Chapter 12. Psychopathology: Biological Basis of Behavioral Disorders
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Richard Harris One of the frequent trials of parenthood is dealing with a picky eater. About 20 percent of children ages 2 to 6 have such a narrow idea of what they want to eat that it can make mealtime a battleground. A study published Monday in the journal Pediatrics shows that, in extreme cases, picky eating can be associated with deeper trouble, such as depression or social anxiety. The study followed a broad spectrum of children who had come to Duke University for routine medical care. Most kids dislike some foods (broccoli is a common villain), but the researchers counted a child as a severely picky eater if his or her food choices were so limited that it made meals at home difficult, and meals out all but impossible. Those extreme cases were rare — just 3 percent of all kids. But, as a group, they were twice as likely as the children who weren't picky to have a diagnosis of depression, and seven times as likely to have been diagnosed with social anxiety, according to the study. Nancy Zucker, director of the Duke Center for Eating Disorders, says parents of children who are extremely finicky may find it useful to seek help, because the kids may not simply outgrow the behavior on their own. And even if they eventually do, it can be disruptive to child and family alike in the meantime. A big question is what to do about less extreme cases, which in the Duke study made up 17 percent of all children. These children have a list of foods that they are reluctant to stray beyond. © 2015 NPR
By Nancy Szokan “This is a story of a family who made mistakes.” Thus Janet Sternburg begins her memoir of a close-knit Jewish family living in Boston. Her grandfather, Philip, was a cold, angry man who abandoned his wife and six children not long after the only son in the family, Bennie, was diagnosed as schizophrenic. As Bennie became increasingly violent and untreatable, the family — advised by a Harvard professor of psychiatry — agreed to submit him to a prefrontal lobotomy. More than a decade later, one of Bennie’s sisters, Francie, sank into a debilitating depression — relentlessly weeping, attempting suicide — and again, the solution was seen to be a lobotomy. While she was growing up, Sternburg accepted the lobotomies as her family’s normalcy. It was decades later, when she was an adult living in California, that it occurred to her to question why such terrible measures had been taken. “The years came back to me when my aunt and uncle were driven to our house” for a regular visit, she writes. As the grandmother cooked and the aunts and uncles talked and played cards, the two lobotomized siblings “sat blankly on the couch — Bennie at one end, virtually unmoving, my aunt crumpled into the far corner. . . . With the sharp return of memories came the realization that even as a child I had a slight awareness . . . that something wrong had been done.” But she also knew her relatives as good and generous people. So she set out to learn what happened, and why. “White Matter: A Memoir of Family and Medicine” is Sternburg’s tale of what she discovered, put in the context of her family’s history.
Steve Connor A computer game designed by neuroscientists has helped patients with schizophrenia to recover their ability to carry out everyday tasks that rely on having good memory, a study has found. Patients who played the game regularly for a month were four times better than non-players at remembering the kind of things that are critical for normal, day-to-day life, researchers said. The computer game was based on scientific principles that are known to “train” the brain in episodic memory, which helps people to remember events such as where they parked a car or placed a set of keys, said Professor Barbara Sahakian of Cambridge University, the lead author of the study. People recovering from schizophrenia suffer serious lapses in episodic memory which prevent them from returning to work or studying at university, so anything that can improve the ability of the brain to remember everyday events will help them to lead a normal life, Professor Sahakian said. Schizophrenia affects about one in every hundred people and results in hallucinations and delusions (Rex) Schizophrenia affects about one in every hundred people and results in hallucinations and delusions (Rex) “This kind of memory is essential for everyday learning and everything we do really both at home and at work. We have formulated an iPad game that could drive the neural circuitry behind episodic memory by stimulating the ability to remember where things were on the screen,” Professor Sahakian said. © independent.co.uk
