Schizophrenia is a severe mental disorder affecting approximately 1% of the world's population. Here, we report the results from a three-stage genomewide screen performed in a study sample from an internal isolate of Finland. An effort was made to identify genes predisposing for schizophrenia that are potentially enriched in this isolate, which has an exceptionally high lifetime risk for this trait. Ancestors of the local families with schizophrenia were traced back to the foundation of the population in the 17th century. This genealogical information was used as the basis for the study strategy, which involved screening for alleles shared among affected individuals originating from common ancestors. We found four chromosomal regions with markers revealing pairwise LOD scores>1.0: 1q32.2-q41 (Z(max)=3.82, dominant affecteds-only model), 4q31 (Z(max)=2. 74, dominant 90%-penetrance model), 9q21 (Z(max)=1.95, dominant 90%-penetrance model), and Xp11.4-p11.3 (Z(max)=2.01, recessive 90%-penetrance model). This finding suggests that there are several putative loci predisposing to schizophrenia, even in this isolate.

The purpose of this article is to describe patients' experiences of being helped during a period of psychiatric hospital care. Psychosis has traditionally been defined in medical and psychological terminology. The focus of psychiatric nursing is the human experience of distress associated with mental illness. The aim of psychiatric care is to promote healing and coping in daily life through support, validation and understanding. The main aim is to re-empower the patient with psychosis by using psychiatric care. The purposive sample consisted of interviews with nine voluntary patients recovering from psychosis. The interviewees told about their experiences of care. The verbatim transcripts were analysed using Giorgi's phenomenological method. Patients experienced care as helpful but unstructured: care facilitated their situation by alleviating the disorders, but it had not been defined by nurses, and the patients made their own conclusions about what care should be like. The care did not reach the inner world of the patients with psychosis. From the patients' point of view, care should protect them from vulnerability and empower/restructure their selves for coping in daily life.

This article describes how ethical guidelines have been applied while interviewing psychiatric patients who were recovering from mental illness, especially from psychosis, to allow nurses to understand these patients' experiences. Because psychiatric patients are vulnerable, their participation in research involves ethical dilemmas, such as voluntary consent, legal capacity to consent, freedom of choice, and sufficient knowledge and comprehension. The first part of this article describes the most important ethical guidelines concerning human research. These have been published by different organizations, departments, committees and commissions for the purpose of protecting human rights and dignity whenever research participants are vulnerable persons or their capacity to consent is limited. At present, however, no special regulations govern research involving adults who have been diagnosed with a condition characterized by mental impairment. Furthermore, a relatively small body of research has documented the effects of various disorders (e.g. psychiatric conditions) on decision-making capacity per se. One basic moral and policy question is whether these individuals should ever be involved in research. The second part of this article concentrates on how the investigator made sure that participating patients had understood their role in this particular piece of nursing research. During the interviews the investigator noticed that some ethical dilemmas required further study and debate because of the lack of consensus on the proposed regulatory provisions on research involving institutionalized persons and their ability to make an informed and voluntary decision.

Evidence gained from the experiences of health professionals in clinical practice is important and forms a basis for focusing next on producing research-based evidence regarding the effects of interventions. The benefits of the interventions we describe must be clearly demonstrated by comparison with usual treatment practices before applying them widely in clinical practice.