Hacker News Reader

Comment by mindgam3 | Hacker News Reader

"At last count, more than 12 percent of Americans ages 12 and older were taking antidepressants. The chemical-imbalance theory, like the revamped DSM, may fail as science, but as rhetoric it has turned out to be a wild success."

The psychological "trauma model" for mental disorders is a compelling counterpoint to the chemical-imbalance theory. The wikipedia article contains some evidence and links to related research:

"A 2005 meta-analysis of schizophrenia revealed that the prevalence of physical and sexual abuse in the histories of people diagnosed with psychotic disorders is very high and has been understudied. This literature review revealed prevalence rates of childhood sexual abuse in studies of people diagnosed with schizophrenia ranging from 45% to 65%"

https://en.wikipedia.org/wiki/Trauma_model_of_mental_disorde...

View on HN

From the same page, “the logic that childhood trauma causes insanity has a serious flaw: If the claim was true, the abuse of millions of children over the years should have caused higher prevalence rates of mental disorders than the literature reveals.”

This is similar to the problem with cannibis which many psychiatrists view as the primary causal factor for schizophrenia and psychosis.

This is a methods problem in my opinion. See for instance this[1]. There are so many cannibis users and so many people who have been traumatized in some way, while the number of those developing schizophrenia is relatively much smaller.

But ask a psychiatrist how many of their psychotic patients used cannibis regularly and you get a pretty clear answer. The psychiatrists don’t get to talk to the millions of cannibis users that don’t develop schizophrenia and so they tend to form their own non-scientific opinions on the origins of schizophrenia. Same with trauma. How many people get to adulthood without some traumatic event occurring. Even on this board it’s got to be a small minority.

[1] https://marginalrevolution.com/marginalrevolution/2018/04/de...

> From the same page, “the logic that childhood trauma causes insanity has a serious flaw: If the claim was true, the abuse of millions of children over the years should have caused higher prevalence rates of mental disorders than the literature reveals.”

This argument makes absolutely no sense to me. 40 million Americans now take psychiatric drugs for depression, anxiety and psychosis, about 1 in 6, most of them longterm. How many millions more need to take drugs before this would qualify as a high enough prevalence rate?

https://www.advisory.com/daily-briefing/2016/12/14/what-psyc...

Most psychiatrists I talked rejected the notion that cannabis causes schizophrenia. They mostly claim genetic causes. My personal opinion from observing close people to me is that if you have predisposition, a psychoactive substance can be enough to nudge you over the edge into psychosis. It's a snowball effect. Of course, more likely is it would be something that raises your dopamine levels, like speed (amphetamine) or cocaine.

I’ve had the opposite experience but maybe it depends on the demographics of the patients that those psychiatrists see. As this peice points out, clinicians are increasingly likely to see the causal link even if researchers are having a hard time establishing that link.[0] I think a large part of that is due to measurement issues and methodological difficulties I alluded to. It took many years to establish the link between cigarettes and cancer. There are scientists who argue against global warming too. So much of science is driven by bias and group think and the pendulum has perhaps swung too far on cannabis. You might ask the psychiatrists you talk to what percentage of their patients with bipolar/schizophrenic type disorders are regular cannabis users.

[0]https://www.nytimes.com/2019/01/17/health/cannabis-marijuana...

There have been twin studies that show genetics plays a huge part in schizophrenia and ADHD.

It's well known that trauma plays a part, but it is obviously not the whole story.

Twin studies: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4623659/ https://www.ncbi.nlm.nih.gov/pubmed/21336711

There's a huge gap between depression and schizophrenia. While I'm sure that child abuse can likely lead to depression, just because you have depression doesn't mean you were abused.

I don’t think anyone is claiming that. I certainly am not. I would however argue that if you have depression there is a high probability of environmental factors which might be contributing (ie bad relationship, work stress, etc)

That's why we have twin studies and adoption studies that show quite clearly how much is genetic and how much is environmental.

I get that, it's just not what your link is saying - it's pretty focused on the development of psychosis.

Reply on news.ycombinator.com