Talk:Schizophrenia/Archive 10

Updates from new manual.
DSM5 manual has been out for several months now, and this article needs to be updated and redrafted in numerous sections to be current and maintain quality.

1)Article as a whole appears to completely overlook the comparison and relationship of this diagnosis with "Personality Disorders" as presented in ICD10 and DSM5, the discussion is completely missing.

2)Lede does not mention relevance of associated personality disorders to Schiz. diagnosis and treatment.

3)"Schneiderian" classification should be discussed under "History" section. It is secondary to both the ICD10 and the DSM5 classification categories and the section should reflect this. They (DSM5 and ICD10) presently do not appear in discussion until section 4 here as "Diagnosis".

4)"Causes" subsection completely ignored personality disorders; possible correction may be with a new subsection, or as a subsection to present "Genetics" subsection; Or, possibly under "Developmental."

5) Very scant "Psychological" subsection under "Mechanisms" compared to more fully developed "Neurological" subsection; Personality Disorders completely ignored in this subsection.

6) "Diagnosis" opening paragraph in subsection mentions only DSM4 and needs to be updated; no mention is made of disagreements and contrasts between DSM5 and ICD10 regarding "Schiz." diagnosis and assessment.

7)"Diagnosis" subsection on "Criteria" is outdated and does not mention DSM5 updates for schizophrenia.

8)"Diagnosis" subsection on "Subtypes" is outdated to DSM5 standards and needs to be re-drafted. ICD-10 classifies the DSM-5 schizotypal personality disorder as a form of schizophrenia rather than as a personality disorder. BillMoyers (talk) 18:47, 10 December 2013 (UTC)


 * Have to read up on DSM5 when I get to work...might take a few days. Cas Liber (talk · contribs) 19:17, 10 December 2013 (UTC)
 * , when you add text, you should cite it. Your addition appears to contain some original research.  Sandy Georgia  (Talk) 19:19, 10 December 2013 (UTC)
 * For the reason Sandy just mentioned, I've reverted it for now, but I'm fine with adding something like it back. --Tryptofish (talk) 20:04, 10 December 2013 (UTC)
 * Are you arguing that personality disorders cause schizophrenia. Text does not fit in the section. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:17, 10 December 2013 (UTC)

ICD-10 classifies schizotypal personality disorder as a form of "Schizophrenia." This is one of 8 edit questions raised above, the others are also useful from DSM5. Can you suggest a better section or subsection for this one. BillMoyers (talk) 23:15, 10 December 2013 (UTC)
 * Were Trypto put it is fine. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:19, 10 December 2013 (UTC)
 * It appears as though DSM5 is recognising what clinicians had suspected and reclassifying schizotypal personality disorder as a form of psychosis rather than as a personality disorder. Now what I don't know right now is whether it has been included within schizophrenia proper or just within the overall group of psychoses (in which case it'd be better on the psychosis page). In any case, neeed to get my hands on a DSM5....Cas Liber (talk · contribs) 23:34, 10 December 2013 (UTC)

Not sure what you are getting at here
Both the differential diagnosis and direct diagnosis of schizophrenia has been influenced by the DSM-5 re-organization of personality disorders into "Clusters." In contrast to DSM-4, the updated DSM-5 published in 2013 now lists personality disorders in exactly the same way as other mental disorders such as schizophrenia, rather than on a separate 'axis' as previously. DSM-5 lists ten personality disorders, grouped into three clusters. Of the three clusters, "Cluster A" is directly relevant to the diagnosis and treatment of schizophrenia as ICD-10 indicates the schizotypal personality disorder is a form of schizophrenia. "Cluster A" includes the three personality disorders:Paranoid personality disorder, Schizoid personality disorder, and Schizotypal personality disorder, the latter described as a pattern of extreme discomfort interacting socially, distorted cognitions and distorted perceptions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:28, 11 December 2013 (UTC)
 * The ref you use to support the first bit does not even mention schizophrenia . Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:29, 11 December 2013 (UTC)

Hello User:Jmh649, The other editor from this morning appeared to request clarification on DSM5 updates to the outmoded DSM4 which was given in the reference you refer to in your comment (User:Cas Liber). "Schizophrenia" can now be diagnosed in at least one of its forms under Cluster A within the DSM5 "Personality Disorders". The remainder of my edit clarifies "Cluster A" which appeared to be unknown to the Talk participants this morning due to its "recent" publication, with further citation given. If you have a psychiatrist with the DSM5 on duty in your ER, then you can confirm this directly. BillMoyers (talk) 03:20, 11 December 2013 (UTC)
 * The first ref does not mention schizophrenia. This looks like WP:OR. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:38, 12 December 2013

Hello User:Jmh649, We have all already discussed in the presence of 4 editors above that ICD10 defines schizotypal personality disorder as a form of schizophrenia, which is covered in the citation given.(Cas Liber (talk), User:Tryptofish, User:SandyGeorgia)If you want to overcite this text with ICD10 cross-refs this can be done. This issue has been addressed in full and in your presence on the Talk section directly above. Your pointed vigilance here is unclear and unsupported by any other editor. Four editors have recognized that the ICD10 reading of the DSM5 personality disorder as schizophrenia is acceptable, and has already been edited into this wikipage with your acknowledgment, "Where Trypto put it is fine." Please note that the multiple references to DSM4 in this article are outmoded and defunct, they are super-ceded by the new DSM5 since last Spring over six months ago. This situation of DSM5 replacement edits for outmoded DSM4 references will be system-wide for Wikipedia in the coming months. Even if you do not have a DSM5 and the benefits of its expertise, this is a current issue. BillMoyers (talk) 13:23, 12 December 2013 (UTC)


 * I have not seen the book, but the table of contents indicates schizotypal PD is classified within the Schizophrenia Spectrum and Other Psychotic Disorders. In which case this would best be discussed on an umbrella page such as psychosis (I need to read up on that to see how synonymous it actually is) or something else, but it is not included within schizophrenia so there is no place to discuss it here. Cas Liber (talk · contribs) 13:51, 12 December 2013 (UTC)

Hello User:Casliber(Cas Liber (talk)), My suggestion is not to disassociate the reading of DSM5 from ICD10. Can you speak to the larger issue of DSM5 updates to system-wide wikipedia use of outmoded DSM4 references. The issue of introducing "Cluster A" (not present in DSM4) in PD for use in schizophrenia diagnosis is only one single issue. BillMoyers (talk) 14:06, 12 December 2013 (UTC)
 * No-one is suggesting we do that.we also have pages on ICD10 and DSM5. There are other target destinations for material that you mention. We are fully intending to update (once I (or any other editor) get a hold of DSM5 and reads it) Cas Liber (talk · contribs) 19:52, 12 December 2013 (UTC)

Typically when one uses refs to write about a topic that the ref does not mention it raises concerns of WP:OR. The article does need updating I agree. The DSM 5 is however controversial and just because it has been published does not mean all previous work is void. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:27, 12 December 2013 (UTC)

The fact that I didn't comment more recently doesn't mean that I agree or disagree with any particular comment by someone else. In the discussion here, I agree with Doc James and Cas Liber. --Tryptofish (talk) 23:37, 12 December 2013 (UTC)


 * Hello User:Casliber(Cas Liber (talk)), User:Jmh649, User:Tryptofish, User:SandyGeorgia, Courtesy first, with appreciation for the quick responses from this morning. Looking at the page count stats from the last day, it is apparent that users want to see the DSM5 upgrades posted and I shall plan to redraft the current edit accordingly to your requests. Is it possible for me to stress the importance that each of you associated with the page management of this wikipage try to get a copy of the DSM5 as quickly as possible. APA has authored the DSM4, and APA has told us that DSM4 is now obsolete and super-ceded by DSM5. DSM4 is over a decade old. As a technical point, schizotypal PD is co-listed in both the "Schiz. Spectrum" section and the separate "PD" section under "Cluster A" of DSM5. Since forty to sixty percent of all psychiatric diagnosis, including schizophrenia, include a second co-diagnosis of at least one of the personality disorders, it is no longer practical to completely isolate the discussion of Schizophrenia from Personality Disorder as it may have been done in the past before DSM5. BillMoyers (talk) 05:10, 13 December 2013 (UTC)


 * I revised it, and I'd like the editors who are MDs to please check whether what I wrote accurately represents what DSM-5 actually says. --Tryptofish (talk) 22:40, 13 December 2013 (UTC)

