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Priol AC, Denis L, Boulanger G, Thépaut M, Geoffray MM, Tordjman S. Detection of Morphological Abnormalities in Schizophrenia: An Important Step to Identify Associated Genetic Disorders or Etiologic Subtypes. Int J Mol Sci 2021; 22:ijms22179464. [PMID: 34502372 PMCID: PMC8430486 DOI: 10.3390/ijms22179464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 12/20/2022] Open
Abstract
Current research suggests that alterations in neurodevelopmental processes, involving gene X environment interactions during key stages of brain development (prenatal period and adolescence), are a major risk for schizophrenia. First, epidemiological studies supporting a genetic contribution to schizophrenia are presented in this article, including family, twin, and adoption studies. Then, an extensive literature review on genetic disorders associated with schizophrenia is reviewed. These epidemiological findings and clinical observations led researchers to conduct studies on genetic associations in schizophrenia, and more specifically on genomics (CNV: copy-number variant, and SNP: single nucleotide polymorphism). The main structural (CNV) and sequence (SNP) variants found in individuals with schizophrenia are reported here. Evidence of genetic contributions to schizophrenia and current knowledge on genetic syndromes associated with this psychiatric disorder highlight the importance of a clinical genetic examination to detect minor physical anomalies in individuals with ultra-high risk of schizophrenia. Several dysmorphic features have been described in schizophrenia, especially in early onset schizophrenia, and can be viewed as neurodevelopmental markers of vulnerability. Early detection of individuals with neurodevelopmental abnormalities is a fundamental issue to develop prevention and diagnostic strategies, therapeutic intervention and follow-up, and to ascertain better the underlying mechanisms involved in the pathophysiology of schizophrenia.
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Affiliation(s)
- Anne-Clémence Priol
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
- Correspondence: (A.-C.P.); (S.T.); Tel.: +33-2-99-51-06-04 (A.-C.P. & S.T.); Fax: +33-2-99-32-46-98 (A.-C.P. & S.T.)
| | - Laure Denis
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
| | - Gaella Boulanger
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
| | - Mathieu Thépaut
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
| | - Marie-Maude Geoffray
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Le Vinatier, 69500 Bron, France;
| | - Sylvie Tordjman
- Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent (PHUPEA), Centre Hospitalier Guillaume Régnier, University of Rennes 1, 35000 Rennes, France; (L.D.); (G.B.); (M.T.)
- CIC (Clinical Investigation Center) 1414 Inserm, Centre Hospitalier Universitaire (CHU) de Rennes, University of Rennes 1, 35033 Rennes, France
- Integrative Neuroscience and Cognition Center (INCC), CNRS UMR 8002, University of Paris, 75006 Paris, France
- Correspondence: (A.-C.P.); (S.T.); Tel.: +33-2-99-51-06-04 (A.-C.P. & S.T.); Fax: +33-2-99-32-46-98 (A.-C.P. & S.T.)
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Henriksen MG, Nordgaard J, Jansson LB. Genetics of Schizophrenia: Overview of Methods, Findings and Limitations. Front Hum Neurosci 2017; 11:322. [PMID: 28690503 PMCID: PMC5480258 DOI: 10.3389/fnhum.2017.00322] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/06/2017] [Indexed: 01/12/2023] Open
Abstract
Genetics constitute a crucial risk factor to schizophrenia. In the last decade, molecular genetic research has produced novel findings, infusing optimism about discovering the biological roots of schizophrenia. However, the complexity of the object of inquiry makes it almost impossible for non-specialists in genetics (e.g., many clinicians and researchers) to get a proper understanding and appreciation of the genetic findings and their limitations. This study aims at facilitating such an understanding by providing a brief overview of some of the central methods and findings in schizophrenia genetics, from its historical origins to its current status, and also by addressing some limitations and challenges that confront this field of research. In short, the genetic architecture of schizophrenia has proven to be highly complex, heterogeneous and polygenic. The disease risk is constituted by numerous common genetic variants of only very small individual effect and by rare, highly penetrant genetic variants of larger effects. In spite of recent advances in molecular genetics, our knowledge of the etiopathogenesis of schizophrenia and the genotype-environment interactions remain limited.
