Most of the biological theories about the cause of schizophrenic symptoms can be explored using various methods of ‘hard’ science, but this type of scientific research, of necessity, always rests on swampy, very unscientific ground. The unscientific swamp on which schizophrenia researchers have to base their theories has a two-fold nature.
Firstly, researchers assume that all the members of a schizophrenic cohort have a common denominator that makes them different from normal people. It is this assumed common denominator that researchers must rely on to point them to the cause of schizophrenia. However, the subjectivity of the diagnostic process, and the absence of any definitive scientific tests to verify diagnoses, means that at the point of first diagnosis there might not be any common denominator of abnormality amongst schizophrenics at all. Because each of them is likely to have been first diagnosed at different places and at different times it is entirely possible they will be no commonality besides the label and the subsequent treatment.
The second problem is the history of neuroleptic medication applicable to almost all schizophrenics who might be available to researchers. Routine psychiatric practice requires that a person be medicated immediately upon diagnosis. Any group of schizophrenics available to a scientific researcher will most likely be composed of people whose brain functioning has been modified by powerful chemicals. The subtle deviations from normal biochemistry and normal brain architecture that researchers sometimes claim to detect can usually be better explained as artefacts of neuroleptic medication than as pre-existing features of the supposed underlying schizophrenia.
This problem is readily apparent to researchers and, while most of them choose to ignore it and continue their research programmes as if it were not a factor, occasionally a researcher will claim to have carried out research on schizophrenics who have had no experience with neuroleptics. However, such claims consistently avoid describing how the groups of ‘never-medicated’ schizophrenics were assembled, so there is always some doubt about the validity of these claims. Occasionally, however, researchers suggest that they were people recruited prior to treatment on their first-admission entry to hospital. If this method of recruitment is actually used, it raises an interesting ethical question about a hospital admission procedure which requires people who are apparently in acute distress to undergo research testing before attention can be given to their own problems. On top of this ethical problem there is also the doubt that confirmation of a distressed person’s lack of prior treatment can be accurately obtained from the person at the point of entry into hospital.
Next: Scanning for Causes
3. Theories Galore: the quest for a cause > 3.1 Biochemical Hypotheses—and Associated Drug Treatments >