Links for Keyword: Schizophrenia

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Major Problem With Compulsory Mental Health Care Is the Medication

By Daniel Bergner If severe mental illness, untreated, underlies the feeling of encroaching anarchy and menace around the homeless encampments of San Francisco or in the subways of New York City, then the remedy appears obvious. Let’s rescue those who, as New York’s mayor, Eric Adams, says, “slip through the cracks” of our mental health care systems; let’s give people “the treatment and care they need.” It sounds so straightforward. It sounds like a clear way to lower the odds of tragic incidents occurring, like the chokehold killing of Jordan Neely, a homeless, psychiatrically troubled man, or the death of Michelle Alyssa Go, who was pushed off a Times Square subway platform to her death by a homeless man with schizophrenia. Improving order and safety in public spaces and offering compassionate care seem to be convergent missions. But unless we confront some rarely spoken truths, that convergence will prove illusory. The problems with the common-sense approach, as it’s currently envisioned, run beyond the proposed solutions we usually read about: funding more beds on hospital psychiatric wards, establishing community-based programs to oversee treatment when people are released from the hospital and providing housing for those whose mental health is made increasingly fragile by the constant struggle for shelter. The most difficult problems aren’t budgetary or logistical. They are fundamental. They involve the involuntary nature of the care being called for and the flawed antipsychotic medications that are the mainstay of treatment for people dealing with the symptoms of psychosis, like hallucinatory voices or paranoid delusions, which can come with a range of severe psychiatric conditions. © 2023 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 28810 - Posted: 06.03.2023

After Writing About Mental Illness, Kay Redfield Jamison Turns to Healers

By Casey Schwartz Kay Redfield Jamison arrives punctually at a towering marble statue of Jesus Christ in the entrance of the old hospital building on Johns Hopkins Medical Campus. Next to it, two guest books are left open to receive the wishes and prayers of those who pass through these halls. “Dear God please help our daughter feel better. …” “Dear Lord, please heal my grandpa and let him live happily. …” This building, decorated with rows of oil paintings of Hopkins doctors and nurses through the ages, is redolent of the history of healing. The desperate, uncertain, even heroic attempt to heal is at the center of Jamison’s new book, “Fires in the Dark: Healing the Unquiet Mind,” out on May 23 from Knopf. “If I could have subtitled it ‘A Love Song to Psychotherapy,’ I would have,” she said. Jamison, 76, her blond hair cut into a bob, wears a colorful floral dress as she makes her way through hallways filled with people in scrubs to a quiet corridor reserved for psychiatry. She is the co-director of the Center for Mood Disorders and a professor of psychiatry. Her bookcase displays her many publications: her psychobiography of the poet Robert Lowell, which was nominated for the Pulitzer Prize, and her books on suicide, on exuberance and on the connection between mania and artistic genius. And, of course, her best-known work, “An Unquiet Mind,” a memoir she published in 1995 in which she went public with her own manic depression, at considerable personal cost. Jamison had been a thriving, sporty high school senior in the Pacific Palisades neighborhood of Los Angeles until suddenly, falling into a deep depression after a mild mania, “I couldn’t count on my mind being on my side,” she said. She was bewildered by what she was going through. Her high school English teacher handed her a book of poems by Robert Lowell, who had struggled all his life with manic-depression, and with whom she felt an instant connection. That same teacher also gave her “Sherston’s Progress,” by the English poet Siegfried Sassoon. More than fifty years later, Sassoon’s book would become one of the central inspirations of “Fires in the Dark.” © 2023 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 28792 - Posted: 05.23.2023

