What Happened After a Nation Methodically Murdered Its Schizophrenics? Rethinking Mental Illness and Its Heritability

Bruce Levine, PhD
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If a nation murdered and sterilized an estimated 73% to 100% of its diagnosed schizophrenics, yet a generation later that nation had a higher rate ofincidence of new cases of schizophrenia than did surrounding nations, shouldn’t we have questions about the claim by the mental health establishment that schizophrenia is highly heritable?

Moreover, since people diagnosed with schizophrenia and other so-called “seriously disabling mental disorders” such as bipolar and major depression have markedly lower reproductive rates compared with the general population but the prevalence of these disorders throughout the industrialized world has increased, shouldn’t we also be asking questions about heritability?

When we begin to question, we discover that (1) scientifically flawed research has been used to promote ideas around mental illness and its heritability, and (2) instead of focusing on nature vs. nurture causes of mental illness, it’s time to consider whether certain phenomena are really symptoms of pathology or instead are inextricable aspects of our humanity.

However, with Big Pharma’s antipsychotic drug bonanza now more than $18 billion annually in the U.S. (orchestrated primarily by increasingly pathologizing behaviors), and with financial dependency on Big Pharma by the psychiatric establishment, including by the American Psychiatric Association (publishers of the DSM, the psychiatric diagnostic bible), it is increasingly unlikely that truths about normality, pathology, and heritability will get out to the general public.

Results of the Nazis’ Attempt to Eradicate Schizophrenia

The genocide of 6 million Jews by the German Third Reich is widely known, but less publicized is the Nazi’s attempt to eradicate other groups, including the Romani, homosexuals, the physically deformed, the developmentally disabled—and people diagnosed with psychiatric disorders. This has been documented my many researchers, including Benno Muller-Hill in Murderous Science: Elimination by Scientific Selection of Jews, Gypsies, and Others in Germany, 1933-1945 and Robert Proctor in Racial Hygiene: Medicine Under the Nazis.

In Nazi Germany, influential promoters of the theory that schizophrenia and other mental illnesses are inherited included psychiatrists Ernst Rüdin and Franz Kallmann. Rüdin was the director of the Genealogical-Demographic Department of the German Institute for Psychiatric Research in Munich, and his research was actually supported by the Rockefeller Foundation. Rüdin believed that schizophrenia is caused by a recessive gene, and advocated that mentally ill individuals should not have children. In 1933, Rüdin was a major force behind the passage of Germany’s first compulsory sterilization law.

Franz Kallmann, a student of Rüdin, was a Berlin psychiatrist who researched schizophrenia in twins. Kallman argued for compulsory sterilization not only for schizophrenics but also for their relatives identified as nonaffected carriers. In 1936, Kallmann emigrated to the United States, where he continued his twin research and later became one of the founders of the American Society of Human Genetics.

Ridding society of burdensome individuals was much of what the “eugenics movement” was about, and this movement was a significant force in the United States and Great Britain.By 1928 in the United States, 21 states had compulsory sterilization laws, most targeting “lunatics” (as the mentally ill were commonly called).While the United States and Great Britain were most responsible for igniting the eugenics movement, it was Nazi Germany, with both massive sterilization and murder (called “euthanasia” by the Nazis), which acted most decisively to accomplish its goals. So, how did it work out?

Schizophrenia Bulletin in 2010 (“Psychiatric Genocide: Nazi Attempts to Eradicate Schizophrenia”) reported that an estimated 73% to 100% of individuals with schizophrenia living in Nazi Germany were sterilized or killed. This psychiatric genocide obviously resulted in a lower prevalence of schizophrenia in Germany immediately after 1945, but not for long.

A generation after the fall of the Third Reich, Schizophrenia Bulletin noted that “the incidence of schizophrenia in Germany were unexpectedly high.” And today, the prevalence of schizophrenia is virtually the same in Germany as it is for other nations in Europe and North America.

