European Stars And Stripes (Newspaper) - April 12, 1986, Darmstadt, Hesse                                Page 16 the stars and stripes saturday april 12,1986 the most devastating mental illness by Philip m. Boffey new York times schizophrenia is emerging As the worst mental health problem facing the unite states. Yet it has Long been the most neglected. Never before in american history have so Many schizophrenics been seen on the streets of american cities screaming aloud to voices Only they can hear proclaiming themselves god warning passers by that the Central intelligence Agency has bugged their brains or simply sitting mute and withdrawn sunk in an apathy so deep that no emotion crosses their faces. But Street people Are Only a part of the problem. Far More victims of this shattering disease now Are in the Homes of their families in the nation s hospitals in nursing Homes Halfway houses or seedy hotels either forgotten or Given care that health experts agree has brought Only limited Relief of their suffering. But there Are now important signs of change. Interviews and an extensive review of medical journals and scientific papers reveal that the nation is moving toward a new Era in both understanding and treating schizophrenia. The new insights Are paradoxical the news to some degree both bad and Good not Only Are More people suffering from schizophrenia but medical and behavioural scientists believe that the disease itself is far More complicated and More resistant to treatment than had been realized. Moreover though much has been Learned about its manifestations the Basic cause remains a mystery. On the other hand for the first time in decades scientists Are expressing cautious Hope that Progress can now be made toward unravelling the inner mysteries of schizophrenia and finding More effective treatments. All told 2 million to 3 million americans 1 percent of the population either have the disorder or will develop it at some Point in their lives according to the National Institute of mental health. The Cost to society is enormous with authoritative estimates ranging from $20 billion annually As calculated by the nigh to $48 billion reported by the Institute of Medicine of the National Academy of sciences. The estimates Are of expenses incurred in providing treatment and social services As Well As the staggering amount of productivity lost As schizophrenics lives Are disrupted. While schizophrenia is by no Means the most common mental illness a 1984 report from the mental health Institute asserted it is probably the most costly and devastating in terms of human  it has never been easy to determine who is schizophrenic All the homeless people who wander the streets Are by no Means suffering from the disorder. But the nigh studies were based on one of the most scientifically precise analyses Ever conducted of schizophrenia. Schizophrenia is the classic disease of madness a disease that can produce symptoms and behaviour so bizarre that people recoil from its victims in fear revulsion or disbelief. Schizophrenics often suffer from delusions hallucinations or a wild disordering of thought processes an inability to think straight. Risk factors in emerging schizophrenia childbirth problems including Low birth weight and unusual birth position. Poor emotional bonding with Mother during the first three years. Poor motor coordination during infancy and other neurological problems in infancy. Separation from parents being raised in an inst old Gat Home or passed Aro re i relatives.ii8iillilli" intellectual def Pil during the school Tyg of of uhf girl in verbal abilities a Lifis cognitive def pm lev such As difficulty in fit Atten social incompetence such As abrasive Ness with teachers and Peers. Confusion and hostility. In communication from Parent to child. New York times current thinking is that schizophrenia usually requires an inherited susceptibility to the disorder. This list Points to some factors implicated in increasing the risk when combined with innate vulnerability. Researchers studied children of schizophrenic parents because they Are known to be at least six times More Likely to develop schizophrenia than other children. Most of the listed factors Are not ordinarily linked to schizophrenia unless genetic susceptibility is already considered to be present. The factors have not been ranked in their relative influence presumably they Are most potent in combination. In periods when their More Florid symptoms Are absent they May show no emotion at All talking in a Flat monotonous voice from a face without expression showing almost no response at All to the people and events around them. Then again at other times the patient May show no signs of disorder. The reasons for All this remain a mystery. Schizophrenia is still regarded As one of the most baffling of All possibly the most Complex Puzzle in biomedicine according to or. Shervert h. Frazier director of the National Institute of mental health. Its cause is unknown its progression unpredictable. Schizophrenia has no cure although drugs can control its most bizarre manifestations. Nor is there any Laboratory test capable of providing an undisputed diagnosis. But rapid strides have been made in understanding some aspects of the disease producing a Small revolution in scientific comprehension and guarded Hope for further advances. The new studies have shown that the Outlook for schizophrenics is by no Means As uniformly dismal As was widely believed just a few years ago. Roughly half of All schizophrenics eventually get better spontaneously Over the course of decades according to five recent studies. There is recognition now that drugs introduced in the late 1950s, Are not by themselves enough that psychotherapy and drugs work Best in tandem. And in Long term care simple management of daily life is proving As important As drugs or psychotherapy. Most important old beliefs have faded that the disturbing outward symptoms the hallucinations and delusions Are the most important aspects of the disease. Less flamboyant deficit symptoms like apathy and inertia Are now regarded by Many experts As constituting the Core of the disorder. Scientists have thus realized belatedly that they were focusing much of their energies for the past three decades on the less important symptoms. Or. E. Fuller Torrey a Washington d.c., psychiatrist who has published some of the most provocative analyses of the origins of schizophrenia believes that the illness was virtually unknown until about 1800, when it appeared suddenly All Over the Western world increased rapidly for about 100 years then levelled off about 1920 and has maintained essentially the same prevalence rate Ever since. He links the appearance and spread of schizophrenia to the Rise of civilization. But Torrey acknowledges that his is a minority View. The mainstream View was expressed in a paper by four scholars from nigh published in a recent Issue of comprehensive psychiatry. They found sketchy descriptions of delusions auditory hallucinations and bizarre behaviour in documents As far  As the third millennium b.c., in cuneiform tablets from ancient Mesopotamia. Although the evidence is not conclusive they said it nevertheless suggests that schizophrenia has existed throughout  the mental emotional and financial toll exacted by this bizarre disease is enormous. Schizophrenics occupy Over half of the Hospital Beds for the mentally ill and retarded in the United states and fully one fourth of All Hospital Beds in the nation according to the Institute of Medicine. Few other mental illnesses disrupt the whole course of their victims lives so completely. Schizophrenia typically strikes men in their late teens or 20s, and women perhaps five years later just at the Point where the victims have finished the Long costly preparation for life and Are embarking on adulthood. For reasons that Are unclear but could be related to hormones the course of the disease is often less severe in women. Recent studies have shown surprising and encouraging evidence that Many cases of schizophrenia eventually cure themselves. They get better but not necessarily Well says or. Howard Goldman a special consultant to the Institute. Today most scientists Are focusing on possible biological or medical causes. Genetic factors clearly play some role according to a Range of research done years ago and refined in More recent studies. The children of a schizophrenic Parent for example have about a 10 percent Chance of developing schizophrenia and of two schizophrenic parents a 39 percent Chance far above the 1 percent Chance in the general population. Most scientists believe that what is inherited is not the disease itself but a vulnerability or predisposition to it. No one however has pinpointed a specific genetic defect responsible