- I have no idea what this actually means. Is this about the removal of the axis II arc? I will chase the ref. Whether or not it is in the source is not the issue, the issue that it is really tangential to the article and has no place here, but is better in the article on personality disorders or on DSM5. I'll try and get the other ref but unless I find something really surprising, I sill think the whole lot should be removed. It makes this article look more like an essay. Cas Liber (talk · contribs) 23:31, 13 December 2013 (UTC)
 * "...the classification of schizophrenia is no longer isolated from personality disorders"
 * Feel free to remove it. I have no objection to doing so. --Tryptofish (talk) 23:40, 13 December 2013 (UTC)

Update
Just looked in DSM5 online - this is all general info - there is nothing really specific and hence it is all tangential and best removed. Cas Liber (talk · contribs) 00:24, 14 December 2013 (UTC)
 * I agree. --Tryptofish (talk) 00:27, 14 December 2013 (UTC)
 * Agree that is the issue. I have ordered a copy of the DSM 5. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:50, 14 December 2013 (UTC)
 * From what I can tell so far, Moyers is using the pretense that this article (badly) needs a DSM5 update to shoehorn in a bunch of other stuff, and he's not familiar either with our standards, policies and guidelines in general, nor our FA standards specifically. Sandy Georgia  (Talk) 07:06, 18 December 2013 (UTC)
 * I have no intention of paying what it costs to obtain a copy of DSM5, but have long fretted that we need to update this article. The concern now is that  understand WP:WIAFA, WP:MEDRS, the citation style on this article, and the sourcing and prose standards that this article should maintain as the updates are done.  His list of needed updates is a starting point.  Sandy Georgia  (Talk) 18:25, 17 December 2013 (UTC)
 * Hello User:Casliber and User:Jmh649, Both of you have seen this post and others placed by User:S. If he/she is claiming to be indigent then possibly one of you can help her obtain a copy or at least the relevant material of DSM5 to at least give him/her a chance of being a responsible editor. My emphasis is strongly that editors who wish to contribute to the DSM5 transition edits are aided by having the DSM5 in hand. Her ad hominems and false ascriptions to me are tiresome in spite of her enthusiasm, something like an ardent RN wishing to take over the department. BillMoyers (talk) 15:02, 18 December 2013 (UTC)
 * , you've got issues. Both  and  know exactly what my qualifications are to edit medical FAs.  Sandy Georgia  (Talk) 17:43, 18 December 2013 (UTC)

Is there anything left to address in this section, or is it ready to be archived? Sandy Georgia (Talk) 18:08, 18 December 2013 (UTC)


 * Hello User:Casliber and User:Jmb649, This material should be retained for the normal archival period of 60-90 days. The material here also shows that User:SandyG is not a nurse practitioner nor a registered nurse in psychiatry, along with her/his boycott of the purchase of a DSM5 manual. Both of you have confirmed the importance to editors on this Page for obtaining the DSM5 this past week-end by your example. This Talk section should be retained at least for the normal archival period of 60-90 days. BillMoyers (talk) 13:37, 19 December 2013 (UTC)
 * I will attempt one more time to do something constructive about approach to editing Wikipedia on his talk page.  Sandy Georgia  (Talk) 14:09, 19 December 2013 (UTC)
 * a talkpage with a wall of text is unhelpful. It is often helpful to archive addressed or duplicated sections manually to assist in addressing points systematically. Cas Liber (talk · contribs) 14:24, 19 December 2013 (UTC)
 * Hello User:Casliber, No-one wants a "wall of text". This material clearly shows that User:S is boycotting the purchase of a DSM-5 manual and the other material should be retained for the normal 60-90 archival period. It is urged that you counsel User:S on the importance of this manual to the integrity of this wikipage. Both you and User:Jmb649 have indicated that you now have the manual and your edits have been enhanced. User:S has sadly also stated on my Talk page that she/he has no knowledge of the difference between a medical doctor and a registered nurse, a peculiar comment for which your counsel to her may help. Your counsel to her on boycotting DSM-5 as she states above would be important. I request that she confine her outbursts to this Talk page alone, such as her/his Schacter errata below for all to see. This subsection on Talk here should be retained for the normal 60-90 day archival period. BillMoyers (talk) 14:23, 21 December 2013 (UTC)

Whoa there
OK, yes, the article is out of date for DSM5. Other than that, some folks please read WP:WIAFA and WP:OWN, and stop introducing MOS errors and various other issues. The lead is a summary of the article; we don't just plop new text into the lead. Text is developed in the body of the article, then summarized to the lead. I've removed this new text, plopped into the lead, for three reasons: 1) it goes in the body; 2) is 2004 really the most recent source for this info; and 3) Featured articles must maintain a consistent citation style-- if you're going to drop something in, at least follow the established citation style.  I find it hard to believe that an almost ten-year-old review is the best we can do here. Sandy Georgia  (Talk) 01:50, 17 December 2013 (UTC)

Janitor and secretary checking in
Please be familiar with WP:WIAFA and WP:OWN when editing a featured article: This article is going to end up de-featured if editors don't start taking more care to discuss edits; I am not going to play secretary indefinitly. [[User:SandyGeorgia|Sandy Georgia  (Talk) 19:05, 17 December 2013 (UTC)
 * 1) We don't use "ibid" on Wikipedia, since text and their citations move around in a dynamic article; we use named refs.  Please review WP:CITE.
 * 2) Books require page nos;, please provide a page range for the Schizophrenia section of DSM5.  Why are you citing ICD-10 to DSM5?  Please provide a quote of what the DSM says on ICD for verification.
 * 3)  I have dozens of times on other pages explained to you how citations are written in this article and at Autism; please stop dropping in cite pmids that I have to clean up.  You are by now an established editor and I should not have to clean up after you.   Will someone with full journal access please check the source to make sure we have sufficiently paraphrased?  The APA guards their copyright stridently and has approached Wikipedia several times in the past when we have duplicated too much of their info (which they make money off of).
 * 4) Speaking of APA and their copyright, the DSM-IV-TR definition in this article needs to be checked; it looks too close to the APA, and they will go after us.  Will someone with DSM-IV-TR please review and paraphrase substantially?  We should be eliminating DSM-IV-TR and paraphrasing the new crit for DSM-V, rather than continuing to list DSM-IV and saying what DSM-V changed.
 * 5) This mess needs to be either cleaned up or removed entirely.  First, why was it in Symptoms, when it discusses history and ICD-10?  Second, there is no complete citation.  I have commented it out pending discussion.


 * are you even reading the talk page? Why have you now added this text twice, still in the wrong place?   And still poorly sourced?   Now it's there twice.  Please read the talk page.  Sandy Georgia  (Talk) 23:31, 17 December 2013 (UTC)
 * The NIMH has stated they are not switching over to the DSM5 from the DSM4TR. The lead editor of the DSM4TR does not consider the DSM5 an update but a disaster. The DSM 5 is not the end all and be all of psychiatry. Agree we need to add details from it and mine just arrived today but this should not replace all mention of the DSM4TR just yet. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:06, 18 December 2013 (UTC)
 * The other thing to be mindful of is copyright issues and using DSM IV or 5 - the most detailed discussion was at Copyright problems/2010 March 9 and as is still active, we can discuss with her to what extent and detail we can discuss the criteria. Cas Liber (talk · contribs) 04:20, 18 December 2013 (UTC)
 * Cas, I was involved last time, so I can answer that. Even though for as long as I've been on the internet, I've known the APA defends its copyright and I was very careful in the articles I wrote, they were tagged too when the APA contacted legal last time.  My articles-- which had no copyvio-- were tagged and had to sit there with a copyvio tag until the entire investigation was finished, and that included darn near any psych article that mentioned DSM.  APA defends its copyright staunchly; everything was tagged until it was cleared.  They don't want our articles being used in place of DSM for diagnosis.  We have to go beyond paraphrasing; we have to do a very good job of rephrasing in our own word such that they can't say we've duplicated enough info that our article can be used for diagnosis.  Right now, the DSM-IV-TR info in this article is probably a trigger; it needs to be rewritten.  That's why we write from secondary sources, and should not be writing these sections at all from the DSM.  Sandy Georgia  (Talk) 06:49, 18 December 2013 (UTC)
 * Hello User:Jmh649 and User:Casliber, First my direct note that both of you now have the DSM5 available following Talk discussion last week which I must acknowledge fully. The transition of DSM4 to DSM5 is highly reminiscent of the transition from DSM3 to DSM4 along with all of the acrimony which took place then as well. To my knowledge most are accepting that there is to a be a re-gearing period of hopefully no longer than 12 to 18 months before DSM5 becomes fully prevalent, very similar to the re-gearing period which occurred at the DSM3 to DSM4 transition when it occurred years ago. This re-gearing period for DSM5, although recognizing that DSM4TR shall "briefly" continue during the re-gearing period, nonetheless recognizes that it is meant to be completely replaced by DSM5. This is not to say that all the acrimonious debates have suddenly disappeared or that they shall not continue until a future DSM-six eventually comes out, however APA has emphatically stated its commitment that DSM5 is to replace DSM4 and DSM4TR fully after the transition period. With regards to the five point outline at the top of this subsection, it may make sense for someone, perhaps either of you, to begin to consider integrating its usable points with the action list of 12 transition edits listed in the previous separate Talk page entry above, and putting it into some sort of preliminary priority (Urgent-Medium-Nonurgent) in order for some over-all tentative plan to start to emerge. With both of you having DSM5 in hand now, you are in a stronger position now to try to do this either singly or together. BillMoyers (talk) 06:25, 18 December 2013 (UTC)
 * First, the argument that has been tossed about on Wikipedia that DSM5 was controversial so editors have not wanted to do the update is bullroar-- DSM5 is DSM5, like it or not, there's controversy with every update, and if an article is to retain Featured status, it has to be updated. We don't need any more long discussions about the need. Second, for copyright issues, we should not be writing from the DSM5-- we should be writing from secondary reviews.  You,  can be thanked for finally forcing a DSM5 update here, but your other edits are damaging the article.  Please engage the talk page competently, and become familiar with Wikipedia's standards, policies and guidelines.  Sandy Georgia  (Talk) 06:54, 18 December 2013 (UTC)