Schizophrenia Bulletin detailed the work of Heinz Häfner at the University of Heidelberg. Häfner reported that in Mannheim, Germany for each year from 1974 to 1980, new incidents of schizophrenia ranged from 48 to 67 per 100,000, averaging 59 per 100,000. Häfner compared the rate of new incidence of schizophrenia in Mannheim, Germany with eleven studies in the Netherlands, Italy, Denmark, Norway, Iceland, the United Kingdom, the United States, and Australia. The non-German locations averaged 24 per 100,000, less than half the incidence rate for Mannheim, Germany. Another study done in Bavaria, Germany in 1974-1975 reported an annual incidence rate of 48 per 100,000, double the incidence of non-German locations. Today, the World Health Organization reports that the prevalence of schizophrenia in Germany is virtually the same as it is for other European and North American nations.

Ironically, the lead author of that 2010 Schizophrenia Bulletin article, E. Fuller Torrey, is perhaps America’s most well-known psychiatrist advocating that schizophrenia and serious mental illnesses are caused primarily by biological factors. Yet, even Torrey rejects the idea that schizophrenia is a “a simple Mendelian inherited disease in which a single gene, or small number of genes, is sufficient to cause the disease.”

Low Reproductive Rates But Increasing Population

A large number of studies confirm the commonsense expectation of a markedly lower reproductive rate in those diagnosed with schizophrenia, depression, and bipolar disorder as compared with the general population.

In Behavioral and Brain Sciences in 2006 (“Resolving the Paradox of Common, Harmful, Heritable Mental Disorders”), Matthew C. Keller and Geoffrey Miller document that in the majority of 14 studies on “schizophrenia” and “psychosis,” reproductive rates were less than 50% of the general population.

Keller and Miller also documents reproductive rates of five studies done on bipolar disorder and affective disorder including depression. Study results show that these populations also have much lower reproductive rates than the general population (rates in the five studies: 70%; 50-62%; 69%; 47-89%; 66%).

From an evolutionary-biological perspective, this lower reproductive rate should ultimately decrease the rate of schizophrenia, bipolar disorder, and depression, but the rate of this population has actually increased. Robert Whitaker in Anatomy of an Epidemic documents that the mental illness disability rate in 2007 (1 in every 76 Americans) had more than doubled from 1987 (1 in every 184 Americans). Examining other statistics besides disability, Whitaker concludes that the rate of U.S. mentally ill population appears to have grown since 1955. And the World Health Organization in 1999, ranked depression as the world’s most devastating illness, projecting depression would climb to second place by 2020.

So, if serious and disabling mental illnesses such as schizophrenia, depression, and bipolar are highly heritable, wouldn’t sterilization and murdering of such people as well as their markedly lower reproductive rates diminish their prevalence, not increase it?

Yet, the National Institute of Mental Health (NIMH) and the rest of the mental health establishment insist that schizophrenia is highly heritable. NIMH states that an identical twin of a person with schizophrenia has a 40 to 65 percent chance of developing the disorder. So, what about all those twin studies that the psychiatry establishment tells us prove that schizophrenia is highly heritable?

Twin Research

In twin studies, heritability is a statistic routinely found by comparing identical twins (monozygotic twins) to same-sex, non-identical/fraternal twins (dizygotic twins) with the intent of teasing out environmental influences.

However, we now know that one major problem with comparing identical twins to fraternal twins to tease out environmental influences is that it’s incorrect to assume that there is an equivalent environmental influence on identical twins and fraternal twins, and so it is incorrect to assume that differences between them can be attributable to genetics.

Specifically, Not in Our Genes authored by biologist R. C. Lewontin and Steven Rose and psychologist Leon Kamin, reports how identical twins—as compared to same-sex fraternal twins—are often treated more similarly by parents, peers, and teachers; have more similar friends; do more similar things; and spend more time with one another. In one study, 40% of identical twins reported that they usually studied together, compared to only 15% of fraternal same-sex twins.

According to psychiatrist Don Jackson’s The Etiology of Schizophrenia, not only does the unique psychological bond of identical twins contribute to their higher concordance rate for schizophrenia on the basis of mutual association, the nature of the identical twinship might itself create conditions leading to the identity problems often experienced by people diagnosed with schizophrenia.

There are many other twin study research problems, according to The Etiology of Schizophrenia and Not in Our Genes, as well as psychologist Jay Joseph’s The Gene Illusion. For example, Franz Kallman’s 1938 high concordance rates of mental illness for identical twins have not been replicated, and in recent twin studies with more modest concordance rates, the diagnosis of schizophrenia is unreliable (see Herb Kutchins and Stuart A. Kirk’s Making Us Crazy for the unreliability of psychiatric diagnoses). Compounding normal psychiatric diagnosis reliability research problems, in many of these twin studies, researchers making diagnoses were not “blind” (in the fashion of proper “double-blind” scientific studies), resulting in potential bias.

