Cause: Social Environment

A familial vulnerability to schizophrenia is agreed even though the exact genes involved seem elusive. But despite epidemiological evidence showing different rates of schizophrenia in sociocultural groups that would be considered genetically similar, the causal role of the environment is still hotly contested. Many service users, social scientists and clinicians are convinced that social factors cause schizophrenia and, therefore, that behavioural or environmental change might offer a more tangible route to prevention than gene manipulation. However, a comparison of the monies given to research into the genetics and the social aetiology of schizophrenia would suggest that funders of research are not convinced. For instance, the Medical Research Council, Wellcome Trust and UK Department of Health have launched Biobank, billed as the largest ever study of nature and nurture. The aim is to investigate complex interactions between genes, lifestyle and the environment. Half a million people between the ages of 45 and 69 will be asked to take part. Unfortunately, the generally earlier onset of schizophrenia will mean that it will be difficult to research in this illness. Would we have benefited from a Biobank for 16- to 25-year-olds?

Is there evidence that social factors cause schizophrenia and, if there is, does it negate or complement the theory that schizophrenia is a genetic illness? We asked Professor Jim van Os from Maastricht University, one of Europe's top social psychiatry researchers, and Professor Peter McGuffin, a psychiatrist and geneticist who heads the Social, Genetic and Developmental Psychiatry Research Centre at the Institute of Psychiatry, London, to debate the question: Can the social environment cause schizophrenia?

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