Psychosis
awareness campaigns benefit first-time sufferers
This recent study
confirms what common sense would tell you - that if you
have public education programs on schizophrenia, people
get treated sooner, with better results for the people who
get schizophrenia.
The research
paper (from Sweden) suggested: "The introduction of
public awareness campaigns about psychotic illnesses, such
as schizophrenia, may encourage people experiencing their
first symptoms of such disorders to seek treatment sooner,
results of a Scandinavian study suggest.
The research
team, led by Dr Ingrid Melle from Ullevaal University Hospital,
Oslo, Norway, says that the time between the onset of psychotic
symptoms and the start of treatment can vary considerably
in people experiencing these symptoms for the first time.
They add that a delay of months or years can have a serious
negative effect on social, occupational and personal functioning."
Source: Journal
of the American Medical Association, Feb. 3, 04
In Canada they've
even started showing advertisements on TV as a public service,
to educate people about schizophrenia, and they have web
sites focused on this issue - see www.psychosissucks.ca
These efforts
are working. I hope we'll see more of it in other countries
- and by educating the public about brain diseases you simultaneously
reduce stigma and educate people about one of the key reasons
why homelessness is so common in the USA, despite its relative
wealth.
The
Roots of Mental Illness
A special report
has been published by the New York Academy of Sciences -
on "The Roots of Mental Illness in Children"
This is a very
technical report (for scientists) but interesting to review
if you want to get deep into the causes of mental illness.
Some short highlights from some of the abstracts include:
"As complications
of pregnancy and birth may be important risk factors for
the development of schizophrenia, studying the "roots"
of schizophrenia in high-risk offspring may better elucidate
the interface between biology, environment, and susceptibility
to illness. Using magnetic resonance imaging (MRI), neurobehavioral
assessments and obstetric histories, we found several significant
correlations between these multiple factors"
In another paper
it was found that "Premature birth can have devastating
effects on brain development and long-term functional outcome.
Rates of psychiatric illness and learning difficulties are
high, and intelligence on average is lower than population
means. Brain imaging studies of infants born prematurely
have demonstrated reduced volumes of parietal and sensorimotor
cortical gray matter regions."
Souce: http://www.annalsnyas.org/content/vol1008/issue1/index.shtml?etoc
Genes and
Environment interaction in schizophrenia
An article in
this month's British Journal of Psychiatry suggests that
"Within schizophrenia-and related disorders, it is
demonstrated that adopted-away offspring of mothers with
schizophrenia-spectrum disorder are significantly more sensitive
to an adverse family rearing pattern than the adoptees of
healthy mothers ."
The study suggests
the protective effect of being reared in a healthy adoptive
family, with the risk for these high-genetic-risk adoptees
developing schizophrenia in healthy families at 1.49% compared
with 13% for those reared in "dysfunctional" families.
This lends significant support to the stress and hereditary
predisposition model of the cause of schizophrenia, in which
environmental stressors have a particularly harmful impact
only on individuals with a genetic vulnerability.
This suggests
families with histories of schizophrenia (that is, where
a person in the family has - in the past - gotten schizophrenia)
that by being more careful in term of family communication
(focusing on lower stress means of communication) that the
incidence of developing schizophrenia could be reduced.
Source: British
Journal of Psychiatry - see:
http://www.schizophrenia.com/prevent2.htm#stress1
Schizophrenia Intervention for
Relapse and High Expressed Emotion
Researchers have
found that costs for patients with schizophrenia who experienced
relapse are up to 400% higher than for a non-relapse group.
The authors suggest that implementing effective relapse
prevention programmes, even if expensive, may reduce the
overall financial cost of treatment as well as improving
overall outcome. Raune et al (pp. 321–326) found that
43% of carers of patients with first-episode psychosis had
high levels of expressed emotion.
(NOTE: Expressed
Emotion is defined to include Frequent Critical attitudes:
Statements of dislike, annoyance, or resentment with accompanying
negative voice tone.)
Although high
expressed emotion was not associated with patient illness
characteristics, it was linked to high levels of burden,
avoidant coping styles and lower perceived patient interpersonal
functioning. It is suggested that cognitive–behavioural
approaches targeting carers’ appraisals may be particularly
important in reducing high expressed emotion in early intervention
services.