What about studies of twins reared apart? There are very few of these kinds of studies, and much of what the general public has heard has been anecdotal stories, and as Jay Joseph in The Gene Illusion points out, “Most pairs come to the attention of researchers and journalists because of their similarities. . . .Stories of similar reared-apart twins are news because they are interesting and compelling; stories about dissimilar twins are not.”

There are a handful of systematic twins reared apart (TRA) studies, the most well known being the 1990 “Sources of Human Psychological Differences: Minnesota Study of Twins Reared Apart” by Thomas J. Bouchard. However, Joseph found important research problems with this most famous TRA study. Of perhaps greatest importance, Joseph points out, most labeled as “identical twin raised apart” don’t actually deserve the status of being called “reared-apart” since most pairs had significant contact with each other. These studies are confounded by the fact that besides sharing the same prenatal environment, the twins typically spent time together in the same family environment (averaging over 5 years together prior to separation), were aware of each other‘s existence when studied, and often had regular contact over a long period of time.

Joseph points out that there are many environmental(non-genetic) factors shared by identical twins labeled as “raised apart” that would lead them to resemble each more than two randomly selected members of the world’s population. In addition to sharing the same prenatal environment and an average of 5 years together in the same family environment, they were likely to elicit more similar treatment because they have the same appearance, almost always the same ethnicity, and are usually raised in the same socioeconomic class and same culture. Also, while Bouchard examined IQ, personality variables, and social attitudes, he did not specifically examine mental illnesses (as it is difficult enough to find identical twins reared apart—Bouchard was only able to find 100— making it exceedingly difficult to find enough identical twins reared apart who had been diagnosed with mental illness).

Yet, biological psychiatrists such as Torrey continue to maintain that serious mental illnesses such as schizophrenia are biological. Torrey argues:

The cause of schizophrenia involves dozens, and perhaps hundreds, of genes and includes common variants such as single nucleotide polymorphisms or less common variants such as copy number variations. Such variants may be carried by large numbers of people, most of whom never develop schizophrenia. It is possible that such genetic variations may cause disease only if they are activated by life experiences such as perinatal hypoxia, nutritional deficiency, infections, or other environmental factors.

Schizophrenia and Western Civilization

What causes schizophrenia? The surprising answer that biological psychiatrist E. Fuller Torrey argues for in his book Schizophrenia and Civilization is Western Civilization. Torrey concludes, “Between 1828 and 1960, almost all observers who looked for psychosis or schizophrenia in technologically undeveloped areas of the world agreed that it was uncommon.” Torrey writes, “There was a steady stream of studies from African countries noting the relative infrequency of schizophrenia,” and he offers other evidence for his thesis from the South Pacific, Tibet, Australian aborigines, and indigenous peoples in Brazil. And Torrey’s own 1973 New Guinea study shows contact with Western Civilization is highly correlated with schizophrenia.

For the biological psychiatrist Torrey, what’s problematic about Western Civilization is something biological. He writes “Viruses in particular should be suspect as possible agents.”

However, what appears to be most problematic about Western Civilization—in contrast to many society’s with little or no schizophrenia—is Western Civilization’s discomfort around people who display certain behaviors outside of ordinary experience. This discomfort results in objectification, coercion, and other forms of violence—emotional and physical.

The behaviors that characterize people diagnosed with schizophrenia are certainly outside most people’s ordinary experience. And in Western Civilization, unlike other civilizations with little or no schizophrenia, there is a strong tendency to label behaviors outside ordinary experience as pathological and to attempt to forcibly control these behaviors. That’s why homosexuality was an official American Psychiatric Association mental illness until the 1970s for which “treatments” were administered—this before psychiatry and society began to become more comfortable with homosexuality.

Does Hearing Voices Make One Mentally Ill?

