Wednesday, February 17, 2010

Childhood trauma and psychosis

Great academic article from 2008 that very credibly disputes the biomedical model of psychiatry. This is just a small excerpt:

From Journal of Post Graduate Medicine:

A recent review of the North American psychiatric literature over the past 40 years concluded that potential social causes of psychosis, including schizophrenia, have been neglected in favor of the advancement of genetic and biological etiologies. [30] However, Kraeplinian conceptualizations of psychotic experiences as merely the symptoms of a disordered brain have been challenged by prominent academicians such as Richard Bentall and others who question the validity and utility of schizophrenia as a conceptual and diagnostic entity, and argue that psychotic experiences lie on a continuum with “normal” functioning and suggest that contemporary conceptualizations of “schizophrenia,” “bipolar disorder,” and associated complaints should take into account the role of adverse environmental factors. [31] Furthermore, in the last ten years there has been renewed interest and a growing body of literature examining the role of social and environmental factors in the etiology of psychosis and schizophrenia. Much of this research has specifically focused on the relationship between childhood trauma, psychosis, and schizophrenia.

A number of significant reviews of the literature examining the relationship between childhood trauma, psychosis and schizophrenia have been published in the last few years. [18],[32],[33],[34] A review by Read et al . [6] summarized research studies and examined other review papers addressing the relationship between childhood trauma, psychosis and schizophrenia. This review examined studies of psychiatric inpatients and outpatients where at least 50% were diagnosed with a psychotic condition. Studies that were included were required to have used interview protocols or questionnaire measures that specified examples of abusive acts to determine abuse, therefore chart reviews were excluded. The review produced weighted averages from 51 studies and reported that the majority of female patients (69%) reported either childhood sexual abuse (CSA) (48%) or childhood physical abuse (CPA) (48%). The majority of male patients (59%) reported either CSA (28%) or CPA (50%). The authors of this review point out that these rates are likely to be underestimates as child abuse is generally under-reported [35] especially by people who are inpatients [36],[37] and men in particular. [38] The bulk of the evidence considered in this review, however, was from studies using cross-sectional designs or uncontrolled group comparisons, which the authors concede can give us useful estimates of the prevalence of childhood trauma in clinical populations, but tell us little about whether the relationship between childhood trauma and psychosis is causal. Consequently, Read and colleagues also examined data from four large-scale studies with more sophisticated methodologies which represent a more robust test of the hypothesis that childhood trauma plays a causal role in psychosis. (read much more here)

Definitely an article to keep handy for those who want academic studies that support an alternative view to the biomedical model.

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