I hope readers of the thread have found my comments to be helpful.
I will elaborate on my previous post with additional insights that have occurred to me.
Number 1: Polygenics of Schizophrenia
Being able to access full genome polygenic scores for a range of human traits is a game changer. This is all the more true in schizophrenia as the onset is
typically at a fairly early age and people are often entirely unprepared. Personally I was at a complete loss to explain what was happening to me --
Even a few months before onset, I had no idea what was about to happen. That's how medical problems have always been for us -- something would go wrong -- we would all
load up into the minivan and rush on the freeway to the nearest mega-hospital's ER. This is not the most economically or medically efficient way to cope with medical
crises, though it has not been overly obvious to us how else to approach them.
However, now with our full genome of polygenic scores with hundreds of polygenic scores all of our medical issues have been revealed to us.
We will already know what is wrong before the emergency happens and can plan so that we will never have medical emergencies again. We have already spent
countless years researching the most relevant of our medical problems. In the past, medical emergencies made health care very demand inelastic for us -- You have
a medical problem? Hand over your wallet! With current genetic technology this logic is rapidly evolving more to the point of us haggling over price perhaps years before we
even need medical services. This type of logic now applies to the most expensive aspects of our medical needs involving chronic type illnesses.
One might guess that if I had been genotyped at birth with a comprehensive psychchip that knowing my genetic risk for schizophrenia would have been extremely useful for
my parents to chart my future. If I had been told 10 years ahead of onset, then I could have been extremely well-prepared for what would happen. 10 years of extensive research could
have made me a near expert in schizophrenia. Having 20 years notice before any symptoms emerged would offer a truly massive advantage. We could have consulted with leading schizophrenia
experts -- if necessary we could have been pre-prescribed anti-psychotics so they were right on the shelf waiting for use-- perhaps we could have used an online app that could identify
the very earliest sign of positive symptoms and take immediate corrective action -- possibly we could have enlisted the community to help us spot very slight signs of onset -- possibly have
pre-arranged a leave of absence from school/work when symptoms emerged. My suspicion is that using these strategies and possibly others, onset would be detected within days and decline
into some minimally functioning state would not occur. As it was, we never were given an explicit schizophrenia diagnosis (that was only revealed with the polygenic scores) and at best all of us
only had a vague general kindergarten level concept of what the illness might be like. With years of pre-warning we could have studied multiple 1,000 page textbooks on schizophrenia.
However, this level of preparation is still not how schizophrenia management is described even in modern abnormal psych textbooks. Instead they still speak of the typical patients as usually a student (perhaps last year of
high school or first year of college) who has been in psychological decline -- often for months -- and then there is some sort of psychiatric emergency and then a rush in a mini-van to the nearest
mega-hospital's ER. The close family usually are the last to know and they often have no idea how to cope with a diagnosis of their children. That is roughly my memory. It was then a great mystery for friends
and family and the community for what was happening. Getting the family involved at birth reasonably would make a profound difference.
Notably one of the important considerations here is that polygenic transmission will not run true over generations. If it were a simple matter of inheriting a dominant trait, then at least one of the parents
would have already experienced the same phenotypic schizophrenia so would have developed a lifetime of coping skills. Yet, with polygenic transmission it is no longer as clear whether either parent had
ever been at clinical risk. There might then be a void of coping strategies. Even if there were family history it is not entirely clear whether this knowledge would be offered to the children. With my family I am
very unclear about the level of understanding of the illness -- from what I have observed there was near total anosognosia. Anosognosia seems almost uniquely diagnostic for schizophrenic illness.
Also with an especially weird type of illness as schizophrenia the type of assortative mating that will ensue largely guarantees that it will not be simple uncomplicated schizophrenia. There will probably be
multiple other behavioral phenotypes involved. That was true for me. My scans reported roughly 4-5 other traits that combine with the schizophrenia. My assessment is that the schizophrenia is probably the least
of my worries -- it has been silent for many years.
Number 2: Embryo Selection?
The above discussion does suggest that an even more powerful approach to schizophrenia management would be to simply continue with polygenic selection even before birth. One might imagine
an initial round of genetic screening of mates and then a round of embryo selection. Such selection would rapidly remove all human genetic illness and problematic traits in a single generation.
However, I am not sure whether I would accept such use of genetic technology. There is this simple mindedness of such a plan that avoids a range of possible problems that could arise in a near
clonal population. It does nonetheless highlight how important it is that we soon effectively resolve problems such as schizophrenia -- if this is not done soon then we will soon have a future clone
world with all of the risks that this could entail.
Edited by mag1, 19 September 2024 - 01:45 AM.
