I think this section is worth emphasizing - mental disorders are as unlikely to be due primarily to underlying genetic issues as getting an infectious disease is:
> "The oft-cited claim, for example, that schizophrenia has a genetic basis has failed to pass scientific muster. As Scull discusses, after failing to find a Mendelian set of genes that could explain schizophrenia, researchers in the 2000s pinned their hopes on new genome-wide association studies (GWAS) that could investigate hundreds of thousands of base pairs in the search for genetic linkages to psychiatric disorders. But GWAS studies have not revealed a clear genetic basis for schizophrenia (or bipolar disorder, for that matter). While combining hundreds of genetic sites can help explain, at best, 8 percent of the observed variance of schizophrenia, it is still possible for an individual to have many of these genetic variations without developing the disease."
There might be some influence - for example, someone born with genetic immunological defects is likely to be more susceptible to various infectious diseases, and there might be some kind of brain development issue that means that some people are less able to cope with high levels of stress, disappointment, trauma and so on - but the claim that this outcome is somehow ordained at birth is nonsensical.
All in all, the science of mental disorders today could be compared to the science of infectious disease in say, 1890 - they didn't have much in the way of understanding of core mechanisms, even if some approaches (surgical sterilization, rigorous post-operative hygiene, etc.) were being shown to reduce mortality.
Probably the most promising tools in this regard are the use of psychedelics under controlled settings to improve outcomes, but even here, the research is basically in its infancy due to the socio-governmental paranoia over these substances.
I do research in this area, and that paragraph is misleading. GWAS was a mistake from the beginning -- it was overhyped and ridiculously oversimplified from an analytic-design perspective. No one should have expected genes of major effect to emerge, and everyone generally agrees with this now. To me it's fine to point to GWAS as a major failure, but it's a major failure with academic systems and how research foci and funding occur, not with the idea of genetics in psychiatric phenomena in general.
What's more realistic to me -- and what I tried to get colleagues to do for years -- is a focus on polygenic risk, where numerous genes have small effect. This research has been more fruitful, but again, it's overhyped and oversimplified (the article mentions this too, briefly). The problem isn't with the idea of genetic influences on mental illness, especially severe mental illness, it's the way that academic research occurs in general.
The truth is, the most likely genetic explanation (which will only be a small part of the pie) -- the one that's been the case all along -- is some combination of polygenic influence, involving some complex cascade of genetic effects, along with very rare mutations occurring within single individuals or families. There's also probably lots about genetics and genetic expression we are totally wrong about in general.
I'm deeply sympathetic with the articles' arguments. Modern psychiatry has really lost its way and has neglected more psychosocial, systems-level explanations, along with things like chemical and microbiological exposures. I myself have written critiques of popular psychiatric genetic positions.
However, I think the underlying problems stem from wanting to shoehorn behavioral science into to some model where it doesn't fit. Typically this is physics or chemistry, or molecular biology. It's not that. It's kind of like that, but not the same. It's also kinda like economics, and kind of like infectious disease science, and kinda like computer science, but not quite like any of those things. But people want to oversimplify it nonetheless, and it becomes this all-or-nothing argument, between the "brainless" and "mindless", and you're not allowed to take some integrative position. Then you get into people in say, physics, complaining that because it's not that it's not scientific, which is also not true. There's just a lot of politics and pendulums swinging back and forth.
Combine this with academic fad-chasing and the funding nonsense that fuels that fire, and you have a recipe for disaster. It's like layers of people wanting to oversimplify things for attention, combined with some kind of narcissistic vulnerability with people wanting to prove they're "real scientists" or "real physicians" and in the end people with problems just end up becoming pawns in this political back-and-forth.
I'm happy to see these articles, but also a little frustrated because although their underlying arguments are on-point, they kind of end up perpetuating the same problems. Yes, part of the problem is that genes just aren't the end-all-be-all explanation for behavior. But part of the problem is we just don't know very much right now. So what will happen is the biopsychiatrists will retort with some new method or R-squared that refutes the specific points, but not the underlying message. And the process will just go round and round.
Some of this is maybe true of academics in general -- oversimplfying things to get attention -- but some of it is made worse by the field not having some consensual agreement that behavior is really complex and not likely to be reducible to anything simple.
I'd compare and contrast the state of the field to something like how modern molecular biology can produce an unambiguous diagnosis of drug-resistant tuberculosis in a patient and prescribe an effective course of treatment, relative to diagnosis and treatment of schizophrenia.
There's no unambiguous physical test for schizophrenia that I've ever heard of, it's just things like patients having auditory hallucinations and so on. There's no known mechanistic pathway (i.e. there's no known defective proteins that the genes express that somehow mess up the auditory pathway in the brain causing such hallucinations). It really sounds more like a mis-wiring-of-neurons type of thing that develops over time in the person, due to external pressures that they're unable to cope with.
Now with infectious disease, there is a great mystery still - out of a thousand people exposed to the same level of the same pathogen, some get sick and some don't. Some of this is explained by previous immunological exposure, but a lot isn't. Some of it is probably genetic in that one's in-born complement of immunological genes likely results in increased resistance or sensitivity to viral and bacterial proteins used to target cells.
What I'd guess here is that people just don't want to admit that mental illness is more of a social problem than a biological one, due to things like mass homelessness (which could cause schizophrenic breaks), poor parenting (which parents would rather blame on 'bad genes' rather than their own personal failures), etc. Of course, the same can be said of the prevalence of infectious disease due to poor public health regimes, contaminated food supplies, etc.
> "The oft-cited claim, for example, that schizophrenia has a genetic basis has failed to pass scientific muster. As Scull discusses, after failing to find a Mendelian set of genes that could explain schizophrenia, researchers in the 2000s pinned their hopes on new genome-wide association studies (GWAS) that could investigate hundreds of thousands of base pairs in the search for genetic linkages to psychiatric disorders. But GWAS studies have not revealed a clear genetic basis for schizophrenia (or bipolar disorder, for that matter). While combining hundreds of genetic sites can help explain, at best, 8 percent of the observed variance of schizophrenia, it is still possible for an individual to have many of these genetic variations without developing the disease."
There might be some influence - for example, someone born with genetic immunological defects is likely to be more susceptible to various infectious diseases, and there might be some kind of brain development issue that means that some people are less able to cope with high levels of stress, disappointment, trauma and so on - but the claim that this outcome is somehow ordained at birth is nonsensical.
All in all, the science of mental disorders today could be compared to the science of infectious disease in say, 1890 - they didn't have much in the way of understanding of core mechanisms, even if some approaches (surgical sterilization, rigorous post-operative hygiene, etc.) were being shown to reduce mortality.
Probably the most promising tools in this regard are the use of psychedelics under controlled settings to improve outcomes, but even here, the research is basically in its infancy due to the socio-governmental paranoia over these substances.