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Sanity and Madness

This chapter explains that the central difficulty in diagnosing and treating mental disorders is reaching a level of agreement about their underlying basis. In this respect, proponents of the view that mental disorders are primarily biological in origin were particularly excited by the Human Genome Project, as they believed this would make it possible to truly get a grip on the nature of such conditions. Genome-wide association studies (GWAS) have now been used to study a range of mental disorders. However, GWAS findings have been contradictory and confusing and this chapter looks at the reasons why, and at a number of possible biological causes of schizophrenia. The chapter then considers a very different way of explaining schizophrenia, one based on the idea that it is not genetics but the social environment that determines whether an individual succumbs to this disorder. A version of this hypothesis sees schizophrenia as primarily the result of defective family relations, and the disorder as a consequence of those distorted relations, but also as a response to wider pressures in society. One psychotherapy approach claimed to have a very good level of success in the treatment of schizophrenia is called 'Open Dialogue.