More
Here's another chunk of text dropped in to the wrong place ( please familiarize yourself with WP:MEDMOS and without a complete citation. I had commented it out pending correct sourcing, but Moyers re-added it.


 * The definition of schizophrenia was substantially refined in 1990 by the ICD-10, as covering a range of specifications which included paranoid schizophrenia (F20.0), hebephrenic schizophrenia (F20.1), catatonic schizophrenia (F20.2), undifferentiated schizophrenia (F20.3), post-schizophrenic depression (F20.4), residual schizophrenia (F20.5), and simple schizophrenia (F20.6). The ICD-10 states that, "The schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and by inappropriate or blunted affect. Clear consciousness and intellectual capacity are usually maintained, although certain cognitive deficits may evolve in the course of time. The disturbance involves the most basic functions that give the normal person a feeling of individuality, uniqueness, and self-direction."
 * cited to: ICD-10, Introductory paragraph on Schizophrenia.
 * The citation is incomplete, this was dropped into a random heading that breached WP:MSH, it overquotes, and it's unclear to me whether it belongs at all, and if so, whether it belongs in Diagnosis or History, but he had placed it in neither. Sandy Georgia  (Talk) 07:12, 18 December 2013 (UTC)
 * Hello User:Jmh649 and User:Casliber, The url was added to this edit to more fully elaborate it as User:Trypt can confirm. This edit is fully documented and can be restored to this Wikipage at any time as consistent with its content. BillMoyers (talk) 15:36, 19 December 2013 (UTC)
 * User:Tryptofish would like to confirm that I agree with Sandy Georgia, Doc James, and Casliber about this point. --Tryptofish (talk) 20:45, 19 December 2013 (UTC)

Unable to verify
"people with schizotypal personality disorder have symptoms similar to schizophrenia, though of milder (subthreshold) intensity. The ICD-10 lists the schizotypal personality disorder as a form of schizophrenia. "

What page number in the DSM 5 supports this?

The ICD 10 ref does not even mention "schizotypal personality disorder" thus how can it support the text in question? Need page on the DSM 5. Removed until this data provided. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:24, 18 December 2013 (UTC)
 * Okay found it on page 104. Will add some back in. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:12, 18 December 2013 (UTC)
 * I added the bit from DSM5. Thx for finding the page number....cheers, Cas Liber (talk · contribs) 04:24, 18 December 2013 (UTC)

✅ Sandy Georgia  (Talk) 18:06, 18 December 2013 (UTC)


 * Hello User:Casliber and User:Jmb649, The sentence about ICD-10 reading of SPD from the above edit is still to be returned to the wikipage. This material has already been rehearsed several times on this Talk page that SPD is listed as F21 in the Schizophrenia section of ICD-10. If you wish to add another url for this or a direct reference to the print edition of ICD-10 for this then you may do this, and return the edit as presented above. Certainly you must know that ICD-10 has singled out this PD for the very purposes of such elaboration. BillMoyers (talk) 18:01, 19 December 2013 (UTC)

Age of onset
In the Epidemiology section:
 * It occurs 1.4 times more frequently in males than females and typically appears earlier in men —the peak ages of onset are 20–28 years for males and 26–32 years for females.

The cited work by Castle et al does not mention the peak ages of onset for males and females. It only mentions that the period of greatest risk for schizophrenia for all people is in the age range 15-34 years.
 * Hum thanks. Will fix with better ref. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 13:42, 9 January 2014 (UTC)

Schacter
Where did this come from? There is no such ISBN. Sandy Georgia (Talk) 07:25, 18 December 2013 (UTC)
 * A child of two parents with schizophrenia has a 46% chance of developing the disorder.

Is this text even needed? Sandy Georgia (Talk) 07:26, 18 December 2013 (UTC)
 * @User S, Please do your research responsibly, this is a very well know text on Psychology. Please explain to all of us how your opinion on the inclusion of this material is of more significance than that of Professor Daniel Schacter at Harvard University in Cambridge Massachussettes who had the opinion of including it in his general book on Psychology. The original edit is worth restoring on this wikipage.
 * Hardcover: Schacter, et al,
 * Publisher: Worth Publishers; 2 Har/Psc edition (June 1, 2011)
 * Language: English
 * ISBN-10: 1429283068
 * ISBN-13: 978-1429283069  BillMoyers (talk) 14:46, 18 December 2013 (UTC)
 * There are a number of refs that support this. Risk is 13% if one parent is affected and nearly 50% if both parents affected.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 16:32, 18 December 2013 (UTC)
 * , my IP can't access that google book. Will you handle this fix?  The citations in this article have fallen into considerable disrepair since its last review.  Sandy Georgia  (Talk) 17:48, 18 December 2013 (UTC)
 * Okay will do. I use the cite tool in the edit box for adding refs. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 17:52, 18 December 2013 (UTC)
 * No worries-- I don't mind cleaning up citations, when necessary, after an editor who carries more than his weight :) :) Sandy Georgia  (Talk) 17:55, 18 December 2013 (UTC)

✅ Sandy Georgia  (Talk) 18:05, 18 December 2013 (UTC)

General
It's not hard to tell just form the mess of citations needing cleanup that this article has not been closely watched since the last FA version; some marginal sourcing has found its way in here, and there has been prose deterioration. The article needs more than a DSM5 update; it needs a thorough check of some of the cruft that has crept in since its last review. Sandy Georgia (Talk) 07:56, 18 December 2013 (UTC)

DSM-IV-TR and copyvio
This version of Schizophrenia is copyvio. Sandy Georgia (Talk) 14:36, 19 December 2013 (UTC)
 * Could someone with access to please check it for copyvio or close paraphrasing in the Criteria section?  Sandy Georgia  (Talk) 14:43, 19 December 2013 (UTC)
 * The numbered list here closely paraphrases material in the article's abstract. Alexbrn talk 15:00, 19 December 2013 (UTC)
 * This is vague:
 * * 2. adds new psychopathological dimensions,
 * * 3. clarifies cross-sectional and longitudinal course specifiers,
 * Sandy Georgia (Talk) 15:25, 19 December 2013 (UTC)
 * These are just listifications of the abstract text: "addition of unique psychopathological dimensions, clarification of cross-sectional and longitudinal course specifiers". For a discussion of "psychopathological dimensions" the article refers us to ; the course specifiers are explained as follows: "the distinction of course specifiers according to their cross-sectional (state) and longitudinal character allows the clinician to document both the current status and the previous course up to the present observation period." Alexbrn talk 15:48, 19 December 2013 (UTC)
 * We could address the too-close-paraphrasing and listification by prosifying that section, while expanding on points 2 and 3. Are you interested?  :) :)  Sandy Georgia  (Talk) 15:51, 19 December 2013 (UTC)
 * I'm a bit out of my comfort zone with the very dense and jargony text on an unfamiliar subject, but I'll have a go. I'll re-write the list to avoid the paraphrasing and it more approachable to a non-expert; we can then see if that can be re-worked into prose. Yes? Alexbrn talk 15:57, 19 December 2013 (UTC)
 * Go for it :) If it's not stellar, someone will fix it!  Sandy Georgia  (Talk) 16:03, 19 December 2013 (UTC)

