> There is a control group of people with schizophrenia who do not take medication. They are found in other nations, cultures and settings, and captured within international studies such as that conducted by WHO.

Yeah, I guess that is true. They aren't neuroimaged such that we can compare their neuroimaging with the neuroimaging of a bunch of people who are on neuroleptics though, are they? It would help our case if they had been...

> It has been repeatedly demonstrated that those individuals have a higher recovery rate.

Yes. We have no idea why, however. Some people say that it is due to the lack of medication. Some people say that it is due to the relative lack of social stigma. Some people say that it is due to a closer family structure.

We don't know whether ventricular enlargement occurs before schizophrenic symptoms (in the cases where people with schizophrenia do have ventricular enlargement) or whether the gradual progression of ventricular enlargement results in more severe symptoms over time (in the cases where people with schizophrenia are developing ventricular enlargement). We don't know whether the causes of the ventricular enlargement are due to a gene switching on or whether they are due to a neuro-degeneration in the brain or whether they are due to a loss of social supports or whether they are due to medication. We don't know whether the ventricular enlargement shrinks as people recover from schizophrenia or whether people recover despite ventricular enlargement.

Sure there have been some studies done... Most often the methodology is criticised (because most often the methodology isn't as rigerous as it should be and so the criticisms are fair). What is interesting is... Trying to find something of a consensus of what you would need to find that would persuade the sceptics of your hypothesis that your hypothesis is most likely to be correct. Design that study and hopefully it will be done one day... At present... Well... Studies often do come up with hopelessly contradictory findings for quite some time... That is the nature of science (and that is how come they change their opinions on such things as whether eggs are good for you).

> This is an indication that schizophrenia is not a degenerative brain disease -- a matter which has already been demonstrated as false through the work of individuals such as Courtenay Harding. Whether they also have larger or smaller ventricles is -- to me -- an irrelevant matter, since ventricle size itself is not an indication of schizophrenia.

It is an indication that schizophrenia is not a degenerative neurological disorder but it doesn't actually rule out the possibility that people recover from the behavioural symptoms of schizophrenia DESPITE ventricular enlargement. We simply don't know whether they have ventricular enlargement or not without neuro-imaging / autopsy.

I don't think that it has been falsified that schizophrenia is a degenerative neurological disease. In the sense that... I don't think that it has been falsified that mental illness is a neurological malfunction. I'm sceptical that it is but I haven't seen a knock down argument against it... Also... Failure to find a neurological abnormality doesn't at all entail that there isn't one there to be found...

The malfunction assumption is one of the framework assumptions of psychiatry. I suppose they are concerned about what would be left of their discipline if the malfunction assumption was shown to be false. That might well make them ignore some of the evidence that seems to support the notion that the malfunction assumption is false. Still... It might well be that there are facts that can ground psychiatry as a science that don't rely on the neurological malfunction assumption. Maybe mental disorders can be characterised as *cognitive* (or *mental*) disorders rather than *neurological* disorders. They have to be careful of encroachment from neurology too...

> Even if we were able to conduct neuroimaging studies on those groups of people, what would it tell us? If they did not have enlarged ventricles would it tell us that they did not have schizophrenia, or would it indicate that the use of neuroleptics produces a change in ventricle size?

If the neuroleptic group showed evidence of progressive neurological degeneration...
And the control group showed lack of neurological degeneration...
(I anticipate problems with how you figure 'degeneration' from 'maturation' or 'functioning okay' from 'abnormal')

Then on the assumption that the neuroleptic and control group were matched for severity and similar in all other relevant respects (which unfortunately is an assumption that has to be made...) then it would follow that if there was a statistically significant difference... Neuroleptics cause neurological degeneration.

If the individuals in the control group showed similar deterioration then that would be evidence that neuroleptics either don't cause deterioration (because the deterioration would likely have happened if the subject hadn't taken the medication). If the individuals in the control group showed less deterioration (but still a significant amound of it)... perhaps compared to neurological changes in a non mentally ill control group over time... then that would show that neuroleptics make the degeneration worse.

If the neurology between the control group and the neuroleptic group is relatively similar (that might be problematic) then it would be interesting to see whether neurological abnormalities found in the initial samples rectified (due to neural plasticity) as the people got better over time...

I dunno. The studies haven't been done... I'd be interested to know, however.

> If we wish to prove a correlation between the use of anti-psychotic medication and ventricle size the study might be useful...

It would show *causation*. Either support or disconfirmation of the hypothesis that 'neuroleptics cause ventricular enlargement' (where the relevant sense of 'cause' is comperable to the notion in 'smoking causes cancer' which is not at all to say that EVERY individual who smokes or who takes neuroleptics has the nasty consequences but just that enough of them do to support the causal claim. How strong the causation is... Would be shown by the study)...

> ...but if we wish to demonstrate that schizophrenia is not a progressive disorder of degeneration... that's already been demonstrated via the WHO study and numerous others.

They aren't studying the presence or absence of neurological degeneration. As such they seem to be silent on the issue. Perhaps one thing we might say is that... When people do deteriorate that is due to neurological deterioration. When people don't deteriorate that is because they have been misclassified as schizophrenic (ha!). That isn't a very satisfactory response in one sense, but it is fairly satisfactory in another. That is why it would be interesting to know what is going on (both behaviourally, neurologically, and cognitively) in individuals who have been diagnosed with schizophrenia over time...