VOL 14, NO 2,1988 231 Schizophrenia and Multiple Sclerosis

of onset, geographical distribution, and immunological responses of patients with schizophrenia and multiple sclerosis (MS) suggest that these two common illnesses of young adults may belong to a similar class of disorders. This review examines some of the sim-ilarities and differences between these two disorders and suggests that epidemiological, immunologi-cal, and viral studies considered useful in the investigation of causal factors in multiple sclerosis may also be pertinent to the search for causes of schizophrenia. The past several years have seen a resurgence of interest in schizo-phrenia as a disorder of the brain. Computerized tomographic (CT) studies have shown relative en-largement of the third and lateral ventricles of 15-20 percent of patients with a diagnosis of schizo-phrenia compared with controls (Johnstone et al. 1976; Weinberger et al. 1979; Boronow et al. 1985). Post-mortem measurements of subcortical nuclei show diminished size of hippocampus, amygdala, parahippocampal gyrus, globus pallidus, or periventricular nuclei in a significant percentage of studied cases compared with controls (Lesch and Bogerts 1984; Bogerts et al. 1985). Gliosis and nerve cell loss in diencephalon, limbic system, and basal ganglia have been described (Nieto and Escobar 1972; Stevens 1982). These data support-ing morphological pathology in schizophrenia have stimulated the search for biological causes of this common and disabling psychosis. There are a number of similari-ties between schizophrenia and multiple sclerosis (MS) that suggest that schizophrenia as well as MS may have an infectious or immuno-logical etiology. Both disorders are characterized by onset in early adult life, and by progressive or remitting-exacerbating course with gradual increase in disability in many cases and spontaneous re-mission in others. Although schizo-phrenia and MS are pathologically and clinically very distinct dis-orders, some formal similarities of clinical course, epidemiology, and immune response suggest that both disorders may belong to a class of disturbances characterized by initial or persistent viral infec-tion that can be followed by altered response of the immune system