Done. I'm not sure exactly what PMC 2833126 is trying to say about the relationship between catatonia and schizophrenia in DSM 5; it rather abstractly mentions a "divorce" between them. Alexbrn talk 16:58, 19 December 2013 (UTC)
 * One of the sources is an editorial?   (BTW, I've never understood why this article needs 158 citations-- is there not one good, recent overview?)  Sandy Georgia  (Talk) 17:54, 19 December 2013 (UTC)
 * Yes, both the "lesser" sources are pointed-to by for fuller information information on the changes in DSM 5. Alexbrn talk 18:06, 19 December 2013 (UTC)
 * , my free time is very patchy at present - I am happy if someone has a go and we come in after to tweak. I do not think updating this section will be as difficult as thought. Just need a clear stretch of time to focus. Cas Liber (talk · contribs) 23:11, 19 December 2013 (UTC)

Internal quality control at Page:Schizophrenia in relation to general Wikipedia quality control.
Recently, one of the users on this wikipage expressed no knowledge of the difference between a "medical doctor" and a "registered nurse", and no knowledge of why this would be important to the writing a wikipage related to medical issues dealing with mental health in general. Most wikipedia users are already familiar with the two-axis approach which Wikipedia takes to the internal quality control of its millions of pages. The one axis is the rating of articles by"Importance" ranging on four gradations from high to low. The second axis used by Wikipedia for internal quality control is that of the "Upgrade" status of the article itself which ranges mostly on an eight part scale from FA and GA articles down to Start and Stub class articles. This is presented as a general frame to explain the gradation scale, also pertinent, of the gradation of hierarchy as it is seen in the medical profession and how this affects the two-axis internal quality control model which Wikipedia uses system wide. The most established medical doctors are those who have become department chairmen at either hospitals or medical schools, and they begin this list intended to be used for discussing related Wikipedia internal quality control issues:

(1) Medical doctors who have become chairmen at hospitals or medical schools, often having written multiple books and medical articles, and supervising multiple research grants and programs, highest level of accomplishment.

(2) Medical doctors who are full Professors and who hold tenured faculty positions and leading universities such as Harvard University.

(3) Medical doctors who have become Attending Physicians at a hospital and have specialized in one of its many branches of medicine, such as Psychiatry, who organize the efforts of lower ranking medical doctors at the hospital and medical interns who are MDs. They may or may not have written journal articles.

(4) Medical doctors who have specialized in one branch of medicine such as Psychiatry and have become board certified in this specialized branch of medicine. They may be treating physicians at a hospital or in private practice with affiliation to a hospital.

(5) Medical doctor who may have specialized in a branch of medicine yet who are unaffiliated with a hospital, medical school, or university, and who are in private practice.

(6) Medical doctors who are general practitioners without any specialization or interns, who serve an important service in their communities in providing needed health care.

(7) Nurses of various degrees of accomplishment who usually assist medical doctors.

This list presents the gradations of advancement within the medical profession in general terms and identifies the importance of this quality among doctors, much as Wikipedia uses standards for internal quality control of its wikipages as described above. There is a significant discussion of the quality of writing of specialized articles in, for example, the medical and/or the legal disciples, which has yet to fully take place at Wikipedia, as to whether an article submitted to Wikipedia benefits if an article is submitted by a high raking medical doctor from the enumeration above, or, if it is no different from a specialized medical wikipage written by a registered nurse of even a bright student. This table enumeration is presented here for general comment of how it might affect the Wikipedia internal quality control for this Schizophrenia wikipage and perhaps other medical wikipages. Is there any benefit to having medical articles written by doctors at the higher levels of the list? Can it potentially have a beneficial effect on Wikipedia quality? BillMoyers (talk) 15:09, 21 December 2013 (UTC)
 * There are big problems with this as it undermines the review of the quality of a page itself. What is to be done if an expert writes an article that others find exception to? And while we have anonymous editing, we have problems with verification of an editor's credentials. This discussion should come off this page and be discussed at WT:MED instead. Cas Liber (talk · contribs) 04:31, 24 December 2013 (UTC)
 * We have levels of evidence. Expert opinion is the lowest level of evidence. We want to use the highest levels of evidence if available. All of course must be published. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:54, 24 December 2013 (UTC)

Robert Sapolsky and shamanism
Shouldn't Robert Sapolsky's theory about shamanism and schizotypalism as the source of schizophrenia be mentioned here? He is clearly a notable source on this subject. http://www.youtube.com/watch?v=4WwAQqWUkpI 173.17.92.242 (talk) 15:58, 28 December 2013 (UTC)
 * Before anyone else objects to Youtube as a source, I'll point out that this is Sapolsky giving a lecture. That said, this strikes me as a better fit for Causes of schizophrenia than here. It's a very speculative theory, albeit from a clearly notable commentator, with little experimental evidence, and it also focuses on what he calls schizotypical personality disorder, and not on schizophrenia per se. --Tryptofish (talk) 21:05, 28 December 2013 (UTC)
 * Pretty much what Tryptofish said...Cas Liber (talk · contribs) 21:49, 28 December 2013 (UTC)
 * Only pretty much? --Tryptofish (talk) 21:56, 28 December 2013 (UTC)
 * (chuckle) look at my userpage at how I use language - I generally understate things - "hypobole" - just a habit...maybe a self-soothing behaviour...just keepin' it casual....Cas Liber (talk · contribs) 22:08, 28 December 2013 (UTC)
 * { --Tryptofish (talk) 22:15, 28 December 2013 (UTC)

Removed for discussion
Psychosocial interventions, particularly family support and education, cognitive behavioral therapy, supported employment, social skills training, and case management services, also significantly improve functioning and quality of life.

17:31, 12 October 2014 (UTC)
 * Okay - I am not an admin over there but will take a look later if I get time. Cas Liber (talk · contribs) 19:56, 12 October 2014 (UTC)
 * I would prefer that you talk to me rather than about me. Please assume good faith, according to Wikipedia guidelines. I have, encouraged by the tag simplified and clarified, added some secondary sources, e.g. NICE and given a simple language translation of that. Please don't assume POV even if I am a bit enthusiastic. Maybe I disagree on some points with some of you, but I have actually done NIMH research on Schizophrenia, published in Archives of general Psychiatry, Schizophrenia Bulletin etc. and I am passionate about the subject. Ex-nimh-researcher (talk) 13:06, 13 October 2014 (UTC)
 * Happy to see you working on simple English Wikipedia aswell. IMO simple English should be top of the language links. Was unable to get consensus for that Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:48, 14 October 2014 (UTC)
 * Thanks for trying. Did you move the link for the sound? I tried to put the simple English link at the bottom of the index. Not a good idea? BY the way, I am very impressed at your work capacity. You beat all in edits on the psych articles. Ex-nimh-researcher (talk) 11:58, 14 October 2014 (UTC)
 * Moved the link for the sound slightly per . Thanks for creating it :-) Doc James  (talk · contribs · email) (if I write on your page reply on mine) 13:14, 14 October 2014 (UTC)
 * It is almopst impossible to fin the link for the simple version. Is there any reason for not putting it at the end of the index so people have the possibility of finding it. I don't understand why anybody would make it difficult for people to find it. Isn't Wikipedia about spreading information?2001:4641:7A49:0:951F:D3DA:B00E:856A (talk) 20:35, 15 October 2014 (UTC)
 * I am putting back the link to the simple version again, very discretely, all the way at the bottom. Please don't remove it James! Let others see if they like it! Think of the dyslexics! On the main page Simple English is the first of the languages. So until we can keep that standard, please let the link be at the bottom of the index. Maybe on both?Ex-nimh-researcher (talk) 21:56, 15 October 2014 (UTC)
 * I am still not supportive as it is in the language links. I will allow others to comment and remove / leave as they wish.
 * Great to see simple English listed first on the main page. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:13, 16 October 2014 (UTC)

Glutamatergic medication

 * ...positive symptoms fail to respond to glutamatergic medication.

Has any new information on this emerged in the decade of drug development and research since that source was published? 137.43.188.209 (talk) 16:41, 15 October 2014 (UTC)


 * There have been a lot of late stage failures in the clinic, people thought this looked pretty good once but nothing has really worked out. Sadly, schizophrenia research has been like waves against the rocks for the last 25 years, with nothing but dopamine agonists really working out. Novel mechanism of action drugs have failed repeatedly in late stage trials.