Psychiatrist Dan Fisher, Director of the National Empowerment Center, was diagnosed with schizophrenia and hospitalized on three occasions, but has long recovered primarily with peer support, and he today rejects the term schizophrenia in favor of the non-disease term “lived experience. Dutch psychiatrist Marius Romme also believes that schizophrenia is a harmful concept, and that hearing voices and other so-called “symptoms” of schizophrenia are not evidence of an illness.

In 2011, Behavioral Healthcare (“So, What’s Wrong with Hearing Voices?”) described the work of a growing international organization, the Hearing Voices Network (HVN), developed around work by Marius Romme and voice hearer Patsy Hage. HVN has grown to encompass hundreds of chapters worldwide. The group’s mission is to nonjudgmentally gather and share among those who hear voices or experience other extreme phenomena.

Two “voice hearers” who had been previously diagnosed with serious mental illness (who also prefer the term “lived experience”) are Daniel Hazen, now executive director of Voices of the Heart, Inc. and Oryx Cohen, now the Technical Assistance Director for the National Empowerment Center. Both Hazen and Cohen believe what was helpful for them was to “de-pathologize” experiences such as hearing voices (see Cohen and other voice hearers talk about their experiences in trailer for the movie Healing Voices).

Cohen notes that phenomena that psychiatry proclaims as symptoms of psychosis are actually reported by 1 in 10 people at some point in their lives, making an individual’s likelihood of experiencing them “about as common as being left handed.” Cohen adds that it is not uncommon for people after the death of a loved one to hear that voice again, and adds that for many of these hearers, “that voice is experienced as a very reassuring thing.” However, vulnerable people who experience such phenomena can become dangers to themselves and create havoc for others when they have become terrified by this phenomena. And being told that such phenomena is evidence of a disease can be extremely frightening. But bolstered by security and support from other voice hearers, Cohen says, “The hearer can come to the conclusion that he or she does not have to listen to the voice.”

Learning to live with voices but not being enslaved by them is actually the strategy used by Nobel prize winning mathematician John Nash that helped him to return to functioning after being diagnosed with schizophrenia for many years. Nash, made famous by the movie A Beautiful Mind, is glad that the movie gave families of those diagnosed with schizophrenia hope of recovery, but he is troubled by many inaccuracies in the movie, including its claim that medication was important to his recovery when in fact he rejected medication (see interview with Nash).

If we accept that hearing voices is not evidence of illness but actually within the normal range of human experience, then, just as in the case of homosexuality, depression, and life-sacrificing altruism, neither genocide nor lower reproductive rates will affect its prevalence.

In other words, if phenomena are inextricably part of our humanity, to eliminate such phenomena, all human beings must be eliminated.

Bruce E. Levine, a practicing clinical psychologist, writes and speaks about how society, culture, politics and psychology intersect. His latest book is Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite. His Web site is www.brucelevine.net

 

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22 COMMENTS

  1. Bruce, thanks for this well-documented and well-reasoned piece debunking the junk science and political agendas that perpetrate the myths of a genetic cause of so-called “mental illness. Re: voice-hearing, Oliver Sacks’s new book Hallucinations is an enlightening consideration of hallucinations- including hearing voices, hearing music, and blind people seeing people and scenes – that are attributed to a wide variety of neurological causes, drugs, sensory deprivation, etc.

  2. Thanks for a very interesting post!

    I’d also like to add, and hope you won’t mind my doing so, that according to Haefner

    “[a]t present, it can neither be proven nor disproven by
    reliable data whether the compulsory sterilization of persons
    suffering from schizophrenia, supposedly a congenital
    disease, and the mass killing of people with
    schizophrenia in the Nazi era considerably reduced the
    risk for schizophrenia in the next generation.”

    See Haefner’s article (open access) for a detailed discussion: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879698/pdf/sbq034.pdf

  3. “However, what appears to be most problematic about Western Civilization—in contrast to many society’s with little or no schizophrenia—is Western Civilization’s discomfort around people who display certain behaviors outside of ordinary experience. This discomfort results in objectification, coercion, and other forms of violence—emotional and physical.”

    I appreciate you clearly making this link between societal constructs and treatment and ways of being that are clinically defined as “schizophrenia” or “psychosis.” I think a lot about the role of culture/setting in subjective experiences of madness and, certainly, being informed that one’s experience is a highly undesirable “disease” will likely lead that experience to experienced as frightening and negative.

