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What is Mental Illness? The Relationship between Religion and Psychiatry. Shari Y. Thompson [email protected] June 20, 2005. Overview. Historical Review of the Relationship with 5 Major Religions Impact of Religion on 20 th Century Psychiatric Practices Acquiring Scientific Knowledge.

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What is mental illness the relationship between religion and psychiatry

What is Mental Illness?The Relationship between Religion and Psychiatry

Shari Y. Thompson

[email protected]

June 20, 2005


Overview
Overview

  • Historical Review of the Relationship with 5 Major Religions

  • Impact of Religion on 20th Century Psychiatric Practices

  • Acquiring Scientific Knowledge


Hinduism
Hinduism

  • 1500 B.C.- One supreme deity but recognizes other gods as facets of the supreme deity

  • All illnesses are caused by animistic beliefs, demons and evil spirits and certain human excesses

  • 100-200 A.D. recorded the first description of insanity with no mention of provisions for caring for the sufferer

  • Segregation of people with mental illness first occurred in the 19th century

  • In 1922, the “lunatic asylums” were called mental hospitals


Buddhism
Buddhism

  • 563 B.C.- 2 forms Mahayana (Buddha is the Savior) and Theravada (individual responsibility)

  • Goal of enlightenment is wisdom and the monastic order is the heart of the spiritual quest

  • A vast spiritual world influences diseases and illnesses

  • Individuals are not responsible for their mental illnesses so they are not persecuted

  • Formal Buddhist writings contain very few comments about psychosis


Judaism
Judaism

  • 2000 B.C.- Belief that God is good and righteous, and His creations, the world and its people are good

  • Emphasis on social services and humanitarian activities

  • Late 12th Century Maimonides described the anatomy of the brain and psychiatric disorders

  • Early 13th Century Maimonides first wrote, “Mental health is as important as physical health.”

  • Stresses prevention not treatment – “The ill cannot serve the Lord properly.”


Islam
Islam

  • 570 A.D.- Mohammed taught respect for the world order allowing Muslims to approach science sooner than Christians

  • Absence of demonic theory of disease advanced medical knowledge

  • 872 A.D. Cairo - First hospital for those suffering mental illness was fashioned after Christian hospitals

  • 12th Century -Sufism ideology of health and illness depended on God alone causing tension with the medical profession during the Middle Ages

  • 13th Century record listed 1400 drugs produced by Arab scientists


Christianity
Christianity

  • 4 B.C.- Christian church came from a faith in Jesus’ resurrection and that he continues to live

  • Gospel writers recorded that healing and exorcism played a role in Jesus’ ministry

  • 4th Century healing through the laying of hands, prayer, fasting, invocation of Christ’s name, sign of the cross, and exorcism

  • Care of those suffering was led by the church leading to extended, organized community care

  • 14th Century pre-scientific demonology gave rise to the Inquisition


Middle ages 14 th 17 th century
Middle Ages (14th – 17th Century)

MIDDLE AGES

Christianity

Buddhism

Hinduism

Judaism

Islam

2000

BC

1000

BC

563

BC

4

BC

570

AD

1300

AD

1600

AD

2000

AD


Scripture
Scripture

  • MATTHEW 4:24

    Tormented with illness and pain

    “And his fame went throughout all Syria: and they brought unto him all sick people that were taken with diverse diseases and torments, and those which were possessed with devils, and those which were lunatick, and those that had the palsy; and he healed them. ”

  • MARK 9:17

    Possessed by devils

    “And one of the multitude answered and said, Master, I have brought unto thee my son, which hath a dumb spirit; ”

  • LUKE 9:39

    Epileptics

    “And, lo, a spirit taketh him, and he suddenly crieth out; and it teareth him that he foameth again, and bruising him hardly departeth from him”


The impact of religion on 20 th century psychiatric practices
The Impact of Religion on 20thCentury Psychiatric Practices

  • Hinduism – yoga and relaxation techniques based on psychophysiological methods that were used to achieve control