Unraveling the Enigma of Schizophrenia

By Joshua C. Kendall Schizophrenia has long been understood to be among the most serious and intractable of all mental disorders. The condition typically begins in early adulthood and lasts a lifetime. Its hallmark features include hallucinations, withdrawal from social situations, and serious problems in cognition, such as a highly irrational belief system and a limited attention span. In “Malady of the Mind: Schizophrenia and the Path to Prevention,” a comprehensive history of this perplexing mental disorder from the Ancient World to the present, Jeffrey A. Lieberman argues that psychiatry has finally turned a corner in determining both what causes schizophrenia and how to treat it. “Due to the progress and success of science,” he concludes, schizophrenia is “a malady of the mind no more.” BOOK REVIEW — “Malady of the Mind: Schizophrenia and the Path to Prevention,” by Jeffrey A. Lieberman (Simon & Schuster, 528 pages). It’s a bold pronouncement to make, given that Lieberman himself admits that the history of psychiatry is filled with declarations of victory over a disorder that nonetheless continues to defy efforts to pin it down. Several once-heralded treatments — say, insulin coma therapy and ice-pick lobotomies, which were both popular in the 1940s — are now dismissed as barbaric. Likewise, while antipsychotic medications, which were introduced with great fanfare in the mid-1950s and remain today’s treatment of choice, can reduce the intensity of the most troubling symptoms for some patients, they are far from a cure. The chapters on past approaches are elegantly written and are helpful in giving context to current debates about how best to address this devastating illness.

A Link Between Hearing Voices and Hearing Your Own Voice

By Veronique Greenwood It is the rare person who likes hearing their own voice on a recording. It sounds fake, somehow — like it belongs to someone else. For neuroscientists, that quality of otherness is more than a curiosity. Many mysteries remain about the origins of hallucinations, but one hypothesis suggests that when people hear voices, they are hearing their own thoughts disguised as another person’s by a quirk of the brain. Scientists would like to understand what parts of the brain allow us to recognize ourselves speaking, but studying this using recordings of people’s own voices has proved tricky. When we talk, we not only hear our voice with our ears, but on some level we feel it as the sound vibrations travel through the bones of the skull. A study published Wednesday in the journal Royal Society Open Science attempted a workaround. A team of researchers investigated whether people could more accurately recognize their voices if they wore bone-conduction headphones, which transmit sound via vibration. They found that sending a recording through the facial bones made it easier for people to tell their voices apart from those of strangers, suggesting that this technology provides a better way to study how we can tell when we are speaking. That is a potentially important step in understanding the origins of hallucinated voices. Recordings of our voices tend to sound higher than we expect, said Pavo Orepic, a postdoctoral researcher at the Swiss Federal Institute of Technology who led the study. The vibration of the skull makes your voice sound deeper to yourself than to a listener. But even adjusting recordings so they sound lower doesn’t recreate the experience of hearing your own voice. As an alternative, the team tried using bone-conduction headphones, which are commercially available and often rest on a listener’s cheekbones just in front of the ear. © 2023 The New York Times Company

Related chapters from BN: Chapter 9: Hearing, Balance, Taste, and Smell; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 6: Hearing, Balance, Taste, and Smell; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 28669 - Posted: 02.15.2023

Behind New York City’s Shift on Mental Health, a Solitary Quest

By Ellen Barry BETHESDA, Md. — The psychiatrist E. Fuller Torrey is 85 years old and has Parkinson’s disease, the tremors at times so strong that his hand beats like a drum on the table. Still, every morning when he reads the newspapers, he looks for accounts of violent behavior by people with severe mental illness, to add to an archive he has maintained since the 1980s. His records include reports of people who, in the grip of psychosis, assaulted political figures or pushed strangers into the path of subway trains; parents who, while delusional, killed their children by smothering, drowning or beating them; adult children who, while off medication, killed their parents with swords, axes or hammers. Dr. Torrey, who has done pioneering research into the biological basis of schizophrenia, has used these stories in service of an argument: that it was a mistake for the United States to shut down its public psychiatric hospitals without adequate follow-up care. And that to remedy this, the government should create systems to compel seriously mentally ill people in the community to get treatment. For much of his career, Dr. Torrey was a lonely voice on this issue, disavowed by patient advocacy groups and by organized psychiatry. But his ideas are now animating major policy shifts, including the announcement by Mayor Eric Adams of New York last month that city officials would send people with untreated mental illnesses to hospitals, even if they posed no threat to others. Dr. Torrey’s influence on New York City’s policy is profound. The mayor’s adviser on this matter is Brian Stettin, who was thrust into mental health policy in 1999 when, as a lawyer in the office of Attorney General Eliot Spitzer of New York, he was asked to draft Kendra’s Law, named for a woman who was pushed in front of a subway train by a man with schizophrenia. The law allows a court to order a person with mental illness to comply with an outpatient treatment plan, risking involuntary commitment if the person refuses. © 2022 The New York Times Company

Many People with Bipolar Disorder Use Cannabis.