    However, I also wonder if particular aspects of Western Civilization itself, e.g. the demands of the regimented Western workplace, the loudness and loneliness of our cities, the codified lack of freedom to express ourselves, and the severe and persistent knowledge that one’s country (in the case of the US) is engaging in horrific things around the globe and that our history is full of blood and injustice…I wonder if perhaps these factors also may contribute to experiences of madness.

    Of course, it seems that really almost any old thing gets called schizophrenia these days – from spiritual exploration, to poetry, to anger and confusion about one’s purpose.

    You’re right – these are core traits of humanity and to be human is not a disease.

    Thank you, also, for the additional history re: fascism and “mental illness.”

  4. \\…Psychiatrist Dan Fisher, Director of the National Empowerment Center, was diagnosed with schizophrenia and hospitalized on three occasions, but has long recovered primarily with peer support, and he today rejects the term schizophrenia in favor of the non-disease term “lived experience.” Dutch psychiatrist Marius Romme also believes that schizophrenia is a harmful concept, and that hearing voices and other so-called “symptoms” of schizophrenia are not evidence of an illness…//

    Bruce, it’s good you remind us that there are a few psychiatrists who do some good, professionally.

    And, thanks for a great post (I’d place the psych-labels more consistently in between inverted quotation marks, but otherwise, it’s perfect). Certainly, you’re correct to indicate the Nazi eugenicists had their science all wrong. Robert Whitaker explains that well – and elaborates, that, they got their ideas from eugenicists here in the U.S. (to any who may be interested in that history, I recommend listening to Bob’s lecture, in the two-hours of audio, at this link:

    http://www.unwelcomeguests.net/613 🙂

    To read my full response (which became too long, to post, as a comment), you can find it in my blog, by clicking on the following link:

    http://beyondlabeling.posterous.com/an-open-letter-to-bruce-levine-phd-psych-psyc

