Is Schizophrenia Associated with Brain Volume Changes Independently of Medication?


Duncan Double, on his Critical Psychiatry blog, published a series of posts exploring the effects of antipsychotics on brain volume and the contention that these changes are tied to ‘schizophrenia.’ “The cerebral atrophy demonstrated by Johnstone et al (1976) was almost certainly due to antipsychotic medication, at least mainly, and was not an indication that schizophrenia is a brain disease.” he writes. “Johnstone et al were wanting to make out that schizophrenia led to a dementing illness, as they found a significant association of increased ventricular size with measures of cognitive impairment. But any cognitive impairment in schizophrenia is functional not organic, so the whole basis of the paper was flawed. And, its misinterpretation has misled a whole generation of psychiatric researchers.”

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  1. You do see the big problem here, don’t you? If a person is truly “treatment naive”, then how can you be sure that he actually does have so-called “schizophrenia”? And, how do you set up a control / experimental group, when you’re giving them ALL neuroleptics? Or do you deny neuroleptics to some, but not others? How carefully can you control for confounding factors? Lapsing both theoretical & hypothetical for a minute, if it were possible to give persons so-called “schizophrenia”, for the sake of testing them – ethical Q?’s aside, – just how would you go about giving them “schizophrenia”?….????….

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    • There have been cases of psychiatrists successfully causing “schizophrenic” thoughts and behaviors in unwitting test subjects. Many started out as members of the “worried well.”

      Dr. Jeffrey Lieberman records an experiment like this in Shrinks. In his case he took people labeled “schizophrenic” who had made significant recoveries after one episode and recreated long-term psychosis with a powerful neuroleptic drug. I guess he got around the legal problem on the grounds that they were already “schizophrenics” despite recovering. He got around the ethical problem by not having a conscience.

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