Links for Keyword: Schizophrenia

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Imagine that, after feeling unwell for a while, you visit your GP. "Ah," says the doctor decisively, "what you need is medication X. It's often pretty effective, though there can be side-effects. You may gain weight. Or feel drowsy. And you may develop tremors reminiscent of Parkinson's disease." Warily, you glance at the prescription on the doctor's desk, but she hasn't finished. "Some patients find that sex becomes a problem. Diabetes and heart problems are a risk. And in the long term the drug may actually shrink your brain … " This scenario may sound far-fetched, but it is precisely what faces people diagnosed with schizophrenia. Since the 1950s, the illness has generally been treated using antipsychotic drugs – which, as with so many medications, were discovered by chance. A French surgeon investigating treatments for surgical shock found that one of the drugs he tried – the antihistamine chlorpromazine – produced powerful psychological effects. This prompted the psychiatrist Pierre Deniker to give the drug to some of his most troubled patients. Their symptoms improved dramatically, and a major breakthrough in the treatment of psychosis seemed to have arrived. Many other antipsychotic drugs have followed in chlorpromazine's wake and today these medications comprise 10% of total NHS psychiatric prescriptions. They are costly items: the NHS spends more on these medications than it does for any other psychiatric drug, including antidepressants. Globally, around $14.5bn is estimated to be spent on antipsychotics each year. Since the 1950s the strategy of all too many NHS mental health teams has been a simple one. Assuming that psychosis is primarily a biological brain problem, clinicians prescribe an antipsychotic medication and everyone does their level best to get the patient to take it, often for long periods. There can be little doubt that these drugs make a positive difference, reducing delusions and hallucinations and making relapse less likely – provided, that is, the patient takes their medication. © 2014 Guardian News and Media Limited

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19336 - Posted: 03.08.2014

Ian Sample, science correspondent Children born to fathers over the age of 45 are at greater risk of developing psychiatric problems and more likely to struggle at school, according to the findings of a large-scale study. The research found that children with older fathers were more often diagnosed with disorders such as autism, psychosis, attention deficit hyperactivity disorder (ADHD), schizophrenia and bipolar disorder. They also reported more drug abuse and suicide attempts, researchers said. The children's difficulties seemed to affect school performance, leading to worse grades at the age of 15 and fewer years in education overall. "We were shocked when we saw the comparisons," said Brian D'Onofrio, the first author of the study at Indiana University in the US. But he added that it was impossible to be sure that older age was to blame for the problems. Scientists have reported links between fathers' age and children's cognitive performance and health before but this study suggests the risks may be more serious than previously thought. The increased risks might be caused by genetic mutations that build up in sperm as men age. Researchers at Indiana University and the Karolinska Institute in Stockholm studied medical and educational records of more than 2.6 million babies born to 1.4 million men. The group amounted to nearly 90% of births in Sweden from 1973 and 2001. Using the records, the scientists added up diagnoses for psychiatric disorders and educational achievements and compared the figures for children born to fathers of different ages. © 2014 Guardian News and Media Limited

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 13: Memory, Learning, and Development
Link ID: 19303 - Posted: 02.27.2014

By MICHAEL HEDRICK I still remember the first group therapy session I went to after I got out of the hospital. I was 20 and had been diagnosed as schizophrenic after a road trip that took me from Colorado to the United Nations building in New York City, my mind riddled with notions of good and evil, demons and angels, and a determination to save the world. Now I was in something of a state of shock, having come to understand that amid the delusions and paranoia that swarmed through my head I was, in reality, insane. A constant need to move felt like ants crawling over my skin, a side effect of the antipsychotic medications I had been prescribed. Every second of every day, I felt like clawing out my eyes and tearing out my hair because I just couldn’t sit still. I held up my front, though. I smiled when I thought I had to and tried to be nice to people. Laughter, however, was not something that was possible, and wouldn’t be for a long time. The group was a dual-functioning therapy technique to address both mental health issues and drug abuse. I had been assigned to it after disclosing that I had a marijuana habit. The doctors had told me that therapy groups were an integral part of my getting better. I agreed to go only to get out of the hospital prison and back home to my warm bed. I sat in a circle with a melting pot of people. There was the construction worker still wearing dusty boots and clothes splattered with mud, and the depressed sorority girl, makeup and hair still impeccable. The two had formed a friendship over their history with methamphetamine. There was the quiet bipolar Hispanic man who spoke only in short staccato sentences, and the rotund marketing guy who introduced himself by saying his drugs of choice were food, cocaine and marijuana. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19302 - Posted: 02.27.2014