    Respectfully,

    ~Jonah

  5. I was really just disturbed, and understandably so; when I was “diagnosed” as being “schizophrenic.” Little did I know the kind of treatment I would get as soon as I was. I’ve actually never been forced on medications, but the very notion that there’s something wrong with your brain, this leads you astray and robs you of the information you need to know in order to actually have the mental tools to understand what’s going on. It’s incredibly confusing to think a legitimate emotional response is a malfunction of the brain. And sanity is made out to be a disabled docile state where a person follows society’s norms like a child getting candy.
    And so, the way things go, I started having whole psychotic episodes after a couple of years; in order to escape, and in order to lose my inhibitions and not be handicapped by people’s thoughts about me; and at the same time act out my inner wounds, so they would become recognizable. People of course have a problem with that. It doesn’t fit into their social constructs. One of the most striking things is how society believes that stress is magic. And when someone isn’t behaving “properly,” you alienate them, try to make them out to be incapable of adding to society, you humiliate them, you poke fun of them, talk about them making up conspiracy theories of what they might do – all of this is considered appropriate behavior. And this is supposed to terrify, shame, humiliated and degrade a person into suddenly becoming a harmonious societal clone. A perfectly working piece of machinery that runs on medications adjusting a chemical/mechanical flaw that’s yet to be proven exists, while the treatment causes such a flaw. And when you have a group of disabled docile people warehoused in foster care facilities, this is some magical healing. Stressing people out, disabling them, is made out to be some kind of magic; and it all exposes how society runs on fear and guilt, and they’re all bankrupting each other. Anyone who’s still free of “debt” to society is target for this. Anyone still human. Anyone whose reflexes haven’t been shackled by fear and guilt and thus “debt,” as in: “I owe my wonderful life to everything I’ve sacrificed to the system, and if you’re not in pain like me about it, you’re not doing your part!” (!?!?!?!?!?! )
    If you’re more rebellious like me, then you actually get stressed out by all of this. You don’t conform. You actually let the stress get to you; and escape in psychotic episodes where you shed your fears and shock people as well as act out how ridiculous society’s programming is by unintentionally making a farce out of it, if there’s any inkling of still trying to fit in. Is there some programming you haven’t let go of, you spin it out to it’s inevitable exposé of showing how it doesn’t work. At best it leads to a joke you can laugh at afterwards. And so, you learn that you don’t need to get stressed out. You learn that you’re actually much more in control of your emotions, and how you respond than you’ve been taught to believe; and you can step back rather than thinking you need to be part of it all. And you learn compassion for all those stuck in it, whoever they are.
    There’s a spiritual healer who died April 2009 named Gene Egidio. When he was a child, he would see auras around people; he knew who would be on the phone before they picked it up; healing would also happen around him. But his parents were concerned, for some reason. Who knows why. It was just too unusual? They took him to a priest, and the priest thought he had been given special gifts by the Devil. Exorcism didn’t work (!?!?!?!). Seriously, here the church is trying to exorcise the kind of consciousness Jesus had from someone. Then they took him to a psychiatrist. Gene ended up having shock treatments for at least a year. He learned to stop seeing auras and the other gifts he was given. In fact he completely forgot about all of it. It wasn’t till later in his life that he remembered, when his life seemingly fell apart, and the healings started happening again, and someone told him he should write a book. Then he started remembering what had happened in his youth. What’s amazing is that Gene had no resentments about it. I think because then he knew the healing would stop. Gene became a healer, he actually has the Russian Cosmonaut medal because of the work he did there. Only two of such medals given out in his lifetime. The other one went to Mitterrand. I had a phone session with Gene because I was interested in spiritual healing (one of the “crazy” things a schizophrenic does is look into spiritual healing and it’s beauty). Not much happened in the phone session; but years later when I did acquire a physical problem, I was going to have another session with Gene, had called his center and had already written out the check to have another session with him. But I watched a healing DVD he has called open eye meditation; and I settled down to take a nap, and somehow knew I would have the healing, would go into the sleep state where healing occurs that hadn’t happened after the phone session. That actually did happen, and the physical problem went away. I never sent the check, just let him know I had been healed. When I looked inside my mind to see where I had gone for the healing to take, where I had gone in my sleep; I saw myself in a place where everything I thought was unforgivable about myself would wash away. If you study A Course in Miracles or have read about people who have had NDE experiences and healing, they talk about the same kind of place. Someplace where the duality of the world slips away. Someplace where we are all one. When you stop hating yourself, when you dare to be human, when you let go of whatever you thought about yourself needed or needs some kind of punishment, is unforgivable and demands retribution; when you let go of this then you find who you really are. And the gist is that you stop believing other people have done unforgivable things. Instead you know how to relate to them, whatever they’ve done. And this could be just leaving them alone and blessing them. It does relieve the stress. And you’re not stressing other people out. And then people are free to respond without all of the guilt and fear they would otherwise think is necessary to keep their guard up. And this happens beyond time and space, I think. This happens within your own thoughts. This happens when you discover who you really are. But then again, these are “schizophrenic,” thoughts to think that we are all connected beyond time and space.
    I wish I could locate the article I read recently, since there are so many since the recent shooting. This one was about a psychiatrist or social worker profiling children in high-school she thought could become violent. What was striking was that the one’s she thought were the most scary were the ones that she said thought they they could hear other people’s thoughts. What if we’re all one? What if when you’re traumatized, and you fail to fit into the system, you start becoming aware of a part of you that doesn’t have these limitations? Limitations the system uses to con people into fear. I highly doubt that this woman who made the statement told these “highly dangerous” children to learn how to love themselves, and when they love themselves they are thinking only positive thoughts. That when you don’t judge others you are giving from a source where there’s no loss, there’s also no need to defend yourself from a loss. Try it once. Send a positive thought to someone and see if you can’t feel that sharing that thought, that idea, isn’t free of loss, as it wouldn’t seem to be would you give something physical away. Isn’t it possible that who we really are (and what every thing is) comes from such a place which has no such loss? It’s hard to imagine that anything could exist if it always had to be wagered against loss, and fear, and use guilt to control people.

  6. Hi Bruce,
    Thank you for another great article.

    I’ve been reading and now it is at the TV that:

    “And the World Health Organization in 1999, ranked depression as the world’s most devastating illness, projecting depression would climb to second place by 2020.”

    I would like to know how this prediction is done and what are the factors that they take into consideration to achieve this number.
    Do they count those who will be depressed because they were prescribed a drug which has as side effect depression?

    Can we rely on WHO?
    Thank you.