question: does Nigerian President Goodluck Ebele Jonathan have a mental problem?

a research study by Marian Iyabode Awolowo., May 2012

My friend Kemi Martin status makes me worry for Nigeria. She must have been deep in thought for asking this important question.

"Is there a Possibility that the President of Nigeria is mentally ill? Is there anything in the DSM IV criteria that matches the pattern of decision making, utterances and general posture that the President has exhibited since taking office? Experts should please check" By Kemi Martins

Good morning Kemi Martins. " According to the World Health Organisation, one in a hundred people will develop schizophrenia at some point during their life. It more commonly affects younger people (during the transition into adulthood) and it affects both males and females, although it tends to affect males at a younger age, more severely and more commonly (Aleman et al., 2003). Schizophrenia is characterised by a number of different symptoms including delusions, hallucinations, disorganised speech patterns, disorganised or catatonic behaviour and withdrawal from normal social activities and behaviours. According to the DSM-IV TR, at least two of these symptoms need to be present for a period of over one month in order for a diagnosis to be made. There are also a number of subtypes e.g. paranoid type schizophrenia which is characterised by a preoccupation with delusional thoughts and prominent auditory hallucinations.

In recent times, there have been debates over whether we should consider schizophrenia as a disease. A disease can be defined as a disturbance in the normal functioning of the body which has a specific cause and has identifiable symptoms (Pescosolido, 2010). For years researchers have tried to apply a definition such as this to schizophrenia by searching for its cause. Some identified symptoms of schizophrenia are similar to those experienced during drug use (e.g. LSD). This led researchers to believe that there was a biochemical component in understanding the cause of schizophrenia. (Wong et al., 1986) found during an autopsy of a patient who suffered from schizophrenia that there was an excess in the number of dopamine receptors. It was therefore concluded that drugs which block the excess dopamine receptors would reduce the symptoms of schizophrenia – this became known as the dopamine hypothesis. However, although these drugs do alleviate some symptoms, they were ineffective at treating the negative symptoms such as withdrawal. More recently, researchers are attempting to find other biochemical imbalances which may account for the symptoms such as glutamate (Javitt and Coyle, 2004).

Another avenue of research which has been pursued is that schizophrenia may have a genetic component. Evidence in support has come from the twin studies where Plomin et al. (1997) found that the chance of an identical twin developing schizophrenia if the other had already been diagnosed with it was one in two. This finding persisted even if the twins had been raised separately, thus eliminating environmental factors. Adoption studies have also found that people are more likely to develop schizophrenia if they have a biological parent with a diagnosis (e.g. Gottesman, 1991). This was not true of adoptive parents, further confirming the genetic link of schizophrenia.

Despite the commonly held belief that schizophrenia was a disease and the research which supported it, there was a huge movement in the sixties which claimed that schizophrenia should not be considered a disease and the whole concept of mental health problems need to be rethought. This movement became known as the anti-psychiatry movement and a key proponent of it was Laing. Laing (1990) makes the revolutionary suggestion that the behaviour of people labelled schizophrenic can be completely understood without resorting to considering it a disease. One of Laing’s arguments against schizophrenia being a disease is that if the time is taken to properly study the behaviour of those suffering from schizophrenia, it can be seen that their behaviour can be explained in terms of beliefs and desires. Reznek (1991), a keen supporter of psychiatry and heavy critic of Laing argues against this notion. He claims that even though the behaviour of a person may be explained in terms of their beliefs and desires, these explanations would be made on an ad hoc basis. Additionally, these desires and beliefs themselves may be the product of the disease.

Another argument used by Laing is that with careful analysis, the apparently unintelligible speech of those suffering from schizophrenia can be understood as being perfectly rational. Laing claims that schizophrenics generally talk in a roundabout way and so their utterances can only be fully understood in the correct context. For example, when patients are questioned by medical professionals in an unnatural surrounding then it is only rational for them to behave in the way that they do. The crux of this is that they are simply reacting to an insane society where the only rational response is to behave apparently insane. Laing claims to have studied in depth the lives of over a hundred of people with diagnoses of schizophrenia and came to the conclusion that schizophrenic behaviour was simply a direct reaction to a disturbing family situation. Rather than considering schizophrenia a disease, it should be thought of as a coping mechanism. This could also tie in with the previously mentioned research: rather than schizophrenia being hereditary, the coping mechanism is passed on genetically. However, as pointed out by Reznek (1991), Laing fails to provide any empirical data for the notion that schizophrenia is caused by abnormal family situations and he doesn’t show that schizophrenic behaviour is a consciously made decision rather than an involuntary reaction to the stressors. Reznek also claims that the analysis of schizophrenic speech is simply a Langian invention.

Based on the two arguments, it is viable for me as a student of psychology to support Reznek arguments in that his (Reznek) contemporary research provides further evidence that schizophrenia has a biological basis. More so, modern brain imaging techniques such as MRI and CT have shown that the grey matter in the brains of people with schizophrenia is 25% less in volume than normal. This is most noticeable in the frontal lobes which are known to be important in thinking and judgement making. Those patients who show the most deviation from normal generally have the more severe symptoms (Thompson et al., 2001).

Although these findings do appear to strengthen schizophrenia as a disease, I do concur that there is still the problem of the unreliability of diagnosis and the cultural relativity of diagnosis (Jablensky, 1987; 1999). Ultimately, the evidence suggests that schizophrenia is in fact a disease although more work still needs to be done in developing more specific criteria for a better diagnosis. It is also crucial that once diagnoses are established, then care programme approach needs to be planned in other to support the patients in managing their antipsychotics drugs, organising three monthly social, health and medical reviews and promoting family intervention so that patients don’t live in isolation. This should be a matter of choice to patients which would be supported by intervention from the community care team."

culled from ‘Is schizophrenia a disease?’ a research study by Marian Iyabode Awolowo., May 2012

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