New Family Oriented Book on
A Comprehensive Resource
By Rachel Miller and Susan Mason
I've reviewed this book and think it is valuable
for any family who has a family member or friend
who suffers from schizophrenia. Its unique in
that it is written in an easy-to-read personal
style that almost anyone should be able to read
and benefit from, and in that it covers the real
stories of 35 different people who have experienced
schizophrenia and incorporates their experiences
and perspectives. With these stories the reader
can get a good idea of what some people have gone
through in their experience with schizophrenia.
I highly recommend it.
"As a parent watching the process of this illness
unfold, I felt confused, fearful, isolated and totally
helpless. This book helped dispel those feelings and
left in their place a better understanding of the
illness and what my child was experiencing. For those
whose lives are touched by schizophrenia, this book
will bring understanding and more. It is like no other
book I've read on the illness to date. Thank you to
those in this book whose courage in telling their
stories is almost unimaginable."
"These stories tell of experiences that all
of us diagnosed with schizophrenia can relate to,
so we don´t feel so alone. And the more people
know about their illness, the easier it is to cope
with the symptoms and the more willing they will be
to accept treatment, including medication. I wish
I had this book when I first got sick."
"No fewer than 35 patients and their clinicians
put a realistic face on schizophrenia. They provide
easily understood answers to the universal questions
about these disorders. The exchange is unique and
the message is empowering. Schizophrenia becomes demystified
and a template of hope and recovery is drawn for patients,
families, and providers. For those seeking a patient
education resource, this little gem gets my enthusiastic
Gerard E. Hogarty, University of Pittsburgh
The disease is not fatal but few diagnoses have the
capacity to instill as much fear in the hearts of
patients and families. Here is a profoundly reassuring
book that shows there can be life after a diagnosis
The book includes thirty-five first-person accounts,
along with chapters by professionals on a wide range
of issues from hospitalization to rehabilitation.
Jargon-free and technically accurate, the chapters
are short and offer up-to-date information on medication,
coping skills, social services, clinical research,
and much more. Patients and their families can read
the book from cover to cover or skip around and select
topics as the need arises.
For more information, or to purchase the book, go
- Diagnosis Schizophrenia
STUDIES OF NEVER-TREATED PATIENTS
CONFIRM SCHIZOPHRENIA IS A BRAIN DISEASE
Abnormalities in brain structure and function not
caused by medications
A paper published in the October 2002 edition of
the journal Schizophrenia Research (released September
20) confirms that schizophrenia is a brain disease,
in exactly the same sense that Parkinson's disease,
Alzheimer's disease, and multiple sclerosis are brain
The paper reviewed 65 research projects carried out
on individuals with schizophrenia who had never been
treated with any antipsychotic medication. In many,
the individual had only recently been diagnosed with
the disease. In recent years, many critics of psychiatry
have suggested that the brain abnormalities described
in schizophrenia are caused by medications being taken
by the patients. This review refutes that thesis.
It is clear that schizophrenia, like many other brain
diseases, produces abnormalities in brain structure
and function. These abnormalities are inherent in
the disease process and not caused by medications.
ABOUT THE PAPER. The study reviewed 65 research projects
carried out on individuals with schizophrenia who
had never been treated with any antipsychotic medication.
In many, the individual had only recently been diagnosed
with the disease. The projects measured the structure
and function of brains of individuals with schizophrenia
and compared these with normal controls. Neurological
and neuropsychological measures of brain function
showed the most consistent and largest differences
between patients and controls. Measures of brain structure,
such as MRIs, and measures of brain metabolism, such
as PET scans, were also significantly different but
less impressive. The brain abnormalities were not
localized to a single part of the brain but instead
implicated a variety of interrelated regions at the
base of the brain.
ABOUT THE AUTHOR. The paper's author, Dr. E. Fuller
Torrey, is executive director of The Stanley Medical
Research Institute in Bethesda, Md., and president
of the Treatment Advocacy Center in Arlington, Va.
"Studies of Individuals with Schizophrenia Never
Treated with Antipsychotic Medications: A Review,"
is the lead article in the October 2002 Schizophrenia
Research. Dr. Torrey is a leading research psychiatrist
specializing in schizophrenia and manic-depressive
illness. He is the author of 20 books and more than
200 lay and professional papers.
