Otago Daily Times

Schizophre­nia and head injuries

- Send questions to: AskAScient­ist, PO Box 31035, Christchur­ch 8444 Or email questions@aska scientist.net

Ian Ford, of Oamaru, asked:

If a schizophre­nic has an accident and is headinjure­d, because of multiple personalit­ies would they take longer to heal mentally?

Richard Linscott, a clinical psychologi­st at the University of Otago, responded:

This is a great question with no straightfo­rward answer. In thinking about this, we need to look at a myth and then several facts about head injury and schizophre­nia.

People with schizophre­nia do not have multiple personalit­ies. The multiplepe­rsonality myth is a misinterpr­etation of the origin of the word schizophre­nia, which Eugen Bleuler coined in the early 1900s by combining schizo, meaning split, and phren, meaning mind. Bleuler, a Swiss psychiatri­st, coined the term to describe what he saw in his patients, namely marked disconnect­ions in emotion and thinking.

Head injuries disrupt the functions of the brain. These often cause problems with thinking, reasoning, rememberin­g, attending, perception, and planning. Most head injuries are mild and, with the right treatment, recovery will occur over weeks or months. When injuries are severe, cognitive problems can be more extensive. They will persist for months and years after the injury and affect employment, social life, and friendship­s.

It turns out that cognitive abilities are also affected in schizophre­nia. Four of every five people with schizophre­nia have marked difficulty with these same cognitive abilities, especially those involving concentrat­ion, memory, and planning. Ironically, before Bleuler coined the term schizophre­nia, the disorder was referred to as dementia praecox,

or premature dementia.

Let’s ramp up the complexity! Head injuries can cause psychiatri­c disorders. In many circumstan­ces, these psychiatri­c disorders can be thought of as reactions to the consequenc­es of the head injury, such as the loss of employment or friends. In these cases, the more severe the injury, the more likely the disorder. The situation with schizophre­nia may be different: Those with a head injury are more likely to develop schizophre­nia, but the odds of developing schizophre­nia are not related to the injury severity.

So, if a person with schizophre­nia were to have a head injury, would they take longer to recover from the head injury than someone who does not have schizophre­nia?

Possibly; possibly not. I’d not bet one way or the other without knowing a hundred different things about the person, including how severe the injury was, how much they have lost because of the injury, and how they cope with schizophre­nia! Even then, it would be superdiffi­cult, if not impossible, to separate the cognitive effects of schizophre­nia and head injury on the person.

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