By JULIE SCELFO Kathryn DeWitt conquered high school like a gold-medal decathlete. She ran track, represented her school at a statewide girls’ leadership program and took eight Advanced Placement tests, including one for which she independently prepared, forgoing the class. Expectations were high. Every day at 5 p.m. test scores and updated grades were posted online. Her mother would be the first to comment should her grade go down. “I would get home from track and she would say, ‘I see your grade dropped.’ I would say, ‘Mom, I think it’s a mistake.’ And she would say, ‘That’s what I thought.’ ” (The reason turned out to be typing errors. Ms. DeWitt graduated with straight A’s.) In her first two weeks on the University of Pennsylvania campus, she hustled. She joined a coed fraternity, signed up to tutor elementary school students and joined the same Christian group her parents had joined at their alma mater, Stanford. But having gained admittance off the wait list and surrounded by people with seemingly greater drive and ability, she had her first taste of self-doubt. “One friend was a world-class figure skater. Another was a winner of the Intel science competition. Everyone around me was so spectacular and so amazing and I wanted to be just as amazing as they are.” Classmates seemed to have it all together. Every morning, the administration sent out an email blast highlighting faculty and student accomplishments. Some women attended class wearing full makeup. Ms. DeWitt had acne. They talked about their fantastic internships. She was still focused on the week’s homework. Friends’ lives, as told through selfies, showed them having more fun, making more friends and going to better parties. Even the meals they posted to Instagram looked more delicious. Her confidence took another hit when she glanced at the cellphone screen of a male student sitting next to her who was texting that he would “rather jump out of a plane” than talk to his seatmate. © 2015 The New York Times Company
Steve Connor Anxiety and depression could be linked to the presence of bacteria in the intestines, scientists have found. A study on laboratory mice has shown that anxious and depressive behaviour brought on by exposure to stress in early life appears only to be triggered if microbes are present in the gut. The study, published in Nature Communications, demonstrates a clear link between gut microbiota – the microbes living naturally in the intestines – and the triggering of the behavioural signs of stress. “We have shown for the first time in an established mouse model of anxiety and depression that bacteria play a crucial role in inducing this abnormal behaviour,” said Premysl Bercik of McMaster University in Hamilton, Canada, the lead author of the study. The scientists called for further research to see if the conclusions applied to humans, and whether therapies that that target intestinal microbes can benefit patients with psychiatric disorders. Previous research on mice has indicated that gut microbes play an important role in behaviour. For instance, mice with no gut bacteria – called “germ-free” mice – are less likely to show anxiety-like behaviour than normal mice. The latest study looked at mice that had been exposed to a stressful experience in early life, such as being separated from their mothers. When these mice grow up they display anxiety and depression-like behaviour and have abnormal levels of the stress hormone corticosterone in their blood, as well as suffering from gut dysfunction based on the release of the neurotransmitter acetylcholine.
Link ID: 21232 - Posted: 07.29.2015
By C. CLAIBORNE RAY Q. Are men more likely to be claustrophobic than women? A. The opposite seems to be true, as is the case in almost all anxiety disorders, large epidemiological studies have found. The reasons for such a gender difference are not clear, and claustrophobia, the feeling of extreme panic when faced with being in a confined or enclosed space, is not as well studied as some other phobias. One situation that has been comparatively well researched is what happens when people need magnetic resonance imaging, which often involves a prolonged period of confinement in a small enclosure, the perfect storm of claustrophobia triggers. A recent study found that certain factors seem to correlate with an increase in claustrophobic reactions, including being female, going into the scanner head first and having a previous negative experience with the test. Another large study involving scanners with a shorter chamber and noise reduction found a significant reduction in claustrophobic reactions, but being female and middle-aged were still associated with a higher rate of claustrophobia. It has often been assumed that claustrophobia develops as a response to a traumatic experience, like being trapped in a closet as a child, but newer research suggests a genetic component. In one study in mice, a single defective gene was associated with claustrophobia. firstname.lastname@example.org © 2015 The New York Times Company
