Member and Site News, Editorials:

• Two new opportunities to participate in schizophrenia research
• Schizophrenia Ups and Downs - personal story by Douglas Brown

Diagnosis and Prevention News

• New Research on Preventing Schizophrenia - Virus Exposure and Choline Supplements
• Prevention of Schizophrenia: can it be achieved? A review article of preventative psychiatry

Medication and Treatment Information

• Metabolic Side-effects of Anti-Psychotic Meds - well known, but little monitored
• Electronic Pill-box in Testing - a secure reminder system for medications
• Internet Positives in Mental Illness Treatment - a case study
• Meds Minimize Brain Damage

In Community, Society, and Media

• Upcoming NAMI events - NAMIWalks to be held in 38 states during summer and fall
• New Interview with John Nash
• Scientology Group Backs Harmful Mental Illness Legislation in Florida

Biology and Current Research:

• MATRICS - a new collaborative research effort from NIMH
• Psychotic Behavior Explained? A return to dopamine sensitivity

Two New Opportunities to Participate in Schizophrenia Research

• Case Western Reserve University (Ohio) is recruiting children with relatives who have schizophrenia for a study investigating the biological and psychosocial risk factors of the disease. This is an NIMH-funded study. For more information, link to the study on our Research and Clinical Trials page. (http://www.schizophrenia.com/trials/casewestern.htm)
  
  
• Participate in an online survey investigating the stigma and discrimination experienced by people in recovery. Investigators: The Center for Psychiatric Rehabilitation at Boston University. Link to the article for more information, and the survey website address. (http://www.schizophrenia.com/sznews/archives/001610.html)

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Schizophrenia Ups and Downs

Editor's note: Special thanks to Douglas James Brown for permission to reprint this article.

I have a disease known as schizophrenia.

Individuals with this disorder vary in their presentation of symptoms. For me, there are days when everything is detailed, scary and frightening, and there are days of seeing things moving around in my apartment that are not really there. There are days where I weep because my life is one big roller-coaster. There are days where extra medication is the only answer.

There are the days where I've been successful. Days in which I function and can make sense of my world and the books I read, such as school texts, are the days where life becomes full of zest and brilliantly wonderful.

Sometimes, however, I feel insecure, dazed and even frightened of people. Then there are the days where I need to take extra medication because of extra stress, which invokes voices and hallucinations. I even fear being alienated by people with or without the illness.

I have my ups and downs.

It is the evenings when I feel most vulnerable to the ghosts surrounding me. Sometimes they make me feel I am "crazy in the head." These apparitions do not harm me; actually, they just move around and act like a group of people who live a life similar to mine.

However, the apparitions live in a different time frame, a different era. Really it is like a parallel world, and they do not really notice that I am around. The strange thing is, though, I notice them.

There are the crying days. On these days, I cry because I am all alone without many friends, and I lack social support networks. I also weep because I cannot function like other people, because I do not fit in, and because of the stigma associated with schizophrenia. I cry because I fear the voices may return when I am feeling "stressed out," and I do not want them to come back.

Medication is a necessary form of treatment for schizophrenia. Individuals on medication respond differently. Some individuals may be over-medicated to the point of slurring words, or sleeping all the time, or even to the point of behaving like a zombie.

For me, medication works and is necessary. It makes me feel great. I feel a lot better on medication.

Although my medications generally work well with my body and mind, there are times I need extra medication such as chlorpromazine. When I hear voices or see the apparitions, I take the chlorpromazine and it helps rid my mind of those disturbances.

I would like to share that I have completed two credits from a nearby college and I plan on obtaining my Writing for Publication Certificate within the next year and a half.

My medications have helped keep me mentally healthy and stable so I can complete my course work.

Thanks to the doctors who have made my life much happier and better, I don't at present experience many of the symptoms I've described in this article.

On medication I can now function like a regular human being and be successful in school and life.

If science didn't provide the medications that we individuals with schizophrenia now have, society might still be isolating us into asylums where they used electroconvulsive therapy, lobotomies and insulin overdoses to free the schizophrenic person from his or her symptoms.