His full bio is available at http://www.psychlaws.org/PressRoom/Bio1.htm
View the full paper online at:
The Sights and Sounds of
By Joanne Siebert, NPR
Aug. 29, 2002 -- The textbook description of schizophrenia
is a listing of symptoms: delusions, hallucinations,
disorganized speech and behavior. But what does schizophrenia
really feel like? NPR's Joanne Silberner reports on
a virtual reality experience that simulates common
symptoms of the mental illness.
Janssen Pharmaceutica, a company that makes a drug
treatment for schizophrenia, has created a multimedia
simulation that it says lets a participant see the
world through the eyes and ears of a person with schizophrenic
illness. Janssen created the simulation as an education
tool for doctors and others who want a more visceral
understanding of the illness.
Silberner, who experienced the simulation, says it
works this way: "For five to 10 minutes, someone
wanting to know what it feels like to have untreated
schizophrenia puts on goggles and headphones, and
sees and hears a range of hallucinations. You can
choose your virtual reality -- what happens on a trip
to the doctor's office, or on a ride on a city bus."
In the program she experienced, a caseworker takes
the schizophrenia patient to a grocery store with
a pharmacy in the back, to refill a prescription.
To create the virtual reality project, technical
director Stephen Streibig consulted a group of people
with schizophrenia, including Daniel Frey, 26. Frey
describes what he and Silberner experienced in the
program: When you first walk into the pharmacy,
youre walking through the aisles and there are
people staring at you, just staring at you from every
aisle. And theres one instance where there is
a woman sort of protecting her children from you when
you walk through the aisle.
Dr. Sam Keith, medical advisor on the virtual reality
project, is a veteran psychiatrist whos heard
thousands of patients describe schizophrenic episodes.
Still, after trying the simulation, Keith said, When
its real, its different -- its very
frightening, its very scary."
Streibig said thats precisely the effect he
hoped to achieve: After years of the illness being
misdiagnosed, mismanaged and stigmatized, he says,
People should understand what its like
to go through this."
Even though schizophrenia patient Frey consulted
on the project, he found the simulation too disturbing
to sit all the way through. When Silberner tells him
she was terrified by the experience, Frey responds,
Yeah, you ought to be
Imagine not being
able to take off the goggles, the helmet."
For the full story, with slides and more information
on the new Janssen Pharmaceutica simulation of schizophrenia
- see the following link:
August 27, 2002
Pill-Splitting Can Yield Cost
Savings on Common Prescription Drugs, Stanford Researchers
STANFORD, Calif., Aug. 29 -- Squeezed by the rising
cost of prescription drugs, health plans and other
health-care organizations are pursuing cost-saving
strategies such as encouraging the use of generics,
using narrowly tailored drug formularies and implementing
multi-tiered co-payment systems.
Now, researchers at Stanford University Medical Center
have confirmed that a less-common strategy - pill-splitting
- could yield significant cost savings without compromising
drug efficacy or safety. They emphasize that pill-splitting
must be implemented with careful controls and begin
with a doctor-patient conversation.
"When properly implemented, pill-splitting can
be a safe, viable cost-saving strategy," said
Randall Stafford, MD, PhD, a researcher at the Stanford
Center for Research in Disease Prevention and lead
author of an article published in the August issue
of the American Journal of Managed Care. "Physicians
should consider using pill-splitting with selected
medications and patients, and patients may want to
bring it up with their doctors."
The researchers emphasized that pill-splitting must
be implemented with drug-specific and patient-specific
criteria to ensure patient safety. Just as certain types
of medications are unsuitable for pill-splitting - including
extended-release medications and those with enteric
coatings - certain patients may be unable to split tablets
consistently and accurately. Such patients may include
those with poor eyesight, loss of a limb, tremors, debilitating
arthritis, dementia or psychosis. The researchers noted
that results are best when the patient uses a pill-splitting
device and is trained to use it.
Pill-splitting should be embarked upon only after a
discussion between physician and patient, Stafford explained.
"We're not advocating this as a global solution.
