Skip to main content Accessibility help

Trajectories of psychosis: towards a new social biology of schizophrenia*

  • Glynn Harrison (a1)



Over the last 2 decades, discourse on the causes of schizophrenia was conducted almost entirely in terms of biological risk factors. This was probably the result of social trends in the research community, and in popular culture, as a wave of techno-optimism promised answers to big human questions in terms of small pixels and even smaller molecules. The human genome project inflated expectations further, and the pharmaceutical industry conspired with the desire of psychiatrists for scientific respectability. ‘Social factors’, whether at macro-societal or locality/family level, came to be seen as ‘fall-out’ from biological mechanisms, a kind of padding to our understanding of human disease. But changes are in the wind. New understandings of the influence of social factors on the long-term outcome trajectories of psychosis, their potential role in risks associated with migration, and recent findings from genetic high risk studies, are raising fresh questions about social factors and causation. This paper does not argue that the evidence (yet) is strong. But after 2 decades of often crudely articulated dualism, it is time once again for social experience to be integrated with more sophisticated theory development and hypothesis testing in the search for the causes of schizophrenia.

Declaration of Interest

the author has received payments from various pharmaceutical companies to deliver lectures and support travel costs to conferences.


Corresponding author

Address for correspondence: Professor G. Harrison, Division of Psychiatry, Cotham House, Cotham Hill, Bristol BS6 6JL (United Kingdom). E-mail:


Hide All

Paper presented at the VI National Congress of the Italian Society of Psychiatric Epidemiology (SIEP), held in Sirmione (BS), 6-8 November 2003.