 * The things that currently look most promising are probably the following: A company called Acadia has a serotonin based drug that worked real well in Parkinson's dementia. Its on hold now in schizo for financial reasons, but they will probably put it back in the clinic soon.  There are also some compounds in phase 3 based on H3 receptors (tiprolisant), and nicotinic receptors (encenicline) and oxytocin (syntocinon).


 * I realize that this post broke a lot of rules about using the Talk page to discuss the subject outside the framing of the article, but it was done with good intent. I won't make a habit of it. Formerly 98 (talk) 19:14, 15 October 2014 (UTC)
 * No, not really - it is a really important subject to discuss at some time - I wanted to find some sourcing discussing the progress (or lack thereof) on the topic of glutaminergic drugs....and there is very little information. At all! And it is significant as it was touted as the Next Big Thing in psychosis treatment several years ago. So all info is critical, particularly how we make treatment coverage as comprehensive as possible. Cas Liber (talk · contribs) 20:02, 15 October 2014 (UTC)

Sorry, that should have read Parkinsons psychosis, not dementia. The H3 and nicotinic compounds are targeted to cognitive impairment. I follow this area somewhat closely and have access to an up to date database of drugs in development if you want to email me (formerly098@gmail.com) for more info, (the database company might notappreciate it if I did a big upload of info from their db to WP). The Arcadia drug looks kind of interesting. Formerly 98 (talk) 21:23, 15 October 2014 (UTC)

And of course antagonists not agonists. Shouldnt do this on my phone....Formerly 98 (talk) 21:25, 15 October 2014 (UTC)


 * Thanks for the replies. This review from 2008 mentions "promising clinical results" against positive and negative symptoms from an mGluR agonist in a phase II trial. Apparently this "has greatly increased interest in non-dopamine approaches to schizophrenia, as it indicates that glutamatergic approaches to may be clinically viable" 137.43.188.210 (talk) 08:54, 16 October 2014 (UTC)
 * Promising, yet we know there has been nothing since, which suggests clinical trials have come to nothing. Hence listing it as promising without a downbeat conclusion is misleading. - am intrigued and will email . You don't have email enabled - just email me with cut-and-pasted text into email. Cas Liber (talk · contribs) 13:15, 16 October 2014 (UTC)

How vast majority of cases cases start (very reliable sources)
For someone who can edit Wikipedia:

In about 75% of cases, schizophreniaa onset occurs with slowly mounting depressive and negative symptoms that involve increasing functional impairment and cognitive dysfunction. Less than 10% of cases start with positive symptoms only. Reports on the duration of the prepsychotic prodromal stage vary widely. Because of differences in study designs and nonrepresentative populations, mean values range from a few months to 9 years.

The onset of schizophrenia usually occurs with depressive and negative symptoms, and functional impairment during a prepsychotic prodromal phase that on average lasts for several years, followed by apsychotic prephase, defined as the period between the first positive symptom and the maximum of positive symptoms, lasting on average for 1 year. Clinical Handbook of Schizophrenia

Approximately 80 – 90% of patients with schizophrenia report a variety of symptoms, including changes in perception, beliefs, cognition, mood, affect, and behavior that preceded psychosis, although approximately 10 – 20% develop psychotic symptoms precipitously without any apparent significant prodromal period (Yung & McGorry, 1996a ). The typical pattern is that the non - specific symptoms and negative symptoms develop first, followed by attenuated, or mild, positive symptoms, together with distress and decreased functioning (Häfner et al., 1998). Schizophrenia - Weinberger

— Preceding unsigned comment added by 93.89.144.5 (talk) 17:56, 7 October 2014 (UTC)
 * I assume you mean this book How do you think we should summarize? By the way content is on page 102.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 19:11, 7 October 2014 (UTC)
 * This is called the prodrome and is already in the article under onset. Cas Liber (talk · contribs) 21:52, 7 October 2014 (UTC)

Excuse me, I don't really know how to even edit this page so I'm seeking your help with you making the small edit steps instead of me. Yes, the prodrome article is there, but I consider the percentages really crucial and very important (that's why I have made the effort in the first place). It is a golden article with such an important thing missing. Here's my suggestion:

... the condition manifested itself before the age of 19.[22] In 75-90 % cases, the onset occurs with slowly mounting depressive and negative symptoms that involve increasing functional impairment and cognitive dysfunction which may be accompanied by changes in perception and beliefs. Less than 10-20 % of cases start with positive symptoms only.

The second source is Weinberger, Harrison - Schizophrenia page 92

- 93.89.144.5 — Preceding unsigned comment added by 93.89.144.5 (talk) 06:24, 10 October 2014 (UTC)
 * The numbers themselves are from a study (i.e. primary source), right? Hang on will look. Cas Liber (talk · contribs) 13:21, 11 October 2014 (UTC)

These are the studies:

Mueser - Clinical Handbook of Schizophrenia (page 102): Häfner, H., Löffler, W., Maurer, K., Hambrecht, M., & an der Heiden, W. (1999). Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatrica Scandinavica, 100,105–118.

Weinberger, Harrison - Schizophrenia (page 92): Yung & McGorry, 1996a — Preceding unsigned comment added by 93.89.144.5 (talk) 14:25, 13 October 2014 (UTC)

So what is the problem? Why it hasn't been edited yet? I don't understand it. It has all requirements. Or make this an offical edit request. Such an important thing that can potentially save lives is still missing there. — Preceding unsigned comment added by 93.89.144.5 (talk) 06:12, 22 October 2014 (UTC)

Long term use of AP meds - negative effect
This is a potentially very important secondary document. Where could this be included? Fuultext is free at http://schizophreniabulletin.oxfordjournals.org/content/early/2013/03/19/schbul.sbt034.full.pdf+html

Does Long-Term Treatment of Schizophrenia With Antipsychotic Medications Facilitate Recovery? Martin Harrow* and Thomas H. Jobe, Schizophrenia Bulletin 2013

Antipsychotic medications are viewed as cornerstones for both the short-term and long-term treatment of schizophrenia. However, evidence on long-term (10 or more years) efficacy of antipsychotics is mixed. Double-blind discontinuation studies indicate significantly more relapses in unmedicated schizophrenia patients in the first 6-10 months, but also present some potentially paradoxical features. These issues are discussed Ex-nimh-researcher (talk) 09:50, 22 October 2014 (UTC)
 * Sure, how do you want to summarize it? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 13:41, 22 October 2014 (UTC)
 * I will work a bit on that, I guess you want it in one or two sentences. Do you think it would fit best in the medication section? Ex-nimh-researcher (talk) 18:37, 22 October 2014 (UTC)
 * Yes, an important point - probably best there at the end of that section (?). But we can rejig for flow. Cas Liber (talk · contribs) 20:22, 22 October 2014 (UTC)
 * How about this: "20 year follow up research on the difference between schizophrenia patients who stayed on their drugs long term and others who stopped their drugs, has shown that there is a sub group of patients who do much better in the long term without drugs. However, patients in this group have more relapses in the first two years after stopping, before the good development starts." I have tried to be as concise as possible, without using technical terms. Ex-nimh-researcher (talk) 13:17, 23 October 2014 (UTC)

It more says "it is unclear the long term effects of antipsychotics".

We already say this "There is little evidence regarding effects from their use beyond two or three years" and were already using that ref in the article
 * The gist of this article is a bit different than "little evidence" It is talking about psychosis becoming wordse in the long run with meds, super sensitivity psychosis, in other words that continuous use creates a chemically induced psychosis through D2 proliferation and/or increased sensitivity.Ex-nimh-researcher (talk) 22:20, 23 October 2014 (UTC)

IMO further details belong in the subarticle not the main article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:31, 23 October 2014 (UTC)


 * I took only a quick pass through this article, but do we know from these observational studies that "there is a subgroup that does much better without drugs"? Or do we simply know that there is a subgroup that does well without drugs? My impression was that there were a lot of statements in the article along the line of "among those who had been stable without drugs for x years (this stated or merely implicit), the relapse rate without drugs was low over the following y years." If the subgroup that does well has substantially different baseline characteristics than the group it is being compared to, the best statement would be "There is a subgroup of patients that does well without drugs", as there is no control group to which one can make the comparison "better".  But admittedly I'm commenting on an article I did not read very closely. Formerly 98 (talk) 15:44, 23 October 2014 (UTC)
 * It says that the evidence of long term effects is mixed. The evidence of harm is "potential". Belongs on the subpage IMO. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:25, 23 October 2014 (UTC)

Effective for negative symptoms
This line was added "Amisulpride is effective in case of negative symptoms of schizophrenia. " It is a 2002 Cochrane review that states "It may also yield better results in some specific outcomes related to efficacy, such as improvement of global state and general negative symptoms."


