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Schizophrenia and the Chinese Famine of 1959-1961—Reply
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In Reply: Dr Altschuler proposes that schizophrenia is a disease of recent origin, an important albeit probably minority view in psychiatry.1 Although provocative, the idea that a disease now widespread in both developed and developing societies emerged only 200 years ago, triggered by as yet unidentified mechanisms, suffers from logical and evidentiary problems.
Early medical treatises and institutional records allegedly make no mention of schizophrenia, a dubious basis for drawing conclusions about disease absence when only a miniscule percent of such documents survive. Suppose no cases of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–defined schizophrenia are found among the original records. Numerous explanations are possible for this silence in the presence of the disorder, including that manifestations of schizophrenia may have changed substantially over time, as they have just in the 20th century2; the shifting boundaries between religion and medicine produced preferential attention to one set . . . [Full Text of this Article]
Richard Neugebauer, PhD, MPH
RN3@columbia.edu
Epidemiology of Developmental Brain Disorders Department
New York State Psychiatric Institute
New York
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