by Clare Wilson AS MANY as 1 in 10 cases of schizophrenia may be triggered by an autoimmune reaction against brain cells, according to early trial results shared with New Scientist. The finding offers the possibility of gentler treatments for this devastating mental illness. Last month, doctors at a conference at the Royal Society of Medicine in London were told to consider an autoimmune cause when people first show symptoms of schizophrenia. People with schizophrenia experience symptoms of psychosis, such as hallucinations, delusions and paranoia. It affects 1 per cent of people in the West and is thought to be caused by overactive dopamine signalling pathways in the brain. Anti-psychotic drugs don't always work wellMovie Camera and have serious side effects. Previous studies had found that antibodies that target the NMDA receptor on neurons trigger brain inflammation, leading to seizures, comas – and sometimes psychosis (Annals of Neurology, doi.org/fdgnpc). In the past few years, these antibodies have also been found in the blood of people whose only symptom is psychosis. In 2010, Belinda Lennox at the University of Oxford tested 46 people with recent onset of psychosis for antibodies known to target neurons. Three people – about 6 per cent – tested positive (Neurology, doi.org/chs532). "The question is whether a larger percentage of cases might have other antibodies which we cannot yet detect," says Robin Murray at the Institute of Psychiatry in London, who wasn't involved in the research. Now Lennox is conducting a larger trial. Early results suggest other antibodies could well be involved. © Copyright Reed Business Information Ltd.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 19251 - Posted: 02.15.2014

Schizophrenia and related mental illnesses can have a devastating effect on people who suffer from them, often making it impossible for them to work or maintain normal social relationships. Antipsychotic drugs are usually the first line of defense, but they can have serious side effects. A new study concludes that psychological approaches could be an alternative for patients who either can’t or won’t take medication, although some critics continue to question the effectiveness of these interventions. Schizophrenia, which can involve hallucinations, delusions, paranoia, emotional problems, and severe difficulty focusing on daily tasks, affects about 1% of populations worldwide. More than 20 antipsychotic medications, such as risperidone, haloperidol, and clozapine, are now on the market, and they are often effective in temporarily relieving the worse symptoms. But when taken for extended periods, such drugs can cause uncontrollable muscle movements, serious weight gain, and higher risk of heart attacks. In recent years, a number of psychiatrists and psychologists have begun to advocate psychological approaches, including an approach called cognitive behavioral therapy (CBT), as an adjunct to antipsychotic drugs. With CBT, which has long been shown to be effective for depression and anxiety disorders, a therapist takes the subject through a series of guided steps designed to explore alternative interpretations and explanations of what he or she is experiencing, with the goal of changing both outlook and behavior. A schizophrenic patient who is having hallucinations might be encouraged to stop trying to fight them off or suppress them, for example, or to stop engaging with voices in his or her head, to test how strong such symptoms really are and how much control they exert over the subject’s life. The technique also involves what practitioners call “normalization”: The patient might be reassured that hearing voices and seeing things that are not there is an experience that many normal people have from time to time, thus reducing some of the anxiety that makes sufferers feel distressed and isolated. © 2014 American Association for the Advancement of Science

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19227 - Posted: 02.08.2014

By James Gallagher Health and science reporter, BBC News Changing the way people think about and deal with schizophrenia could be as effective as drugs, say researchers. Cognitive behavioural therapy is an officially recommended treatment, but is available to less than 10% of patients in the UK with schizophrenia. A study published in the Lancet indicates CBT could help the many who refuse antipsychotic medication. Experts say larger trials are needed. About four-in-10 patients benefit from taking antipsychotic medication. But the drugs do not work for the majority and they cause side-effects such as type 2 diabetes and weight gain. Up to half of patients with schizophrenia end up not taking the drugs. The study looked at cognitive behaviour therapy in 74 people. The therapy works by identifying an individual patient's problem - such as hearing voices, paranoid thinking or no longer going out of the house - and developing techniques to deal with them. Prof Tony Morrison, director of the psychosis research unit at Greater Manchester West Mental Health Foundation Trust, said: "We found cognitive behavioural therapy did reduce symptoms and it also improved personal and social function and we demonstrated very comprehensively it is a safe and effective therapy." It worked in 46% of patients, approximately the same as for antipsychotics - although a head-to-head study directly comparing the two therapies has not been made. Douglas Turkington, professor of psychiatry at Newcastle University, said: "One of our most interesting findings was that when given the option, most patients were agreeable to trying cognitive therapy." BBC © 2014

