Review Concludes Child Abuse a Factor in Psychosis

PRESS RELEASE 29 Oct. 2005

Review by International Researchers Concludes That Child Abuse is a Causal Factor for Psychosis And Schizophrenia

On Oct. 22 child psychologist Oliver James wrote, in the UK newspaper, The Guardian:

"The psychiatric establishment is about to experience an earthquake that will shake its intellectual foundations. When it has absorbed the juddering contents of the latest edition of one of its leading journals, Acta Psychiatrica Scandinavica, it will have to rethink many of its most cherished assumptions. Not since the publication of RD Laing¹s book Sanity, Madness and the Family, in 1964, has there been such a significant challenge to their contention that genes are the main cause of schizophrenia and that drugs should be the automatic treatment of choice. With his colleagues, guest editor John Read, a leading New Zealand psychologist, slays these sacred biological cows.

There are already signs of a change in perspective. In August, the president of the American Psychiatric Association bemoaned his profession's subservience to the drug companies and the fact that 'we have allowed the bio-psycho-social model to become the bio-bio-bio model'. Read's earthquake may trigger a landslide."

The November edition of leading scientific journal, Acta Psychiatrica Scandinavica, includes several new research papers documenting the relationship between trauma and psychosis. Oliver James is referring to "Childhood trauma, psychosis and schizophrenia: A Literature review with theoretical and clinical implications". Authors Dr John Read (Auckland, New Zealand), Professor Jim van Os (Maastricht), Professor Tony Morrison (Manchester) and Dr Colin Ross (Richardson, Texas), review 218 studies and conclude:

"Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one."

They point out that until recently the relationship has been "minimized, ignored or denied" due to "rigid adherence to a rather simplistic biological paradigm, inappropriate fear of being accused of family-blaming, avoidance of vicarious traumatization on the part of clinicians ands researchers, and rediagnosing from psychosis to PTSD, dissociative disorders and other non-psychotic diagnoses once abuse is discovered."

THE REVIEW DOCUMENTS THAT, ON AVERAGE, 69% OF FEMALE INPATIENTS AND 59% OF MALE INPATIENTS AROUND THE WORLD HAVE BEEN EITHER SEXUALLY OR PHYSICALLY ABUSED AS CHILDREN.

Earlier small studies suggesting a causal link with schizophrenic symptoms, in the USA and New Zealand, have, in the last two years, been confirmed by three large scale studies in the Netherlands (4045 subjects - Acta Psychiatrica Scandinavica, 2004), England (8,580 - British Journal of Psychiatry, 2004), and California (17,337 - Child Abuse & Neglect, 2005). All three studies found, after controlling for other social demographic and psychiatric variables, that people who had been abused as children were several times more likely to exhibit psychotic symptoms such as hallucinations or delusions in adulthood. In the Netherlands study, those who had suffered the most extreme levels of child abuse were 48 times more likely to be psychotic than non-abused subjects.

The Guest Editors for the edition - psychologists Tony Morrison and John Read and psychiatrist Doug Turkington (Newcastle University) comment, in the Editorial of the Acta edition:

"The link between trauma and psychosis has a growing body of empirical support."

"Helping service users to identify any links between their traumatic experiences and current psychotic symptoms may help normalize their experiences."

Dr John Read, editor of the controversial book 'MODELS OF MADNESS' (Routledge, 2004, published in Swedish 18.10.2005), which documents research showing that OTHER SOCIAL FACTORS (poverty, discrimination, bullying etc.) HAVE A CAUSAL ROLE IN PSYCHOSIS:

"I believe this edition of Acta will be a historical landmark in the waning of the pessimistic, reductionist, bio-genetic model of serious mental disorders that, with eager support from the pharmaceutical industry, has dominated mental health theory and practice for far too long."

"If our mental health services are to become truly evidence-based service users and their families can look forward to finally being asked about adverse life events and offered support that addresses the social causes of their difficulties. There are now a range of psychological approaches, including cognitive therapy, that have proven effective with psychosis. These are being actively promoted by the International Society for the Psychological Treatments of Schizophrenia." [www.isps.org]"

"The implications for prevention are also enormous."

ENDS

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