Cognitive Therapy
may Reduce Command Hallucinations
Cognitive therapy
for command hallucinations administered to ‘high-risk’
patients resulted in large and significant reductions in
compliance with voices. Using a case–control design
v. treatment as usual, Trower et al (pp. 312–320) also
observed improvements in the degree of conviction in the
power of voices and the need to comply, and in the levels
of distress and depression. Although a small study with
the problems of the control condition, it suggests promising
clinical results that are durable and definitely worthy
of further study using a randomised controlled design.
Source: British
Journal of Psychiatry, (Issue (2004) 184: A15 )
Personal
Stories of Managing Schizophrenia - A very good audio recording of
four people's stories of their successes in fighting schizophrenia.
Four Lives - we
highly recommend this internet-based audio program about 4 people
who suffer from mental illness (two of the people featured have schizophrenia/schizoaffective
disorder). In fact our own Pamela Wagner is interviewed here. Many
people are familiare with Pamela through her blog on schizophrenia.com
(see Wagblog) and excellent writing that have been featured here in
the newsletter before.
http://www.lcmedia.com/mind317.htm
In this special presentation
by The Infinite Mind (a production of Lichtenstein Creative Media)
are the stories of four people dealing with mental illness today,
whose extraordinary lives and work offer hope and inspiration to all
of us.
Included on the program
are Texas State Representative Garnet Coleman, a champion of healthcare
reform and mental health issues who also has manic-depressive illness;
Meera Popkin, a professional musical theatre actress who has appeared
on Broadway and in London's West End, who was diagnosed with schizophrenia;
and twin sisters Pam Wagner and Carolyn Spiro, who have written a
book about Pam's struggle with schizoaffective disorder and how that
has affected their relationship. Carolyn herself is a psychiatrist
trained at Harvard Medical School.
Dartmouth
Student Creates On-Campus Support Group for People with Mental Illnesses
like Schizophrenia
The following article about
university support groups is an idea that we think is a great one
- in fact we'd like to see a major push for college mental illness
support groups in colleges and Universities around the world - because
of the importance of early treatment in positive outcomes for schizophrenia,
and because the first signs of schizophrenia usually show up during
college years or shortly afterward.
It seems like this should
be a major area of focus for support groups (like Schizophrenia Society
of Canada, and NAMI in the US) over the coming years - groups for
both the mentally ill, and their siblings. Or perhaps these groups
should simply share a lot of information and resources so that they
can help each other help people.
The article states:
"A new chapter of
the national student mental health group, Active Minds, may soon be
meeting at Dartmouth. Having met with the Harvard chapter of the organization,
Joanne Kim '05 now intends to bring Active Minds to Hanover.
Kim was already volunteering
as a Sexual Abuse Peer Advisor and a volunteer at the Dartmouth-Hitchcock
psychiatric ward when she attended a meeting of the Harvard chapter
over Winter break.
When she returned to campus
and witnessed some peers dealing with mental health issues, Kim decided
an advocacy group would provide beneficial support network, complementing
the services already provided at Dartmouth, she said.
"Many disorders like
schizophrenia and depression emerge around college age," she
added. "With the formation of Active Minds, people who haven't
been introduced to psychology yet can get a safe place to be open
about their experiences and form alliances."
The group is even considering
hosting events on campus to raise awareness. One possiblity cited
is bringing Andy Berman to campus to speak about his best-selling
"Electro Boy," a memoir on bipolar disorder that will be
turned into a movie starring Tobey Maguire.
It seems that these groups
are already starting to spring up around the US - here are some of
their web pages:
The Main Organization or
Focal point for these groups seems to be:
http://www.activemindsoncampus.org/
The Full List of Chapters
can be seen at:
http://www.activemindsoncampus.org/chapters.htm
The
Effects of Age on Cognitive Deficits in Schizophrenia
A new article
in Psychiatric Times talks about The Effects of Age on Cognitive
Deficits in Schizophrenia. In the article it states that:
"Cognitive
deficits are increasingly being recognized as a central feature of
schizophrenia. Some impairments are present before the hallmark positive
symptoms of the illness emerge, and moderate-to-severe impairments
across many cognitive domains are detectable at the time of the first
episode. Cognitive deficits appear to be largely consistent in severity
across changes in clinical state and appear stable from emergence
of the first episode until after middle age . These findings suggest
that cognitive deficits are not simply a consequence of the symptoms
of the illness or its treatment. Studies of cognitive deficits in
schizophrenia have moved from descriptive to predictive since their
link to functional outcome has been well-replicated. Thus, cognitive
deficits are now recognized as an important treatment goal."