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19212 - Posted: 02.06.2014

By BENEDICT CAREY BETHESDA, Md. — The police arrived at the house just after breakfast, dressed in full riot gear, and set up a perimeter at the front and back. Not long after, animal rights marchers began filling the street: scores of people, young and old, yelling accusations of murder and abuse, invoking Hitler, as neighbors stepped out onto their porches and stared. It was 1997, in Decatur, Ga. The demonstrators had clashed with the police that week, at the Yerkes National Primate Research Center at nearby Emory University, but this time, they were paying a personal call — on the house of the center’s director, inside with his wife and two teenage children. “I think it affected the three of them more than it did me, honestly,” said Dr. Thomas R. Insel, shaking his head at the memory. “But the university insisted on moving all of us to a safe place for a few days, to an ‘undisclosed location.’ “I’ll say this. I learned that if you’re going to take a stand, you’re going to make some people really angry — so you’d better believe in what you’re doing, and believe it completely.” For the past 11 years, Dr. Insel, a 62-year-old brain scientist, has run an equally contentious but far more influential outfit: the National Institute of Mental Health, the world’s leading backer of behavioral health research. The job comes with risk as well as power. Patient groups and scientists continually question the agency’s priorities, and politicians occasionally snipe at its decisions. Two previous directors resigned in the wake of inflammatory statements (one on marijuana laws, one comparing urban neighborhoods to jungles), and another stepped down after repeatedly objecting to White House decisions. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 1: Biological Psychology: Scope and Outlook
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 1: An Introduction to Brain and Behavior
Link ID: 19202 - Posted: 02.04.2014

By RICHARD A. FRIEDMAN, M.D. “How the Federal Government Destroyed the Mental Illness Treatment System”: That subtitle is the opening shot across the bow in this jeremiad of a book by the psychiatrist Dr. E. Fuller Torrey. It could just as well have read: “How a group of well-intentioned, starry-eyed idealists made a hash of mental health care.” You could hardly blame them for trying, though. The care of people with serious mental illness was long a national disgrace. By the 1950s, slightly more than half a million psychiatric patients resided in overcrowded and underfunded state mental hospitals, often under appalling conditions. Related Coverage Enter a group of high-minded psychiatrists with a vision to “create a brave new world, a mentally healthy America,” in Dr. Torrey’s words. Armed with little more than optimism, they helped start the National Institute of Mental Health and set in motion an ambitious agenda for the next half-century: closing the state mental hospitals, initiating a federal takeover of the mental health system, and creating a nationwide network of community mental health centers. Reform was well underway when President John F. Kennedy endorsed this new era in mental health in a 1963 speech, calling for a “bold new approach” in which “reliance on the cold mercy of custodial isolation will be supplanted by the open warmth of community concern and capability.” Those were heady days in American psychiatry, when psychoanalysis and the mental hygiene movement held sway and promised to cure all manner of ills by early intervention and improving the social environment. In hindsight, the therapeutic zeal of these professionals was impressively naïve: They were certain that severely mentally ill patients in state hospitals — many living there for decades — would magically adjust to the community and do well with outpatient treatment. How wrong they proved to be. © 2014 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19127 - Posted: 01.14.2014

By Tia Ghose and LiveScience Neurons derived from schizophrenic patients. Image: Dr. Kristen Brennand, Salk Institute for Biological Studies. Some so-called jumping genes that copy and paste themselves throughout the genome may be linked to schizophrenia, new research suggests. The new study, published Jan. 2 in Neuron, suggests these jumping genes may alter how neurons (or nerve cells in the brain) form during development, thereby increasing the risk of schizophrenia, study co-author Dr. Tadafumi Kato, a neurobiologist at the RIKEN Brain Science Institute in Japan, wrote in an email. Jumping genes, or retrotransposons, are mobile genetic elements that copy and paste themselves at different places throughout the genome. About half of the human genome is made of these mysterious elements, compared with the 1 percent of genes that actually code for making proteins, Kato said. Earlier studies had found that a certain type of jumping gene, known as long interspersed nuclear element-1 (LINE-1), was active in human brain cells. Kato and his colleagues wondered whether they might play a role in mental illness. To find out, the team conducted a post-mortem analysis of 120 human brains, 13 from patients who had been diagnosed with schizophrenia. The team found a higher number of LINE-1 copies in the brains of schizophrenics compared with other groups. © 2014 Scientific American

