NORMAN Q. BRILL, M.D.; JAMES F. CORCORAN, M.D.; SAMUEL EIDUSON, PH.D.; LEWIS L. JUDD, M.D.; PHILLIP R. A. MAY, M.D.; ROBERT STOLLER, M.D.; RICHARD WALTER, M.D.
It seems increasingly likely that schizophrenia is a symptom complex of disordered thinking, feeling, and behavior rather than a single disease. While psychogenic factors seem to play an important role in most instances, no pattern of environmental and emotionally traumatic factors has ever been found that would inevitably lead to the development of schizophrenia. It appears that hereditary, constitutional, and environmental factors contribute in varying proportions to the development of schizophrenic disorders. Observation of newborn infants suggests they are born with different temperaments and personalities that will react to the same stresses in different ways. The time in life (that is, the stage of development) when stress occurs is believed by many to be as important as the nature of the stress. Experiences that could be satisfactorily dealt with at age five or six might be traumatic and overwhelming at two or three.
Neurophysiologic and biochemical abnormalities that may be contributory (or concomitant) factors in schizophrenia will probably be defined as investigatory techniques as they are further developed. Suggestive findings have already been described in controlled studies of average-evoked auditory and visual-evoked brain potentials, and the Russian neuropsychiatrist Snezhnevsky (1), using a toposcope—a 50-channel electroencephalogram—has described a pattern of activity in schizophrenics that differs from normals.
Although new drugs have been very helpful in the management of schizophrenic patients, present treatment methods leave much to be desired. As long as the causes of the illness are not known, treatment will continue to be empirical.
BRILL NQ, CORCORAN JF, EIDUSON S, JUDD LL, MAY PRA, STOLLER R, et al. Schizophrenia. Ann Intern Med. ;70:107–125. doi: 10.7326/0003-4819-70-1-107
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Published: Ann Intern Med. 1969;70(1):107-125.
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