We with schizophrenia need to be thankful for scientific discoveries and continue to advocate further research so a cure for schizophrenia is found.

Douglas James Brown lives in Burlington, Canada

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New research on Schizophrenia Prevention - Viruses and Choline

New research published in the American Journal of Psychiatry (look up the abstract at http://www.pubmed.com) supports the theory that the risk for developing schizophrenia can be increased if a pregnancy mother is exposed to the toxoplasmosis virus (commonly carried by cats). The study noted that individuals with schizophrenia were 2.42 times more likely than controls to have been exposed to high Toxoplasma levels. This taxoplasmosis link to schizophrenia is a theory that Dr. E. Fuller Torrey initiated (I believe) over a decade ago - and the data supporting it continues to be published. See supporting research studies: (http://www.schizophrenia.com/hypo.html#cats) . Official study title: Maternal exposure to toxoplasmosis and risk of schizophrenia in adult offspring.

In other news, research from Duke University is providing an update on the benefits of choline supplements for brain development. Research with rats has repeatedly shown that babies born to mothers who eat more choline (naturally found in eggs and some meats) are smarter on memory testing. suggesting that choline plays an important role in memory and brain function by positively affecting the brain's physical development. See research on why pregnant women may benefit from supplementation with a nutrient called choline. (http://www.schizophrenia.com/prevent3.htm#choline)

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Prevention of schizophrenia - can it be achieved?

Cheng Lee, Thomas H. McGlashan and Scott W. Woods
CNS Drugs 2005; 19 (3): 193-206

This is a very well written recent review article that takes a look at the idea of preventative psychiatry. Is/Will it be possible to detect schizophrenia at an early enough stage to prevent the full illness? The article talks about the financial and social impacts of schizophrenia, understanding the role of risk factors, stages of the illness and finally what possible steps might be possible before and after detection of the onset of symptoms.

Costs of schizophrenia:
According to the article, the costs of schizophrenia in 1990 (for society) were over 30 BILLION dollars. Half of that was spent on treatments and the other on lost work/decreased production and other associated costs. The estimate was to nearly double by 1995. Current figures are unavailable, but the costs are expected to be much higher still.

Prevention of Schizophrenia:
In beginning a discussion regarding prevention of illness, it is helpful to review the different types of prevention one usually considers. The first is primary prevention. This is the type of prevention that seeks to eliminate the disease well before it starts, usually at a population level. In schizophrenia it involves continued research into the genetics and other causes of schizophrenia such that one could predict risk more effectively and identify people who are likely to be at increased risk before they have problems. Secondary prevention involves mitigating difficulties already encountered. With schizophrenia, this means making interventions in people labeled as having “prodromal” symptoms of the illness. This means that they may be having certain, often nonspecific, symptoms that often relate to an eventual onset of schizophrenia. With increased refinement in the future, we may be able to more specifically target for earlier treatments those who are in the prodromal phase of the illness to prevent the downward spiral often seen with severe illness. Lastly, there is tertiary prevention. This involves educating the public about schizophrenia such that the general awareness is helpful in identifying potential consumers and is more understanding of the issues that face those with schizophrenia.

Primary Prevention strategies:
The authors discuss the role of obstetrical complications in understanding the cause and first possible opportunity for primary prevention. While certain complications have been linked to schizophrenia, there has not been good conclusive evidence that obstetrical complications cause schizophrenia. However, the benefit of trying to reduce complications has more than just psychiatric implications. Additionally, the benefits that these efforts might have are more likely to be seen in developing countries and a places with higher rates of these types of complications.

Other primary measures include sharpening our genetic theories. Right now there are several genes that are thought to be involved. It is a very complicated picture however, as even identical twins (who have the same genes) only have about a 50% chance of both having schizophrenia if one twin has it. That means that there is more than just a genetic explanation. However, using other factors, it may ultimately be possible to determine who are the highest risk children and make sure that they are given the resources needed to help prevent the onset of schizophrenia.

The authors also discuss looking at impaired attention as a predictor of future outcome. Using particular markers of attention, there have been findings that show that differences as early as 12 years old can be used to predict outcome.

Secondary Prevention strategies:
The main theme of secondary prevention is recognition in the prodromal stage of the illness. That means to pick up on symptoms that are causing difficulty but have not led to the full syndrome and a conclusive diagnosis of schizophrenia. Many people with prodromal symptoms develop other psychiatric illness or no illness at all. The symptoms that are considered prodromal are generally not specific to schizophrenia and that causes the wide variation of outcome. However, it is important to begin to understand who might benefit from treatment at an earlier stage and who might never need full schizophrenia treatment. There are several different rating scales that can be used to assess for the severity of prodromal symptoms. Often that data is put together with family history and other factors such as attentional testing and other neuropsychiatric tests to help make a prediction.

There is data that suggests that the duration of untreated psychosis (DUP) relates to overall outcome. The shorter the DUP is, the better the prognosis in certain aspects of the illness. This leads people to consider treating patients before they are severely psychotic in order to minimize the DUP. There is still controversy though to the best time to initiate treatment however. It has been shown that longer DUP is usually seen in people who have prominent negative symptoms, lower level of functioning before onset of symptoms and in those with a more subtle onset to their psychosis. There have been some industry sponsored studies recently using antipsychotics to treat prodromal symptoms. While there have been the usual and expected side effects, there also has been a decrease rate of conversion to psychosis in the small studies. In addition, treatment of the prodrome is not with out risk. First, it is possible that the patient will not develop schizophrenia and wouldn’t otherwise need the medication. Perhaps they would respond to aggressive cognitive therapy or another treatment modality. Also, once someone receives a diagnosis, they carry it with them. There are still stigmas associated with mental illness and therefore it is with caution that one prematurely would want to put a label on someone. However, preventing the syndrome would likely lessen the amount of stigma that one has to face because there would be less unusual behavior and less of a chance that they would stand out from a crowd based on the illness.

Tertiary prevention strategies:
The strategies in this part of the paper refer to aggressively treating people in the midst of their first major episode such that they have a decreased progression of the illness. The goal is to also decrease the DUP such that the overall prognosis can be improved. There is reason to believe that early, aggressive treatment is helpful. First episode patients generally require less medication and are more responsive to treatment. While some disagree, most say that it is helpful for protection sake to begin chronic antipsychotic therapy. Without such therapy, it is estimated that 80% of patients will have a relapse. However, individual variation exists such that a blanket statement regarding treatment is not possible.

Conclusion:
Schizophrenia is a devastating disease. There are several points in the development of the syndrome when one can be brought to clinical attention. Further research must be done to help identify the best treatments at the various stages of the illness. Ultimately, with such therapies, we’ll be able to decrease the DUP for more people and improve the prognosis for those who have already become psychotic, while also helping prevent more episodes of psychosis in the first place.

Supported by grants to Dr McGlashan from the National Alliance for Schizophrenia and Affective Disorders (NARSAD) and from the UK National Institute of Mental Health (MH01654). Dr McGlashan has also received research support from Eli Lilly Company. Supported by grants to Dr Woods from the Donaghue Foundation and MH61282 from the US National Institutes of Health. Dr Woods has also received research support from pharmaceutical companies including Eli Lilly, Janssen and Bristol-Myers Squibb.

Click here to find the article on PubMed, or do a search by article title/author name at http://www.pubmed.com

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FDA Warning issued on antipsychotics for elderly with dementia

The U.S. Food and Drug Administration warned Monday that "off-label" -- unapproved -- use of certain drugs used to treat behavioral disorders such as schizophrenia can be potentially fatal to elderly patients with dementia. The FDA's warning specifically related to atypical antipsychotic drugs that are approved for the treatment of mania and schizophrenia.

More Information: FDA advisory/Warning on Anti-Psychotics (http://www.fda.gov/cder/drug/advisory/antipsychotics.htm)

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Metabolic side-effects of anti-psychotics: well-known, little monitored

A news release from the Medical College in Georgia highlights the challenge of Diabetes and Schizophrenia. An excerpt is posted below; the original article may be viewed at the following link on the schizophrenia.com website at http://www.schizophrenia.com/sznews/archives/001630.html

April 4, 2005

Psychiatrists are doing a “modest” job of monitoring for weight gain, diabetes and other metabolic problems that may result from use of the newer antipsychotics for schizophrenia, researchers say.

Nearly all of the 258 members of the American Psychiatric Association in Georgia, Ohio and Iowa responding to a survey said they considered metabolic side effects serious or very serious, say researchers from the Medical College of Georgia, University of Iowa and Northcoast Behavioral Healthcare in Ohio.

However monitoring for these problems – including getting baseline data on personal and family health history as well as baseline and regular checks of height and body weight, waist circumference, blood pressure, fasting blood glucose and lipid levels – largely goes undone, researchers say of findings being presented during the 10th International Congress on Schizophrenia Research April 2-6 in Savannah, Ga.

“What we have found is that metabolic problems often associated with these drugs are a substantial concern and that clinicians are slowly beginning to change their practice to reflect that concern,” said Dr. Peter F. Buckley, lead investigator on the study and chair of the MCG Department of Psychiatry and Health Behavior.

Antipsychotics, such as clozapine and risperidone, which have come on the market in the last 10-15 years are touted for an improved ability to treat the delusions and hallucinations of schizophrenia without damaging muscle control, Dr. Buckley says. Parkinson-like tremors have been associated with older antipsychotics.

“These newer drugs are definitely more effective, they are just not without their own side effects,” Dr. Buckley says. “Some of those side effects fit unfortunately well with what’s happening in the world and America with rampant problems with obesity and type 2 diabetes.”

Groups such as the American Diabetes Association, the American Psychiatric Association and the American Association for Clinical Endocrinologists, have weighed in, making recommendations for evaluating and monitoring adverse metabolic effects. However, much like the current study, a 2004 phone survey of 300 psychiatrists commissioned by a pharmaceutical company showed while most were aware of metabolic consequences many had not incorporated recommendations for dealing with them into their practice.

...

For more information about the risk of metabolic side effects, including diabetes, from antipsychotic medications, please see the following articles on schizophrenia.com:

Olanzapine, Clozapine, and Diabetes (http://www.schizophrenia.com/sznews/archives/001321.html)
Risk of New-Onset Diabetes Cases from Antipsychotics Small (http://www.schizophrenia.com/sznews/archives/000998.html)
Atypical Antipsychotics Affect Blood Glucose Levels (http://www.schizophrenia.com/sznews/archives/000608.html)

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Electronic Pill-Box in Testing

We've just learned of a new product that is in development that sounds like it could be of value to people who have schizophrenia.

The Med-eMonitor electronic pill (more info available at http://www.informedix.com) box reminds patients when to take medicine and alerts doctors if a patient stops taking medication.

The device sends this information to a secure Web server, where practitioners monitoring a patient's care can see the information and intervene quickly if the patient stops taking medicine or reports ill-effects. The Web server also updates the device with new alerts, like upcoming doctor visits or changes in dosages.

Dawn Velligan directs the division of schizophrenia-related disorders at the University of Texas Health Science Center and is testing the device in a small clinical trial of schizophrenia patients. She receives consulting fees from Informedix.

Preliminary results from the trial are both striking and statistically significant. Before the study, said Velligan, patients were taking medications as directed only about 50 percent of the time. With Med-eMonitor, adherence rose to 94 percent. Patients could also lead more independent lives. One patient who needed her parents' help to take pills was able to do so on her own using this device.

MORE INFORMATION:
View Article on Electronic Pill Box (http://www.cioinsight.com/article2/0,1397,1779768,00.asp)

Company Developing Pill Box: Informedix, Inc. (http://www.informedix.com/)

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Internet Positives in Mental Illness Treatment - a case study

A very interesting new study was recently published (Feb. 1st)in the Journal of the American Academy of Child and Adolescent Psychiatry (http://www.jaacap.com/). In this study they looked at how the internet could be used as a positive developmental tool for a 15 year old boy who suffers from psychosis (the broader term that covers schizophrenia, and bipolar disorder and related disorders).

The case study "emphasizes some of the ways in which the Internet may have a positive impact on adolescent development, further research is indicated to evaluate the contexts in which the Internet serves healthy developmental processes and those in which its influence is potentially deleterious"

This study confirms what we see here at the schizophrenia.com web site - we hear from many people about how the web site and the chance to meet so many other people with the same challenges as them allows them to socialize much more easily and enjoyably than they could ever previously do. We hope to see more research like this in the future - and are open to working with Universities to work on studies like this, for larger samples.

Some good quotes that give a sense of what is covered in the research are below:

Case study: the Internet as a developmental tool in an adolescent boy with psychosis

Journal of the American Academy of Child and Adolescent Psychiatry
No. 2, Vol. 44; Pg. 187; ISSN: 0890-8567

"Despite the potential problems commonly associated with online communication, the Internet does offer a range of positive opportunities for adolescents. Most adolescents use the Internet for academic sources to assist with their schoolwork, to explore creative or cultural interests, and to communicate with friends and family. The Internet can also allow adolescents (especially those in isolated social settings) to make contact with others sharing their special interests, sexual orientation, or disabilities, while protecting their anonymity. For children and adolescents with social language difficulties, as in the case of those with pervasive developmental disorders, the de-emphasis of paraverbal cues and other challenges of face-to face communication may be an asset. These youngsters get the opportunity to practice less intimidating social interactions online."

CASE STUDY

Mark, a 15-year-old boy, had intractable seizures since the age of 18 months. He had mild early psychomotor developmental delays that improved with intensive physical therapy. At 9 years of age, he developed psychotic symptoms that became chronic throughout his adolescence and were complicated by concurrent grand mal seizures. He started home schooling at age 11 after several months of hearing a voice that repeatedly told him that his teacher had had sex with him. By this point, Mark was unmanageable in the classroom due to agitation and socially intrusive behaviors. His seizures were so debilitating that he became more isolated at home with frequent medical hospitalizations. Hence, during his early adolescent years, there were few social interactions outside those with his family. At age 14, Mark had a vagal nerve stimulator inserted that resolved his grand mal seizures.

Before the onset of his psychotic symptoms, the computer was very important to him, and he attained sophisticated computer skills with the help of his father. The Internet allowed Mark to socialize with peers and assisted him in his home study. He played many Internet games, including some involving virtual pets. He became interested in a virtual pet Web site through which he could be a virtual pet owner, check out shops, and buy food and toys for his "pet." Other aspects of this fantasy included owning his own store and selling virtual pets and stock in a virtual company related to the pets. The Web site also had chat rooms for other children who owned virtual pets.

In addition, Mark used a chat group for children who have seizure disorders. This experience allowed him to share his worries and thoughts with other youngsters with seizures. He established a close friendship with John, a boy with a similar problem. These contacts helped decrease Mark's sense of isolation.

An e-mail approximately 1 year after discharge read as follows: "Hi Dr. Dude! Remember me? It's Mark, the red-headed boy who made you a Web site at the hospital. Thanks to you and Clozaril, I'm back in school and doing very well! I even have friends now." He communicated plans to start his own dog-walking business with the friend from the chat group for children with seizure disorders.

...

This case illustrates some ways in which the Internet can serve as a tool for promoting development. In Mark's case, use of the Internet assisted him in transitioning, first with his therapist and then with his friend John, from social isolation to integrating back into school with his peers. Mark had started corresponding with John through a chat group for teens with similar medical problems. Over time, this Internet relationship turned into a real-life friendship in which the two teens started a dog-walking service together.

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Meds Minimize Brain Damage

A new research study provides some early but positive signs that the newer antipsychotic medications may be better at minimizing the brain damage (specifically the gray matter loss that is common in the early stages of the onset of schizophrenia - see http://www.schizophrenia.com/disease.htm#significant for further details).

This is only one study, (so it needs to be confirmed by independent third parties) - and it may have been funded by the drug company involved (as they usually are), so results could potentially be biased. Lastly, there is a weakness from this study in terms of the lack of another control group – people who have schizophrenia, but are un-medicated.

Unfortunately, its difficult to interpret results from this study because the interpretation strongly depends on the unmedicated group that should/could have been included in the test (but wasn't).

If an un-medicated group had shown that the worst gray matter loss, one could then conclude that antipsychotic drugs prevent progressively deteriorating of gray matter.

Since there was not unmedicated control group we have to agree with this conclusion from the Archives of General Psychiatry article, that: "the differential treatment effects on brain morphology could be due to haloperidol-associated toxicity".

Following is the press release on the study:

Study shows new antipsychotic drug prevents brain loss in schizophrenia

New York, NY, April 4, 2005 --- A new brain imaging study of recently diagnosed schizophrenia patients has found, for the first time, that the loss of gray matter typically experienced by patients can be prevented by one of the new atypical antipsychotic drugs, olanzapine, but not by haloperidol, an older, conventional drug. The study, published in today's Archives of General Psychiatry, also confirmed previous studies that show patients who experience less brain loss do better clinically.

"This is a really big breakthrough," says the study's leader, Jeffrey Lieberman, M.D., director of the New York State Psychiatric Institute and chairman of psychiatry at Columbia University Medical Center. "The drugs we have for schizophrenia can't cure people who've been sick for years, but this study shows that the newer atypical drugs, if started early, can prevent the illness from progressing. If our findings are confirmed, one could argue that we should treat new patients with atypical drugs like olanzapine rather than older conventional medications such as haloperidol and chlorpromazine."

Gray matter contains the bulk of the brains cell's and the billions of connections among the cells. Loss of gray matter in patients with schizophrenia has been linked to social withdrawal and progressive deterioration in cognition and emotion--which are among the least responsive symptoms to medications.

To see if antipsychotic drugs could slow the initial brain changes in new patients, Dr. Lieberman and colleagues at 14 sites in North America and Europe measured brain volume and cognitive changes in 263 first-episode schizophrenia patients and 58 non-schizophrenic volunteers over a two-year period. Half of the patients received the atypical antipsychotic olanzapine and the other half took the conventional antipsychotic haloperidol. Dr. Lieberman initiated the study when he was professor of psychiatry at the University of North Carolina, which also coordinated the research.

The study found that, on average, haloperidol-treated patients lost about two percent of their gray matter, or about 12 cubic centimeters. No changes were detected in the olanzapine-treated patients and the normal volunteers. Patients who lost gray matter, particularly in the frontal lobe of the brain, also had greater problems with cognitive functioning, as measured by tests of verbal fluency, verbal learning and memory.

Schizophrenia has always been known as a disease that causes progressive worsening of symptoms and deterioration in function, but only in the last 10 years have researchers found that the brains of schizophrenics are also progressively deteriorating.

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Upcoming NAMI events - NAMIWalks to be held in 38 states during summer and fall

DATELINE: ARLINGTON, Va. April 7

ARLINGTON, Va., April 7 /PRNewswire/ -- NFL quarterback Terry Bradshaw. Nobel Prize winner John Nash. President Abraham Lincoln. Profiles of courage and recovery from mental illness. Today, tens of thousands of Americans are taking to the streets to raise public awareness that recovery is indeed possible.

Sponsored by the National Alliance for the Mentally Ill (NAMI) -- the nation 's largest grassroots organization dedicated to improving the lives of people with mental illnesses -- NAMIWalks will raise a profile of hope in 50 locations in 38 states during April and May (Mental Health Month), and during the summer and fall -- including October's Mental Illness Awareness Week.

The walkathons raise money for research, education, support and advocacy. For lists of teams and celebrated sponsors, visit http://www.nami.org/namiwalks.

"NAMIWalks are an amazing phenomenon," said NAMI executive director Michael Fitzpatrick. "You don't have to be famous to raise awareness. Friends and neighbors come together, many of whom may not have mental illness in their own families, but still know someone affected by depression, bipolar disorder, schizophrenia, or other conditions."

"NAMIWalks are about individuals and families," Fitzgerald said. "They are about education. They are about communities and the future."