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Affiliation(s)
- Mads G. Henriksen
- Mental Health Center Glostrup, University Hospital of CopenhagenCopenhagen, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of CopenhagenCopenhagen, Denmark
- Center for Subjectivity Research, University of CopenhagenCopenhagen, Denmark
| | - Julie Nordgaard
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of CopenhagenCopenhagen, Denmark
- Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, University of CopenhagenCopenhagen, Denmark
| | - Lennart B. Jansson
- Mental Health Center Glostrup, University Hospital of CopenhagenCopenhagen, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of CopenhagenCopenhagen, Denmark
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Rivollier F, Lotersztajn L, Chaumette B, Krebs MO, Kebir O. [Epigenetics of schizophrenia: a review]. Encephale 2014; 40:380-6. [PMID: 25127897 DOI: 10.1016/j.encep.2014.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/30/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Schizophrenia is a frequent and disabling disease associated with heterogeneous psychiatric phenotypes. It emerges during childhood, adolescence or young adulthood and has dramatic consequences for the affected individuals, causing considerable familial and social burden, as well as increasing health expenses. Although some progress has been made in the understanding of their physiopathology, many questions remain unsolved, and the disease is still poorly understood. The prevailing hypothesis regarding psychotic disorders proposes that a combination of genetic and/or environmental factors, during critical periods of brain development increases the risk for these illnesses. Epigenetic regulations, such as DNA methylation, can mediate gene x environment interactions at the level of the genome and may provide a potential substrate to explain the variability in symptom severity and family heritability. Initially, epigenetics was used to design mitotic and meiotic changes in gene transcription that could not be attributed to genetic mutations. It referred later to changes in the epigenome not transmitted through the germline. Thus, epigenetics refers to a wide range of molecular mechanisms including DNA methylation of cytosine residues in CpG dinucleotides and post-translational histone modifications. These mechanisms alter the way the transcriptional factors bind the DNA, modulating its expression. Prenatal and postnatal environmental factors may affect these epigenetics factors, having responsability in long-term DNA transcription, and influencing the development of psychiatric disorders. OBJECT The object of this review is to present the state of knowledge in epigenetics of schizophrenia, outlining the most recent findings in the matter. METHODS We did so using Pubmed, researching words such as 'epigenetics', 'epigenetic', 'schizophrenia', 'psychosis', 'psychiatric'. This review summarizes evidences mostly for two epigenetic mechanisms: DNA methylation and post-translational histone modifications. RESULTS First, in terms of epidemiology and transmission, the theoretical model of epigenetics applies to schizophrenia. Then, most environmental factors that have proved a link with this disease, may generate epigenetic mechanisms. Next, mutations have been found in regions implied in epigenetic mechanism among populations with schizophrenia. Some epigenetic alterations in DNA regions have been previously linked with neurodevelopmental abnormalities. In psychosis, some authors have found methylation differences in COMT gene, in reelin gene and in some genes implicated in dopaminergic, serotoninergic, GABAergic and glutamatergic pathways. Histone modifications have been described, in particular the H3L4 histone methylation. Finally, we tried to underline the difficulties in epigenetic research, notably in psychiatry, and the limits in this matter. CONCLUSION The epigenetic field may explain a lot of questions around the physiopathology of the complex psychiatric disease that is schizophrenia. It may be a substratum to the prevailing hypothesis of gene x environment interaction. The research in the matter is definitely expanding. It justifies easily the need to improve the effort in the domain to overpass some limits inherent to the matter.
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Affiliation(s)
- F Rivollier
- Service hospitalo-universiaire, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire « physiopathologie des maladies psychiatriques », université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France
| | - L Lotersztajn
- Service hospitalo-universiaire, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire « physiopathologie des maladies psychiatriques », université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France
| | - B Chaumette
- Service hospitalo-universiaire, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire « physiopathologie des maladies psychiatriques », université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France
| | - M-O Krebs
- Service hospitalo-universiaire, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire « physiopathologie des maladies psychiatriques », université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France
| | - O Kebir
- Service hospitalo-universiaire, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire « physiopathologie des maladies psychiatriques », université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France.