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19098 - Posted: 01.04.2014

People with severe mental illness such as schizophrenia or bipolar disorder have a higher risk for substance use, especially cigarette smoking, and protective factors usually associated with lower rates of substance use do not exist in severe mental illness, according to a new study funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. Estimates based on past studies suggest that people diagnosed with mood or anxiety disorders are about twice as likely as the general population to also suffer from a substance use disorder. Statistics from the 2012 National Survey on Drug Use and Health indicate close to 8.4 million External Web Site Policy adults in the United States have both a mental and substance use disorder. However, only 7.9 percent of people receive treatment for both conditions, and 53.7 percent receive no treatment at all, the statistics External Web Site Policy indicate. “Drug use impacts many of the same brain circuits that are disrupted in severe mental disorders such as schizophrenia,” said NIDA Director Dr. Nora D. Volkow. “While we cannot always prove a connection or causality, we do know that certain mental disorders are risk factors for subsequent substance use disorders, and vice versa.” In the current study, 9,142 people diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features, and 10,195 controls matched to participants according to geographic region, were selected using the Genomic Psychiatry Cohort program. Mental disorder diagnoses were confirmed using the Diagnostic Interview for Psychosis and Affective Disorder (DI-PAD), and controls were screened to verify the absence of schizophrenia or bipolar disorder in themselves or close family members. The DI-PAD was also used for all participants to determine substance use rates.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19090 - Posted: 01.04.2014

By MICHAEL M. PHILLIPS Roman Tritz’s memories of the past six decades are blurred by age and delusion. But one thing he remembers clearly is the fight he put up the day the orderlies came for him. “They got the notion they were going to come to give me a lobotomy,” says Mr. Tritz, a World War II bomber pilot. “To hell with them.” The orderlies at the veterans hospital pinned Mr. Tritz to the floor, he recalls. He fought so hard that eventually they gave up. But the orderlies came for him again on Wednesday, July 1, 1953, a few weeks before his 30th birthday. This time, the doctors got their way. The U.S. government lobotomized roughly 2,000 mentally ill veterans—and likely hundreds more—during and after World War II, according to a cache of forgotten memos, letters and government reports unearthed by The Wall Street Journal. Besieged by psychologically damaged troops returning from the battlefields of North Africa, Europe and the Pacific, the Veterans Administration performed the brain-altering operation on former servicemen it diagnosed as depressives, psychotics and schizophrenics, and occasionally on people identified as homosexuals. The VA doctors considered themselves conservative in using lobotomy. Nevertheless, desperate for effective psychiatric treatments, they carried out the surgery at VA hospitals spanning the country, from Oregon to Massachusetts, Alabama to South Dakota. The VA’s practice, described in depth here for the first time, sometimes brought veterans relief from their inner demons. Often, however, the surgery left them little more than overgrown children, unable to care for themselves. Many suffered seizures, amnesia and loss of motor skills. Some died from the operation itself. Mr. Tritz, 90 years old, is one of the few still alive to describe the experience. “It isn’t so good up here,” he says, rubbing the two shallow divots on the sides of his forehead, bracketing wisps of white hair.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19083 - Posted: 12.31.2013

Imagine this: Every day, you can feel people looking at you warily. They want to hurt you. Even the police are out to get you. You try to rid your mind of all the ill-intentioned people, but you can't ignore the other thing that is gnawing at you. Those bugs on your arm won't leave you alone, no matter how often you gouge at them. Such are the hallucinations and paranoia felt by those with a stimulant drug addiction. Sometimes the substance abuse is so severe it causes neurological damage and psychosis becomes a chronic condition. Combine untreated addiction with homelessness and physical health problems, and you get a health emergency. Vancouver police and the region's health authorities are desperately trying to figure out how to help the most vulnerable of mentally ill drug addicts. The province estimates that roughly 130,000 people in British Columbia suffer from a severe addiction and/or mental health illness. But police and emergency workers are increasingly dealing with a much smaller group of people whose brains have been damaged by their stimulant addiction and who appear to be responsible for random violent acts on Vancouver's streets. Dr. Nader Sharifi, addiction medicine lead with the Fraser Health Authority, said there are few good treatment options for those people. "It's a bit of a challenging question, because what we have available isn't necessarily structured for this patient sub-type. It's either structured for addiction, or structured for mental health illness, but not necessarily the two together." © CBC 2013

