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Blindness and schizophrenia
Medical Hypotheses
BLINDNESS
6: 1327-1328,
1980
AND SCHIZOPHRENIA
Louise Mead Riscalla,
8 Lahiere Avenue, Edison, NJ 08817, USA. ABSTRACT
The implications of both blindness and schizophrenia are discussed with reThe ward charts of gard to the etiology and treatment of schizophrenia. hospitalized patients in a section for the blind of a state psychiatric hospital were examined to determine if there were any patients who were both It was found that none of the patients diagblind and had schizophrenia. nosed as schizophrenic was totally blind on admission. Two patients diagnosed as schizophrenic were partially blind due to loss of the left eye sustained in a fight and iritis of the right eye respectively. INTRODUCTION Horrobin proposed that all of the concepts regarding the etiology of schizophrenia may be related ultimately to a failure of normal prostaglandin (PG) synthesis and/or action, particularly of prostaglandins of the 1 series (1). Defects in pineal function have been postulated in the etiology of schizophrenia (2) on the basis of a melatonin deficiency (3,4) which will also decrease the PGEl. Hot-robin mentioned that pineal activity is increased in blind people and a review of the literature and requests for information disclosed only one case of schizophrenia in a blind person (1,2). There is preliminary evidence to indicate that blindness might be a protection against schizophrenia because of the elevated melatonin levels reported in blind individuals (1,2). There is a need, based on Horrobin's concepts (1,2) for systematic studies to ascertain the existence of individuals who are both blind and schizophrenic. In order to fulfil this need a study was done to ascertain if there were any individuals in a state hospital who were both blind and schizophrenic. Individuals with schizophrenia are often hospitalized, so that a psychiatric hospital provides a setting for the study of individuals with schizophrenia and other forms of mental illness, many of whom also have physical disorders such as diabetes, arteriosclerosis and possibly blindness. METHOD AND SUBJECTS The ward charts of a total of 32 patients who were hospitalized in a section for the blind of a state psychiatric hospital were examined to determine the visual status and diagnosis at the time of admission. The group was composed of 24 females and 8 males who ranged in age from 52 to 97. No information was available regarding melatonin levels on any of the patients. RESULTS One patient who was totally blind on admission had a non-psychotic diagnosis, and only one patient with a psychotic diagnosis (organic brain syndrome due to generalized arteriosclerosis) was totally blind on admission. None of the patients
1327
diagnosed diagnosed sustained patients partially blind or later in sclerotic
as schizophrenic was totally blind on admission. Two patients as schizophrenic were partially blind, due to loss of the left eye in a fight and iritis of the right eye respectively. Of all the who had a psychotic diagnosis, including schizophrenia, four were blind and one was totally blind on admission. Those who were not partially blind on admission and who became blind or partially blind their hospital stay had cataracts, diabetic retinopathy or arterioretinopathy. DISCUSSION
AND CONCLUSION
The results of this survey in a large state psychiatric hospital support Horrobin's suggestion that blindness is very rare in patients with schizophrenia (1,Z). Furthermore it appears that blindness is unusual in patients with any psychotic diagnosis since the majority of patients in this type of hospital are psychotic yet only one patient in the unit with a psychotic Further research is needed before a diagnosis had been blind on admission. definitive conclusion that blindness protects against schizophrenia can be reached. The melatonin levels in blind people should be explored further with particular attention to the cause of the elevated melatonin concentrations because of the variability in the etiology of blindness (e.g. diabetes, glaucoma, injury from chemicals, explosions or foreign objects, brain tumours, etc.). Since it appears that blindness is rare in patients with psychosis, including schizophrenics, it would be worthwhile to study the possibility of Such a study melatonin deficiency in individuals with psychotic diagnoses. might yield differences, for example, in melatonin deficiencies within the various diagnostic categories of psychosis, or might reveal similarities betFurther research should be done on ween other psychoses and schizophrenia. the melatonin deficiency already found in schizophrenia (3,4) because it could lead to a treatment for schizophrenia by replenishing or compensating for the melatonin deficiency, therefore eliminating the need for many psychotropic drugs with their harmful side effects. REFERENCES Schizophrenia: reconciliation of the dopamine, prostaglandin 1. Horrobin DF. Lancet 1: 529, 1979. and opioid concepts and the role of the pineal gland. The role of prostaglandin El deficiency in schizophrenia: 2. Horrobin DF. Paper presented at the Conference interactions with do,pamine and opiates. of the Schizophrenia Assocation of Great Britain, London, May, 1979. 3. McIsaac WM. A biochemical 30: 111, 1961.
concept of mental disease.
Postgrad Med
4. Smith JA. The pineal gland: its possible significance in schizophrenia. In Hemmings G and Hemmings WA (eds) The Biological Basis of Schizophrenia. pp 105-119, University Park Press, Baltimore, 1978.