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Gejman PV, Sanders AR, Kendler KS. Genetics of Schizophrenia: New Findings and Challenges. Annu Rev Genomics Hum Genet 2011; 12:121-44. [DOI: 10.1146/annurev-genom-082410-101459] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Pablo V. Gejman
- Center for Psychiatric Genetics, NorthShore University HealthSystem Research Institute, and University of Chicago, Evanston, Illinois 60201;
| | - Alan R. Sanders
- Center for Psychiatric Genetics, NorthShore University HealthSystem Research Institute, and University of Chicago, Evanston, Illinois 60201;
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Departments of Psychiatry and Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298;
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Abstract
Schizophrenia is a complex genetic disorder manifesting combined environmental and genetic causation. Recently, genome-wide association experiments yielded remarkable new experimental evidence that is leading to a better understanding of the genetic models and the biological risk factors involved in schizophrenia. These studies have discovered uncommon copy number variations (mainly deletions) and common single nucleotide polymorphisms with alleles associated with schizophrenia. The aggregate data provide support for polygenic inheritance and for genetic overlap of schizophrenia with autism and with bipolar disorder. It is anticipated that the application of a myriad of tools from systems biology, in combination with biological functional experiments, will lead to a delineation of biological pathways involved in the pathophysiology of schizophrenia, and eventually to new therapies.
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Affiliation(s)
- Pablo V Gejman
- Department of Psychiatry and Behavioral Sciences; and Research Institute, Center for Psychiatric Genetics, NorthShore University HealthSystem Research Institute, Evanston, IL 60201, USA.
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The relevance of the concept of nonshared environment to the study of environmental influences: A paradigmatic shift or just some gears slipping? Behav Brain Sci 2010. [DOI: 10.1017/s0140525x00056247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
AbstractOne of the most important findings that has emerged from human behavioral genetics involves the environment rather than heredity, providing the best available evidence for the importance of environmental influences on personality, psychopathology, and cognition. The research also converges on the remarkable conclusion that these environmental influences make two children in the same family as different from one another as are pairs of children selected randomly from the population.The theme of the target article is that environmental differences between children in the same family (called “nonshared environment”) represent the major source of environmental variance for personality, psychopathology, and cognitive abilities. One example of the evidence that supports this conclusion involves correlations for pairs of adopted children reared in the same family from early in life. Because these children share family environment but not heredity, their correlation directly estimates the importance of shared family environment. For most psychological characteristics, correlations for adoptive “siblings” hover near zero, which implies that the relevant environmental influences are not shared by children in the same family. Although it has been thought that cognitive abilities represent an exception to this rule, recent data suggest that environmental variance that affects IQ is also of the nonshared variety after adolescence.The article has three goals: (1) To describe quantitative genetic methods and research that lead to the conclusion that nonshared environment is responsible for most environmental variation relevant to psychological development, (2) to discuss specific nonshared environmental influences that have been studied to date, and (3) to consider relationships between nonshared environmental influences and behavioral differences between children in the same family. The reason for presenting this article in BBS is to draw attention to the far-reaching implications of finding that psychologically relevant environmental influences make children in a family different from, not similar to, one another.
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Contributions of the biometrical approach to individual differences in personality measures. Behav Brain Sci 2010. [DOI: 10.1017/s0140525x00055965] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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On the need for longitudinal evidence and multiple measures in behavioral-genetic studies of adult personality. Behav Brain Sci 2010. [DOI: 10.1017/s0140525x00056028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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The unmapped methodological territory between one gene and many comprises some intriguing environments. Behav Brain Sci 2010. [DOI: 10.1017/s0140525x00055977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Why does human twin research not produce results consistent with those from nonhuman animals? Behav Brain Sci 2010. [DOI: 10.1017/s0140525x00056211] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Evolutionary hypotheses and behavioral genetic methods: Hopes for a union of two disparate disciplines. Behav Brain Sci 2010. [DOI: 10.1017/s0140525x00055990] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Shared experience and similarity of personality: Positive data from Finnish and American twins. Behav Brain Sci 2010. [DOI: 10.1017/s0140525x0005617x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
The observation that schizophrenia is more commonly observed among the relatives of individuals with schizophrenia than in the general population does not indicate the mechanism that produces such familiality occurs. Adoption designs permit evaluation of the role of genetic factors in schizophrenia independently of the influence of family environments. Results from studies of adoptees with schizophrenia and their biological and adoptive relatives indicate that genetic factors play a highly significant role in the risk for schizophrenia. This genetically mediated risk to relatives includes an increased prevalence of both schizophrenia and a nonpsychotic syndrome analogous to schizophrenia, but does not represent a general liability to other forms of psychopathology. Although adoption studies have convincingly demonstrated an important role for genetic factors in schizophrenia, the necessity and specificity of such factors, their precise identity, and their interaction with environmental influences remain unknown.
