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The Syndrome of Schizophrenia: Unresolved Questions and Opportunities for Research

The Fifty-second Maudsley Lecture, delivered before the Royal College of Psychiatrists in London, 17 November, 1978

Published online by Cambridge University Press:  29 January 2018

Seymour S. Kety
Affiliation:
Harvard University, Mailman Research Center, McLean Hospital, Belmont, Massachusetts
Seymour S. Kety
Affiliation:
Harvard University, Mailman Research Center, McLean Hospital, Belmont, Massachusetts

Extract

The concept of mental illness which Henry Maudsley developed and espoused has a special significance at this time. Psychiatry appears to have entered a new phase in its evolution as a mental science, in which its dependence on both the biological and the psychosocial disciplines is recognized, in which clinical observations are made under carefully controlled conditions, and where hypotheses lead to research rather than conclusions. This maturation was encouraged and predicted by Henry Maudsley who, more than a century earlier, had synthesized from the knowledge of his time a prospectus of psychiatric progress which anticipates much of our present thinking, often in considerable detail and striking exactitude.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Abenson, M. H. (1970) EEGs in chronic schizophrenia. British Journal of Psychiatry, 116, 177–89.CrossRefGoogle ScholarPubMed
Albee, G. W. (1967) The relation of conceptual models to manpower needs. In Emerging Concepts of Mental Health (ed. Cowen, E.). New York: Appleton-Century-Crofts.Google Scholar
Bird, E. D., Barnes, J., Iversen, L. L., Spokes, E. G., Mackay, A. V. P. & Shepherd, M. (1977) Increased brain dopamine and reduced glutamic acid decarboxylase and choline acetyl transferase activity in schizophrenia and related psychoses. Lancet, ii, 1157–9.Google Scholar
Birley, J. L. T. & Brown, G. W. (1970) Crises and life changes preceding the onset of relapse of acute schizophrenia. British Journal of Psychiatry, 116, 237333.Google Scholar
Bleuler, E. (1911) Dementia Praecox or the Group of Schizophrenias. Translated by Zinkin, H. New York: International Universities Press, 1950.Google Scholar
Book, J. A., Wetterberg, L. & Modrzewska, K. (1978) Schizophrenia in a north Swedish geographical isolate 1900–1977. Clinical Genetics, 14, 373–94.CrossRefGoogle Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241–58.Google Scholar
Carpenter, W. T. Jr., Strauss, J. S. & Muleh, S. (1973) Are there pathognomonic symptoms in schizophrenia: An empiric investigation of Kurt Schneider's first-rank symptoms. Archives of General Psychiatry, 28, 847–52.Google Scholar
Davison, K. & Bagley, C. R. (1969) Schizophrenia-like psychoses associated with organic disorders of the central nervous system: A review of the literature. In British Journal of Psychiatry, Special Publication No. 4: Current Problems in Neuropsychiatry (ed. Herrington, R. N.), 113–84.Google Scholar
Dohrenwend, B. P. (1975) Sociocultural and sociopsychological factors in the genesis of mental disorders. Journal of Health and Social Behavior, 16, 365–92.Google Scholar
Fenner, F. (1971) Infectious disease and social change. Medical Journal of Australia, 2, 10991102.CrossRefGoogle Scholar
Fish, B. (1975) Biologic antecedents of psychosis in children. In Biology of the Major Psychoses (ed. Freedman, D. X.). Research Publications, Association for Research in Nervous and Mental Disease, 54, 4483.Google Scholar
Garmezy, N. (1975) The experimental study of children vulnerable to psychopathology. In Child Personality and Psychopathology: Current Topics, 171216. New York: Wiley.Google Scholar
Goldfarb, W. (1961) Childhood Schizophrenia. Cambridge: Harvard University Press.Google Scholar
Gottesman, I. I. & Shields, J. (1972) Schizophrenia and Genetics: A Twin Study Vantage Point. New York: Academic Press.Google Scholar
Hanshaw, J. B., Scheiner, A. P., Moxley, A. W., Gaev, L., Abel, V. & Scheiner, B. (1976) School failure and deafness after ‘silent’ congenital cytomegalovirus infection. New England Journal of Medicine, 295, 468–70.Google Scholar
Hare, E. H., Price, J. S. & Slater, E. (1974) Mental disorder and season of birth: a national sample compared with the general population. British Journal of Psychiatry, 124, 81–6.CrossRefGoogle ScholarPubMed
Hawk, A. B., Carpenter, W. T. Jr. & Strauss, J. S. (1975) Diagnostic criteria and five-year outcome in schizophrenia. Archives of General Psychiatry, 32, 343–7.CrossRefGoogle ScholarPubMed
Heston, L. L. (1966) Psychiatric disorders in foster home reared children of schizophrenic mothers. British Journal of Psychiatry, 112, 819–25.CrossRefGoogle ScholarPubMed
Heston, L. L. & Denney, D. (1968) Interactions between early life experience and biological factors in schizophrenia. In The Transmission of Schizophrenia (eds. Rosenthal, D. and Kety, S. S.), 363–376. Oxford: Pergamon Press.Google Scholar
Higgins, J. (1966) Effect of child rearing by schizophrenic mothers. Journal of Psychiatric Research, 4, 153–67.CrossRefGoogle ScholarPubMed
Hill, D. (1957) The encephalogram in schizophrenia. In Schizophrenia: Somatic Aspects (ed. Richter, D.). London: Butterworths.Google Scholar
Hirsch, S. R. & Leff, J. P. (1975) Abnormalities in Parents of Schizophrenics. Maudsley Monograph No. 22. London: Oxford University Press.Google Scholar
Holzman, P. S., Proctor, L. R., Levy, D. L., Yasillo, N. J., Meltzer, H. Y. & Hurt, S. W. (1974) Eye-tracking dysfunctions in schizophrenic patients and their relatives. Archives of General Psychiatry, 31, 143–51.Google Scholar
Iversen, L. L. & Rose, S. P. R. (eds.) (1973) Biochemistry and Mental Illness. Biochemical Society Special Publication No. 1. London: Biochemical Society.Google Scholar
Johnstone, E. C., Crow, T. J., Frith, C. D., Stevens, M., Kreel, L. & Le Hustard, J. (1978) The dementia of dementia praecox. Acta Psychiatrica Scandinavia, 57, 305–24.Google Scholar
Kagan, J. & Klein, R. E. (1973) Cross-cultural perspectives on early development. American Psychologist, 28, 947–61.Google Scholar
Karlsson, J. L. (1966) The Biologic Basis of Schizophrenia. Springfield, Ill.: C. C. Thomas.Google Scholar
Kennard, M. A. & Levy, S. (1952) The meaning of the abnormal encephalogram in schizophrenia. Journal of Nervous and Mental Disease, 116, 413–18.Google Scholar
Kety, S. S. (1959) Biochemical theories of schizophrenia. Science, 129, 1528–32; 1590–6.Google ScholarPubMed
Kety, S. S. (1972) Toward hypotheses for a biochemical component in the vulnerability to schizophrenia. Seminars in Psychiatry, 4, 233–8.Google Scholar
Kety, S. S., Rosenthal, D., Wender, P. H. & Schulsinger, F. (1968) The types and prevalence of mental illness in the biological and adoptive families of adopted schizophrenics. In The Transmission of Schizophrenia (eds. Rosenthal, D. and Kety, S. S.), 345–62. Oxford: Pergamon Press.Google Scholar
Kety, S. S., Rosenthal, D., Wender, P. H., Schulsinger, F. & Jacobsen, B. (1975) Mental illness in the biological and adoptive families of adoptive individuals who have become schizophrenic: A preliminary report based on psychiatric interviews. In Genetic Research in Psychiatry (eds. Fieve, R. R., Rosenthal, D. and Brill, H.), 147–65. Baltimore: The Johns Hopkins University Press.Google Scholar
Kety, S. S., Rosenthal, D., Wender, P. H. (1978) Genetic relationships within the schizophrenia spectrum: evidence from adoption studies. In Critical Issues in Psychiatric Diagnoses (eds. Spitzer, R. L. and Klein, D. F.), 213–23. New York: Raven Press.Google Scholar
Kinney, D. K. & Jacobsen, B. (1978) Environmental factors in schizophrenia: new adoption study evidence and its implications for genetic and environmental research. In The Nature of Schizophrenia (eds. Wynne, L. C., Cromwell, R. L. and Matthysse, S.), 38–51. New York: Wiley.Google Scholar
Kinney, D. K. & Matthysse, S. (1978) Genetic transmission of schizophrenia. Annual Reviews of Medicine, 29, 454–73.CrossRefGoogle ScholarPubMed
Knapp, P. C. (1908) Confusional insanity and dementia praecox. Journal of Nervous and Mental Disease, 35, 609–14.Google Scholar
Koehler, K., Guth, W. & Grimm, G. (1977) First rank symptoms of schizophrenia in Schneider-oriented German centres. Archives of General Psychiatry, 34, 810–13.CrossRefGoogle Scholar
