Why psychiatrists need to keep up with technology

It may well be the case that for humans being fearful of spiders, insects, and heights is to some degree 'hardwired' in our brains as it gives us a survival edge. This is all well and good but it is striking that phobias don't really keep up to date. People are afraid of flying in planes but it is the sense of loss of control or being high up that they fear; they're not generally afraid of the aeroplane as an object. Few people have phobias about things that represent a risk in the modern world such as fatty foods, driving or cigarettes.  

 Eugen Bleuler who first introduced the term schizophrenia in 1908.

Eugen Bleuler who first introduced the term schizophrenia in 1908.

As part of my day job I work with people who have schizophrenia and in this condition the symptoms people report do change with the times. In this condition people experience hallucinations often hearing a voice. They also develop delusions. These are strong false beliefs that they can't be dissuaded of whatever evidence you give them. Unfortunately, these are often frightening or distressing.

There have been a number of studies looking at how the symptoms people experience in schizophrenia change over time and based on the social and technological changes in society. An interesting study (1) and book (see review in Time)  from a group in Slovenia looked at the changes over time and massive political and cultural change.

They found that patients reported delusions which had religious content much less once the Communist state was formed in 1941 but these returned in the 1980's with the end of communism. People rapidly introduced TV and Radio into their beliefs as they entered use. 

The same effect has been noted across the world as time and culture changes (2). It is a common finding that persecutory delusions -- the belief that others are against you -- have increased in the last few decades as countries become more industrialised; perhaps due to societies becoming more fragmented.

At one level this may seem simply an intellectually interesting observation, but it holds, I think, a more important message for those helping people with mental health problems: we have to be interested in and know something about a persons background and culture to help and understand them.

It also means as a psychiatrist who is getting older and more out of touch I'll have to make some attempt to keep up with modern technology, but I can rely on Andres and Richard for that!

(1) Psychopathology of Schizophrenia in Ljubljana (Slovenia) From 1881 To 2000: Changes in the Content of Delusions in Schizophrenia Patients Related To Various Sociopolitical, Technical and Scientific Changes, B. ŠkodlarM.Z. Dernovšek and M. Kocmur

International Journal of Social PsychiatryMarch 2008vol. 542: pp. 101-111.

(2) Delusion content across the 20th century in an American psychiatric hospital, Brooke J. Cannon and Lorraine Masinos Kramer

Int J Soc Psychiatry May 1, 2012 58323-327