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Affiliation(s)
- L J Ingraham
- Center for Professional Psychology at George Washington University, DC, USA.
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Poinso F, Gay MP, Glangeaud-Freudenthal NMC, Rufo M. Care in a mother-baby psychiatric unit: analysis of separation at discharge. Arch Womens Ment Health 2002; 5:49-58. [PMID: 12510199 PMCID: PMC2877088 DOI: 10.1007/s00737-002-0134-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Joint psychiatric admission to a Mother-Baby Unit (MBU) enables a mother to obtain care for psychiatric disorders and simultaneously receive support in developing her identity as a mother. This care is meant to prevent attachment disorders and mother-baby separation. Outcome at discharge, however, may differ according to the mother's admission diagnosis. Demographic data, clinical features of parent and child, and clinical outcome of 92 consecutive admissions of mothers and their children to a MBU in Marseille were collected over a period of eight years (1991-1998). Separations occurred in 23% of the joint admissions. Women with acute postpartum psychoses and major depressive disorders had better outcomes than those with chronic psychoses: at discharge, the latter were more often separated from their children. In those cases, however, MBU admission provided time to arrange the best placement for the child. Outcome was less predictable for non-psychotic personality disorders and depended not only on the mother's disease but also on her family and social context.
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Affiliation(s)
- F Poinso
- Psychiatric Parent-child Unit, Sainte-Marguerite Hospital, CHU Marseille, France.
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Affiliation(s)
- S S Kety
- McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
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Higgins J, Gore R, Gutkind D, Mednick SA, Parnas J, Schulsinger F, Cannon TD. Effects of child-rearing by schizophrenic mothers: a 25-year follow-up. Acta Psychiatr Scand 1997; 96:402-4. [PMID: 9395160 DOI: 10.1111/j.1600-0447.1997.tb09936.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We conducted a 25-year follow-up study of 50 children of schizophrenic mothers, consisting of 25 children reared by their mothers and 25 children reared apart. The children's adult psychiatric status was evaluated in a 3-h structured interview employing a battery of syndrome check-lists and scales. A slightly higher incidence of psychopathology (including schizophrenia-spectrum disorders) was found among the reared-apart subjects. This may possibly be attributed to their greater genetic predisposition, as suggested by their mothers' more severe illnesses. Lifetime diagnoses do not provide evidence that psychopathology in offspring at genetic risk is increased by rearing by a schizophrenic mother.
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Affiliation(s)
- J Higgins
- Department of Psychology, University of California, Santa Barbara, USA
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Bouchard TJ, McGue M. Genetic and Rearing Environmental Influences on Adult Personality: An Analysis of Adopted Twins Reared Apart. J Pers 1990; 58:263-92. [DOI: 10.1111/j.1467-6494.1990.tb00916.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shared environment and cultural inheritance. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Genes and environmental factors in the determination of behavioral characters. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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How do vulnerability effects relate to the nonshared environment? Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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The myth of the shared environment. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x0005603x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Evaluation of gene–environment interaction requires more precise description of both environment and behavior. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Behavior genetics moves beyond percentages – at last. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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A cumulative model of within-family differences. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Niche picking by siblings and scientists. Behav Brain Sci 1987. [DOI: 10.1017/s0140525x00056107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Mendlewicz J, Sevy S. Genetic and immunological factors in affective disorders and schizophrenia. PROGRESS IN BRAIN RESEARCH 1986; 65:1-15. [PMID: 3538158 DOI: 10.1016/s0079-6123(08)60637-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
A quotation from Edward Mapother can serve admirably as text for this address: ‘In practically all properly investigated cases of insanity, it is found that it is the result of a summation of multiple causes, effective in combination, though inadequate singly. It is this that renders all controversy between extremists of the physiogenic and psychogenic schools so futile’ (Lewis, 1969, p 1359). In the same year, 1922, in his Salmon Lecture, Adolf Meyer said: ‘The overmechanization of psychiatry … (has) led to too much reliance on chemistry and physiology as curealls in mental ills, while psychoanalysis, by laying too much emphasis on the subconscious and sex, has lost sight of the … functions of the conscious mind and has … disregarded the fact that man is subject to physical … biological … and social laws' (Meyer, 1922).
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