In 1957 Rhoda Torrey was about to enter her freshman year of college when
she experienced what her mother termed a "nervous breakdown."
Fifty years later, Rhoda Torrey is hospitalized again, now in New York's
Mohawk Valley State Psychiatric Institute.
In the intervening years, her brother Fuller Torrey, M.D., moved by Rhoda's
illness and puzzled by the explanations doctors in the late 1950s offered the
family, would pursue a career as a psychiatric clinician, researcher, and
fierce advocate for treating schizophrenia as a neurobiological illness.
In a spate of widely read books, such as his 1982 Surviving
Schizophrenia, Torrey challenged the prevailing theories that blamed
families and parents and offered a different narrative based on emerging
evidence that schizophrenia is a disease of the brain.
In part because of Torrey's influence, the notion that schizophrenia is
caused by bad parenting now seems as archaic as bloodletting.
"Things are obviously very different today, but in my era it had an
extremely toxic effect on my mother, who tended to accept what authorities
told her," Torrey told Psychiatric News.
As a scientist at the National Instittue of Mental Health (NIMH), and later
at the Stanley Medical Research Institute and in his own independent research,
Torrey has been one of the foremost proponents of an infectious etiology for
schizophrenia. While not yet embraced by the mainstream, the infectious
hypothesis is no longer a concept on the
Fuller Torrey, M.D.: "In my most unguarded moments, I like to
think I will live long enough to see vaccines to prevent many or most cases of
Credit: Clay Blackmore
Today, he is associate director for laboratory research at the Stanley
Medical Research Institute (he was executive director until 2003) and
president of the Treatment Advocacy Center, an organization that advocates for
laws permitting involuntary treatment of patients with severe mental
"Fuller gets as much credit as anyone for moving American psychiatry
from a psychoanalytic foundation to a biological one," said APA Trustee
Roger Peele, M.D., who was chair of the department of psychiatry at St.
Elizabeths Hospital in Washington, D.C., and hired Torrey as a staff
psychiatrist in 1977.
"His provocative books and his plausible, although yet to be proven,
concept as to the cause of schizophrenia contributed to a focus on the
biological. His call for change was markedly enhanced by not remaining
academic. He is combative—when public agency chiefs heard he was due to
be on national TV, they ran to their bunkers—and he has used pithy
public pronouncements to hammer home the need for public research monies to be
devoted to a biological understanding of people with the most disabling of
As early as fourth grade, Torrey said, he had a "life plan" to
be a doctor, expecting to be a small-town practitioner like those he knew in
the upstate New York town where he was raised. By his teens he was determined
also to spend time as a doctor in third-world countries.
So after medical school at McGill University, he spent two years in
Ethiopia serving as staff physician to 600 Peace Corps volunteers and
developing preventive health programs for the local population. By that time,
his sister was very ill, and he had already taken an interest in psychiatry;
when he returned to the United States, he entered a psychiatry residency at
"I was also leaning toward pediatrics, but as I became more aware of
how much was not known about the brain, it just seemed like the last
frontier," Torrey said. "When I was in medical school [physicians]
were starting to do open-heart surgery. I thought, 'Well, it's an interesting
pump, but that's all it is.' Whereas the brain is this enormously complex
organ, and remarkably little is known about it."
At McGill and later at Stanford, he was exposed to a biological approach to
mental illness; he recalls that a first-year instructor at McGill, Hans
Lehman, M.D., was known as the first clinician in North America to use
chlorpromazine. The medical school was housed next door to the Montreal
Neurological Institute, a premier neuroscience center.
But Torrey concedes that his antipathy toward nonbiological explanations
stems from the experience of his sister's illness.
"Schizophrenia is a terrible disease to have, as bad as any disease
we know of, and it's a huge burden to bear for families," he said."
To have on top of that the burden of being told you caused it is almost
Torrey worked as a staff psychiatrist at St. Elizabeths for nine years.
Peele recalled that Torrey worked with the most challenging patients and
established a goal of using no seclusion or restraints on acute admission
units two decades before it became the nation's goal.
Although he had been publishing papers on various topics since completing
medical school, it was not until after he left St. Elizabeths that he began to
think of himself as a researcher. He became principal investigator of NIMH's
Schizophrenia/Bipolar Disorder Twin Study, and he and colleagues produced more
than a dozen publications showing differences in crucial brain structures
between affected and unaffected siblings in twin pairs.
