Talking to The Demons; Schizophrenia is no longer seen as a genetically predetermined disease.

Byline: Tara Pepper

Mike Harris left Cambridge, England, for university in Scotland filled with the natural enthusiasm for starting an independent life. But he couldn't handle all the partying and drugs on campus. After a year he had moved back with his parents. A few years later he tried again, but once again he had to leave. Harris (not his real name) was plagued by voices and "static in my head" and went for long periods without sleep or food. "At one point I thought I could save the world by not eating or washing. I had very unrealistic beliefs," he says.

Harris was hospitalized several times and underwent inpatient psychiatric treatment, but what finally brought him back from the brink of schizophrenia was an intensive combination of group, individual and family psychotherapy, and help with social skills. At the Young People's Service, a psychiatric clinic in Cambridge, patients shop, cook and eat together, and help each other to negotiate their phobias.

Not long ago schizophrenia was considered an incurable, lifelong disease caused by an unlucky combination of genes. Sufferers were condemned to a lifetime on drugs. Now scientists are beginning to uncover evidence that schizophrenia is heavily influenced by environmental factors. Their research has huge implications for treatment. Doctors now believe that therapy and social work are the preferred method of treatment for most schizophrenics. "Patients really must have therapy in order to improve," says University of Newcastle psychiatrist Dr. Douglas Turkington. "Medication alone will not do it."

A study published last month in Acta Psychiatrica Scandinavica, the most definitive look at schizophrenia to date, argues that trauma or childhood abuse is a factor in the development of the disease. While schizophrenia is the product of a complex interplay between a host of environmental and genetic factors, it seems that "genes do not cause the outcome, but identify those who might be susceptible to the environmental risks," says Dr. Mary Clarke, a psychiatric researcher at Ireland's Royal College of Surgeons. A review of 46 studies of schizophrenics by Auckland University psychologist John Read found that 59 percent of male inpatients and 69 percent of females had experienced childhood physical or sexual abuse. In a separate study, which included physical neglect and physical or emotional abuse, the level rose to 85 percent of males and 100 percent of women. Says Read: "We have around the world millions of people with a diagnosis that masks the true social causes, and therefore prevents people from getting help which would be more effective and humane."

The cumulative impact of this research has swayed opinion in the profession's highest echelons. At the American Psychiatric Society's annual conference in August, the organization's president, Steven S. Sharfstein, noted that antipsychotic medicines now generate $6.5 billion in ...