It needs to be conducted in the context of doctor-patient
communication." He noted that the list of 11 medications
he identified for pill-splitting isn't exhaustive and
may differ depending on local practices and
The researchers acknowledged that some physicians
are reluctant to suggest pill-splitting because of
concerns that patients may be unwilling or unable
to split pills accurately. Stafford's research suggests
that pill-splitting is likely to be safe and effective
with appropriate screening, but he said further research
is needed o this question.
He noted that pill-splitting would help those who
pay for prescription drugs out-of-pocket, including
the uninsured and some Medicare beneficiaries. For
them, pill-splitting "may make newer, more expensive
medications available to people who might not otherwise
Potential cost savings from pill-splitting:
Clonazepam [Klonopin]/Panic disorder; epilepsy/41
Citalopram [Celexa]/Depression/46 percent savings
Atorvastatin [Lipitor]/High cholesterol/33 percent
Paroxetine [Paxil]/Depression; anxiety/46 percent
Nefazodone [Serzone]/Depression/49 percent savings
Sertraline [Zoloft]/Depression/46 percent savings
Olanzapine [Zyprexa]/Schizophrenia; bipolar disorder/31
*average potential cost savings of pill-splitting,
in percentage terms, over varying dosages of each
Medical Food for Tardive
Drug as food reduces involuntary body movements.
Tarvil, formulated as a "medical food,"
was introduced at a medical meeting and is said
to be the first product to effectively manage the
symptoms of tardive dyskinesia (TD) in men. Tarvil
decreases the symptoms that occur secondarily to
the anti-psychotic medications used to treat severe
mental illness, such as schizophrenia. TD affects
as many as one million people in the U.S. Clinical
research shows that a decreased ability to clear
phenylalanine is associated with symptoms of TD
in men. Tarvil is a powdered pineapple-flavored
drink mix. The recommended usage, under guidance
of a physician, is three times a day, dependent
on the patient's body weight and condition.
(Source: SHS North America, Rockville, MD; presentation
at the 155th Annual American Psychiatric Association
Meeting in Philadelphia.)
August 9, 2002
Risperdal Consta to be launched in United Kingdom
UK Joins Germany next week in introducing first
long-acting, injection form of atypical antipsychotic
Saunderton, United Kingdom - The Medicines Control
Agency in the United Kingdom has approved Janssen-Cilag's
Risperdal Consta [risperidone], clearing the way
for the launch next week of the only approved long-acting
injection developed for a newer-generation, atypical
antipsychotic. The UK action follows the recent
approval of Risperdal Consta in Germany, where the
product will be launched next week as well. In a
number of other countries, Risperdal Consta is in
late-stage regulatory review.
Janssen Pharmaceutica Release: Germany Approves
First Atypical Antipsychotic To Be Available As
180 Years After Gregor Mendel,
UC Irvine Researchers Unlocking Secrets of Genetics
IRVINE, Calif., July 29, 2002
" Gene Chips on the Brain Unlocking Cause
of Mental Disorders"
Schizophrenia and depression are two common and
devastating mental diseases; their cause is still
unknown. But some advanced computer technology is
helping Dr. William Bunney, chairman of psychiatry,
and his colleagues find genes that are most closely
associated with the disorders. Using new "microarray
chips" that contain information on tens of
thousands of genes in the brain, the researchers
are looking for differences in gene activation between
normal brains and people who died with these disorders.
"With microarrays we can identify genes that
are significantly different in schizophrenia and
depression, and discover brain pathways that may
help us understand the dysfunctions in these illnesses,"
September 23, 2002 Monday Final Edition
Speaker (Fred Frese) surmounted his own mental
BYLINE: SUSAN SCHWARTZ
Twelve years after he was declared insane and committed
to an Ohio state hospital at 25, dazed and delusional
with paranoid schizophrenia, Fred Frese was promoted
to chief psychologist at the largest hospital in
the system that had confined him.
Despite repeated hospitalizations over a 10-year
period, he was able to hold jobs, he married, had
children and earned a master's and doctoral degree.
