Childhood antecedents of schizophreniaBMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6991.1410a (Published 27 May 1995) Cite this as: BMJ 1995;310:1410
EDITOR,—Andrew D Paterson is correct to point out the abundant evidence of a genetic contribution in the aetiology of schizophrenia, but I take exception to his conclusions regarding treatment.1 He makes a basic error in assuming that just because a biological factor can be shown to be of primary importance in the aetiology of a condition then it must follow that suitable treatments must also be limited to the biological. Even if, as seems the case, environmental factors are of minimal importance in the aeriology of schizophrenia, we must not neglect the psychological and social aspects of management. We should remember, for example, that it is a simple dietary intervention that is required in phenylketonuria, an autosomal recessive disorder whose genetics are far better understood than schizophrenia.
Paterson's statement that “it is questionable whether psychotherapeutic intervention will have any influence on the expression of the disease” is surprising in the light of the fact that in his previous paragraph he quoted McGuffin et al as stating, “there is good evidence that psychosocial factors, such as high expressed emotion at home or life events, can hasten relapses or precipitate onsets.”2 Surely it is now time to move on from this Platonic dualism separating soul and body, mind and brain, to a medicine that recognises and treats the whole person with whatever interventions prove to be effective.