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BLINDNESS
6: 1327-1328,
1980
AND SCHIZOPHRENIA
Louise Mead Riscalla,
8 Lahiere Avenue, Edison, NJ 08817, USA. ABSTRACT
The implications of both blindness and schizophrenia are discussed with reThe ward charts of gard to the etiology and treatment of schizophrenia. hospitalized patients in a section for the blind of a state psychiatric hospital were examined to determine if there were any patients who were both It was found that none of the patients diagblind and had schizophrenia. nosed as schizophrenic was totally blind on admission. Two patients diagnosed as schizophrenic were partially blind due to loss of the left eye sustained in a fight and iritis of the right eye respectively. INTRODUCTION Horrobin proposed that all of the concepts regarding the etiology of schizophrenia may be related ultimately to a failure of normal prostaglandin (PG) synthesis and/or action, particularly of prostaglandins of the 1 series (1). Defects in pineal function have been postulated in the etiology of schizophrenia (2) on the basis of a melatonin deficiency (3,4) which will also decrease the PGEl. Hot-robin mentioned that pineal activity is increased in blind people and a review of the literature and requests for information disclosed only one case of schizophrenia in a blind person (1,2). There is preliminary evidence to indicate that blindness might be a protection against schizophrenia because of the elevated melatonin levels reported in blind individuals (1,2). There is a need, based on Horrobin's concepts (1,2) for systematic studies to ascertain the existence of individuals who are both blind and schizophrenic. In order to fulfil this need a study was done to ascertain if there were any individuals in a state hospital who were both blind and schizophrenic. Individuals with schizophrenia are often hospitalized, so that a psychiatric hospital provides a setting for the study of individuals with schizophrenia and other forms of mental illness, many of whom also have physical disorders such as diabetes, arteriosclerosis and possibly blindness. METHOD AND SUBJECTS The ward charts of a total of 32 patients who were hospitalized in a section for the blind of a state psychiatric hospital were examined to determine the visual status and diagnosis at the time of admission. The group was composed of 24 females and 8 males who ranged in age from 52 to 97. No information was available regarding melatonin levels on any of the patients. RESULTS One patient who was totally blind on admission had a non-psychotic diagnosis, and only one patient with a psychotic diagnosis (organic brain syndrome due to generalized arteriosclerosis) was totally blind on admission. None of the patients
1327
diagnosed diagnosed sustained patients partially blind or later in sclerotic
as schizophrenic was totally blind on admission. Two patients as schizophrenic were partially blind, due to loss of the left eye in a fight and iritis of the right eye respectively. Of all the who had a psychotic diagnosis, including schizophrenia, four were blind and one was totally blind on admission. Those who were not partially blind on admission and who became blind or partially blind their hospital stay had cataracts, diabetic retinopathy or arterioretinopathy. DISCUSSION
AND CONCLUSION
The results of this survey in a large state psychiatric hospital support Horrobin's suggestion that blindness is very rare in patients with schizophrenia (1,Z). Furthermore it appears that blindness is unusual in patients with any psychotic diagnosis since the majority of patients in this type of hospital are psychotic yet only one patient in the unit with a psychotic Further research is needed before a diagnosis had been blind on admission. definitive conclusion that blindness protects against schizophrenia can be reached. The melatonin levels in blind people should be explored further with particular attention to the cause of the elevated melatonin concentrations because of the variability in the etiology of blindness (e.g. diabetes, glaucoma, injury from chemicals, explosions or foreign objects, brain tumours, etc.). Since it appears that blindness is rare in patients with psychosis, including schizophrenics, it would be worthwhile to study the possibility of Such a study melatonin deficiency in individuals with psychotic diagnoses. might yield differences, for example, in melatonin deficiencies within the various diagnostic categories of psychosis, or might reveal similarities betFurther research should be done on ween other psychoses and schizophrenia. the melatonin deficiency already found in schizophrenia (3,4) because it could lead to a treatment for schizophrenia by replenishing or compensating for the melatonin deficiency, therefore eliminating the need for many psychotropic drugs with their harmful side effects. REFERENCES Schizophrenia: reconciliation of the dopamine, prostaglandin 1. Horrobin DF. Lancet 1: 529, 1979. and opioid concepts and the role of the pineal gland. The role of prostaglandin El deficiency in schizophrenia: 2. Horrobin DF. Paper presented at the Conference interactions with do,pamine and opiates. of the Schizophrenia Assocation of Great Britain, London, May, 1979. 3. McIsaac WM. A biochemical 30: 111, 1961.
concept of mental disease.
Postgrad Med
4. Smith JA. The pineal gland: its possible significance in schizophrenia. In Hemmings G and Hemmings WA (eds) The Biological Basis of Schizophrenia. pp 105-119, University Park Press, Baltimore, 1978.
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