Among those was a 1990 article in the New England Journal of
Medicine demonstrating that subtle neuroanatomical
differences—namely, small anterior hippocampi and enlarged lateral and
third ventricles—are consistent neuropathologic features of
All the while, Torrey had been fascinated by the possibility that
schizophrenia had an infectious origin. As early as 1973 he published an
article in Lancet on the topic, "Slow and Latent Viruses in
Schizophrenia" (July 7, 1973).
He was drawn especially to the work of the late British psychiatric
epidemiologist, Edward Hare, M.D. Writing in the 1970s and 1980s, Hare was
interested in what he believed was a real increase in the incidence of
psychosis in the 19th and 20th centuries (as opposed to an increase in
diagnosis, as others have held), a fact that he believed precluded a merely
In addition, Hare had documented a marked increase in late-winter and
early-spring births among people with schizophrenia. Along with the evidence
for increasing incidence, this pointed to an infection, possibly acquired
during winter months in utero.
"I started doing those studies here and replicated the same seasonal
variation," Torrey said. "I began to think that this is a really
odd disease if you are only thinking of genes or bad mothers."
Since the 1970s, Torrey has published more than 30 articles on seasonal
variation and possible infectious causes of schizophrenia, focusing especially
on the feline parasite Toxoplasma gondii. He credits Robert Yolken,
M.D., a professor of neurovirology and infectious disease at Johns Hopkins
University School of Medicine—with whom he has collaborated on many
studies—as indispensable to advancing the infectious hypothesis.
In a recent meta-analysis of 42 studies on antibodies to Toxoplasma
gondii in patients with schizophrenia carried out in 17 countries over 50
years, Torrey and colleagues found a significant increase in the presence of
antibodies among patients.
The report, "Antibodies to Toxoplasma Gondii in Patients
With Schizophrenia: A Meta-Analysis," was published in the November 2006
"Until about seven years ago, the infectious hypothesis was
considered far out," Torrey said. "While it's not mainstream now,
it has become at least respectable."
A critical development, he said, was the discovery that Helicobacter
pylori was a major cause of peptic ulcers. "This had a profound
effect," Torrey said. "If ulcers can be caused by infectious
agents, then who knows what else can be caused by infectious
The more recently discovered "prion diseases," such as the
so-called "mad cow" disease, that are infectious in nature and
remain latent in the brain for many years seem to fit well with the typical
pattern of schizophrenia.
Torrey believes the infectious hypothesis will someday be shown to explain
the "vast majority" of schizophrenia cases.
"The infectious hypothesis is remarkably compatible with existing
theories," Torrey said. "There are genetic antecedents to many
infectious agents, so it is likely that someone genetically predisposed to
schizophrenia would be more severely affected by an infectious agent.
"And it is entirely compatible with neurodevelopmental theories since
we believe the majority of cases are caused by infectious agents that get in
the brain in early childhood or in utero and remain latent until
If Torrey is right that the disease has an infectious cause, then it is
reasonable to assume that a vaccine could someday be preventative.
"There are currently ongoing five or six studies using
anti-Toxoplasmosa gondii agents as an add-on treatment for
schizophrenia," he said. "In my most unguarded moments, I like to
think I will live long enough to see vaccines to prevent many or most cases of
Meanwhile, the person with schizophrenia Torrey knows best survives as a
reminder of the toll the disease takes on a life. Though she lived for 10
years in group housing in the community, Rhoda Torrey has spent much of the
past five decades as an inpatient.
"She is on the most severely affected end of the spectrum, especially
for women," Torrey told Psychiatric News. "It will be 50
years this fall since she first became sick, and she is still anything but
In a 1992 article titled "Remembrance of Psychosis Past" in the
Journal of the California Alliance for the Mentally Ill, Torrey
described the shadow the illness cast on the family and the intimation it
leant him that the brain—no less than the heart or the lungs or the
eyes—is an organ at the mercy of a capricious nature.
"Since the illness has always seemed to be a purely random event,
like most other diseases, it has given me an appreciation of the transitory
nature of health and the vulnerability of our brains," he wrote."
Except for chance, I could just as easily have spent 25 years in a
state psychiatric hospital."
An abstract of Torrey's 1990 article, "Anatomical Abnormalities in the Brains
of Monozygotic Twins Discordant for Schizophrenia," is posted at<http://content.nejm.org/cgi/content/abstract/322/12/789>.
An abstract of "Antibodies to Toxoplasma Gondii in Patients With Schizophrenia: A
Meta-Analysis" is posted at<http://schizophreniabulletin.oxfordjournals.org/cgi/content/abstract/33/3/729>.▪