Letter: Physical causes of schizophrenia

Sir: Dr David Hill's letter of 11 January, 'Compulsory drugs are not the answer', was full of dangerous misinformation. He implied that people with schizophrenia should not receive any medical treatment, but should have some sort of social help, since their illness was caused by 'poverty, child abuse, unemployment and homelessness'. These would be innocuous fantasies if schizophrenia were not such a devastating illness.

Schizophrenia is a physical disease of the brain, probably caused by a combination of genetic and other factors. Stress can certainly trigger relapses, but this is true of many illnesses. Drugs are a successful treatment in two-thirds of patients (not 10 per cent), and a recently introduced drug, Clozapine, helps those who do not initially get better.

The involuntary movements of tardive dyskinesia are a side-effect in 15 per cent (not 50 per cent) of patients who take these drugs for more than one year; and 70 per cent get better when the drug is stopped. Recent historical research has shown that people with schizophrenia used to get this movement problem before these drugs were available. Therefore the movements may be a complication of schizophrenia itself.

Only 7 per cent of inpatients in psychiatric hospitals and wards are involuntary patients. There is a high suicide rate in schizophrenia. Bringing someone into hospital, when their families are at their wits' ends and when they themselves do not realise they are ill, can be life-saving.

Yours sincerely,

PETER WHITE

Consultant Psychiatrist

St Bartholomew's Hospital

London, EC1

12 January