causing schizophrenia, the disorder is one of neurobiological deterioration, frequently marked biochemically by overly active dopamine transmission/reception in the nervous system. Political anarchy or trauma (e.g. terrorism) may cause stress, in response to which existing mental health conditions may aggravate (symptoms get more frequent or pronounced); but these factors don’t cause schizophrenia. At worst, they can aggravate it. In her recent interview, published in Recovering the Self (Vol. 3, No 4), author Susie Dunham, who wrote the book Beyond Schizophrenia about her son’s battle with the disease, said, “There are professionals with many ‘letters’ following their names as credentials, who actually believe that a traumatic event triggers the disease! I happen to espouse the teachings of Dr. E. Fuller Torrey who wrote the book entitled Surviving Schizophrenia and has studied the disease for decades. Dr. Torrey suggests that traumatic incidents are simply concomitant in young people’s lives and have little or nothing to do with the disease’s onset.” Indeed, living in Pakistan, an average person isn’t traumatized by terror events to cause a serious psychological disorder, let alone a neurobiological one. Terrorism appears in news and is received like other bad news. A decade of violent frenzy has made terror news kind of routine, something you can watch on TV while having your supper. The exception will be those who personally suffer from or witness an act of terror. But even in that case, the resulting problem will likely be PTSD (post-traumatic stress disorder), as happens with some soldiers and security personnel who have been in the war zone. Then the fact the statistics given in the post in question are also of dubious authenticity, i.e. 1.4 million patients in Pakistan, reflects in the comment of a well-read psychology graduate Asadullah, “This simply isn’t an academic claim. In a country where we haven’t conducted a population census for over a decade, claiming that 1.4 million people are suffering from schizophrenia is akin to a deliberate attempt to sound ridiculous.” In a 2008 paper, researchers from Agha Khan University wrote: “The correct prevalence of schizophrenia in Pakistan cannot be known and thus the seriousness of the condition will always be masked.” How the mental health experts in the said workshop found out in just three years the prevalence of schizophrenia in Pakistan is a question this media post at least didn’t bother to answer. The problem thus also seems to be with media, even some well-reputed sources, which is far too lame when it comes to science and research. Not many in Pakistan would be able to catch the definition of schizophrenia, let alone its nature, causes, and risk factors, which are rarely described in media posts such as the one discussed here. Science, health, and research are treated in the same manner as political propaganda whereby anybody can say anything and everything regardless of any care of consequence. Someday perhaps, Pakistani media will take the pains to get writers and editors having actual knowledge of the essentials of science and health—including mental health.
Wednesday, October 19, 2011
On schizophrenia in Pakistan
Ernest Dempsey — Some interesting news for all those who have serious interest in psychology, or broadly in mental health: political anarchy can cause schizophrenia. This claim, mind-boggling as it sounds, was made earlier this month, as reported in a news post on Express Tribune. Difficult to deal with, this revelation has not only put psychology research in Pakistan to question but also the seriousness of media in knowing what they are publishing. The claim in question was made in some workshop in Peshawar, the same city that has been in headlines for a major plagiarism issue this year, and it says political anarchy, terrorism, and social and economic disorders have resulted in an increased number of schizophrenia patients in the country. Very difficult to swallow indeed! Coming to the main claim later, it’s a pain to see words flung around without verifying their very existence. We know about ‘social circumstances’ and ‘economic crisis’, and of course ‘psychological disorders’ or ‘personality disorders’ etc; but social and/or economic disorders? A disorder is, in terms of health, a disease or problematic health condition. What possibly can ‘social and economic disorders’ mean? Maybe these terms will become meaningful in future unforeseen, but not as we know language today. Now to the cause of schizophrenia, well, before the appearance of this bombastic ‘finding’, political anarchy/terrorism and socio-economic were never scientifically related to schizophrenia in causal context. Schizophrenia is a neurobiological condition affecting the thinking faculty of patients, who gradually lose sensing reality as it appears to what are considered ‘normal’ people. Such conditions as schizophrenia fall in the category of ‘psychosis’. Depression commonly accompanies schizophrenia, but not always. And the two are different by nature as professor of psychiatry Elyn R. Saks notes in her book The Center Cannot Hold, “Depression, even psychotic depression, was primarily a disorder of feelings… schizophrenia was a thought disorder, a disorder that was psychotic at its core.” (p. 221.) With genes involved in causing schizophrenia, the disorder is one of neurobiological deterioration, frequently marked biochemically by overly active dopamine transmission/reception in the nervous system. Political anarchy or trauma (e.g. terrorism) may cause stress, in response to which existing mental health conditions may aggravate (symptoms get more frequent or pronounced); but these factors don’t cause schizophrenia. At worst, they can aggravate it. In her recent interview, published in Recovering the Self (Vol. 3, No 4), author Susie Dunham, who wrote the book Beyond Schizophrenia about her son’s battle with the disease, said, “There are professionals with many ‘letters’ following their names as credentials, who actually believe that a traumatic event triggers the disease! I happen to espouse the teachings of Dr. E. Fuller Torrey who wrote the book entitled Surviving Schizophrenia and has studied the disease for decades. Dr. Torrey suggests that traumatic incidents are simply concomitant in young people’s lives and have little or nothing to do with the disease’s onset.” Indeed, living in Pakistan, an average person isn’t traumatized by terror events to cause a serious psychological disorder, let alone a neurobiological one. Terrorism appears in news and is received like other bad news. A decade of violent frenzy has made terror news kind of routine, something you can watch on TV while having your supper. The exception will be those who personally suffer from or witness an act of terror. But even in that case, the resulting problem will likely be PTSD (post-traumatic stress disorder), as happens with some soldiers and security personnel who have been in the war zone. Then the fact the statistics given in the post in question are also of dubious authenticity, i.e. 1.4 million patients in Pakistan, reflects in the comment of a well-read psychology graduate Asadullah, “This simply isn’t an academic claim. In a country where we haven’t conducted a population census for over a decade, claiming that 1.4 million people are suffering from schizophrenia is akin to a deliberate attempt to sound ridiculous.” In a 2008 paper, researchers from Agha Khan University wrote: “The correct prevalence of schizophrenia in Pakistan cannot be known and thus the seriousness of the condition will always be masked.” How the mental health experts in the said workshop found out in just three years the prevalence of schizophrenia in Pakistan is a question this media post at least didn’t bother to answer. The problem thus also seems to be with media, even some well-reputed sources, which is far too lame when it comes to science and research. Not many in Pakistan would be able to catch the definition of schizophrenia, let alone its nature, causes, and risk factors, which are rarely described in media posts such as the one discussed here. Science, health, and research are treated in the same manner as political propaganda whereby anybody can say anything and everything regardless of any care of consequence. Someday perhaps, Pakistani media will take the pains to get writers and editors having actual knowledge of the essentials of science and health—including mental health.