Hide All
Barker, D.J.P. (1992) (Ed.). Fetal & Infant Origins of Adult Disease. Papers written by the Medical Research Council Environmental Epidemiology Unit London. British Medical Journal Books: London.
Barker, D.J.P.Forsén, T., Uutela, A., Osmond, C. & Eriksson, J.G. (2001). Size at birth and resilience to effects of poor living conditions in adult life: longitudinal study. British Medical Journal 323, 12731276.
Boydell, J.Van Os, J.McKenzie, K.Allardyce, J.Goel, R., McCreadie, R.G. & Murray, R.M. (2001). Incidence of schizophrenia in ethnic minorities in London: ecological study into interactions with environment. British Medical Journal 323, 13362001.
Carter, J.C. & Fairburn, C. (2002). Cognitive-behavioural self-help for binge eating disorder: a controlled effectiveness study. Journal of Consulting and Clinical Psychology 66, 616623.
Cormac, I., Jones, C, Campbell, C. & Silvera de Mota Neto, J. (2003). Cognitive behaviour therapy for schizophrenia (Cochrane Review). Cochrane Library, Issue 1.
Eaton, W. & Harrison, G. (2001). Life chances, life planning and schizophrenia: a review and interpretation of research on social deprivation. International Journal of Mental Health 30(1), 5881.
Eisenberg, L. (2004). Social psychiatry and the human genome: contextualising heritability. British Journal of Psychiatry 184, 101103.
Gilvarry, C.M., Walsh, E., Samele, C, Hutchinson, G., Mallett, R., Rabe-Hesketh, S., Fahy, T., Van Os, J. & Murray, R.M. (1999). Life events, ethnicity and perceptions of discrimination in patients with severe mental illness. Social Psychiatry and Psychiatric Epidemiology 34, 600608.
Harrison, G. & Eaton, W. (2002) Migration and the Social Epidemiology of Schizophrenia (ed. Häfner, H). Steinkopff Verlag: Darmstadt.
Harrison, G., Owens, D., Holton, A., Neilson, D. & Boot, D. (1988). A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine 18, 643657.
Harrison, G., Glazebrook, C, Brewin, J., Cantwell, R., Dalkin, T., Fox, R., Jones, P. & Medley, I. (1997). Increased incidence of psychotic disorders in African Caribbean migrants to the UK. Psychological Medicine 27, 799806.
Harrison, G., Hopper, K., Craig, T., Laska, E., Siegel, C, Wanderling, J., Dube, K.C., Ganev, K., Giel, R., an der Heiden, W., Holmberg, S.K., Janca, A., Lee, P.W.H., Leon, C, Malhotra, S., Marsella, A.J., Nakane, Y., Sartorius, N., Shen, Y., Skoda, C, Thara, R., Tsirkin, S.J., Varma, V., Walsh, D. & Wiersma, D. (2001). Recovery from psychotic illness: a 15 and 25 year follow-up study. British Journal of Psychiatry 178, 506517.
Hopper, K. & Wanderling, J. (2000). Revisiting the developed versus developing country distinction in course and outcome in schizophrenia: results from ISoS, the WHO Collaborative Follow-up project. Schizophrenia Bulletin 26(4), 835846.
Huang, Z.J., Kirkwood, A., Pizzoruss, O.T., Porciatti, V., Morales, B., Bear, M, Maffei, L. & Tongewaw, A.S. (1999). BDNF regulates the maturation of inhibition and the critical period of plasticitiy in mouse visual cortex. Cell 98, 789795.
Hutchinson, G., Takei, N., Bhugra, D., Fahey, T.A., Gilvarry, C, Mallett, R., Moran, P., Leff, J. & Murray, R.M. (1997). Increased rate of psychosis among African-Caribbeans in Britain is not due to an excess of pregnancy and birth complications. British Journal of Psychiatry 171, 145147.
Jablensky, A.N., Sartorius, N. & Ernberg, G. (1992). Schizophrenia: Manifestations, Incidence and Course in Different Cultures: a World Health Organisation 10-Country Study. Psychological Medicine, Monograph Supplement No. 20, pp. 197.
Knobbout, D.A.B., Ellenbrook, B.A. & Cools, A.R. (1996). The influence of social structure on social isolation in amphetamine-treated Java monkeys. Behavioural Pharmacology 7(5), 417429.
Maguire, E.A., Gaddian, D.G., Johnsrude, I.S., Good, C.D., Ashburner, J., Frackowiak, R.S.T. & Frith, C.D.. (2000). Navigation-related structural change in the hippocampi of taxi drivers. Proceedings of the National Academy of Sciences of the United States of America 97(8), 43984403.
Marmot, M. (2001). Aetiology of coronorary heart disease. British Medical Journal 323, 12611262.
Marmot, M.G., Smith, G.D., Stansfield, S., Patel, C, North, F., Head, J., Whtie, I., Brunner, E. & Feeney, A. (1991). Health inequalities among British Civil Servants: the Whitehall II Study. Lancet 337, 13871393.
Rosenthal, D. (1963). The Genain Quadruplets. Basic Books: New York.
Sharpley, M.S. & Peters, E.R. (1999). Ethnicity, class and schizotypy. Social Psychiatry and Pscyhiatric Epidemiology 34, 507512.
Sullivan, P.F., Kendler, K.S. & Neale, M.C. (2003). Schizophrenia as a complex trait. Evidence from a meta analysis of twin studies. Archives of General Psychiatry 60(12), 11871192.
Tienari, P., Wynne, L.C., Sorri, A., Lahti, I., Laksy, K., Moring, J., Naarala, M., Mieminen, P. & Wahlberg, K. (2004). Genotype-environment interaction in schizophrenia-spectrum disorder. Long term follow up study of Finnish adoptees. British Journal of Psychiatry 184, 216222.
Wahlberg, K., Wynne, L., Oja, H., Keskitalo, P., Pykalainen, L., Lahti, I., Moring, J., Naarala, M., Sorri, A., Seitamaa, M., Lasky, K., Kolasssa, J. & Tienari, P. (1997). Gene-environment interaction in vulnerability to schizophrenia: findings from the Finnish Adoptive Family Study in Schizophrenia. American Journal of Psychiatry 154, 355362.
Weinberger, D.R., Berman, K.F., Suddath, R. & Torrey, E.F. (1992). Evidence for a prefrontal-limbic network in schizophrenia: a magnetic resonance and regional cerebral blood flow study of discordant nonozygotic twins. American Journal of Pyschiatry 149, 890897.
Wolffe, A.P. & Matzke, M.A.. (1999). Epigenetics: regulation through repression. Science 286, 481486.


Trajectories of psychosis: towards a new social biology of schizophrenia*

  • Glynn Harrison (a1)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed