Psycho-Babble Medication Thread 116746

Shown: posts 1 to 4 of 4. This is the beginning of the thread.

 

Genes PLUS environment: So what is environment??

Posted by Randal on August 17, 2002, at 20:07:36

Hi,

I read with interest today Time magazine's cover story on bipolar disorder in kids http://www.time.com/time/covers/1101020819/story.html Overall, it is an outstanding article, wery well done. However, one passage struck me:

"Bipolar disorder, like Schizophrenia, depression and certain anxiety conditions, is powerfully influenced by surroundings. When an identical twin suffers from bipolar, the other twin has only a 65% chance of developing it too. Conversely, adopted children with no genetic legacy for bipolar have a 2% chance of coming down with the condition if they are raised in a home with one nonbiological bipolar parent. Clearly, something is in play besides mere genes, and that something is environment. Raise a child in a steady and stable home, and you reduce the odds that the illness will gain a toehold, which is why counselors work hard to teach parents and kids how to minimize family discord."

So mental illnesses are partly genetic, partly environmental. Fine. However, it is not at all clear to me that "environmental" means the social/psychological environment of the kid, particularly his family life. While I am admittedly not familiar with the research in the field, it seems more much more likely to me that "environmental" would turn out to be largely things that affect the early development of a child's brain--most likely during fetal development and very early childhood. This could include things like infections, physical trauma, hormonal changes in the mother, drug/alcohol abuse by the mother, etc. I do know that there is a tremendous amount of research in the schizophrenia field about how infections (influenza for example) while the mother is pregnant might turn genetic susceptibility into the actual disease.

Factors that would affect the brain and are not "genetic" start at conception and would presumably have the greatest impact at early stages of development. The article in Time implies that the "environmental" component of the disease is the child's "surroundings" neglecting completely the period before birth when most of brain development occurs. Not to mention physical influences on a child's brain such as illness, nutrition, head trauma, etc.

To me, suggesting that the "surroundings" are what comprises the non-genetic component seems a bit simplistic and almost certainly wrong. Worst of all, if I were a parent with a bipolar kid I would interpret the Time article to mean that I am responsible for providing an environment that turned my child's genetic susceptibility into a potentially debilitating disease. I would be astonished if the environmental component of a child's bipolar disorder were caused by something like his parent's divorce instead of a physical factor that affected brain development. I don't think "blame the parents" is the right answer.

Anyway, I just wanted to make sure that people reading such an article do not misinterpret what is meant by environment.

I am curious whether there is anyone doing research or who is familiar with research on the non-genetic factors influencing the development of mental illness and could provide some insight here.

Just hoping I could stimulate some debate here and see if there is any real evidence as to what "environmental" influences can increase the chances of the serious, biologically and genetically based mental illnesses.

Randal

 

Re: Genes PLUS environment: So what is environment??

Posted by Seamus2 on August 17, 2002, at 20:23:28

In reply to Genes PLUS environment: So what is environment??, posted by Randal on August 17, 2002, at 20:07:36

Good trailhead for discussion, especially the qualifying terms of "nuture" vs. "nature" in scientific studies.

I'd put the dividing line at "separated at birth".

But this thread isn't about medications, so I suggest re-posting it at Psych-Babble Social

http://www.dr-bob.org/babble/social/

Seamus

 

Re: Genes PLUS environment: So what is environment?? Seamus2

Posted by Randal on August 17, 2002, at 20:58:05

In reply to Re: Genes PLUS environment: So what is environment??, posted by Seamus2 on August 17, 2002, at 20:23:28

> Good trailhead for discussion, especially the qualifying terms of "nuture" vs. "nature" in scientific studies.
>
> I'd put the dividing line at "separated at birth".
>
> But this thread isn't about medications, so I suggest re-posting it at Psych-Babble Social
>
> http://www.dr-bob.org/babble/social/
>
> Seamus
>
Seamus,

Thanks, right after I posted, it occurred to me that maybe this wouldn't be the best place since it isn't about medication.

However, I think the issue is relevant to a lot of people who are interested in the medical end of things. First of all, I'm sure MANY people have read the Time article and so I think discussion of it is appropriate. A big part of the article involves the drug treatment of bipolar or potentially bipolar kids. If there are any misconceptions in the article these should be cleared up. Second, the idea of whether children are "born" bipolar or whether their parents can keep it from happening is directly relevant to drug treatment. A 3 year old who shows clear signs of becoming bipolar: do you try to change his environment, or do you think about initiating drug treatment? If his "surroundings" are what will decide whether full-blown illness develops, it makes a huge difference.

I also think a lot of the people who are interested in the research and medical aspects of mental illness are also interested in its genesis. My guess is that the crowd we have here, which is pretty savvy, would be open to such a discussion. I think this is the appropriate audience.

If the post generates little response I'll repost it on the other board.

Thanks,

Randal

p.s. work on a mouse model of schizophrenia has shown that even before birth the fetuses are not equal. I remember hearing a talk that showed that influenza, I believe, led to illness in 50% of the genetically identical mice with a genetic predisposition--whether they developed the disease depended on their position in the uterus. Amazing stuff!

 

Redirect in part: Genes PLUS environment

Posted by Dr. Bob on August 18, 2002, at 8:52:48

In reply to Re: Genes PLUS environment: So what is environment?? Seamus2, posted by Randal on August 17, 2002, at 20:58:05

> > this thread isn't about medications, so I suggest re-posting it at Psych-Babble Social
>
> A big part of the article involves the drug treatment of bipolar or potentially bipolar kids. If there are any misconceptions in the article these should be cleared up.

IMO, the initial question, "So what is environment??", is in fact more social than biomedical, so I've reposted it to PSB:

http://www.dr-bob.org/babble/social/20020813/msgs/28868.html

But I also agree, discussion about the drug treatment of bipolar or potentially bipolar kids should stay here.

Bob


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.