Schizophrenia linked to childhood sexual abuse

16.01.2002
By SIMON COLLINS

Schizophrenia has been linked to childhood sexual abuse by a groundbreaking study led by Auckland researchers.

The psychologists' research, published in an American medical journal, has found that 50 per cent of female psychiatric inpatients surveyed in 15 international studies said they were sexually abused as girls.

It says women in psychiatric hospitals are at least twice as likely as other women to have been abused.

Male psychiatric inpatients reported childhood sexual abuse rates of between 22 and 39 per cent, "at least double" the rates among men in general.

"That doesn't prove that schizophrenia is caused by child abuse," said the principal researcher, Auckland University clinical psychologist John Read.

"We are saying that for a significant proportion of people diagnosed as schizophrenic, early child abuse will have played a role."

Schizophrenia is a general term for a number of severe mental disorders involving disturbed thought processes, withdrawal from reality, and various emotional and behavioural symptoms.

About 1 per cent of New Zealanders will experience some episodes of schizophrenia during their lifetime.

The findings could lead to changes in the way doctors treat schizophrenic patients, placing less emphasis on drugs.

The paper was co-written by American child psychiatrist Bruce Perry, Auckland University psychologist Andrew Moskowitz and South Auckland Healthcare psychologist Jan Connolly. It appears in the latest issue of Psychiatry: Interpersonal and Biological Processes.

It includes a finding by Professor Perry that the physical changes in brains of abused children are similar to those in adults with schizophrenia.

"If you go into the brain of a person diagnosed as schizophrenic, you find all sorts of brain dysfunctions, and therefore it's assumed that it's a biological illness," Dr Read said.

"They miss the rather obvious point that there are all sorts of things that happened in those people's lives that caused those brain patterns and biochemical imbalances."

In 20 years of clinical experience before he took up a senior lectureship at Auckland seven years ago, Dr Read found that almost every patient could identify traumas that caused his or her schizophrenia.

Apart from child abuse, common traumas included losing parents and relationship breakups. Some became distressed by social trauma.

"For example, people in the bottom socio-economic bracket are several times more likely to be diagnosed schizophrenic than people in the top bracket," he said.

"Ethnic minority groups and indigenous people are diagnosed schizophrenic several times more often than the dominant culture."

Dr Read said medication - the most popular treatment - worked for only a third of patients.

The Auckland branch chairman of the Schizophrenia Fellowship, psychologist Dr Geoff Bridgman, said the research should be treated cautiously.

"There is no doubt that people who are schizophrenics have had major experience of abuse in many if not most cases, but they are post-illness," he said.

"Once you become ill, you are increasingly at risk of abuse. Historically, in terms of institutional care, you are almost automatically at risk of abuse."