Jessie Rack If you've ever had hiccups in a quiet room, you know how embarrassing and completely uncontrollable they can feel. What if, instead of the hiccups, your body jerked involuntarily or you blurted out words without meaning to? That's a rough idea of what living with Tourette syndrome can be like. Designers of a new computer program called TicHelper hope that they will be able to help children recognize and control these impulses themselves. People with Tourette's perform repetitive movements or vocalizations called tics. A simple tic might be something like head jerking, eye blinking, or throat clearing, and a complex tic might involve patterns of movement or saying multiple words or phrases. We don't know exactly what causes Tourette's, says Douglas Woods, a psychologist at Texas A&M University. Woods, who is also co-chair of the Tourette Association of America Medical Advisory Board, is one of the minds behind TicHelper. "Sometimes kids will grow out of [Tourette's]," Woods says. But if the wait-and-see approach isn't working, and the tics are interfering with daily life, there are a few treatment options. One option is medication. Woods says there are a few different antipsychotic drugs that are used to manage Tourette syndrome, but they have side effects and don't always work. An alternative to pharmaceutical treatment is behavioral therapy. A form of behavioral therapy called comprehensive behavioral intervention for tics, or CBIT for short, is commonly used. CBIT training teaches people with Tourette's to recognize the onset of a tic and to perform a different behavior when they feel one coming on. © 2015 NPR
Link ID: 21208 - Posted: 07.23.2015
By Andrea Alfano Unexpectedly losing a loved one launched 18-year-old Debra* into an episode of major depression, triggering dangerous delusions that landed her in a hospital. Her doctor immediately started her on an antidepressant and on risperidone (Risperdal), an antipsychotic. In little more than a month, her weight shot up by 15 pounds. “Gaining weight made it even more difficult for me to want to leave my house because I felt self-conscious,” Debra says. In the medical community, antipsychotics are well known to cause significant weight gain. Gains of 20 to 35 pounds or more over the course of a year or two are not unusual. Debra's doctor never warned her, though, leaving her feeling like she was losing herself both mentally and physically. The situation is not uncommon, according to psychiatrist Matthew Rudorfer, chief of the somatic treatments program at the National Institute of Mental Health, who points out that although the U.S. Food and Drug Administration carefully tracks acute side effects such as seizures, it pays less attention to longer-term complications such as weight change. Perhaps taking their cue from the FDA, doctors tend to downplay weight-related risks that accompany many psychiatric drugs, Rudorfer says. But for Debra and many others, these side effects are not trivial. The three types of psychiatric drugs that can seriously affect body weight are reviewed below. According to a 2014 review of eight studies, as many as 55 percent of patients who take modern antipsychotics experience weight gain—a side effect that appears to be caused by a disruption of the chemical signals controlling appetite. Olanzapine (Zyprexa) and clozapine (Clozaril) are the top two offenders; studies have shown that on average these drugs cause patients to gain more than eight pounds in just 10 weeks. These two drugs also bear the highest risk of metabolic syndrome, which encompasses weight gain and other related disorders, including type 2 diabetes, according to a 2011 study of 90 people with schizophrenia. Although most antipsychotics are associated with weight gain, aripiprazole (Abilify) and ziprasidone (Geodon) stand out for their lower risk. © 2015 Scientific American
T. M. Luhrmann AMERICANS are a pretty anxious people. Nearly one in five of us — 18 percent — has an anxiety disorder. We spend over $2 billion a year on anti-anxiety medications. College students are often described as more stressed than ever before. There are many explanations for these nerves: a bad job market, less cohesive communities, the constant self-comparison that is social media. In 2002 the World Mental Health Survey found that Americans were the most anxious people in the 14 countries studied, with more clinically significant levels of anxiety than people in Nigeria, Lebanon and Ukraine. To be clear, research suggests that anxiety is at least partially temperamental. A recent study of 592 rhesus monkeys found that some of them responded more anxiously than others and that as much as 30 percent of early anxiety may be inherited. Yet what is inherited is the potential for anxiety, not anxiety itself. Life events obviously play a role. Another, less obvious factor may be the way we think about the mind: as an interior place that demands careful, constant attention. Humans seem to distinguish between mind and body in all cultures, but the sharp awareness of mind as a possession, distinct from soul and body, comes from the Enlightenment. It was then, in the aftermath of the crisis of religious authority and the scientific revolution, that there were intense debates about the nature of mental events. Between 1600 and 1815, the place where mental stuff happened — the “thing that thinks,” to use Descartes’s phrase — came to seem more and more important, as George Makari, a psychiatrist and psychoanalyst, explains in his forthcoming book, “Soul Machine: The Invention of the Modern Mind.” From this, Mr. Makari writes, was developed the psychological mind and psychoanalysis and an expectation that personal thoughts and feelings are the central drivers of human action — not roles, not values, not personal sensation, not God. In the United States, the enormous psychotherapeutic and self-help industry teaches us that we must pay scrupulous attention to inner experience. To succeed and be happy, we are taught, we need to know what we feel. © 2015 The New York Times Company