For more information, dates and locations, or to register for a walk, please see:

http://www.nami.org/namiwalks

We have posted a new interview with John Nash (now 76 years old), Princeton professor and subject of the award winning movie A Beautiful Mind. Please view the interview online at: http://www.schizophrenia.com/sznews/archives/001617.html

MORE INFORMATION: JOHN NASH (http://www.schizophrenia.com/famous.htm#john)

There is much good research going on in schizophrenia - with new advancements being announced almost every day.

But - there are always some groups stuck firmly in the 15th century, and one of these groups is (ironically enough) known as "Scientology" - which for some unknown reason believes that every organ but the brain can be get damaged or diseased. Its as if they've completely ignored the progress in neuroscience and schizophrenia during the past 100 years; a truly disturbing situation. How many thousands or tens of thousands of children could be hurt by the delays of treatment caused by these recent efforts by Scientologists?

This story (see below) is just in from Florida. We think advocacy groups nationwide will work very hard to counter these ill-informed efforts by scientologists and others who may have similarly uninformed opinions:

St. Petersburg Times (Florida)
April 9, 2005 Saturday

Scientologists push mental health law

Opponents say the legislation takes advantage of lingering stigma and will deter parents from seeking help for their children.

Legislation backed by an offshoot of the Church of Scientology aims to discourage public school students from seeking mental health services.

The measure would require schools to tell parents that any mental health treatment would be part of a student's permanent record, which is true only in limited cases now.

It also would require school officials to tell parents that no medical test can diagnose mental illness, they can refuse psychological screening and that students can't be barred from school activities if they refuse treatment.

[Editorial note - it will be interesting to see what Scientologists do when blood tests for schizophrenia -- or other similar tests -- finaly make it to wider availability - though of course, with these types of bill they never will]

The bills (HB209 and SB1766) are being pushed by the Citizens Commission on Human Rights, or CCHR (http://www.cchr.org/), established in 1969 by the Church of Scientology to carry out its mental health mission. Scientologists oppose psychiatry and other mental health services.

The sponsors, Tampa Republican Sen. Victor Crist and Miami Beach Republican Rep. Gustavo Barreiro, were guest speakers recently at Scientology's anniversary celebration. Crist touted the bill at the event and Barreiro gave the church an award for its volunteer efforts during last summer's hurricanes.

Barreiro acknowledged that the Scientology group approached him about sponsoring the bill and wrote parts it. But he said he's sponsoring the bill because he believes in it.

The legislation is being fought by several mental health organizations, including the state Office of Suicide Prevention.

...opponents say the bill could dissuade some parents from seeking treatment for a child with mental illness.

Mental illness is noted in student records only if the school is involved in treatment or the illness requires special education, according to the state Department of Education.

Opponents say the bill's backers are taking advantage of the lingering shame over mental illness to further an anti-psychiatry agenda.

MATRICS (Measurement and treatment to improve cognition in schizophrenia)
View the official website at: http://www.matrics.ucla.edu/

Recently, a special issue of the journal Schizophrenia Research (December, 2004) was devoted to discussing a new research initiative spearheaded by the National Institute for Mental Health (NIMH) and in collaboration with researchers around the country including Stephen Marder from UCLA (see recently posted interview here). The goal of this research initiative is to lead to collaborations with pharmaceutical companies, academics and governmental researchers to develop medications that will target the cognitive aspects of schizophrenia. Schizophrenia may be most well known for effects on perceptions (i.e. hallucinations, delusions, paranoia) but it may be the effects on working memory and cognition that are the most long lasting and damaging to patients. There are many effective medications available for treating the psychotic symptoms, but currently no medications are approved to help treat the cognitive deficit that many people with schizophrenia endure.