Kohn, M. L. (1968) Social class and schizophrenia: a critical review. In The Transmission of Schizophrenia (eds. Rosenthal, D. and Kety, S. S.), 155–73. Oxford: Pergamon Press.Google Scholar
Kohn, M. L. (1976) The interaction of social class and other factors in the etiology of schizophrenia. American Journal of Psychiatry, 133, 177–80.Google Scholar
Kohn, M. L. & Clausen, J. A. (1955) Social isolation and schizophrenia. American Sociological Review, 20, 265–73.Google Scholar
Kraepelin, E. (1913) Dementia Praecox and Paraphrenia. Translated by Barclay, R. M. from the 8th German Edition of the ‘Text-book of Psychiatry. Vol. III part 2, on Endogenous Dementias’. Edinburgh: E. & S. Livingstone (1919).Google Scholar
Langfeldt, G. (1939) The Schizophreniform States. Copenhagen: Munksgaard.Google Scholar
Lewis, A. (1951) Henry Maudsley: his work and influence. Journal of Mental Science, 35, 609–14.Google Scholar
Liem, J. H. (1974) Effects of verbal communications of parents and children: a comparison of normal and schizophrenic families. Journal of Consulting Clinical Psychology, 42, 438–50.Google Scholar
Matthysse, A. G. & Matthysse, S. (1978) Bacteriophage models of neurotopic virus specificity. In Neurochemical and Immunologic Components in Schizophrenia (eds. Bergma, D. and Goldstein, A. L.), 111–121. New York: A. R. Liss.Google Scholar
Matthysse, S. (1978) Etiological diversity in the psychoses. In Genetic Epidemiology (eds. Chung, C. S. and Morton, N. E.), 311–28. New York: Academic Press.Google Scholar
Matthysse, S. & Pope, A. (1975) The approach to schizophrenia through molecular pathology. In Molecular Pathology (eds. Good, R. A., Day, S. D. and Yunis, J. J.), 744–68. New York: C. C. Thomas.Google Scholar
Maudsley, H. (1872) The Physiology and Pathology of Mind. New York: Appleton & Co.Google Scholar
McNeil, T. F. & Kaij, L. (1978) Obstetric factors in the development of schizophrenia: Complications in the births of preschizophrenics and in reproduction by schizophrenic parents. In The Nature of Schizophrenia (eds. Wynne, L. C., Cromwell, R. L. and Matthysse, S.), 401–29. New York: Wiley & Sons.Google Scholar
Medical Research Council (1970) Biochemical Research in Psychiatry: Survey and Proposals. London: H.M. Stationery Office.Google Scholar
Mellor, C. S. (1970) First rank symptoms of schizophrenia. British Journal of Psychiatry, 117, 1523.Google Scholar
Menninger, K. (1928) The schizophrenic syndrome as a product of acute infectious disease. Archives of Neurology and Psychiatry, 20, 464–81.Google Scholar
Mitsuda, H. (1965) The concept of ‘atypical psychoses’ from the aspect of clinical genetics. Acta Psychiatrica Scandinavia, 41, 372–7.Google Scholar
Morton, L. A., Kidd, K. K., Matthysse, S. & Richards, R. (1979) Recurrence risks in schizophrenia: Are they model dependent? Behavior Genetics (in press).CrossRefGoogle Scholar
Mosher, L. R., Pollin, W. & Stabenau, J. R. (1971) Identical twins discordant for schizophrenia: Neurologic findings. Archives of General Psychiatry, 24, 422–30.Google Scholar
Nauta, W. J. H., Smith, G. P., Faull, R. L. M. & Dome-sick, V. B. (1978) Efferent connections and nigral afferents of the nucleus accumbens septi in the rat. Neuroscience, 3, 385401.Google Scholar
Pope, H. & Lipinski, J. (1978) Differential diagnosis of schizophrenic and manic-depressive illness. Archives of General Psychiatry, 35 (7), 811–36.Google Scholar
Richter, D. (1976) The impact of biochemistry on the problem of schizophrenia. In Schizophrenia Today (eds. Kemali, D., Bartholini, G. and Richter, D.), 71–86. Oxford: Pergamon Press.Google Scholar
Rieder, R. O., Donnelly, E. F., Herdt, J. R. & Waldman, I. N. (1979) Sulcal prominence in young chronic schizophrenic patients: CT scan findings associated with impairment on neuropsychological tests. Psychiatry Research, 1, 19.CrossRefGoogle ScholarPubMed
Roberts, E. (1972) An hypothesis suggesting that there is a defect in the GABA system in schizophrenia. In Prospects for Research on Schizophrenia (eds. Kety, S. S. and Matthysse, S.). Neurosciences Research Program Bulletin, 10 (4), 468–82.Google Scholar
Rochford, J., Detre, T., Tucker, G. J. & Harrow, M. (1970) Neuropsychological impairments in functional psychiatric disease. Archives of General Psychiatry, 22, 114–19.Google Scholar