  • Buddhism – Direct meditation may enhance psychotherapy and Zen-derived Morita suggested as a form of treatment for social phobias and specific obsessions

  • Judaism – 52% of psychotherapists in American cities are Jewish-Sigmund Freud and his followers made a profound impact on psychiatry from the perspective of clinicians, researchers, and patients


Impact of religion on 20 th century practices contin d
Impact of Religion on 20thCentury Practices Contin’d

  • Islam – employ elements of Islamic worship in group psychotherapy success in relieving psychiatric symptoms and re-grounding spiritual faith

  • Christianity – reform mental hospitals to improve conditions of care and mainstreamed the language for psychoanalysis


Is there a role for clergy in mental health care
Is there a Role for Clergy in Mental Health Care?

  • Points to consider:

    • Religious life of Americans

    • Religious practices, beliefs, and values may help prevent illness

    • Religious commitment may influence decisions about mental health care

      ***Clergy may support and complement traditional medical care***


Summary
Summary

  • The study and treatment of mental illnesses have been influenced by societies’ views of the spiritual world

  • Belief in an evil or supernatural causation is not problematic per se, the issue is how that view influences the care of individuals with mental illnesses

  • Are we a society that persecutes suffering individuals or do we provide the best care and treatment that technology will allow


Summary contin d
Summary Contin’d

  • Medical practices are guided by the true inspiration of religions - compassion, fairness, sense of justice, and love

  • The continuing challenge is to be truly worthy of our moral responsibilities and intellectual inheritance.


2 nd biggest breakthrough in 2003
2ND BIGGEST BREAKTHROUGH IN 2003

  • Decoding Mental Illness

    • www.sciencemag.org/cgi/content/full/302/5653/2039


What is risk
What is Risk?

Genetics – the genes you inherit from your parents

Environment – stress, smoking, drugs…


The Human Genome Sequence

is Done (ca.2003)

Nucleotides: 3 billion

Genes: 25,000

Proteins: 600,000

SNPs: 6 million


What is risk1
What is Risk?

Genetics – the genes you inherit from your parents

Environment – stress, smoking, drugs…


Genetic loci linked to schizophrenia
Genetic Loci Linked to Schizophrenia

GAD1

DISC1

1

2

3

4

5

NRG1

DTNBP1

GRM3

MRDS1

6

7

8

9

10

11

12

G72

13

14

15

16

17

18

COMT

19

20

21

22

X

Y

= genome-wide significance


The path from here to there…

cognition

schizophrenia

temperament

Cells:

subtle molecular abnormalities

Genes:

multiple susceptibility alleles each of small effect

Systems:

abnormal information processing

Behavior:

complex functional interactions and emergent phenomena


Functional genomics in human brain

Risk allele/haplotype

how does it do it?

cognition

gene and protein expression

neuroimaging



Neuropathology

  • GOAL

  • To use postmortem human brains to discover the cellular and molecular mechanisms that lead to schizophrenia


Neuropathology brain collection
Neuropathology Brain Collection

  • Total number of brains = 861.

  • Number collected since last year = 359.

  • Clinical history ( phone screening, medical records, interviews with next of kin), neuropathology and toxicology screening yields:

    normal controls = 100; schizophrenics = 55.

  • Molecular biology screening (pH, in situ histochemistry hybridization, 28s/18s ratios and capillary electrophoretic analysis (Agilent) yields:

    normal controls = 86; schizophrenics = 39.



Low SES

Immigration

Urbanicity

Substance abuse

Poor cognitive performance

Other psychiatric disorder

Schizophrenia

Social withdrawal

Older father

Perinatal complications

Genetic predisposition


Acknowledgements

Special Thanks:

Dr. Daniel Weinberger

Dr. Joel Kleinman

Dr. Karen Berman

All the Principle Investigators and

Support Staff at the National Institute of Mental Health/NIH

Genes, Cognition, and Psychosis

Program (GCAP)

Clinical Brain Disorders Branch (CBDB)

CONSUMERS, FAMILIES, AND SUPPORTERS


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