Opening a debate on schizophrenia

Oliver James's trenchant review (Think Again, October 22) that finds early traumatic history in many diagnosed with schizophrenia is certainly borne out in psychoanalytic treatment. Talking freely of immensely painful matters from the past, usually taken seriously for the first time, can begin a return to a more alive mental state. Such analytic treatment takes time and can bring hope. The easier psychiatric course is to ignore the feelings, invariably repeating, in Ferenczi's term, "the terrorism of suffering" from the past, to the professional hypocrisy that has no time to listen today. Dispensing antipsychotic medication means not needing to listen to a traumatically complex and emotionally draining story often at the heart of the illness.

Dr Jonathan Sklar
Psychoanalyst, London
I'm a professor of human genetics, and I would be intrigued to know more about the "gender-linked genetic inheritance" mentioned by Oliver James in his article on schizophrenia. Could it possibly be the same thing as the sex-linked inheritance that I teach our students about? I was also fascinated by his revelation that there is no difference between the genetic material (DNA) of schizophrenics and non-schizophrenics. My colleagues and I have just had a paper accepted by the American Journal of Medical Genetics, where we show a five times greater risk of schizophrenia in people who carry a certain version of the gene DISC1. People who have this gene disrupted by chromosome damage have almost a 100% chance of schizophrenia or a similar illness. Both of these phenomena are just differences in DNA.
Prof Duncan Shaw
University of Aberdeen
I have just attended a conference run by the International Centre for the Study of Psychiatry and Psychology. Clear evidence for brain-disabling and long-term damage caused by the use of psychotropic drugs was presented. What was particularly staggering to me was the wealth of research studies that show this, stretching back to the 1960s, which all the latest neurological test procedures are confirming.
I hope Oliver James's timely essay starts a much-overdue debate in this country. The overweening hegemony of the current bio-psychiatric model as the explanation for extremes of emotional distress results in increasing reliance on drug and electro-shock treatment. This must be challenged. There are clear benefits of talking therapies, not to mention human kindness, empathy care and support; these need to be promoted.
Sadly, confronting established ideology in this area can be professionally damaging and personally bruising. Dr Peter Breggin, the author of Toxic Psychiatry, managed to halt the use of brain surgery on young children in the US; for this he was ostracised by the profession. In this country Dr Bob Johnson, the author of Emotional Health, has faced similar difficulties

Sue Johnson
Director, James Nayler Foundation
To call people schizophrenic, as Oliver James does most liberally, is to define them, label and name them by their illness. Something that medicine is belatedly trying to eschew.

John Foskett
Dorchester, Dorset
The imminent arrival of avian flu in Europe has made it clear how dangerous flu can be to those who are most at risk from it. The government rightly gives priority to immunise people with chronic conditions such as asthma, diabetes and chronic heart and kidney conditions, people using immunosuppressant drugs and those over 65.
Yet there is one group of people the NHS is failing to prioritise: those with severe mental-health conditions. A person with schizophrenia is four times more likely than average to die from a respiratory infection. It is essential this and every autumn that GPs invite patients with severe mental-health conditions to get immunised against flu. We call on the Department of Health to issue urgent guidance to this effect to all practices across the country.

Dr Alan Cohen
General Practitioner
Angela Greatley
Sainsbury Centre for Mental Health
And six others