Letters; July 2008; Scientific American Magazine; by Staff Editor; 2 Page(s)

In ¿White Matter Matters,¿ R. Douglas Fields reports that myelination problems are implicated in schizophrenia. Certain studies have found that the long-term outcome for schizophrenia patients is better in developing countries than in developed ones. Because myelin formation continues into one¿s 20s and is affected by experience, is it possible that an enriched living situation could help such patients recover some impaired myelin? Or that psychiatric drugs (less available in developing countries) blunt neuronal activity that could assist further myelination?

FIELDS REPLIES: The parallel between schizophrenia recovery rates and reliance on medication in developing and developed countries is interesting and may offer practical insights. But schizophrenia is a complex disorder that has both genetic and environmental components, making it difficult to conclude that either one¿s drug therapy or living situation provides a superior approach to treatment.