What Caused This to Happen?

January 13, 2015 9:45 PM

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"What caused this to happen?" is usually one of the first questions asked by patients and their families following a psychotic episode, suicide attempt, or manifestation of any serious mental illness. In earlier times, the explanations ranged from an imbalance of the "humours" to demonic possession. More recently, there have been "schizophrenogenic" or "refrigerator" mothers and "abusive" or "toxic" fathers. Modern scientists and clinicians point to a mix of genetic and environmental factors but these explanations are rarely satisfying and do little to stem the tide of guilt, shame, and blame that surrounds mental illness as much today as during the witch hunts of centuries past.

Of course, genetics and environment are important. But their effects are probabilistic. With the exception of a few rare mutations that appear causal for autism, genetics confers a tendency for height, personality, and risk for mental illness through the aggregate effects of hundreds of common varia...

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