A journey through schizophrenia science

BBC Radio 4’s The Life Scientific recently profiled psychiatrist, schizophrenia researcher and stand-up chap, Robin Murray, who talks about how his understanding of the condition has drastically changed over the years.

It’s a fascinating journey through how our theories about the mental illness, most associated with having delusions and hallucinations, has evolved through time – taking in everything from the anti-psychiatry of R.D. Laing to modern neurogenetic studies.

As a young man, Murray lived in an Asylum in Glasgow for two years, mainly because it offered free accommodation to medical students. Struck by how people’s minds could play tricks on them and the lack of proper research into the condition, he resolved to put the study of schizophrenia on a more scientific footing. Fifteen years ago he believed schizophrenia was a brain disease. Now, he’s not so sure.

Despite decades of research, the biological basis of this often distressing condition remains elusive. Just living in a city significantly increases your risk (the bigger the city the greater the risk); and, as Murray discovered, migrants are six times more likely to develop the condition than long term residents. He’s also outspoken about the mental health risks of smoking cannabis, based both on his scientific research and direct experience working at the Maudsley Hospital in South London.

You can listen to the streamed version on the programme page but to download the podcast you have to go to a completely different page and search through the list. Why? No-one knows.

Link to page with streaming audio.
Link to podcast page.

Of both lovers and epilepsy

Saint Valentine is the patron saint of both lovers and epilepsy – sadly, a little known fact.

There is one wonderful example of this divine coupling, however, where the passionate saint appears alongside EEG traces on 1998 postage stamp from Italy.

This description is from a brief 2003 article from the Journal of Neurology, Neurosurgery & Psychiatry on the stamp.

EEG has been illustrated on a number of stamps. An Italian stamp of 1988 shows a pictorial representation of an EEG and St Valentine (Stanley Gibbons no. 1989, Scott no. 1743). St Valentine was the first bishop of Temi in Umbria. Some of the mythology is not entirely clear, but St Valentine was probably a physician who was martyred by the Romans on February 14, 273. He is patron saint of both lovers and epilepsy. There are also other patron saints of epilepsy.

Legend has it that St Valentine miraculously cured a young fiancee, Serapia, afflicted with a mysterious illness, thought now to be epilepsy. Sites where St Valentine was thought to have lived or visited became pilgrimage destinations for cure of the disorder. These destinations included Rome and Temi in Italy, Ruffach in France (where a hospital for epilepsy was later built), Poppel in Belgium, and Passau in Germany. Soon after Valentine’s death young lovers started making pilgrimages to Temi to be blessed by the Bishop on the 14th hour of every month for eternal love.

It’s worth noting that this recounts the traditional story of Saint Valentine although the actual history seems a little fuzzy and there were likely many historical people who have been blended into the image of the love-promoting holy man.

However, this also makes Valentine’s Day the day of both love and epilepsy, or as I like to think of it, lovers with epilepsy.

Link to JNNP article on epilepsy and Valentine stamp.

Violence and delusional pets

I’ve just read a striking article recounting cases of violence associated with delusions about household pets. Although the academic paper is locked, a copy is available online as a pdf.

The curious study was published in a 1987 edition of Behavioral Sciences and the Law and includes three extended case studies of defendants charged with aggressive crimes who had “psychotic perceptions and delusions involving their pet animals”.

Several weeks before the alleged killing, Mr. A’s cat appeared to be pregnant, so he made a nesting box for it. He said his wife disliked his cat because of its grey color. One day Mr. A dropped a jar of molasses, thereby spilling the contents. He lamented to himself that he no longer had control over picking up and holding objects. Upon seeing the cat’s strange green eyes, he concluded that voodoo was being perpetrated against him through the cat as a medium, and the cat was therefore responsible for his loss of control. It occurred to him that Cleopatra and the ancient Egyptians were surrounded by cats. He associated cats with the ancient past and evil spirits. He decided to shoot the cat in order to “break the spell” against him. However, killing his cat failed to dispel his sense of being fragmented and persecuted.

From the time he shot his cat until his wife was mortally shot several days later, Mr. A’s psychosis worsened; his thinking became more disorganized and lacking in reality adherence. Time seemed to have stopped. He perceived a striking deterioration in his wife’s appearance. “She looked so grey (her criticism of the cat), like a craven image… she looked sick.”

The author notes that the first description of this phenomenon was actually in the Edgar Allen Poe short story The Black Cat where the narrator develops delusions about his cat and eventually kills his wife.

Many thanks to Keith Laws for finding this unusual footnote in the forensic psychiatry literature.

pdf of article on violence and pet delusions (via @Keith_Laws)
Link to locked academic paper in journal.

