Where The Holistic Rubber Meets The Scientific Road

eSchizophrenia

On some days, I think that nothing good ever comes out of computers! But here’s something…

Schizophrenia is still one of the most stigmatized medical conditions. Most people are distinctly uncomfortable being present with patients who carry on conversations with imaginary voices in their head.

Modern drugs suppress many of the disturbing symptoms, such as hallucinations. But that comes at a price. An individual so drugged suffers loss of cognitive function and deeper insights that make up humanness. The patient is left with deficits that make it hard to process information, learn, remember and plan. Too often, despair brought on by a lifetime of struggle ends in suicide.

That’s why the latest, extremely promising results from a computer “brain training” approach to treating schizophrenia. If the computer-based tools can be further refined, there is real hope of restoring patients’ cognitive abilities to the healthy range, and maybe even safeguarding susceptible individuals from them the initial decline.

The key test will be whether the lab results translate into significant improvements in quality of life. Particularly important will be a trial led by Bruce Wexler of Yale University, who is testing whether such training improves performance in the workplace. This will be important in societies that marginalize those who are unable to hold down a job, particularly for people with genuine difficulties who are wrongly labelled lazy or stupid.

Alongside further developments in treatment, there needs to be a better public understanding of the problems faced by those with schizophrenia. Over the past decade or so, psychiatrists who specialize in the condition have come to realize that the cognitive deficits are more debilitating than the hallucinations.

Word of this revised understanding has been slow to get out, however, in part because the official criteria used to define schizophrenia – laid down in a volume published by the American Psychiatric Association called the Diagnostic and Statistical Manual of Mental Disorders (DSM) – do not include the cognitive symptoms.

That should change in the next edition of the DSM, due in 2012, but efforts to inform the public of the full nature of schizophrenia need not wait until then.

Schizophrenia has been misunderstood and misrepresented perhaps more than any other disease. For most people, it is a strange and rather frightening condition. Yet, although a schizophrenic individual is truly psychotic, the most common mass shootings and rampages actually come from patients suffering with unregulated depression.

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