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19075 - Posted: 12.28.2013

By JULIE CRESWELL RALEIGH, N.C. — As darkness fell on a Friday evening over downtown Raleigh, N.C., Michael Lyons, a paramedic supervisor for Wake County Emergency Medical Services, slowly approached the tall, lanky man who was swaying back and forth in a gentle rhythm. In answer to Mr. Lyons’s questions, the man, wearing a red shirt that dwarfed his thin frame, said he was bipolar, schizophrenic and homeless. He was looking for help because he did not think his prescribed medication was working. In the past, paramedics would have taken the man to the closest hospital emergency room — most likely the nearby WakeMed Health and Hospitals, one of the largest centers in the region. But instead, under a pilot program, paramedics ushered him through the doors of Holly Hill Hospital, a commercial psychiatric facility. “He doesn’t have a medical complaint, he’s just a mental health patient living on the street who is looking for some help,” said Mr. Lyons, pulling his van back into traffic. “The good news is that he’s not going to an E.R. That’s saving the hospital money and getting the patient to the most appropriate place for him,” he added. The experiment in Raleigh is being closely watched by other cities desperate to find a way to help mentally ill patients without admitting them to emergency rooms, where the cost of treatment is high — and unnecessary. While there is evidence that other types of health care costs might be declining slightly, the cost of emergency room care for the mentally ill shows no sign of ebbing. Nationally, more than 6.4 million visits to emergency rooms in 2010, or about 5 percent of total visits, involved patients whose primary diagnosis was a mental health condition or substance abuse. That is up 28 percent from just four years earlier, according to the latest figures available from the Agency for Healthcare Research and Quality in Rockville, Md. By one federal estimate, spending by general hospitals to care for these patients is expected to nearly double to $38.5 billion in 2014, from $20.3 billion in 2003. © 2013 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 19071 - Posted: 12.27.2013

Amanda Mascarelli In children with certain gene variants, symptoms similar to common learning disabilities could be omens of serious psychiatric conditions. People who carry high-risk genetic variants for schizophrenia and autism have impairments reminiscent of disorders such as dyslexia, even when they do not yet have a mental illness, a new study has found. The findings offer a window into the brain changes that precede severe mental illness and hold promise for early intervention and even prevention, researchers say. Rare genetic alterations called copy number variants (CNVs), in which certain segments of the genome have an abnormal number of copies, play an important part in psychiatric disorders: Individuals who carry certain CNVs have a several-fold increased risk of developing schizophrenia or autism1. But previous studies were based on individuals who already have a psychiatric disorder, and until now, no one had looked at what effects these CNVs have in the general population. In a study published today in Nature2, researchers report that people with these variants but no diagnosis of autism or a mental illness still show subtle brain changes and impairments in cognitive function. “In psychiatry we always have the problem that disorders are defined by symptoms that patients experience or tell us about, or that we observe,” says study co-author Andreas Meyer-Lindenberg, a psychiatrist and the director the Central Institute of Mental Health in Mannheim, Germany, affiliated with the University of Heidelberg. This work, on the other hand, provides a glimpse into the biological underpinnings of people who are at risk of psychiatric disorders, he says. The team searched a genealogical database of more than 100,000 Icelanders, focusing on 26 genetic variants that have been shown to increase the risk of schizophrenia or autism. They found that 1,178 people in the database, or 1.16% of the sample, carried one or more of these CNVs. © 2013 Nature Publishing Group

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 13: Memory, Learning, and Development
Link ID: 19053 - Posted: 12.19.2013

