Tuesday, November 21, 2006

Researchers: Broken home linked to psychosis

People from broken homes may be more prone to psychotic illnesses such as schizophrenia, research suggests.

Researchers said their findings suggest the illnesses are not simply brain diseases, but linked to factors such as social adversity.

They found much higher rates among black people, who were also more likely to come from broken homes.

The study, by London's Institute of Psychiatry, will appear in the journal Psychological Medicine.

The researchers examined data on people in south east London, Bristol and Nottingham, including 780 who showed signs of a psychotic illness.

They found schizophrenia was nine times more common in people from African Caribbean origin, and six times more common in people from black African origin than in the white British population.

In a second paper, they found that separation from one or both parents for more than a year before the age of 16, as a consequence of family breakdown, was associated with a 2.5 fold increased risk of developing psychosis in adulthood.

Family breakdown of this type was found to be more common in the African-Caribbean community (31%) than the white community (18%).

Researcher Dr Craig Morgan said: "These findings provide evidence that early social adversity may increase the risk of later psychosis.

"Such early adversity may be one factor contributing to the high rate of psychosis in the African-Caribbean population."

More work needed

However, Dr Morgan said more work was needed to fully understand how specific types of early social adversity might interact with pyschological and biological factors to cause psychosis.

Professor Robin Murray, who also worked on the research, said: "For the last 30 years the traditional view has been that psychosis is largely a genetic brain disease, and most psychiatrists have thrown out the view that social factors can have a major impact.

"These findings suggest it is not just a brain disease, and that social factors can also contribute to the onset of illness."

Professor Murray dismissed the idea that drug taking might contribute to raised rates of psychosis among the black population.

He said evidence showed that drug taking was no higher among black people than the general population.

He said it was possible that the discrimination and disruption encountered by migrants to the UK might play a role in their increased vulnerability to psychosis.

Paul Corry, of the mental health charity Rethink, said there was evidence to suggest that although psychotic illness was linked to the genes, it often took an external trigger for symptoms to become apparent.

He said: "These findings underline the need to approach the treatment of schizophrenia not just in purely medical, drug-based terms, but also by taking into account the wider social context that the patient is inhabiting at the time, and trying to ensure they are offered relevant support."

It is thought that around 1% of the population develop schizophrenia, or related conditions, such as manic psychosis, and depressive psychosis.

Up to 300,000 people have been diagnosed with schizophrenia in the UK.

All the conditions are associated with hallucinations, delusions and bizarre forms of behaviour.

Pyschotic illnesses have been linked to raised levels of the mood-altering chemical dopamine in the brain.

The Institute of Psychiatry is based at King's College London.

Wednesday, November 01, 2006

Judge rules against boy’s circumcision

This is a most interesting legal decision. According to the Chicago Tribune,
In a case that has been closely watched by anti-circumcision groups nationwide, a Cook County judge ruled Tuesday that the medical benefits of the procedure are not clear enough to compel a 9-year-old Northbrook boy to be circumcised against his will.

The boy's mother and her new husband had claimed the operation was necessary to prevent recurrent episodes of redness and discomfort. The boy's father sought a court order barring the circumcision, which he called an "unnecessary amputation."

The mother has sole custody, but their 2003 parenting agreement gave her ex-husband a say in non-emergency medical decisions. The Tribune is not naming the parents in order to protect the boy's privacy.

In a written opinion handed down Tuesday, Circuit Court Judge Jordan Kaplan said, "The evidence was conflicting and inconclusive as to any past infections or irritations that may have been suffered by the child.

"Moreover," he continued, "this court also finds that the medical evidence as provided by the testimony of the expert witnesses ... is inconclusive as to the medical benefits or non-benefits of circumcision as it relates to the 9-year-old child."

Kaplan said the boy, as a minor, cannot make his own medical decisions but had indicated in a written statement that he does not want to be circumcised...
Clearly the court would not have intervened had the biological father not objected, but should courts ban genital mutilation of all minor males? If not, then why should the mutilation of minor females not also be permitted?

What types of unnecessary mutilation should be legally acceptable, and whose opinion should prevail? Who defines "medical"? If mutilation should be banned due to the lack of medical justification, should there be a religious exemption? If circumcision is not medically justifiable, what about ear piercing? Should a father be able to prevent his ex-wife from piercing her 9-year-old daughter's ears, with or without the child's consent? What if the child objects to the piercing? At what age should a child's opinion be considered by a court on such a matter?

It should never be taken lightly when a court's judgement replaces that of a parent, but I think that circumcision, except when medically indicated, if such a case can really exist, can properly be banned by courts. When a person reaches the age of majority he can always decide to be mutilated. But how can I then justify the ear piercing of a minor?