Rosenthal, D., Wender, P. H., Kety, S. S., Schulsinger, F., Welner, J. & Østergaard, L. (1968) Schizophrenics’ offspring reared in adoptive homes. In The Transmission of Schizophrenia (eds. Rosenthal, D. and Kety, S. S.), 377–91. Oxford: Pergamon Press.Google Scholar
Rosenthal, D., Wender, P. H., Kety, S. S., Schulsinger, F., Welner, J. & Rieder, R. O. (1975) Parent-child relationships and psychopathologic disorder in the child. Archives of General Psychiatry, 32, 466–76.Google Scholar
Schneider, K. (1959) Clinical Psychopathology. Translated by Hamilton, M. W. New York: Grune & Stratton.Google Scholar
Schopler, E. & Loftin, J. (1969) Thought disorders in parents of psychotic children. Archives of General Psychiatry, 20, 174–81.Google Scholar
Shields, J., Heston, L. L. & Gottesman, I. I. (1975) Schizophrenia and the schizoid: The problem for genetic analysis. In Genetic Research in Psychiatry (eds. Fieve, R. R., Rosendial, D. and Brill, H.), 167–97. Baltimore: Johns Hopkins University Press.Google Scholar
Slater, E. (1958) The monogenic theory of schizophrenia. Acta Genetica et Statistica Medica, 8, 50–6.Google Scholar
Spitzer, R. L., Endicott, J. & Gibbon, M. (1979) Crossing the border into borderline personality and borderline schizophrenia: The development of criteria. Archives of General Psychiatry, 36, 1724.CrossRefGoogle ScholarPubMed
Stevens, J. R. (1973) An anatomy of schizophrenia? Archives of General Psychiatry, 29, 177–89.CrossRefGoogle ScholarPubMed
Strömoren, E. (1965) Schizophreniform psychoses. Acta Psychiatrica Scandinavica, 41, 483–9.Google Scholar
Suomi, S. J. & Harlow, H. F. (1972) Social rehabilitation of isolate reared monkeys. Developmental Psychology, 6, 487–96.CrossRefGoogle Scholar
Thudichum (1884) A Treatise on the Chemical Constitution of the Brain. London: Balliere, Tindall & Cox.Google Scholar
Torrey, E. F. & Peterson, M. R. (1976) The viral hypothesis of schizophrenia. Schizophrenia Bulletin, 2, 136–46.Google Scholar
Tsuang, M. T., Dempsey, G. M. & Rauscher, F. (1976) A study of ‘atypical schizophrenia’, Archives of General Psychiatry, 33, 1157–60.Google Scholar
Tucker, G. J., Campion, E. W. & Silberfarb, P. M. (1975) Sensorimotor functions and cognitive disturbance in psychiatric patients. American Journal of Psychiatry, 132, 1721.Google Scholar
Vaillant, G. E. (1978) A 10-year follow-up of remitting schizophrenics. Schizophrenia Bulletin, 4, 7885.Google Scholar
Waring, M. & Ricks, D. F. (1965) Family patterns of children who become adult schizophrenics. Journal of Nervous and Mental Disease, 140, 351–64.CrossRefGoogle Scholar
Watt, N. F. (1974) Childhood and adolescent routes to schizophrenia. In Life History Research in Psychopathology, vol. 3 (eds. Ricks, D. R., Thomas, A. and Roff, M.), 194–211. Mineapolis: University of Minnesota Press.Google Scholar
Weinberger, D. R., Torrey, E. F., Neophytides, A. N. & Wyatt, R. J. (1979) Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry, 36, 735–9.Google Scholar
Welner, J. & Strömoren, E. (1958) Clinical and genetic studies on benign schizophreniform psychoses based on a follow-up. Acta Psychiatrica et Scandinavica, 33, 377–99.CrossRefGoogle ScholarPubMed
Wender, P. H., Rosenthal, D. & Kety, S. S. (1968) A psychiatric assessment of the adoptive parents of schizophrenics. In The Transmission of Schizophrenia (eds. Rosenthal, D. and Kety, S. S.), 235–50. Oxford: Pergamon Press.Google Scholar
Wender, P. H., Rosenthal, D., Kety, S. S., Schulsinger, F. & Welner, J. (1974) Cross-fostering: A research strategy for clarifying the role of genetic and experiential factors in the etiology of schizophrenia. Archives of General Psychiatry, 30, 121–8.Google Scholar
Wender, P. H., Rosenthal, D., Rainer, J. D., Greenhill, L. & Sarlin, B. (1977) Schizophrenics’ adopting parents: Psychiatric status. Archives of General Psychiatry, 34, 777–84.CrossRefGoogle ScholarPubMed
Wynne, L. C., Singer, M. T. & Toohey, M. L. (1976) In Schizophrenia 75: Psychotherapy, Family Studies, Research (eds. Jorstad, J. and Ugelstad, E.), 413–51. Oslo: University of Oslo Press.Google Scholar
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