Source: Psychiatric
Times, http://www.psychiatrictimes.com/p040341.html
Movie
- Before They Fall Off the Cliff
Sorry if this
is old news - but we only recently came across this movie.
One family's
bout with schizophrenia is the topic of a documentary by longtime
St. Louis News Anchor Art Holliday, who will present his award-winning
documentary, "Before They Fall Off the Cliff,"
Dr. Fred Nute,
social sciences instructor and chairman of the department, said the
documentary "presents a great opportunity for us to increase
public awareness of mental health issues, especially learning more
about the fallout that mental illness can have on the family, as well
as society at large."
Released in
2002, the hour-long film is about a St. Louis family's tragedy with
schizophrenia. It is Holliday's first documentary, and has received
wide critical acclaim from mental health organizations in St. Louis
and beyond.
For more information
on the movie - see the web site at:
http://www.beforetheyfall.com/
Gene
Mutations and Schizophrenia
The more you
read this news the more that it seems that the fundamental cause of
schizophrenia is likely to be damage or changes to the genes (i.e.
mutations in the genes) - either in the past (and therefore passed
down through generations) or in the present - through such things
as exposure to toxins, lead exposure, nutritional deficiencies, etc.
- that cause further gene damage.
This
recent report form Montreal and Toronto supports this, saying
"Different combinations of genetic mutations may give rise to
diverse human traits, including complex diseases such as schizophrenia,
say scientists at the University of Toronto (U of T) and McGill University
in Montreal."
Because our
global genetic network studies map out how cells work, these studies
have implications that may help us in understanding the foundation
of complex inherited diseases, such as glaucoma, type 2 diabetes and
schizophrenia," said Bussey, a professor in McGill's biology
department
Schizoaffective
Radio Interview on the Infinite Mind:
This week's
episode of the award-winning public radio show - The Infinite Mind
- focuses on schizoaffective disorder, which is John Cadogan's diagnosis.
John, and sister Anne,
were interviewed for the hour-long show, which includes a segment
about the family's experience
and our film, People Say I'm Crazy.
http://www.lcmedia.com/mind315.htm
More information
on the Movie: http://www.peoplesayimcrazy.com
Fetal
sex hormone exposure may predispose humans to schizophrenia.
This research
(and previous research) suggests that "The differentiation of
the human brain is triggered by sexual steroid hormones in the fetus.
The development of both the urogenital system and the appendicular
skeleton are under common control by the HOX genes. "
Apparently
these genes that are triggered by sexual steroid hormones also control
finger length - because it states that "Generally men have longer
ring fingers than index fingers, whereas in women these fingers are
close to equal,"
In this study
"The distance of the tip of the index and ring finger was measured
from the tip of the third digit in 80 male and 80 female, right-handed
patients with DSM-IV diagnosis of schizophrenia and in 80 right-handed
healthy comparison men and women. Schizophrenic men and women showed
a more ''feminine'' phenotype of the index and ring fingers in both
hands than same-sex controls."
Perhaps they'll
soon include a finger length analysis as part of the diagnosis process
for schizophrenia (in addition to the new smell test being developed,
and brain scans) - progress is starting to speed up in schizophrenia
research it seems.
Hmmm...Looking
down at my hands - I see that my ring finger is substantially shorter
than my middle/index finger - not a good sign.
Glutamate
and Schizophrenia
The March
6th issue of New Scientist magazine has an article on how the next
round of breakthrough drugs for schizophrenia (and other, related
disorders) may be targeted at Glutamate in the brain.
The story
- titled "The Master Switch" states that the brain's central
circuits were once a no-go area for drug treatments. But not any more,
and there could be a medical revolution in the making.