By Sandra Steingard, What does it mean that the man who killed 12 people at the Washington Naval Yard had told people that he was “hearing voices”? I have spent 30 years as a psychiatrist treating people who are psychotic. Almost every day I meet with individuals who hear voices that no one else hears, are sure the TV or radio is talking to them or have such confused thinking that it is hard to understand what they are trying to tell me. Sometimes these patients lead quiet lives. But not uncommonly these voices get them into trouble. I’ve had patients who call the police repeatedly, demanding that they stop bugging their phone. And others who stay up all night talking back at the voices. Some accuse family members of being involved in the torment. In many cases, this is a frightening experience — for the people I see and those who love them. And the labels we use — “schizophrenia,” “bipolar disorder,” “psychosis” — only crudely capture these experiences. About 60 years ago, a group of drugs was discovered that appeared to quiet the voices, improve the clarity of thought and lessen the preoccupation with delusion beliefs. Originally called major tranquilizers and later renamed antipsychotic drugs, these have been considered essential for the treatment of people with schizophrenia. Once it was clear that these drugs were helpful in the short term, questions arose over how long people should remain on them. Studies done in the 1970s and 1980s looked at people who were stabilized after being treated with antipsychotic drugs for several months and then followed them for up to two years. Some continued on the drugs, while others stopped taking them. The relapse rate was much higher in the group that stopped the medications. Based on these studies, treatment guidelines now state that people should stay on anti-psychotics indefinitely. The problem with “indefinitely” is that antipsychotic drugs have many troubling side effects. © 1996-2013 The Washington Post

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19011 - Posted: 12.10.2013

Daniel Freeman and Jason Freeman Which illness frightens you most? Cancer? Stroke? Dementia? To judge from tabloid coverage, the condition we should really fear isn't physical at all. "Scared of mum's schizophrenic attacks", "Knife-wielding schizophrenic woman in court", "Schizo stranger killed dad", "Rachel murder: schizo accused", and "My schizophrenic son says he'll kill… but he's escaped from secure hospitals 7 times" are just a few of dozens of similar headlines we found in a cursory internet search. Mental illness, these stories imply, is dangerous. And schizophrenia is the most dangerous of all. Such reporting is unhelpful, misleading and manipulative. But it may be even more inaccurate than it first appears. This is because scientists are increasingly doubtful whether schizophrenia – a term invented more than a century ago by the psychiatric pioneer Eugen Bleuler – is a distinct illness at all. This isn't to say that individuals diagnosed with the condition don't have genuine and serious mental health problems. But how well the label "schizophrenia" fits those problems is now a very real question. What's wrong with the concept of schizophrenia? For one thing, research indicates the term may simply be functioning as a catch-all for a variety of separate problems. Six main conditions are typically caught under the umbrella of schizophrenia: paranoia; grandiosity (delusional beliefs that one has special powers or is famous); hallucinations (hearing voices, for example); thought disorder (being unable to think straight); anhedonia or the inability to experience pleasure; and diminished emotional expression (essentially an emotional "numbness"). But how many of these problems a person experiences, and how severely, varies enormously. Having one doesn't mean you'll necessarily develop any of the others. © 2013 Guardian News and Media Limited

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 18930 - Posted: 11.16.2013

By JOHN RUDOLF GUATEMALA CITY — DONALD RODAS, a baby-faced man in his late 20s with paranoid schizophrenia, arrived at Guatemala’s only public psychiatric hospital last year after being charged with murdering his parents. He says he often wanders freely through the sprawling facility of dilapidated one-story buildings and wooded courtyards, where detainees charged with crimes mingle with ordinary patients and the developmentally disabled. He sees ugly things. Those who refuse their medication are beaten and put in the “little room,” a barren isolation cell, he said. Desperate women sell their bodies for as little as 5 quetzales, or less than a dollar, to afford basic necessities. “I see when they have sex for money,” Mr. Rodas said in halting English. “To buy food. All they have is beans.” The United States began emptying out its vast asylum system in the 1960s, spurred by scathing reports of abuse and neglect, like a 1946 Life magazine exposé that described many institutions as “little more than concentration camps.” The transition to community-based care cut the institutionalized population by more than 90 percent by 1994. But community care resources failed to match demand in the United States, leading to widespread homelessness and an influx of the mentally ill into jails and prisons. Even so, deinstitutionalization is widely credited with ending the abuse and neglect that made mental institutions synonymous with a nightmarish netherworld. Yet this asylum-based model of mental health care remains the standard across much of the globe. In many poor and developing countries, thousands of mentally ill people are warehoused in dirty and dangerous institutions. Health experts and advocates who monitor such facilities say the picture varies little from country to country: overcrowded wards lacking in privacy; poor sanitation; physical and sexual abuse; routine use of restraints and long-term solitary confinement; and forced treatment, including electroshock without consent. The rights of patients judged to be mentally ill are easily stripped by the courts and are difficult if not impossible to regain. © 2013 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 18868 - Posted: 11.04.2013