Individual ecstasies: the revelatory experience conference

On March 23rd London will host a unique conference on the neuroscience, psychiatry and interpretation of revelatory visionary experiences.

It’s been put together by Quinton Deeley from our research group at the Institute of Psychiatry and brings together cognitive neuroscientists, anthropologists, religious studies scholars, psychologists and psychiatrists to discuss different ways of understanding ‘revelatory experiences’.

Mental health professionals frequently encounter people who report experiences of God or supernatural beings speaking or acting through them to reveal important truths. In some cases it is difficult to know to what extent such experiences are best explained as ‘illness’, or represent experiences which are accepted and valued within a person’s religious or cultural context. Indeed, revelatory experiences form a key part of the formation and development of major world religions through figures such as prophets, visionaries, and yogins, as well as in the religious practice of shamans and others in traditional smaller scale societies.

Why are revelatory experiences and related altered states of consciousness so common across cultures and history? What neural and other processes cause them? When should they be thought of as due to mental illness, as opposed to culturally accepted religious experience? And what value should or can be placed upon them? In this one day conference leading scholars from neuroscience, psychiatry, theology and religious studies, history and anthropology gather to present recent findings, and debate with each other and the audience about these fundamental aspects of human experience.

Rarely do we get the chance to look at visionary experiences from so many diverse angles so it should be a fascinating day.

Full details at the link below. See you there.

Link to details of Revelatory Experiences conference.

A culture shock for universal emotion

The Boston Globe looks at the increasing evidence against the idea that there are some universally expressed facial emotions.

The idea that some basic emotions are expressed universally and have an evolutionary basis was suggested by Darwin in his book The Expression of the Emotions in Man and Animals.

The concept was further explored by psychologist Paul Ekman who conducted cross-cultural research and reported that the expression of anger, disgust, fear, happiness, sadness and surprise were universal human characteristics.

However, these ideas have recently been challenged and a debate recently kicked off in an issue of Current Directions in Psychological Science and the Globe article does a great job of covering the fight and its fall out.

…psychologists Azim Shariff and Jessica Tracy detail accumulated evidence that they argue makes the case for an evolutionary view of emotional expressions [pdf]. Some, they say, may have evolved for a physiological purpose — widening the eyes with fright, for instance, to expand our peripheral vision. Others may have evolved as social signals. Meanwhile, in a commentary, Barrett lays out a point-by-point counterargument [pdf]. While humans evolved to express and interpret emotions, she contends, specific facial expressions are culturally learned.

Barrett believes that the universality of recognizing facial expressions is “an effect that can be easily deconstructed,” if, for instance, subjects are asked to give their own label to faces instead of choosing from a set of words. In another recent paper [pdf] in the same journal, she argues that a growing body of research shows our perception of facial expressions is highly dependent on context: People interpret facial expressions differently depending on situation, body language, familiarity with a person, and surrounding visual cues. Barrett’s own research has shown that language and vocabulary influence people’s perception of emotions. Others have found cultural differences in how people interpret the facial expressions of others — a study found that Japanese people, for instance, rely more than North Americans on the expressions of surrounding people to interpret a person’s emotional state.

A fascinating discussion that tackles a taken-for-granted psychological assumption that is now being challenged.

Link to Globe piece on culture and facial expression.

Group sync

The New Yorker has a fantastic article on how creativity and innovation spring from group structure and social interaction.

The piece is framed as tackling the ‘brainstorming myth’ – as the well-known idea generation method has been comprehensively but unknowingly debunked many times – but the article is really much wider and explores what sort of social interactions lead to creativity and progress.

As well as looking at lab studies it also weaves in some wonderful historical examples of how diverse environments and relationships have led to everything from Broadway success to scientific advance.

A few years ago, Isaac Kohane, a researcher at Harvard Medical School, published a study that looked at scientific research conducted by groups in an attempt to determine the effect that physical proximity had on the quality of the research. He analyzed more than thirty-five thousand peer-reviewed papers, mapping the precise location of co-authors. Then he assessed the quality of the research by counting the number of subsequent citations.

The task, Kohane says, took a “small army of undergraduates” eighteen months to complete. Once the data was amassed, the correlation became clear: when coauthors were closer together, their papers tended to be of significantly higher quality. The best research was consistently produced when scientists were working within ten metres of each other; the least cited papers tended to emerge from collaborators who were a kilometre or more apart. “If you want people to work together effectively, these findings reinforce the need to create architectures that support frequent, physical, spontaneous interactions,” Kohane says. “Even in the era of big science, when researchers spend so much time on the Internet, it’s still so important to create intimate spaces.”

A compelling, comprehensive read.

Link to The New Yorker piece ‘Groupthink’.