 * This is a tentative conclusion and thus IMO not a sufficient summary. We already discuss this agent with newer refs. Here is a 2010 Cochrane review which addresses a slightly different question.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:12, 17 October 2014 (UTC)


 * Hey thanks for letting me know about the new Cochrane review regarding Amisulpride. So sorry did not know about this. I was actually trying to look at the Amisulpride's efficacy to improve negative symptoms of Schizophrenia and this was all I could find. I will try to look into some more sources of info. Raysujoy8 (talk) 13:26, 28 October 2014 (UTC) — Preceding unsigned comment added by Raysujoy8 (talk • contribs) 08:14, 17 October 2014 (UTC)
 * To be honest, a great many patients have negative symptoms that are resistant to all intervention, though some may be ameliorated to varying degrees by various interventions. I am interested as well as personally I have noticed some slight (positive differences) with amisulpride over other medications, but we need to stick to secondary sources. cheers, Cas Liber (talk · contribs) 19:35, 28 October 2014 (UTC)

Semi-protected edit request on 3 November 2014
{{edit semi-protected|Schizophrenia|answered=yes}

... the condition manifested itself before the age of 19.[22] In 75-90 % cases, the onset occurs with slowly mounting depressive and negative symptoms that involve increasing functional impairment and cognitive dysfunction which may be accompanied by changes in perception and beliefs. Less than 10-20 % of cases start with positive symptoms only.

Book: Mueser - Clinical Handbook of Schizophrenia (page 102). Study: Häfner, H., Löffler, W., Maurer, K., Hambrecht, M., & an der Heiden, W. (1999). Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatrica Scandinavica, 100,105–118.

Book: Weinberger, Harrison - Schizophrenia (page 92). Study: Yung & McGorry, 1996a

93.89.144.5 (talk) 19:50, 3 November 2014 (UTC)
 * Not done. Secondary sources are needed per WP:MEDRS Best Doc James  (talk · contribs · email) 21:22, 3 November 2014 (UTC)

Hafner et al.(1992, 1993) reported on the early symptomatology of schizophrenia and observed that in the vast majority of cases the disease started solely with negative symptoms. http://schizophreniabulletin.oxfordjournals.org/content/28/3/415.full.pdf page 2

These initial negative symptoms are often referred to as the prodromal period of schizophrenia. http://www.nhs.uk/Conditions/Schizophrenia/Pages/Symptoms.aspx — Preceding unsigned comment added by 93.89.144.5 (talk) 08:08, 4 November 2014 (UTC)

Why isn't there, a recovery referential?
I believe it is the preposition of wikipedia and the best interest for the families of schizos to read on this page, an recovery composition. Why isn't there one? Wikipedia is an encyclopedia of informative references with the absence of an 'recovery composition'. — Preceding unsigned comment added by 107.184.185.234 (talk • contribs) 03:21, 23 November 2014‎ (UTC)
 * i am sorry but what do you mean by "recovery composition"? thanks. Jytdog (talk) 03:35, 23 November 2014 (UTC)
 * Yes, the expression is lost on me too. Cas Liber (talk · contribs) 06:07, 23 November 2014 (UTC)

Semi-protected edit request on 7 December 2014
I would like to add content relevant to the "Genetic" section of schizophrenia. I found it very surprising that the page was missing information (even mention!) of major susceptibility genes GAD67,  RELN, and  BDNF. I would like to add content relevant to epigenetic mechanisms of the pathogenesis of schizophrenia, since genetics alone do not cause the disease, but work in conjunction with a number of other factors.

I would also like to add content within the "Developmental" portion of this page. I noticed that there was no clear explanation as to why stress may lead to the genesis of schizophrenia. I provide a mechanism that not only explains a possible link between stress and the onset of schizophrenia, but also relate it to a genetic susceptibility (which I expand upon within the Neuregulin 1 page.)

Jgalvin2015 (talk) 15:59, 7 December 2014 (UTC)

❌ This is not the right page to request additional user rights. If you want to suggest a change, please request this in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ". Please also cite reliable sources to back up your request. - Arjayay (talk) 16:37, 7 December 2014 (UTC)

Research Suggesting Cultural Construct
https://www.sciencenews.org/article/hallucinated-voices%E2%80%99-attitudes-vary-culture Research in "hearing voices" in other cultures. In Ghana and India people more likely to hear positivity from voices. They often hear them as voice of family member or attribute them to a god. This would suggest some of the concept of schizophrenia is a Western construction that doesn't completely match reality. This should be acknowledged in the page. — Preceding unsigned comment added by 73.26.167.92 (talk) 05:10, 12 December 2014 (UTC)

Add content about the encouraging research done about pregnenolone
Please add this to the end of the medication section of schizophrenia and before Psychosocial.

Pregnenolone has been shown to help decrease negative symptoms of schizophrenia like problems with attention, memory, and reasoning. "Treatment with adjunctive pregnenolone significantly decreased negative symptoms in patients with schizophrenia or schizoaffective disorder in a pilot proof-of-concept randomized controlled trial, and elevations in pregnenolone and allopregnanolone post-treatment with this intervention were correlated with cognitive improvements [Marx et al. (2009) Neuropsychopharmacology 34:1885-1903]. Another pilot randomized controlled trial recently presented at a scientific meeting demonstrated significant improvements in negative symptoms, verbal memory, and attention following treatment with adjunctive pregnenolone, in addition to enduring effects in a small subset of patients receiving pregnenolone longer-term [Savitz (2010) Society of Biological Psychiatry Annual Meeting New Orleans, LA]. A third pilot clinical trial reported significantly decreased positive symptoms and extrapyramidal side effects following adjunctive pregnenolone, in addition to increased attention and working memory performance [Ritsner et al. (2010) J Clin Psychiatry 71:1351-1362]. Future efforts in larger cohorts will be required to investigate pregnenolone as a possible therapeutic candidate in schizophrenia, but early efforts are promising and merit further investigation. This article is part of a Special Issue entitled: Neuroactive Steroids: Focus on Human Brain." --Envisioneerthefuture (talk) 01:59, 20 January 2015 (UTC)


 * Interesting - we can't use a primary source but I see that it is cited in a Review Article, i.e. this one. Will take a look as I think we can figure something out. Fulltext here Cas Liber (talk · contribs) 02:07, 20 January 2015 (UTC)
 * Okay, I have added the review article, but it lists a large number of drugs wiht some smidgen of possible benefit and pregnenolone is way down the list.....alot of drugs should be mentioned before it is I think....Cas Liber (talk · contribs) 11:09, 20 January 2015 (UTC)


 * I think you are correct when you say it is further down the list, on the other hand it is the only supplement that was rated as having "significant" positive effect. Others were not mentioned as being as significant as the pregnenolone.

We should use this quote from the review articles " A proof-of-concept trial evaluating adjunctive therapy with pregnenolone (a neurosteroid) 500 mg/day demonstrated significantly greater improvement in negative symptoms. Two subsequent, small studies also supported the benefit of pregnenolone in schizophrenia."
 * I believe it is imperative that those suffering from this illness know that there is a very promissing drug for them to try that is over the counter and costs 5 dollars for 90 doses of the amount specified in the study, which is twice as much as is needed. I learned of the research in from a post about it by an adminstrator of the schizophrenia.com forum: http://forum.schizophrenia.com/t/vitamin-pregnenolone-new-treatment-for-schizophrenia-anyone-trying-it/11631
 * There is more supporting literature listed there as well. Envisioneerthefuture (talk) 21:21, 20 January 2015 (UTC)
 * I would also add the research of the anti-inflammatory treatment options as well (that are also listed in the other drugs section of the part for emerging treatments for negative symptoms before the pregnenolone mention.)
 * I have not much experience with inflammation theory of pathology, but I have researched and experimented with pregnenolone, for myself and so many people it has practically eliminated negative symptoms. Example: I have schizophrenia and experienced a lot of attention, memory, sentence verification problems. Before the treatment, I could not read a textbook for more than 10-20 minutes, yet after starting treatment, I can read, research, learn, and work indefinitely for at least 10-12 hours a day. My scores for verbal fluency went from 15 percentile to 53 percentile using the assessments on the cambridge brain science website. What will it take to get this information on the wikipedia page for easy access? Envisioneerthefuture (talk) 21:39, 20 January 2015 (UTC)


 * It's not our goal here to save the world by spreading the word about the latest new thing, however wonderful it is. Our goal is to be reliable.  That means only including information about something when it is sufficiently well documented to give strong assurance that the story isn't going to change in the near future.  Personal stories, unfortunately, are not helpful -- actually they are harmful -- because they get in the way of understanding the message conveyed by reliable published sources. Looie496 (talk) 15:57, 24 January 2015 (UTC)


