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The Week: Jared Loughner's separate reality

What do experts mean when they say Tucson shooter Jared Loughner shows symptoms of schizophrenia? A guide to this complex disorder

January 28, 2011-

What is schizophrenia?
It’s the most serious and intractable form of mental illness, marked by delusional thinking, hallucinations, and an inability to function in daily life. Schizophrenics often hear internal voices that issue commands or make terrifying statements—a symptom that inspired the coining, a century ago, of the term “schizophrenia,” from the Greek for “splitting of the mind.” Modern psychiatry has identified several forms of schizophrenia, with symptoms ranging from bizarre emotional affect and fragmented and wandering attention to poor self-care and strange thought and speech patterns. “A running vacuum cleaner called me filthy names,” said Marcia Murphy in a published account of her schizophrenic episodes. “Laundry machines, air conditioners, cars, and motorcycles all taunted me. The flame on the gas stove also spoke. Sometimes I thought I heard footsteps of huge invisible men following me. As the wind blew, it whispered messages in my ears.”

How do people develop schizophrenia?
It appears to be at least partly genetic. Recent research suggests that genes predisposing a person to the disorder may also be “turned on” in the womb or in early childhood by environmental influences, including exposure to viruses and the cat-borne protozoan Toxoplasma gondii. Use of drugs, including marijuana, may also trigger and exacerbate underlying symptoms. Contrary to what psychiatrists once thought, schizophrenia is not the result of poor parenting or trauma, though trauma, too, can accelerate its onset. Studies of schizophrenics’ brains show clear biological indicators, including chemical dysfunctions and structural anomalies. Throughout much of human history, schizophrenia and other mental illnesses were attributed largely to demonic possession, and one common treatment was drilling a hole in the skull to let the demons out. In the mid-20th century, “modern” doctors in the U.S. renewed that barbaric practice by performing 18,000 lobotomies, in which the prefrontal lobe of very difficult patients—mostly schizophrenics—was surgically removed to make them more docile.

How common is the disorder?
Roughly 1 percent of adults will be diagnosed with schizophrenia in the course of their lifetimes. This rate has varied little over time and across borders, suggesting that a nation’s culture has little direct effect on the onset of the disease. In the U.S. there are about 2.4 million diagnosed schizophrenics, making the disease almost 10 times less prevalent than mood disorders like depression and bipolar disorder. Most schizophrenics appear to function normally in childhood and into their teens. (Loughner, for example, has been described by friends as sweet, caring, and basically normal until about age 15.) Among men, the average age of onset is 19; among women, it’s 22. Sometimes, schizophrenics show no symptoms into their mid to late 20s.

Are schizophrenics violent?
The vast majority are not. Advocates for the mentally ill say schizophrenics are no more likely to commit crimes than other people, and the damage they inflict is usually on their own lives. (The average life span of schizophrenics is about 15 years shorter than the general population’s.) But for people suffering from the most problematic form of the disorder, paranoid schizophrenia, the risk of violent behavior is real. Paranoid schizophrenics combine a grandiose sense of self-importance with delusions that they’re being followed, persecuted, or controlled. Dr. E. Fuller Torrey, a psychiatrist who’s studied the connection between schizophrenia and crime, concluded that about 1,000 homicides are committed by schizophrenics every year. (This estimate has been disputed by advocates for the mentally ill). Whatever the exact numbers, it’s clear that some schizophrenics do respond to their delusions with murder. In one grisly case in 2008, schizophrenic Vince Li suddenly pulled out a large knife while traveling on a Greyhound bus in Canada, and severed a sleeping passenger’s head, holding it aloft and taunting passengers and police. Li later said that he’d been told by the voice of God that his victim was evil.



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