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Although a large number of factors have been proposed to play a role in the etiology of schizophrenia, no single environmental factor has yet been established with compelling certainty. Moreover, if phenomena such as monozygotic twin discordance for schizophrenia may be accounted for by random or epigenetic events, as some would even argue (McGuffin et al. 1994), there may be no room for environmental...
The fact that the rates of concordance for schizophrenia among monozygotic twins is far below 100% proves that non-genetic factors must be operant for the development or not of the disease. Such factors have frequently been discussed as related to the environment and were recently summarized elsewhere (Häfner 2002). They comprise obstetric complications, maternal psychopathology during pregnancy,...
In recent decades, those searching for the causes of schizophrenia have not been especially interested in the social and cultural environment of their subjects. To some extent this is understandable: the prospect of models of risk in which causal agents are embedded in the social environment, operating at micro-, mezzo-, and macro levels, with untold complexities of interaction, has not seemed overly...
For clinical purposes, psychosis is defined as a discrete entity that can be identified by applying certain criteria. This does not mean, however, that this condition exists as such in nature. Disease at the level of the general population generally exists as a continuum of severity rather than an all-or-none phenomenon (Rose and Barker 1978). Evidence that variation in the psychosis phenotype can...
The four papers represent widely varying perspectives and data. They are all informative, but it is difficult to draw a general summary message that applies to all. Therefore I comment on each one individually, making comparisons and drawing common conclusions where possible.
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