Anne Trafton, MIT News Office Schizophrenia patients usually suffer from a breakdown of organized thought, often accompanied by delusions or hallucinations. For the first time, MIT neuroscientists have observed the neural activity that appears to produce this disordered thinking. The researchers found that mice lacking the brain protein calcineurin have hyperactive brain-wave oscillations in the hippocampus while resting, and are unable to mentally replay a route they have just run, as normal mice do. Mutations in the gene for calcineurin have previously been found in some schizophrenia patients. Ten years ago, MIT researchers led by Susumu Tonegawa, the Picower Professor of Biology and Neuroscience, created mice lacking the gene for calcineurin in the forebrain; these mice displayed several behavioral symptoms of schizophrenia, including impaired short-term memory, attention deficits, and abnormal social behavior. In the new study, which appears in the Oct. 16 issue of the journal Neuron, Tonegawa and colleagues at the RIKEN-MIT Center for Neural Circuit Genetics at MIT’s Picower Institute for Learning and Memory recorded the electrical activity of individual neurons in the hippocampus of these knockout mice as they ran along a track. Previous studies have shown that in normal mice, “place cells” in the hippocampus, which are linked to specific locations along the track, fire in sequence when the mice take breaks from running the course. This mental replay also occurs when the mice are sleeping. These replays occur in association with very high frequency brain-wave oscillations known as ripple events.

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders
Link ID: 18798 - Posted: 10.17.2013

Alison Abbott In a sign that psychiatric-disease research is entering a new era, the pharmaceutical giant Novartis has hired an expert in neural circuitry, rather than pharmacology, to head its relaunched neuroscience division. The appointment of 42-year-old Ricardo Dolmetsch, who has spent his entire career in academic research, signifies a radical policy shift for the company, as it moves away from conventional neurotransmitter research to concentrate on analysing the neural circuitry that causes brain diseases. The decision suggests Novartis is confident that after years of fruitless research in the field, revolutionary advancements in, for example, genetic and stem-cell technologies will pay dividends. The company intends to hire 100 new staff members for the department over the next 3 years. But the move is risky: even if it pans out, new drugs for common disorders such as schizophrenia could be decades away from reaching the market. Dolmetsch, a former senior director at the Allen Institute for brain Science in Seattle, Washington, who has also worked at Stanford University School of Medicine in California, says that his new role gives him access to previously unimaginable resources. “I had this idea that big pharma was a slow, plodding, conservative giant,” he says. “I was surprised by the depth of science at Novartis.” An expert in autism spectrum disorder, he was also attracted by the prospect of contributing to the development of therapies — something that academic institutions are poorly equipped to do — particularly because one of his own sons has autism. There was “not much enthusiasm” for studying disease at the Allen Institute, which focuses instead on basic research into brain science, he says. © 2013 Nature Publishing Group

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 13: Memory, Learning, and Development
Link ID: 18763 - Posted: 10.09.2013

By T. M. LUHRMANN STANFORD, Calif. — THE specter of violence caused by mental illness keeps raising its head. The Newtown, Conn., school killer may have suffered from the tormenting voices characteristic of schizophrenia; it’s possible that he killed his mother after she was spooked by his strange behavior and tried to institutionalize him. We now know that Aaron Alexis, who killed 12 people at the Washington Navy Yard on Monday, heard voices; many observers assume that he, too, struggled with schizophrenia. To be clear: a vast majority of people with schizophrenia — a disease we popularly associate with violence — never commit violent acts. They are far more likely to be the victims of violence than perpetrators of it. But research shows us that the risk of violence from people with schizophrenia is real — significantly greater than it is in the broader population — and that the risk increases sharply when people have disturbing hallucinations and use street drugs. We also know that many people with schizophrenia hear voices only they can hear. Those voices feel real, spoken by an external, commanding authority. They are often mean and violent. An unsettling question is whether the violent commands from these voices reflect our culture as much as they result from the disease process of the illness. In the past few years I have been working with some colleagues at the Schizophrenia Research Foundation in Chennai, India, to compare the voice-hearing experience of people with schizophrenia in the United States and India. The two groups of patients have much in common. Neither particularly likes hearing voices. Both report hearing mean and sometimes violent commands. But in our sample of 20 comparable cases from each country, the voices heard by patients in Chennai are considerably less violent than those heard by patients in San Mateo, Calif. © 2013 The New York Times Company

Related chapters from BP7e: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: Biological Basis of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 18681 - Posted: 09.21.2013