5 - 10 - 49. Schizophrenia Pathophysiology. A Century of Frustration (13-46)

5 - 10 - 49. Schizophrenia Pathophysiology. A Century of Frustration (13-46)

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Hello, this mini lecture is entitled Schizophrenia Pathophysiology, A Century of Frustration. Because as you'll see, history shows that we do not yet have an idea about what causes schizophrenia. In fact, over the past century, each advance in biology and technology has been tried out on schizophrenia. Schizophrenia has become a kind of touch stone for neuroscience. Are we there yet? Do we have an explanation for schizophrenia? Early in the twentieth century the great German scientists followed their passion for classifying, in this case, mental disorders. And in, in the 30s' the Nazi's had the idea that the Aryan race was a pure one and that to the extent that other genes got mixed up in the Aryan genes, there would be mental illness. As a reaction, in part, to this totally genetic view of schizophrenia, American psychiatrists formulated the so-called schizogenetic mother hypothesis, in which it was all environmental. And the behavior of the mother lead a child to have schizophrenia. This was at about the same time that Bettelheim was developing the so-called refrigerator mother hypothesis of autism, since roundly rejected. In the 1950s, the great Caltech chemist Linus Pauling was developing the idea that sickle cell anemia, a monogenic disease is caused by a change at a single amino acid in a protein sequence. That was remarkable at the time and Pauling, who was quite audacious, had the idea that perhaps all diseases were caused by molecules. In 1968, he published a paper entitled Orthomolecular Psychiatry in which he explained how all psychiatric diseases might be caused by the small molecules. So, that was his idea and he applied the most advanced technique available at that time to that idea. And this most advanced technique available was paper chromatography. You remember those experiments in high school where you took a bit of filter paper or a paper towel, and you stuck it in an ink well, and the ink got separated into its different components which climbed up the paper. Well, that was the advanced technique that Linus Pauling used to figure out whether schizophrenics had a molecule that was not there in the urine of normal patients or vice versa. he found nothing. But the key idea that you applied the best technique you had at the time continues. In 1955, when chlorpromazine was accidentally discovered as an antipsychotic, this had two results. First of all, it became possible to release from mental institutions, those patients who had been
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living in mental institutions. As you can
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