By SIMON COLLINS
A classic "nature or nurture" debate has been reignited by research claiming that childhood sexual abuse is often a factor in causing schizophrenia.
The research, led by Auckland University clinical psychologist Dr John Read, concludes that treatment of schizophrenia should include helping patients to talk about the traumas
that may have helped bring on the disease.
But an emeritus professor of psychiatry at the university, Dr John Werry, insisted yesterday that the illness was genetic and needed medication.
"There is no good evidence to show that schizophrenia is caused by sexual abuse or any other psycho-social factors," he said.
"Though one needs to be cautious, the highest probability ... is that it is a genetic disorder, and that the answer will not come from studies like Dr Read's but from molecular biology."
Mental health workers and people who have suffered from schizophrenia - estimated to affect 1 per cent of people during their lifetimes - lined up yesterday on both sides of the argument.
A mental health advocate at Auckland Healthcare, Debra Lampshire, who has suffered schizophrenia herself, said she was not surprised at Dr Read's finding that 50 per cent of female psychiatric inpatients said they had been sexually abused.
She said many patients did not consider that they had been abused, because there was no sexual penetration, yet they had experienced "horrendous things".
The clinical director of the Richmond Fellowship, Dr Michael Reid, said he would "absolutely endorse" Dr Read's findings.
"I would say, in almost a majority of cases, that a significant number of people who we work with, who are diagnosed with schizophrenia, have also been abused in some form as a child," he said.
He said the mental health profession had increasingly seen medication as the "frontline intervention", and had not always been good at dealing with the underlying factors that made people unwell.
But Dr Werry said there was no dispute that stresses, particularly experiences that made people feel denigrated or rejected, made things worse for people who already had schizophrenia.
"That has been known for at least 50 years. So there is actually very little, I would think, that is new in this study except any implication that this is a cause rather than an aggravating feature," he said.
Psychiatrists had always tried to treat patients "holistically" rather than relying purely on medication.
nzherald.co.nz/health