"Lilly,
and most of its competitors, now believe that this circuit is the
key to a new class of molecule that will revolutionise the treatment
of mental illness -- including many currently intractable or poorly
treated diseases such as addiction, anxiety, schizophrenia, epilepsy
and chronic pain. Almost every major pharmaceutical company is developing
similar molecules. And while none is yet close to the market, some
neuroscientists believe they will be the biggest shake-up in central
nervous system medicine for decades.
The compounds
that are getting neuroscientists excited are based on glutamate, the
brain's primary neurotransmitter, or communication molecule. Just
about every circuit in the central nervous system uses glutamate,
so in theory, drugs that target glutamate signalling have the potential
to treat almost any brain disorder."
Bita Moghaddam,
a neuroscientist at the University of Pittsburgh in Pennsylvania,
suggests in the article that this has the potential to be a major
move forward for treatment of schizophrenia - and states that "We
are stuck on serotonin for depression, dopamine for schizophrenia
and GABA for anxiety. This is the first time we're going beyond these
old ideas."
He further
states that "there is a lot of evidence to show that an underactive
glutamate system plays a big role in the disease. For example, if
you give healthy people drugs that block glutamate receptors, they
become psychotic."
Vitamin
D in boys to avoid schizophrenia in men
It has been
reported that researchers from Australia find that doses of vitamin
D in early life could help reduce the onset of schizophrenia in men.
In males,
the use of at least 2000 IU of vitamin D during the first year after
birth was associated with a reduced risk of schizophrenia compared
to those on lower doses," reported the Australian researchers,
adding that for females there was ‘no significant association’
between either the frequency or dose of vitamin D supplements and
schizophrenia.
Source: 'Vitamin
D supplementation during the first year of life and risk of schizophrenia:
a Finnish birth cohort study,' April 2004 issue of Schizophrenia Research
(2004) 67:237-245.
Why
Some Schizophrenics Are Hard to Treat
A new research
paper out of UPenn suggests that "Cell damage caused by free
radicals could be the reason why some people with schizophrenia don't
respond to treatment"
The article
also states that:
"damage
was evident in neurons located in a part of the brain called the hippocampus,
which is associated with complex memory activities. The number of
neurons with evidence of this damage was 10 times higher in the brains
of those with schizophrenia than in the normal brains."
This may also
help to explain why so many people with schizophrenia appear to have
memory related problems, and why antioxidant vitamins seem to help
some people with schizophrenia.
Source: http://www.ajc.com/health/content/shared-auto/healthnews/agng/517800.html
The study
was published in a recent issue of the American Journal of Geriatric
Psychiatry.
Note: For
more information on vitamins and schizophrenia see the section titled
"Other Treatments, Vitamins" on the schizophrenia.com homepage.
New
technology facilitates Meds adherence for patients
This recent
news on drug delivery systems could help people with schizophrenia
quite a lot - you only need to remember to take your meds once every
two weeks. Watch for it soon.
(Source: MIT
News Release) "New drug delivery systems can keep drugs at desirable
levels in the body and avoid the need for frequent doses, which can
help patients better adhere to their therapy regimen, according to
Robert S. Langer, Ph.D."
"Polymers
for delivering drugs in patients with schizophrenia have just been
approved by the FDA," Dr. Langer stated. "These patients
previously had to take a pill daily to control their symptoms--now
they can take the drug every two weeks. Polymers that continuously
release medications to treat alcoholism and diabetes are currently
in clinical trials."
Source: http://www.eurekalert.org/pub_releases/2004-03/ama-ntf022604.php
FDA tentatively
OKs Generic Version of Risperdal antipsychotic
The U.S. Food and Drug
Administration has tentatively approved a generic antipsychotic medicine
from Mylan Laboratories Inc., the company said.
Risperidone is the generic
form of Risperdal, a widely prescribed drug produced by Janssen Pharmaceutica
Products LP to treat schizophrenia. Janssen is a New Jersey-based
unit of Johnson & Johnson.
Mylan said its Risperidone
application to the FDA was a so-called first-to-file opportunity.
In those cases, pharmaceutical companies that are first-to-file applications
and receive FDA approval are entitled to a period of exclusive marketing
rights.
Early
Schizophrenia Screening Test 
