Why is Nature’s article about schizophrenia so important

Neuron

Some time ago, understanding mental illness was more like cheering for a football team: people would wear a team’s T-shirt and cheer the way they pleased. Some cheered for psychotherapy and argued that medicine did no good, while others praised medication and said that psychotherapy was like a placebo. The conception of the psyche was made of multifaceted and disaggregated theories, and each one could choose a “way” to understand his or her patient, and it could have nothing to do with the way another person understood the same suffering.

Even today, we see this breakdown. The other day, I offered an explanation for (interpretation of) the depressive condition of a patient. He soon started talking about physical symptoms and minimizing the facts of his life. He suspected that an explanation of his depression would prevent him from receiving any medication for it. As if he were wrongly conjecturing that we either understand it or medicate it.

In the twenty-first century, a new perspective took hold of the mind sciences: the translational perspective. This perspective includes the understanding that medication changes the connections between neural networks; the idea that psychotherapy is able to change neurotransmission; the finding that environmental factors, such as living in big cities, changes brain architecture; and the evidence that non-drug therapies like meditation and exercise have positive physical effects on the brain. Finally, all mental phenomena were conceived of as having their basis in the brain, but not in a way that reduces any and all phenomena of psychic life to simple electrical impulses. In other words, it is understood now that everything happens in the physical brain (oddly enough, many previous conceptions surreptitiously did not incorporate this idea), but not in a simplistic, direct or reductionist way. As such, this recent perspective does not eliminate symbols and the unconscious from psychology; quite the opposite.

This is the translational research perspective. It is not only interested in knowing if it works but also why. Researchers began to investigate how cities do harm to people’s brains, how psychotherapy and meditation act on the neurons, and so on.

The study, published in Nature, is important because it is prototypical of the years of philosophical transformation that the conception of the human mind has passed through. It involves collaboration between more than 20 countries, a survey of more than 30,000 individuals, and large, translational research. It is not sufficient to know that a particular gene is more prevalent in individuals with schizophrenia. One must also know how that gene works. Step by step, the findings related to the complement factor 4 revealed that it has to do with inflammation and the neuronal pruning process that occurs in the adolescence of every individual. Along with environmental factors, altered genes predispose some individuals to schizophrenia by mechanisms that are beginning to be unveiled. These are theories that have been suggested for a long time, but only now is there a way to understand them.

Findings like this integrate theories on mental health into an increasingly unique and solid body of knowledge, where all areas communicate and deal with the same brain. They deal with the same conception of mind (or at least with similar concepts). Therefore, we will all soon be wearing the same T-shirt and cheering for the same team.


 

Ref.: Schizophrenia risk from complex variation of complement component 4. Sekar et al., Nature, 2016.

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