Twitter is for observations and speculation right? And getting comments on your ideas. So here we go. Working in a forensic psychiatry service, plenty of our inpatients have a diagnosis of schizophrenia. During this pandemic, our service has reduced leave

to that point that now for 3 weeks noone has had leave outside the unit. Many of the patients I know are spending most of their day in their rooms doing little, just out for meals. They are following social distancing rules to the nth degree. They are not complaining.

Are they doing this because they are generally highly compliant? – well it’s a forensic service, so think a bit. In truth, this is what some people with schizophrenia will do if left to themselves; a lot of psychiatry is about encouraging patients to be more active.

But in this current environment, the behaviours are very sensible. Those patients have a group of behaviours that reliably reduce their risk of infection and they don’t need to consciously activate them (unlike hand washing say). They are far less likely to get infected than me

or my colleagues who still do plenty of social interaction with our work. I wear PPE on the ward as I am a risk to patients. Being blunt they are more likely to survive this pandemic than staff.

That’s the observation. Now standing back a bit; it is generally accepted that genetics plays a major part in the development of schizophrenia. Twin and adoption studies have shown this repeatedly This post is not about the causes of schizophrenia

and does not mean environmental factors are unimportant of course. Just that if you think genetics has no role, then don’t waste your time reading this. One question has always been how can genes that lead to such a serious illness survive in the population?

How can having these genes help anyone live and reproduce? Pandemics like this one are not new in history, they have occurred repeatedly. A group of genes that generate behaviour patterns that reduce infection risk, would be likely to expand in the population during a pandemic.

So could schizophrenia have evolved as a way of surviving pandemics ?

There will be I know be many flaws in this logic