 * envisioneer you are new to Wikipedia.  Please read WP:MEDRS and WP:MEDMOS.   Also WP:OR.  What you write in the last paragraph has no place here, and we generally avoid the cutting edge of anything.  And we do not give medical advice; please see the disclaimer at the bottom of every page which has a "medical disclaimer" statement. Jytdog (talk) 18:22, 24 January 2015 (UTC)


 * Thanks for the advice the first responder made an edit that helps people know about the emerging research. He referenced a good review article. I would like to see more about emerging research. Can we expand the Research directions section. There is a lot of research about different etiologies of the symptoms and treatment targets that should be made aware to people learning about it. This review article, not original research, reviews the treatments from the inflammation theories. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641824/

Envisioneerthefuture (talk) 23:05, 24 January 2015 (UTC)


 * That is an interesting paper - part of the problem is that the topic is huge and generally sticking to what is common practice has been what we have to do to keep the size of the article manageable. However, I do agree that that paper could do with a line or two sourced to it in this article. NB: There is a daughter article - Management of schizophrenia - where some of this could be looked in more detail. Cas Liber (talk · contribs) 05:42, 25 January 2015 (UTC)


 * Okay, I made a start - musing on how much detail is necessary in this umbrella article as none of these agents are used in this way in clinical practice, but maybe some limited expansion is ok......hmmmm Cas Liber (talk · contribs) 05:49, 25 January 2015 (UTC)

Semi-protected edit request on 11 February 2015
A medical device that uses H-coil for deep transcranial magnetic stimulation (Deep TMS) as a noninvasive treatment for depression, schizophrenia, and other neurological disorders, depending on licensing in different countries. https://en.wikipedia.org/wiki/Brainsway

Germanbrother (talk) 08:27, 11 February 2015 (UTC)
 * High quality ref per WP:MEDRS needed Doc James  (talk · contribs · email) 08:52, 11 February 2015 (UTC)

Disputed tag
The user who tagged the article "disputed" did not give a reason, but I suggest removing the tag, unless someone indicates there is newer terminology. Sandy Georgia (Talk) 00:14, 5 March 2015 (UTC)
 * here is a post to Teahouse, and
 * here is a Google scholar search restricted since 2011 on positive and negative symptoms
 * Yup a little strange. Doc James  (talk · contribs · email) 02:49, 5 March 2015 (UTC)
 * more sad than strange. mental illness just sucks. suffering and very little help.   not much positive about it indeed.  :(   Jytdog (talk) 02:53, 5 March 2015 (UTC)
 * I've inquired privately about help in this matter.  Sandy Georgia  (Talk) 07:18, 5 March 2015 (UTC)
 * Might be best to close their accounts ability to edit. Doc James  (talk · contribs · email) 16:44, 6 March 2015 (UTC)
 * That's not justified yet. I've run into this sort of thing lots of times.  Usually an editor who doesn't accomplish anything after several attempts will just give up. Looie496 (talk) 15:56, 7 March 2015 (UTC)
 * I have received some concerning emails. Doc James  (talk · contribs · email) 17:34, 7 March 2015 (UTC)
 * You need to flag it with the WMF. Cas Liber (talk · contribs) 19:59, 7 March 2015 (UTC)
 * They have not edited recently. Doc James  (talk · contribs · email) 20:05, 7 March 2015 (UTC)
 * My emails were not responded to. Sandy Georgia  (Talk) 20:48, 7 March 2015 (UTC)

edit semi-protected
change "In 2013 about 16,000 people died from schizophrenia"

to

"In 2013 about 16,00 people died from behavior related-to or caused by schizophrenia"

schizophrenia is a mental not a physiological disease. You cant die directly from it

99.235.23.2 (talk) 04:08, 22 March 2015 (UTC)


 * ✅ Also changed "about" to "estimated" per source. -- haminoon  ( talk ) 04:41, 22 March 2015 (UTC)

chinese / schizophrenia
is there a study on schizphrenia patients in ethnicity? given the large number of symbolic characters that need to be remembered by heart by ethnic chinese and the symbolic interpretation of language, maybe more chinese fit into the schizophrenia symptoms by western standards? — Preceding unsigned comment added by 69.172.72.45 (talk) 21:52, 5 April 2015 (UTC)

Semi-protected edit request on 24 April 2015
replace 'inactivity' with 'avolition'

Volkovjames (talk) 01:41, 24 April 2015 (UTC)


 * Yeah, I'll pay that. done. Cas Liber (talk · contribs) 05:36, 24 April 2015 (UTC)
 * We should try to use simpler English. "A lack of motivation" is close enough and way simplier. Doc James  (talk · contribs · email) 12:56, 24 April 2015 (UTC)
 * Except that it is not synonymous and carries connotation of laziness...not good WRT stigma and mental health. Cas Liber (talk · contribs) 13:59, 24 April 2015 (UTC)
 * Time for a thesaurus ... most readers will have to look up the word avolition. Sandy Georgia  (Talk) 14:03, 24 April 2015 (UTC)
 * I had one growing up, but we couldn't figure out what to feed it and it died. Formerly 98 talk 14:18, 24 April 2015 (UTC)
 * I suppose I should add that I don't feel strongly enough to argue about it as I can see the merits of "lack of motivation" anyway. Cas Liber (talk · contribs) 14:34, 24 April 2015 (UTC)
 * I am happy with other wording, but it should be understandable English, at least for the lead. Doc James  (talk · contribs · email) 14:42, 24 April 2015 (UTC)

Pronunciation
The pronunciation is wrong: "/ˌskɪtsɵˈfrɛniə/ or /ˌskɪtsɵˈfriːniə/". Instead of ɵ (read th as in thing), it should be ə (read as the a in about).

http://www.oxforddictionaries.com/us/definition/american_english/schizophrenia IPA: http://www.oxfordlearnersdictionaries.com/us/definition/english/schizophrenia?q=schizophrenia — Preceding unsigned comment added by 89.88.98.184 (talk) 14:53, 1 May 2015 (UTC)

Image caption
This caption was awful: unecessarily long and convoluted, off-topic detail, and it wasn't clear to me which was which; can those knowledgeable pls check that my edit didn't get it backwards (which is more active in orange, controls or schizophrenia)? Sandy Georgia (Talk) 15:53, 3 May 2015 (UTC)

Brain training seems to help with neuroplasticity
http://www.human-memory.net/disorders_schizophrenia.html

"Schizophrenics often have difficulty encoding, storing and recalling words, although recent advances in the understanding of neuroplasticity have led to some promising new treatments. It has been shown that schizophrenic symptoms can be improved by stimulation, particularly through the regular repetition of some simple (although progressively more challenging) auditory and visual exercises. As brains change physically through neuroplasticity, many of the abnormal patterns in the brain which characterize schizophrenia are removed. In addition, levels of the protein BDNF (brain-derived neurotrophic factor), which is lower than normal in schizophrenics, are also increased to near normal levels. Similar treatments may even be used to prevent the onset of schizophrenia in people exhibiting early warning signs of the disorder."

I can't really say I enjoy the wiki page, half of it discusses things which most people wouldn't understand and the one photo of a schizophrenic we have never took drugs after his episodes and lived to 86 before he died in a limo-wreck. — Preceding unsigned comment added by 71.167.70.44 (talk) 04:11, 11 June 2015 (UTC)
 * We simply summarize the best avaliable literature. Meaningful pictures of mental illnesses are hard to come by. Doc James  (talk · contribs · email) 07:09, 14 June 2015 (UTC)

On older adults
It says if they have schizophrenia they are twice as likely to have dementia "The rates were 64.46% versus 32.13% for people without schizophrenia."(http://schizophrenia.com/?p=278) observe,

"Researchers from the Regenstrief Institute and the Indiana University Center for Aging Research who followed over 30,000 older adults for a decade have found the rate of dementia diagnosis for patients with schizophrenia to be twice as high as for patients without this chronic, severe and disabling brain disorder."

https://www.regenstrief.org/news/dementia-diagnosis-twice-likely-if-older-adult-has-schizophrenia-cancer-less-likely/ — Preceding unsigned comment added by 71.167.59.130 (talk) 18:02, 20 July 2015 (UTC)

"In a study of long-term in-patients with schizophrenia who had survived into old age, Harvey et al (1999a) followed up a group for 30 months using the Clinical Dementia Rating (CDR). Over this period, 30% of the patients deteriorated, from a baseline of minimal or mild cognitive and functional impairment to impairments severe enough to warrant a secondary diagnosis of dementia."

http://apt.rcpsych.org/content/18/2/144

Schizophrenia, toxoplasmosis, and minocycline
I am surprised to see that there is no mention of the correlation between schizophrenia and toxoplasmosis, a correlation that is stronger than that of any genes yet discovered and schizophrenia and yet genes are mentioned in the Schizophrenia article. See: Toxoplasmosis and specifically Toxoplasmosis and especially the meta-analysis.