Link ID: 21189 - Posted: 07.20.2015
By Tori Rodriguez Many studies have examined the effects of sufficient versus insufficient sleep on mental health. A new study, published in February in the Journal of Youth and Adolescence, takes a more nuanced look, attempting to determine just how much each hour less per night really costs—where teenagers are concerned. The researchers surveyed an ethnically diverse sample of 27,939 suburban high school students in Virginia. Although teenagers need about nine hours of sleep a night on average, according to the National Institutes of Health, only 3 percent of students reported getting that amount, and 20 percent of participants indicated that they got five hours or less. The average amount reported was 6.5 hours every weekday night. After controlling for background variables such as family status and income, the researchers determined that each hour of lost sleep was associated with a 38 percent increase in the odds of feeling sad and hopeless, a 42 percent increase in considering suicide, a 58 percent increase in suicide attempts and a 23 percent increase in substance abuse. These correlational findings do not prove that lack of sleep is causing these problems. Certainly the reverse can be true: depression and anxiety can cause insomnia. “But the majority of the research evidence supports the causal direction being lack of sleep leading to problems rather than the other way around,” says study co-author Adam Winsler, a psychology professor at George Mason University. © 2015 Scientific American
Allison Aubrey The idea that fermented foods — including yogurt and kefir — are good for us goes way back. But could the benefits of "good bacteria" extend beyond our guts to our brains? Nobel prize-winning scientist Elie Metchnikoff (also known as Ilya Ilich Mechnikov) first observed a connection between fermented milk and longevity among Bulgarian peasants more than a century ago. "Metchnikoff is regarded by many as the father of probiotics," says Gregor Reid of the University of Western Ontario, who published a look back at Metchnikoff's contributions. Metchnikoff came up with "the scientific rationale for the use of live microbes in the prevention and treatment of infections," according to Reid. And back in 1907, he says, Metchnikoff hypothesized that replacing or diminishing the number of bad bacteria in the gut with lactic acid bacteria — like the kind found in yogurt and kefir — "could normalize bowel health and prolong life." But Metchnikoff's ideas were ignored for decades. Reid says after the discovery of penicillin, science focused on the use of antibiotics to kill off harmful bacteria. It's only recently, Reid says, that the importance of beneficial bacteria has come into the limelight. More than a century ago, Élie Metchnikoff, a Nobel prize-winning microbiologist, hypothesized that lactic acid bacteria — like the kind found in our yogurt — was important to gut health and longevity. More than a century ago, Élie Metchnikoff, a Nobel prize-winning microbiologist, hypothesized that lactic acid bacteria — like the kind found in our yogurt — was important to gut health and longevity. © 2015 NPR
Link ID: 21166 - Posted: 07.14.2015
By James Gallagher Health editor, BBC News website Smoking could play a direct role in the development of schizophrenia and needs to be investigated, researchers say. The team at King's College London say smokers are more likely to develop the disorder and at a younger age. Published in the Lancet Psychiatry, their analysis of 61 separate studies suggests nicotine in cigarette smoke may be altering the brain. Experts said it was a "pretty strong case" but needed more research. Smoking has long been associated with psychosis, but it has often been believed that schizophrenia patients are more likely to smoke because they use cigarettes as a form of self-medication to ease the distress of hearing voices or having hallucinations. The team at King's looked at data involving 14,555 smokers and 273,162 non-smokers. It indicated: 57% of people with psychosis were already smokers when they had their first psychotic episode Daily smokers were twice as likely to develop schizophrenia as non-smokers Smokers developed schizophrenia a year earlier on average The argument is that if there is a higher rate of smoking before schizophrenia is diagnosed, then smoking is not simply a case of self-medication. Dr James MacCabe, from the Institute of Psychiatry, Psychology and Neuroscience at King's, said: "It's very difficult to establish causation [with this style of study], what we're hoping that this does is really open our eyes to the possibility that tobacco could be a causative agent in psychosis, and we hope this will then lead to other research and clinical trials that would help to provide firmer evidence." Clearly most smokers do not develop schizophrenia, but the researchers believe it is increasing the risk. The overall incidence of the condition is one in every 100 people normally, which may be increased to two per 100 by smoking. © 2015 BBC
Patricia Neighmond Some antidepressants may increase the risk of birth defects if taken early in pregnancy, while others don't seem to pose the same risks, a study finds. The question of whether antidepressants can cause birth defects has been debated for years, and studies have been all over the map. That makes it hard for women and their doctors to make decisions on managing depression during pregnancy. To try to untangle the question, researchers at the Centers for Disease Control and Prevention analyzed federal data on more than 38,000 women who gave birth between 1997 and 2009. They looked at the number of birth defects among babies and asked women whether they took any antidepressants in the month before getting pregnant or during the first three months of pregnancy. The study, published Wednesday in The BMJ, found no association between the most commonly used antidepressant, sertraline (Zoloft), and birth defects. Forty percent of the women who took antidepressants took sertraline. They also found no increased risk of birth defects with the antidepressants citalopram (Celexa) and escitalopram (Lexapro). But the analysis did find an association between birth defects and the antidepressants fluoxetine (Prozac) or paroxetine (Paxil). That included heart defects, abdominal wall defects, and missing brain and skull defects with paroxetine, and heart wall defects and irregular skull shape with fluoxetine. The relative risk increased 2 to 3.5 times, depending on the defect and the medication. That may sound like a lot, but Jennita Reefhuis, an epidemiologist and lead researcher in the study, says "the overall risk is still small." © 2015 NPR
by Jessica Griggs Manoeuvring the colourful tiles of Tetris can help block flashbacks of traumatic events, even after the memory has fixed itself in your mind. Playing the game could be an easy way to reduce the risk of post-traumatic stress disorder (PTSD). After any event, there is a window of about six hours where memories are consolidated and cemented in the mind, says Emily Holmes at the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, UK. Sleeping on the memory strengthens it further. If an event is particularly traumatic, vivid memories of it can reoccur. These intrusive flashbacks are distressing for anyone, but in a proportion of cases they can persist and contribute to PTSD. For example, about half of people who have been raped go on to develop PTSD, as do a number of asylum seekers and people who have been tortured. About 20 per cent of people who have been in a serious car accident are affected by the condition. There are effective treatments for people who are diagnosed with PTSD, but nothing currently exists to help prevent people from developing it in the days and weeks after the initial trauma. Holmes and her colleagues think a dose of Tetris could be the answer. In 2009, they showed that playing the game four hours after being exposed to trauma reduced the number of subsequent flashbacks. But getting the game into a person's hands immediately after they have been raped, for example, won't always be practical, so the team tested whether it could still work a day later – after the memory had been consolidated and slept on. © Copyright Reed Business Information Ltd.
by Andy Coghlan "I was completely revitalised," says Karen. "Suddenly, I could be sociable again. I would go to work, go home, eat dinner and feel restless." Karen (not her real name) experienced this relief from chronic fatigue syndrome while taking a drug that is usually used to treat the blood cancer lymphoma and rheumatoid arthritis (see "Karen's experience", below). She was one of 18 people with CFS who reported improvements after taking rituximab as part of a small trial in Bergen, Norway. The results could lead to new treatments for the condition, which can leave people exhausted and housebound. Finding a cause for CFS has been difficult. Four years ago, claims that a mouse virus was to blame proved to be unfounded, and some have suggested the disease is psychosomatic. The latest study implicates the immune system, at least in some cases. Rituximab wipes out most of the body's B-cells, which are the white blood cells that make antibodies. Øystein Fluge and Olav Mella of the Haukeland University Hospital in Bergen noticed its effect on CFS symptoms in 2004, when they used the drug to treat lymphoma in a person who happened to also have CFS. Several months later, the person's CFS symptoms had disappeared. A small, one-year trial in 2011 found that two-thirds of those who received rituximab experienced relief, compared with none of the control group. The latest study, involving 29 people with CFS, shows that repeated rituximab infusions can keep symptoms at bay for years. © Copyright Reed Business Information Ltd