Here are some highlights from the series of articles published in the journal Schizophrenia Research:

1. Marder and Fenton – This article highlights the goals of the MATRICS initiative. The authors comment that current medications, while effective for treatment of psychosis in many individuals, do not help alter the course of the cognitive aspects of schizophrenia. The MATRICS study is designed to help bring together the various entities needed to develop medications that can be helpful in ways other than in treatment of positive symptoms of psychosis (e.g delusions). According to the authors, “Neuropsychologists and neurophysiologists with an interest in schizophrenia rekindled an interest in cognition in schizophrenia. There is a greater recognition that impairments in domains that include memory, attention, executive functioning, verbal fluency, and psychomotor performance are experienced, to some degree, by the great majority of individuals with schizophrenia and that these impairments are core features of the disorder.” It is thought that the cognitive features are more consistent and do not wax and wane like some of the positive symptoms can. Also, they are seen as more predictive of future outcome than the level of hallucination and therefore are an important target. The authors describe how there are rodent and other animal models that have recently demonstrated new potential targets for treatment in this area leading to optimism that these targets will also be useful in humans. However, there are many hurdles that preclude immediate development. First there are financial obstacles to overcome. However, the financial gain that a company would reap from such a medication however would be substantial. There is also some difficulty over the standard in which patients will be measured. There are many possibilities, but none that has been decided upon yet.

see the full report on this research at: MATRICS

Citation:
Schizophrenia Research, Volume 72, Issue 1 , 15 December 2004,

The following is from a press release from Oregon Health & Science University:

OHSU scientist helping explain basis of psychotic behavior
Findings could lead to improved treatments for schizophrenics, amphetamine abusers

PORTLAND, Ore. -- An Oregon Health & Science University researcher is among an international team closing in on why many people with schizophrenia and other psychotic disorders are "supersensitive" to the powerful neurotransmitter dopamine.

David Grandy, Ph.D., associate professor of physiology and pharmacology, OHSU School of Medicine, co-authored a study appearing recently in Proceedings of the National Academy of Sciences that found a link between dopamine supersensitivity and increased levels of a dopamine receptor with a particularly high affinity for dopamine.

Dopamine is a neurotransmitter found in the brain that plays an important role in the regulation of behavior involved in movement control, motivation and reward, and the dopamine system is thought to be essential to the brain's response to drugs of abuse, especially opiates and psychostimulants.

Supersensitivity to dopamine, which affects some 70 percent of individuals with schizophrenia, can take the form of a low tolerance to antipsychotics, amphetamines and other drugs, including drugs of abuse, that trigger dopamine's release in the brain. The latest discovery could someday lead to the development of drug therapies that temporarily bring people with psychosis into a more normal, less-sensitive state and make them more amenable to antipsychotic treatment.

It also could help scientists find ways to turn down the activity of the dopamine D2 receptor in individuals for whom dopamine sensitivity can be dangerous, such as prolonged drug abusers.

"It does appear that wherever you see supersensitivity, you see high-affinity dopamine D2 receptors as the predominant form," said Grandy, a pioneer in the study of the dopamine neurotransmitter system. "But to say you're going to then reverse supersensitivity by changing the D2-high status, we haven't done that. To do that, we have to be able to selectively manipulate the system in such a way that we could drive the receptor from high-to low-affinity or otherwise effect its ability to signal efficiently by some drug treatment."

While supersensitivity is only determined by observing behavioral changes, and the high-affinity D2 is verified pharmacologically, "what we're showing is a very strong correlation between the presence of a higher proportion of high-affinity D2 in a population of receptors in animals that show supersensitivity to dopaminergic drugs," Grandy added.

The study also further confirms the importance of the dopamine system in understanding and treating psychosis.

"The bottom-line, take-home message is that there are a lot of different things that all seem to converge on this system," Grandy said. "It's like all roads lead to Rome. The D2 system still seems to be very important in terms of psychosis and amphetamine-mediated disorders."

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The study was led by Philip Seeman, M.D., Ph.D., professor emeritus of pharmacology at the University of Toronto, Canada. Grandy's work in this study was supported by the National Institute on Drug Abuse and the National Institute of Mental Health.

Source: OHSU news releases. Visit www.ohsu.edu/news/ to view this and other articles

To read more about the role of dopamine and other neurotransmitters (glutamate, GABA, serotonin) that may play a role in schizophrenia pathophysiology, please visit http://www.schizophrenia.com/research/