Related: thus I am not surprised to see there is no mention of minocycline as a possible treatment for both the positive and, even more importantly, the difficult to treat negative symptoms of schizophrenia. See: Minocycline and its references, especially the meta-analysis.

Someone who oversees this Schizophrenia article should add information about this area of research.

Will Antibiotic Fulfill Its Psychosis-Fighting Promise? (2012) http://psychnews.psychiatryonline.org/doi/full/10.1176%2Fpn.47.16.psychnews_47_16_10-a

Successful Use of Add-on Minocycline for Treatment of Persistent Negative Symptoms in Schizophrenia (2013) http://neuro.psychiatryonline.org/doi/full/10.1176/appi.neuropsych.11120376
 * What you have posted here is a case report and a popular press piece. Please read WP:MEDRS. Will look at the other links. Doc James  (talk · contribs · email) 05:37, 9 August 2015 (UTC)
 * The section on Toxoplasmosis was horrible. I have fixed it. Yes a tentative association. This ref states "Toxoplasma gondii, Cytomegalovirus, Chlamydia spp., and all types of Human Herpes Virus or Influenza, is associated to an increased risk for adult schizophrenia" The proposed mechanism of minocycline does not appear to be through an effect on toxoplasmosis.  Doc James  (talk · contribs · email) 06:18, 9 August 2015 (UTC)
 * Added a sentence here about the possible association. Doc James  (talk · contribs · email) 07:32, 9 August 2015 (UTC)

Suggestion
I would like a doctor to check possible link with demodex. And maybe you can find this article interesting. eye-test-identifies-people-with-schizophrenia — Preceding unsigned comment added by 2A02:214C:8031:4200:F183:D34E:A8F3:B844 (talk) 20:28, 10 September 2015 (UTC)

Cannabis as a contributory factor
As someone who has lived with a schizophrenic for many years, has associated with others and has read most of the literature on the subject, I can say, with confidence that cannabis typically does not induce or exacerbate the symptoms of schizophrenia. In fact, cannabis tends to be used by schizophrenics to cope with the symptoms of their disease. Some of the studies that have come out claiming otherwise tend to have a political agenda, in my educated opinion. Does anyone out there have an opposing opinion? XenoRasta (talk) 20:27, 11 May 2015 (UTC)
 * this is not a forum for discussing the disease or how people cope. If you are talking about article content, what we rely on are published sources  - reviews in the biomedical literature and statements by major scientific/medical bodies. Jytdog (talk) 20:33, 11 May 2015 (UTC)
 * We just go with the best available sources and many state a link. Doc James  (talk · contribs · email) 22:16, 11 May 2015 (UTC)
 * I can say with much emphasis that cannabis helps schizophrenics with "mundane" problems, if there however is a strain perhaps that doesn't have THC then yes it may give them the social effect without the lackiluster performance. I'd also like to add the schizo's may be more functional better if they have the social means to acquire weed. So the schizophrenic's they're working with may just be the brighter one's. — Preceding unsigned comment added by 71.167.70.44 (talk) 04:13, 11 June 2015 (UTC)
 * You need a excellent source. Doc James  (talk · contribs · email) 22:24, 11 June 2015 (UTC)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3730190/ "schizophrenics with better reaction times" http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165946/ "the entourage effect" Schizophrenia is really symptom's of something going on at a smaller level. http://www.iflscience.com/brain/scientists-closer-ever-discovering-cause-schizophrenia

So the schizophrenia being treated is mostly just being covered up and in the long run, having too many useless connections in the brain(unneeded copies of DNA uninhibited) may lead to faster aging and dementia/alzheimers, which is largely ignored in favor of the "rotten brain" imagery Pharma produces to scare meth addicts and over medicated people. http://www.medicalnewstoday.com/articles/266102.php — Preceding unsigned comment added by 71.167.70.44 (talk) 07:16, 13 June 2015 (UTC)

this article is medically irresponsible and misleading
In a statistically significant number of people, there is a causal link between cannabis usage and the later development of psychosis; psychosis is a very negative outcome for these people. This article attempts to downplay that causal link by selectively quoting the sources and burying the causal link in disclaimers. My sources are the sources used in the article. For people with the risk factors (genetics, etc.), cannabis use is sufficient to cause their psychosis; just as smoking does not cause lung cancer in all people who smoke cigarettes, cannabis is not sufficient to cause psychosis in all people who smoke it; however, the links are causal. Read the paragraph of the article, then click the links to referenced studies online: they contain the clear recommendation that adolescents avoiding cannabis use would significantly decrease the rate of onset of psychosis. 96.246.59.19 (talk) 20:40, 11 October 2015 (UTC)
 * Thanks and clarified. Doc James  (talk · contribs · email) 22:04, 12 October 2015 (UTC)

Differential Diagnosis: Delusional disorder
The changes that took place in the DSM-5 affected the differential diagnosis between Delusional Disorder and Schizophrenia. I'm proposing that in the differential diagnosis section for the Schizophrenia page, for the sentence about Delusional Disorder, the words 'non-bizarre' should be removed from the brackets that describe the delusions in delusional disorder. For example, at the moment, the sentence reads 'Delusions ("non-bizarre") are also present in delusional disorder ... '. I'm proposing that the sentence be changed to ' Delusions are also present in delusional disorder ...', or alternatively ' Delusions ("bizarre" or "non-bizarre") are also present in delusional disorder... '.

The reason for my proposal is due to the change in the distinction to 'bizarre' delusions between DSM-IV and DSM-5.

In the DSM-IV, if bizarre delusions were present, only one of the criterion A symptom had to be present for this to be diagnosed as Schizophrenia. So essentially, it was formerly enough that if only a delusion was present, if it were bizarre, the bizarre delusions alone were enough to classify it as Schizophrenia.

Also, in the DSM-IV, Delusional Disorder could only consist of non-bizarre delusions, with bizarre delusions being an exclusion.

However, in the DSM-5, this qualification has changed. The such criterion in DSM-IV that if a delusion was bizarre, the delusion alone would qualify it as Schizophrenia has been removed. At the same time, with the diagnosis of Delusional Disorder, there is now a specifier to include bizarre delusions, in the absence of fulfilling criterion A of Schizophrenia, that being 2 or more of the symptoms listed in Criterion A of Schizophrenia. So essentially, previously if only bizarre delusions were present, the DSM-IV would have categorised this as Schizophrenia in the former classifications, but the DSM-5 now currently classifies this as Delusional Disorder in the current classification.

So with regards to the proposal I am making, by removing the words 'non-bizarre' in the brackets of the originally mentioned sentence, or by adding the word 'bizarre', I believe that both Schizophrenia and Delusional Disorder will be more accurately described by this page in the differential diagnosis.

This essentially affects the subset of people who suffer only from bizarre delusions, without any other of the symptoms listed in Criterion A of Schizophrenia. This moves them from a diagnosis of Schizophrenia, to a more accurate diagnosis of Delusional Disorder as per the DSM-5.

As someone who is recovering from the DSM-5 classification of Delusional Disorder, I have found this distinction to be of the utmost importance to my diagnosis and treatment, especially as I have suffered from bizarre delusions, and the content of my delusions are represented by the most significant types of delusions in Delusional Disorder, that being Erotomania, Fear of Persecution, and Grandiosity [so I have had a mixed type of Delusional Disorder]. Without this distinction offered by DSM-5, my treatment and recovery could not have been as pinpoint as it has been, as although I suffer mostly from the features described in Delusional Disorder, I would have been previously diagnosed by the DSM-IV as having Schizophrenia, simply because I have suffered from some delusions that are bizarre during illness, at the absence of any other of the Criterion A symptoms of Schizophrenia. So I believe this distinction has ramifications of diagnosis for this particular class set of people with bizarre delusions at the absence of any of the other Criterion A symptoms of Schizophrenia.

Thanks, Dtar.

Dtar (talk) 15:26, 1 November 2015 (UTC)
 * I will take a look when I get home and have my DSM5 in front of me. Doc James  (talk · contribs · email) 22:39, 1 November 2015 (UTC)