A few months ago someone forwarded to me an article about an interesting and potentially useful piece of research.   See http://ow.ly/4zUZw. Rusty Gage and his group at the Salk Institute had managed to make induced pluripotent stem cells from skin cells taken from a person with schizophrenia.  The hope is that, somehow, watching these cells, particularly after they differentiate into neurons, can provide some clues into the causes and nature of schizophrenia, a truly terrible disease.  And their paper, in the May 12, 2011 issue of Nature, reported some evidence that neurons made from those cells behaved abnormally.

So far, so good.  So why am I writing this post?    Because of the headline in the news story –

Schizophrenic Brain Cells Created in a Lab

What does it mean to say that a brain cell, in a Petri dish, is “schizophrenic”?  The DSM IV-TR requires that the three following criteria be met before diagnosing schizophrenia:

1.            Characteristic symptoms: Two or more of the following, each present for much of the time during a one-month period (or less, if symptoms remitted with treatment).

1. • Delusions
   • Hallucinations
   • Disorganized speech, which is a manifestation of formal thought disorder
   • Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
   • Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation)

If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other, only that symptom is required above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.

2.            Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care, are markedly below the level achieved prior to the onset.

3.            Significant duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if symptoms remitted with treatment).

So which of those criteria do these stem cells meet?  Are they delusional?  Do they dress inappropriately?  Are they socially dysfunctional?

Cells don’t have schizophrenia. There are, as far as I know, exactly zero types of brain cells found only in the brains of schizophrenics and not in the brains of non-schizophrenics.  We don’t even know whether there is anything different about the individual brain cells of people who have schizophrenia – that’s a useful thing for this research to explore.

I wonder whether I’m making too much of this, but this story bothers me.  It bothers me because it is wrong.  It bothers me because it is dumb.  And it bothers me because it reinforces for the already too susceptible public a mindless reductionism – disease X is a product of an X gene, or an X cell, or some other X factor.  But it also bothers me because I wonder whether sometimes, when I’m in a hurry, I commit similar errors.

We need to hold journalists to high standards of accuracy.  Yes, they cannot include every reservation, limitation, or qualification in their stories, but they need to get the main points.  But we need to hold ourselves to an even higher standard.  Let it not be said, as Pogo (for you “non-old” readers, Pogo was a Pleistocene era comic strip) said long ago:  “We have met the enemy and he is us.”

Hank Greely