Among his accomplishments, Frese, now 61, holds
university faculty appointments, has published extensively
and is a longtime activist on behalf of people with
serious mental illnesses. Since retiring from the
hospital in 1995, he has traveled extensively, sharing
his experience of living successfully with an often-devastating
mental illness. He'll be in Montreal on Wednesday.
Schizophrenia, believed to result from a combination
of biological and environmental factors, typically
develops between the ages of 17 and 25. Classic
symptoms include an inability to separate fantasy
from reality and the hearing of inner voices.
Historically, schizophrenia was viewed as a degenerative
disorder from which no one recovered. In recent
years, however, the notion that recovery is possible
has gained momentum.
"With mental illness, we can't talk about
cure," said Ella Amir, executive director of
AMI-Quebec, a support group for families living
with mental illness.
"I think recovering is a process which is
ongoing, which may involve some relapses along the
way. It is not something you do and finish doing.
Recovery means putting an accent on what these people
Frese considers himself recovering, not recovered.
"My experience is that mental illness is much
more analogous to diabetes," he said. "With
proper care you can function in a normal mode, but
you always have vulnerabilities."
In A Beautiful Mind, Russell Crowe portrayed mathematician
John Nash who, like Frese, emerged from the stranglehold
of paranoid schizophrenia. Frese liked that the
film showed that "a person with the disorder
can make significant contributions." Just as
Friday, 23 August, 2002,
15:50 GMT 16:50 UK, BBC News Service
Mystery particle' in schizophrenics
Tests will continue on the particles A tiny
particle found in the spinal fluid of schizophrenia
patients is baffling doctors who cannot work out
what it is. The Swedish researcher involved has
even suggested it might be "a new form of
life", although other experts say this is
However, it could mean that doctors have a reliable
test for schizophrenia. The study, led by experts
at the Karolinska Institute in Stockholm, involved
giving 22 schizophrenics, and 38 apparently healthy
"control" patients lumbar punctures
to get a sample of their cerebrospinal fluid.
Tiny spherical particles were found in the fluid
from 20 of the 22 schizophrenic patients, but
only two out of the 38 controls. The study then
focused on trying to work out what the particles
actually were. First a simple method of scanning
for the presence of DNA - basic genetic code -
failed to reveal anything.
He suggested that the next step might be to use
more detailed tests to analyse the particles further.
He added that it was unlikely that similar experiments
could be carried out here or in the US, as ethical
approval for lumbar punctures on schizophrenic
patients for this reason would be difficult to
The research was published in the journal Neuroscience
For Full BBC News Article on this: http://news.bbc.co.uk/1/hi/health/2212766.stm
EPA (Omega 3 Fatty Acid) Useful Add-on Therapy
By: Laurie Barclay, MD
Sept. 9, 2002 Ethyl-eicosapentaenoic acid
(EPA) may be a useful add-on therapy for schizophrenia,
according to results of a randomized, placebo-controlled
trial published in the September issue of the
American Journal of Psychiatry. Patients who were
still symptomatic after six months of standard
therapy had a significant reduction in both positive
and negative symptoms after 12 weeks of treatment.
"Extrapyramidal symptoms and limited efficacy
are serious limitations of conventional antipsychotics,
while high acquisition costs have put the novel
antipsychotics beyond the reach of patients in
lower-income countries," write Robin Emsley,
MD, from the University of Stellenbosch, Cape
Town, South Africa, and colleagues. "Omega-3
polyunsaturated fatty acids may offer an affordable
"EPA may be an effective, safe, and well-tolerated
add-on treatment in chronic schizophrenia,"
the authors write. "If efficacy in psychosis
and tardive dyskinesia is confirmed, it is likely
to lead to revision of our understanding of the
pathophysiology and treatment of these disorders."
Am J Psychiatry. 2002;286(6):159(9):1596-1598
and Age Web Site News
30 September 2002
Aripiprazole looks promising for treating schizophrenia
Researchers in the US have found aripiprazole effective
for the treatment of positive and negative symptoms
of schizophrenia and schizoaffective disorder.
Aripiprazole has a unique pharmacological profile
in that it acts as a potent partial agonist at dopamine
D2 receptors, a partial agonist at serotonin 5-HT1A
receptors, and an antagonist at 5-HT2A receptors.
J Clin Psychiatry 2002; 63: 763771
CyDex, Inc. Announces Second
U.S. Approval of a Captisol-Enabled Prescription
OVERLAND PARK, Kan.,
CyDex announced the second U.S. approval of a Captisol-Enabled
Geodon for Injection (ziprasidone mesylate), the
first atypical antipsychotic intramuscular
therapy for rapid control of acute agitation in
schizophrenia from Pfizer Inc.
CAPTISOL is an advanced formulation system that
improves the solubility of drug compounds.
Pfizer received clearance from the Food and Drug
Administration for use of Geodon for Injection to
rapidly control agitated behavior in patients with
schizophrenia. Geodon for Injection , an intramuscular
formulation for acute therapy, complements Geodon
(ziprasidone HCl) capsules that have been available
in the United States since the first quarter of
2001. Pfizer first launched both the oral and intramuscular
forms in 2000 in Sweden (under the trade names Zeldox
and Zeldox IM). Zeldox IM is currently approved
in seventeen other countries including Germany,
Spain and Brazil .
Edmonton Journal September
LENGTH: 690 words
A personal look at schizophrenia
By Mike Sadava
Alex Viszmeg's film about schizophrenia doesn't
have the Hollywood lustre of A Beautiful Mind, but
his first-hand knowledge of the illness could take
the viewer further into understanding the nature
of the beast.
Viszmeg's 42-minute video Invisible Odyssey, which
premieres Thursday night at the Metro Cinema, might
be the first movie on the subject made by someone
who suffers from schizophrenia.
At a preview he gave me Tuesday in the offices
of FAVA, the Film and Video Arts Society of Alberta,
I found the film to be enlightening, disturbing
like a bad drug trip, at times overwhelming, yet
striking a note of hope.
Interviews, electronic music, surrealistic poetry,
clips from the classic Lon Chaney movie The Wolf
Man and clips from an old National Film Board series
about schizophrenia are interwoven with footage
from Viszmeg's experimental films and random images.
It's not exactly pleasant viewing, hearing about
the voices in people's heads, paranoia and the strange
hallucinations, but it starts to give an inkling
of what it's like to suffer from this illness.
In an interview in the FAVA smoking room (like
most schizophrenics, Viszmeg is a chain smoker),
he says he was concerned about turning people off
when he made the movie, but he was also determined
not to softpedal the reality of the disease. "It's
sort of a sketch of what it's like. But everyone
is individual, and everyone has his own story."
The upbeat ending comes from sufferers and medical
professionals alike talking about the improvements
in drug therapies, and how people with schizophrenia
can improve their lives by doing activities they
are passionate about. For example, an artist who
describes how he takes refuge in sketching during
the dark moments asserts that people with schizophrenia
productive, that they are not "discards"
"I wanted the ending to be up -- it's a dark
journey, but to come out of it with some hope."
This film has been the product of Viszmeg's journey
through schizophrenia and more than 25 years' worth
of involvement in film.
Now 48, he graduated from Ryerson in film arts
in 1978. Acetate seems to run in the blood of the
Viszmeg family -- his brother was the late Joe Viszmeg,
a well-known Edmonton filmmaker who received national
exposure for his moving films about his battle with
cancer, which killed him three years ago.
A native of Cobourg, Ont., Alex moved to Edmonton
in the 1980s after Joe was established here and
was working at post-production and film processing,
and making his own experimental films.
He was diagnosed with schizophrenia in 1989, after
what he calls a long period of denial.
Ironically, film, which has been his salvation,
also may have contributed to the onset of schizophrenia.
He was working in total darkness processing film,
and his mind started playing tricks on him.
He has been living on a disability pension and
is on medication, but thankfully on a dosage that's
low enough that he doesn't suffer from the bloating
that's a common side-effect of the drug therapy.
He got the idea for the video about five years
ago, after noticing a dearth of information in the
media about schizophrenia.
With support from the Canada Council, the Alberta
Foundation for the Arts and FAVA, he started production
in 1999. He hopes it will get play in festivals
and be used for educational purposes, and possibly
He says it's neither a narrative nor a documentary,
but an effort to fit a bunch of pieces together.
The clips from The Wolf Man, for instance, draw
out a parallel between a mental illness and the
mythical stigma of being a werewolf.
"The Wolf Man, he's torn inside about what's
happening to him and he doesn't know what's going
03 September 2002
Use of schizophrenia medications not a case
of new replacing old
Researchers from the US find that the dynamic nature
of pharmacotherapy for schizophrenia makes it important
for both conventional and atypical antipsychotics
to be included in drug formularies.
Douglas Leslie (Yale School of Medicine, New Haven,
Connecticut) and Robert Rosenheck (Veteran's Affairs
Connecticut Mental Illness Research, Education,
and Clinical Center, West Haven, Connecticut) looked
at how the newer atypical antipsychotics, clozapine,
risperidone, olanzapine, and quetiapine, have been
"diffused" in a national healthcare system.
Of 27,323 patients, 12,440 received conventional
antipsychotics, 7649 received risperidone, 6613
were prescribed clozapine, and the remaining 621
Patients who had stable prescriptions of clozapine
were the least likely to be switched (18%), while
patients receiving quetiapine were the most likely
to be switched (37%).
Interestingly, those with regular prescriptions
of conventional antipsychotics stayed on their medication
the longest before switching.
Furthermore, olanzapine was the most common drug
for patients to be switched to (1907), followed
by risperidone (1581), conventional antipsychotics
(1140), quetiapine (758), and clozapine (40).
The team notes that only 31% of patients who switched
maintained a stable regimen on their new medication.
Based on the findings, the team concludes "that
the growth in the use of atypical medications does
not result from a simple replacement of the older
drugs with the newer agents but from a more dynamic
process of iterative decision making."
The study is published in the American Journal
Am J Psychiatry 2002; 159: 15341540
21 August 2002 Amisulpride improves depressive
symptoms in schizophrenia
Researchers have found amisulpride to be superior
to haloperidol and risperidone for the treatment
of depression in patients with schizophrenia.
Noting that the treatment of affective symptoms
in patients with schizophrenia remains a challenge,
Jozef Peuskens (Universitair Centrum Sint Jozef,
Kortenberg, Belgium) and colleagues pooled data
from three separate studies involving 612 patients
with schizophrenia who were treated with amisulpride,
risperidone, or haloperidol.
Eur Neuropsychopharm 2002; 12: 305310
September 27, 2002
NEUROLOGY: deCODE publishes landmark study linking
the Neuregulin 1 gene to schizophrenia
deCODE genetics (DCGN) announced the publication
of a paper describing the company's work on the
genetics of schizophrenia.
The paper presents data from deCODE's population
genetics research linking Neuregulin 1 to schizophrenia,
as well as the results of subsequent functional
studies underscoring the role of this gene in the
pathology of the disease. The Neuregulin pathway
has yielded druggable targets, which deCODE is employing
in its collaboration with Roche to discover new
and more effective treatments for schizophrenia.
The paper, entitled "Neuregulin 1 and susceptibility
to schizophrenia," has been published in the
online edition of the American Journal of Human
deCODE scientists succeeded in establishing the
link between schizophrenia and the Neuregulin 1
gene, located on the short arm of chromosome 8,
by leveraging the company's resources for pinpointing
key genes involved in common diseases. These include
a genealogical database covering the entire Icelandic
population; unrivalled genotyping capacity and know-how;
and the company's high-density genetic map of the
human genome. deCODE's research brought together
genome-wide and detailed genotypic data from more
than 800 volunteer patients and unaffected relatives
from across Iceland.
The findings reported are further supported by
at least five previous studies that offered suggestive
linkage between schizophrenia and a region on the
short arm of chromosome 8 containing the Neuregulin
September 27, 2002
HEADLINE: SCHIZOPHRENIA: Cause may be interaction
of genes and viruses in glia cells
A report in the open-access journal BMC Psychiatry
presents a new hypothesis that may explain the causes
The hypothesis hinges on glia, a special type of
cell that is important for the maintenance of the
connections between brain cells. By re-examining
previously published research, the authors suggested
that schizophrenia may be caused by a combination
of defective genes, which result in deficiencies
of a variety of growth factors in glia, and infection
by viruses, which may further weaken the glia. They
concluded that this "weakening" of glia
may result in the breakdown of connections between
brain cells leading to the development of schizophrenia.
It is clear that schizophrenia has a strong genetic
component; however analysis of individual genes
alone will not give us a full understanding the
causes of schizophrenia.
Irving Gottesman, one of the authors of this paper
and originator of the now widely accepted polygenic
model of schizophrenia explained, "The investigation
of individual genes in isolation has its limitations
since virtually all important biological phenomena,
from normal brain functioning to schizophrenia,
are the result of complex systems. What is needed
is a systems approach for understanding the development
This insight motivated Gottesman, and his colleagues
Hans Moises and Tomas Zoega, to apply such an approach
to previously published results of schizophrenia
Human brains are made up of two main types of cells,
nerve cells, which carry electrical impulses around
the brain and glia, which are important for the
normal development of the brain in the young and
the maintenance of nerve connections in adults.
The authors argued that many of the genes implicated
in the development of schizophrenia code for factors
involved in the development of glia cells.
In addition they hypothesized that some viral infections
may cause additional weakening of glial cells, which
in turn may lead to the disruption of brain cell
connections and the development of schizophrenia.
"Epidemiological data indicate that all humans
must harbor viruses in the glial cells of their
brains, and since reproduction is a necessity for
these viruses to survive, it seems reasonable to
presume that they are reproducing at low levels
in glial cells and that this results in an additional
weakening of glial functioning", explained
This new provocative hypothesis bridges the gap
between several previously unrelated schizophrenia
hypotheses, most notably the genetic, the neurodevelopmental
and the virus hypotheses, thereby providing a unifying
explanation for the development of schizophrenia.
It is hoped that by testing this hypothesis in the
laboratory, researchers will come up with new ways
of treating this debilitating brain disease.
I just got this link (below) from one of the top
schizophrenia researchers (Dr. Irv. Gottesman).
If you're more scientifically inclined - this may
be of interest:
The Guardian (London)
September 17, 2002
No smoke without fear: Is there really a link
between cannabis and psychosis? Robin Murray is
in no doubt
BYLINE: Robin Murray
As a consultant psychiatrist working in the Maudsley
Hospital, which serves the Brixton area, I have
been surprised that in all the recent discussions
about cannabis, there has been virtually no mention
of the drug's relationship to psychosis.
Psychiatrists have known for 150 years that heavy
consumption of cannabis can produce hallucinations.
This was thought to be rare and transient until
the 1980s when, as cannabis consumption rose across
Europe and the USA, it became apparent that people
with chronic psychotic illnesses were more likely
to be daily consumers of cannabis. Here in Britain,
for example, people with schizophrenia do not take
more alcohol, heroin, or ecstasy than the rest of
us - but they are twice as likely to smoke cannabis
regularly. Since people with schizophrenia have
a miserable life, most psychiatrists initially thought
that if the odd spliff brought them some pleasure,
what was the harm? Then, in the mid-90s, a Dutch
psychiatrist named Don Lintzen from the University
Clinic in Amsterdam noted that people with schizophrenia
who used a lot of cannabis had a much worse outcome
than those who didn't. This was confirmed by other
studies, including a four-year follow-up at the
Maudsley Hospital. Those who continued to smoke
cannabis were three times more likely to develop
a chronic illness than those who didn't.
Why does cannabis exacerbate psychosis? In schizophrenia,
the hallucinations result from an excess of a brain
chemical called dopamine. All the drugs that cause
psychosis - amphetamines, cocaine and cannabis -
increase the release of dopamine in the brain. In
this way, they are distinct from illicit drugs such
as heroin or morphine, which do not make psychosis
The distraught parents of a young man diagnosed
with schizophrenia tell me that their son was a
very bright child with no obvious psychological
problems. Then, in his mid-teens, his school grades
deteriorated and he seemed to have trouble thinking
clearly. He complained that people were talking
about him behind his back.
After years of increasingly bizarre behaviour,
he dropped out of school, job and university, and
was finally admitted to a psychiatric unit, overwhelmed
by paranoid fears and persecution by voices. The
parents tell me that, at some point during this
downward spiral, they realised their son was dependent
on cannabis. The National Schizophrenia Fellowship
(Rethink) is full of parents who see cannabis as
the cause of their son's or, less commonly, daughter's
Psychiatrists began to wonder if cannabis could
actually cause psychosis as well as make established
psychosis worse. A famous study interviewed 50,000
conscripts into the Swedish Army about their drug
consumption and followed them up. Those who were
heavy consumers of cannabis at 18 were six times
more likely to be diagnosed with schizophrenia over
the next 15 years than those did not take it.
This year, Dutch epidemiologist Jim Van Os published
the results of his study, in which 7,500 people
were interviewed about their drug consumption and
followed up for three years. Once again, regular
consumers of cannabis were more likely to develop
psychosis than those who didn't. Two other studies
with similar findings are in progress.
It is perhaps surprising that it took the professionals
so long to reach this conclusion. For example, it
is widely accepted in Jamaica that too much ganja
can cause paranoia. Several famous Rastafarians
spent their last years incarcerated in Bellevue,
the squalid mental hospital in Kingston, among them
the legendary ska trombonist, Don Drummond.
Cannabis is now one of the biggest problems on
in-patient psychiatric wards in England's major
cities. It is common at Maudsley for those making
progress to relapse suddenly. The explanation comes
when a urine sample tests positive for cannabis.
The same effect has been shown at Yale Medical School,
where volunteers were given THC - the major active
ingredient of cannabis - by injection. Psychotic
symptoms could be produced in normal subjects, and
people with schizophrenia had a brief exacerbation
of their psychosis.
So will reclassifying cannabis cause more people
to become psychotic? The incidence of schizophrenia
in south London has doubled since the 1960s; the
use of cannabis and cocaine could be a factor. The
increase in the prevalence and the deteriorating
outcomes of schizophrenia due to cannabis use is
the main reason why psychiatric services in London
are in such a mess.
Any public debate on cannabis needs to take account
of the risks as well as the pleasure. Pro-marijuana
campaigners claim, extrapolating from their Saturday-night
joint, that cannabis is totally safe. Yet they would
be unlikely to claim that a bottle of vodka a day
is healthy on the basis of sharing a bottle of Chablis
No drugs that alter brain chemistry are totally
safe. Just as some who drink heavily become alcoholic,
so a minority of those who smoke cannabis daily
go psychotic. Society has to balance the enjoyment
that the majority get from cannabis with the harm
it causes to a vulnerable few.
Robin Murray is professor of psychiatry at the
Institute of Psychiatry, and consultant psychiatrist
at the Maudsley Hospital.
10 September 2002
Multiple genes behind schizophrenia in isolated
US scientists have found that even in the most
remote populations, schizophrenia is associated
with multiple genes.
William Byerley (University of California, Irvine)
and colleagues investigated the genetic basis of
schizophrenia in the geographically and culturally
isolated population of Palau in Micronesia.
Using markers every 10 centimorgans (cM), the researchers
genotyped five, large multigenerational schizophrenia
pedigrees, and found the number of affected/unaffected
individuals in each family varied from 11/21 to
Fitting a simple dominant and recessive model to
the data, the team were able to calculate a substantial
logarithm of odds (LOD) score for each family. A
LOD score of above 3 indicates that two loci are
close together on a chromosome and are likely to
be inherited together.
"Predictably, the most informative pedigrees
produced the best linkage results," the scientists
comment. They reveal that one pedigree produced
a LOD of 3.4 for the dominant model, with seven
of nine individuals with schizophrenia, mainly third
or fourth degree relatives, sharing a 15 cM haplotype
on chromosome distal 5q.
A second pedigree showed a promising LOD of 2.6
for the recessive model on chromosome distal 3q,
while two other pedigrees showed modest LODs (>2)
for 5q and 9p. The fifth pedigree produced no evidence
of linkage, the researchers report.
Writing in the journal Molecular Psychiatry, Byerley
et al conclude: "Similar to the results for
other populations, our results suggest that there
are multiple genes conferring liability to schizophrenia
even in the small population of Palau (roughly 21,000
individuals) in remote Oceania."
Mol Psychiatry 2002; 7: 689694