Nancy Shute Powerful antipsychotic medications are being used to treat children and teenagers with ADHD, aggression and behavior problems, a study finds, even though safer treatments are available and should be used first. "There's been concern that these medications have been overused, particularly in young children," says Mark Olfson, a professor of psychiatry at Columbia University who led the study. It was published Wednesday in JAMA Psychiatry. "Guidelines and clinical wisdom suggest that you really should be using a high degree of caution and only using them when other treatments have failed, as a last resort." Olfson and his colleagues looked at prescription data from about 60 percent of the retail pharmacies in the United States in 2006, 2008 and 2010. That included almost 852,000 children, teenagers and young adults. Teens were most likely to be prescribed antipsychotics, with 1.19 percent getting the drugs in 2010, compared to 0.11 percent in younger children. Boys were more likely to be given the medications. Antipsychotic medications like clozapine and olanzapine are used to treat schizophrenia, bipolar disorder and some symptoms of autism. They have not been approved by the Food and Drug Administration to treat aggression and ADHD, but are prescribed off label to reduce disruptive behavior. FDA Debates Safety Of Antipsychotic Drugs In Kids Use of antipsychotics in children has been questioned because the drugs can have serious side effects, including tremors, weight gain, increased diabetes risk and elevated cholesterol. © 2015 NPR
Boys are more likely than girls to receive a prescription for antipsychotic medication regardless of age, researchers have found. Approximately 1.5 percent of boys ages 10-18 received an antipsychotic prescription in 2010, although the percentage falls by nearly half after age 19. Among antipsychotic users with mental disorder diagnoses, attention deficit hyperactivity disorder (ADHD) was the most common among youth ages 1-18, while depression was the most common diagnosis among young adults ages 19-24 receiving antipsychotics. Despite concerns over the rising use of antipsychotic drugs to treat young people, little has been known about trends and usage patterns in the United States before this latest research, which was funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health. Mark OlfsonExternal Web Site Policy, M.D., M.P.H., of the Department of Psychiatry, College of Physicians and Surgeons and Columbia University and New York State Psychiatric Institute, New York City, and colleagues Marissa King, Ph.D., Yale, New Haven, Connecticut, and Michael Schoenbaum, Ph.D., NIMH, report their findings on July 1 in JAMA Psychiatry. “No prior study has had the data to look at age patterns in antipsychotic use among children the way we do here,” said co-author Michael Schoenbaum, Ph.D., senior advisor for mental health services, epidemiology and economics at NIMH. “What’s especially important is the finding that around 1.5 percent of boys aged 10-18 are on antipsychotics, and then this rate abruptly falls by half, as adolescents become young adults.” “Antipsychotics should be prescribed with care,” says Schoenbaum. “They can adversely affect both physical and neurological function and some of their adverse effects can persist even after the medication is stopped.”
By Bret Stetka Plenty of us have known a dog on Prozac. We have also witnessed the eye rolls that come with the mention of canine psychiatry. Doting pet owners—myself included—ascribe all kinds of questionable psychological ills to our pawed companions. But in fact, the science suggests that numerous nonhuman species do suffer from psychiatric symptoms. Birds obsess; horses on occasion get pathologically compulsive; dolphins and whales, especially those in captivity, self-mutilate. And that thing when your dog woefully watches you pull out of the driveway from the window—that might be DSM-certified separation anxiety. “Every animal with a mind has the capacity to lose hold of it from time to time,” wrote science historian and author Laurel Braitman in her 2014 book Animal Madness. But at least one mental malady, while common in humans, seems to have spared other animals: schizophrenia, which affects an estimated 0.4 to 1 percent of adults. Although animal models of psychosis exist in laboratories, and odd behavior has been observed in creatures confined to cages, most experts agree that psychosis has not typically been seen in other species, whereas depression, obsessive-compulsive disorder and anxiety traits have been reported in many nonhuman species. This raises the question of why such a potentially devastating, often lethal disease is still hanging around plaguing humanity. We know from an abundance of recent research that schizophrenia is heavily genetic in origin. One would think that natural selection would have eliminated the genes that predispose to psychosis. A study published earlier this year in Molecular Biology and Evolution provides clues as to how the potential for schizophrenia may have arisen in the human brain and, in doing so, suggests possible treatment targets. It turns out that psychosis may be an unfortunate cost of having a big brain that is capable of complex cognition. © 2015 Scientific American
