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Jan Golembiewski

on 8 July 2018

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Transcript of sz3

The Atmospheric
The Geographic
Here we have a simple solution with complex foundations: The social defeat hypothesis (Selten & Cantor Graae, 2007) proposes that genetic factors such as colour of skin, poor hearing, low IQ and socio-environmental factors (social isolation, poverty etc.) destroy resilience and this leads to a personal breakdown, much like rats experience when 'socially defeated' in controlled experiments. It's suggested that this triggers dopaminergic sensitisation.
McGrath et al's work on Vitamin D deficiency searches for a single solution - not an easy one to map, like cholera. More like pellagra.

Atmospheric factors, such as long northern European winters and skin colour does appear to correlate with an increase in the incidence of schizophrenia. The theory goes that Immigrants from Africa and the Caribbean are especially prone because when skin is dark it reflects more UVB (which is used to synthesize vitamin D.)

A vitamin D deficiency might be a confounding variable caused by spending too much time in unhomely and culturally unyeilding indoor environments being babysat while dad and mum work long hours.
The Urban
the vitamin D deficiency hypothesis
The Social
The place of place in the epidemiology of schizophrenia

Jan A Golembiewski BFA BArch MArch PhD
Psychological Design (Founder)
Centre for Mental Health and Urban Design (Fellow)
Schizophrenia Research Institute (Fellow)
Dementia Training Australia (Expert Reference Group)
For Faris and Dunham, the term 'race' was a circumlocution of 'Italian.' Now it has been stripped of the language of prejudice and is bundled with genetics. For McGrath et al, race means UV reflectivity of skin, for Selten & Cantor-Graae it is in established racist mores.
VICE (now read: drugs)
Caspi's 2005 study of epigenetic mutations of the COMT gene are a good example.
This has been appropriated by the vitamin D deficiency hypothesis of McGrath Et al.
most researchers still see the urban environment as a proxy for something else...
All the usual suspects: but 80 years on
Just as medicine doesn't regard the body as a singular thing, but a confluence of genetics, history and biology.
The demands of commerce.
There are messages everywhere.
'Access to the fountain is
one of the ways to find respite is to ignore the negative demands and embrace the positive ones.
Golembiewski, J. (2012). Medical Hypotheses 78: 7-10.
Excess of excitability voxels in fMRI of whole frontal lobe. Catatonic (C) and paranoid (P) psychotic patients are compared to healthy controls (H) while being exposed to negative, positive and neutral images.
there are the demands of transport, there are dangers everywhere.
Van Os, Rutten, et al. (2008). Suggest that the urban environment might contain unspecified epi-genetic triggers.
Delusions are fed by experiences and perceptions. Paranoid types are particularly sensitive to negative environmental messaging. This urban scene contains one of many peculiarly salient 'messages' in the Camberwell area - an area of especially high local variation. This may help explain how a 10 minute walk makes all measures of paranoid psychosis significantly worse. (Ellet et al 2008)
reading the urban environment
The social environment also makes demands
Utilization Behavior
(l'Hermitte 1986) is when people lose neural inhibition and can't prevent themselves from acting on objects they find. Here a patient has found a syringe and is giving her doctor a jab.
Shitij Kapur:
aberrant salience 2003

Roy Wise:
reward salience 1989
The living environment (home) provides the principal filter for the ecological effects the factors that urbanicity draw together: society, civic services, poverty, atmosphere, geography and collective identity. The living environment is also – and possibly more importantly, the primary milieu for self-expression and for behaviour, especially during childhood or whenever social networks are depleted.
The homes of patients with schizophrenia frequently become horrible places. This may be as much cause as symptom of a deteriorating condition. A condition where a person's psychological defenses against the pressures of society, long winters, poor health, poverty and isolation simply fail.
Epigenetic hypotheses
Social Defeat
Ecogenetic, pathological and deficiency hypotheses including DVD hypothesis, Tox Gondii, childood virus etc.
The Living
Urban syndrome
Even after demographic factors have been discounted, between 25 and 33% of all incidence can be traced back to urbanicity in a 'by dosage' basis. This remains remarkably consistent over many studies and over many areas. (Kelly et al 2010, VanOs et al 2010)
Jan A Golembiewski PhD
Specialist in the psychopharmacology of the built environment and in passive treatment through mental facility design.

Papers: http://usyd.academia.edu/
This paper is based on Curēus (2013) 5(3): e106.
The research of Faris and Dunham into the incidence of ‘insanity’ in Chicago also found a locus of concentration – the inner city slum area. But no pump was to be found. Instead, the authors pointed to various other factors which they assumed were causal - but in an unspecified but complex way: race, migration status, poverty, 'vice' and access to sunlight.
Mapping insanity: 1939
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