Link ID: 21101 - Posted: 06.27.2015
Matthew C Keller & Peter M Visscher Epidemiological studies and anecdotal evidence show overlap between psychiatric disorders and creativity, but why? A new study uses genome-wide association data from schizophrenia and bipolar disorder to show that genetics are part of the explanation. Thinkers contemplating the human condition have long associated creativity with psychiatric illness—the 'mad genius' archetype. According to Aristotle, “no great genius was without a mixture of insanity.” And there are the oft-repeated anecdotes: the psychotic breaks of Vincent van Gogh and John Nash, the manic and depressive episodes of Virginia Woolf and Ernest Hemingway. There is, in fact, some empirical evidence that the psychological factors underlying psychiatric disorders are linked to increased creativity. Unaffected relatives of those with bipolar disorder (BD) have greater creativity1 and are over-represented in creative professions2, and similar findings have been reported for schizophrenia (SCZ)2, 3. What these studies have not shown is whether this overlap is a result of genetic variation that influences both creativity and BD/SCZ or whether some environmental factor explains the association. For example, highly unstructured rearing environments might contribute to both creativity and risk of the disorders. Understanding whether shared gene variants are responsible for the overlap is important. It can help to elucidate the biological underpinnings of these disorders and shine light on the puzzle of why psychiatric diseases persist in the population. Power et al.4, in work reported in this issue of Nature Neuroscience, asked whether creativity and psychiatric disorders might be associated through common variation in the genome. They used a large discovery sample of 86,292 adults from Iceland and four replication samples totaling over 27,000 adults from Sweden and the Netherlands. All had genome-wide SNP genotyping and their professions were known. None of them knowingly suffered from a psychiatric illness. About 1% of them were artists, including actors, dancers, musicians and writers. © 2015 Macmillan Publishers Limited
By JAIME LOWE The manila folder is full of faded faxes. The top sheet contains a brief description of my first medically confirmed manic episode, more than 20 years ago, when I was admitted as a teenager to U.C.L.A.’s Neuropsychiatric Institute: “Increased psychomotor rate, decreased need for sleep (about two to three hours a night), racing thoughts and paranoid ideation regarding her parents following her and watching her, as well as taping the phone calls that she was making.” I believed I had special powers, the report noted; I knew ‘‘when the end of the world was coming due to toxic substances’’ and felt that I was the only one who could stop it. There was also an account of my elaborate academic sponsorship plan so I could afford to attend Yale — some corporation would pay for a year of education in exchange for labor or repayment down the line. (Another grand delusion. I was a B-plus student, at best.) After I was admitted to the institute's adolescent ward, I thought the nurses and doctors and therapists were trying to poison me. So was the TV in the rec room. I warned my one friend in the ward that its rays were trying to kill him. The generator outside my window was pumping in gas. The place, I was sure, was a death camp. I refused meds because they were obviously agents of annihilation. It took four orderlies to medicate me: They pinned me to the floor while a nurse plunged a syringe into my left hip. Over time, I became too tired to refuse medication. Or perhaps the cocktail of antipsychotics started working. The Dixie cup full of pills included lithium, which slowly took hold of my mania. After a few weeks, I stopped whispering to the other patients that we were all about to be killed. Eventually, I stopped believing it myself. Mark DeAntonio, the U.C.L.A. psychiatrist who was treating me, said I had bipolar disorder. Here’s the phrasing from the National Institute of Mental Health: ‘‘unusually intense emotional states that occur in distinct periods called ‘mood episodes.’ Each mood episode represents a drastic change from a person’s usual mood and behavior. An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode.’’ The generic definition doesn’t quite cover the extremes of the disease or its symptoms, which include inflated self-esteem, sleeplessness, loquaciousness, racing thoughts and doing things that, according to the Mayo Clinic, ‘‘have a high potential for painful consequences — for example, unrestrained buying sprees, sexual indiscretions or foolish business investments.’’ © 2015 The New York Times Company
Link ID: 21094 - Posted: 06.25.2015