By Gary Stix Many people with bipolar disorder have a strong attraction to marijuana. A 2019 review of 53 studies found that almost a quarter of a combined sample of 51,756 individuals with the condition used cannabis or had a problematic pattern of consumption (cannabis use disorder), compared with 2 to 7 percent in the general population—and an earlier study placed usage estimates still higher. Cannabis and bipolar disorder do not go particularly well together. Consumption may increase manic and psychotic symptoms, and there may be a greater risk of suicide. But can the allure of cannabis be explained as a mere form of substance misuse? Why are people with bipolar disorder so attracted to marijuana? Could they be getting any possible benefit from it? Alannah Miranda of the University of California, San Diego, is a postdoctoral scholar working with U.C.S.D. psychiatry professors William Perry and Arpi Minassian to explore these questions. Miranda presented her and her colleagues’ unpublished work at this year’s giant Society for Neuroscience conference, which attracted more than 24,000 people earlier this month. She talked to Scientific American about what she discovered in this continuing study, which has been funded by the National Institute on Drug Abuse. [An edited transcript of the interview follows.] Tell me about what you’re studying. I’m researching the effects of cannabis on cognition in people with bipolar disorder. People with bipolar disorder report that it’s helping alleviate some of their symptoms in terms of issues related to memory, attention, focus and anxiety. © 2022 Scientific American,

Why Do Mental Illnesses—From Depression to Schizophrenia—Raise the Risk of Dementia?

By Claudia Wallis Age is the single biggest risk factor for dementia, with the odds doubling about every five years after age 65. But many things influence those odds for a given individual. Genetic vulnerability is a contributor, as are so-called modifiable risk factors such as smoking, cardiovascular disease, social isolation, and impaired hearing and vision. Certain mental conditions, particularly depression and schizophrenia, have also been linked to dementia. But because depression can itself be a sign of cognitive decline, the causality has been a bit muddy. Earlier this year an analysis of data from New Zealand provided the most convincing evidence to date linking many kinds of mental illness with dementia. That study raises important questions about the reasons for this increased risk and what could be done to reduce it. The study looked at the health records of 1.7 million New Zealanders born between 1928 and 1967 covering a 30-year period ending in mid-2018. It found that those with a diagnosed mental disorder—such as anxiety disorders, depression or bipolar disorder—had four times the rate of ultimately developing dementia compared with people without such a diagnosis. For those with a psychosis such as schizophrenia, it was six times the rate. Among people who developed dementia, those with a psychiatric disorder were affected 5.6 years earlier, on average. The study did not examine biological, social or other reasons for the increased risk, but research on dementia points to several possible explanations. “There might be shared genetic risk factors,” suggests psychologist Leah Richmond-Rakerd of the University of Michigan, lead author of the study. Recent studies have found some overlap in genetic markers associated with Alzheimer's disease and those linked to bipolar disorder and to major depression. Long-term use of psychiatric medications could also be playing a role in dementia, but Richmond-Rakerd and her co-authors do not think it is a major contributor. © 2022 Scientific American,

Related chapters from BN: 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: The Biology of Behavioral Disorders; Chapter 13: Memory and Learning
Link ID: 28391 - Posted: 07.12.2022

The Limits of Drug-Based Psychiatry

By Joshua C. Kendall About 40 years ago, Daniel Bergner’s younger brother, Bob, then 21 and a college dropout, had a psychotic break. He became delusional; he was convinced that he might be the messiah and that he could cure their grandfather’s Alzheimer’s disease. Worn down by insomnia, Bob was also neglecting his personal hygiene. Out of desperation, the brothers’ parents arranged to have Bob committed to a locked psychiatric unit, where he was soon pumped up on a heavy dose of Haldol, an antipsychotic medication. Shortly after Bob was hospitalized, their father handed Daniel a popular book by the late Ronald Fieve — first published in 1975— on mood disorders. According to this prominent psychopharmacologist, psychiatry was undergoing “a third revolution,” which was leading to new and highly effective drug cures for major mental disorders, including schizophrenia, bipolar disorder, and major depression. This book, notes Daniel Bergner in “The Mind and the Moon: My Brother’s Story, The Science of Our Brains, and the Search for Our Psyches,” gave his parents hope that his brother’s condition could be treated. “It was as if they had ingested the book’s sentences and elevated its paragraphs to articles of faith,” he writes. “They were immediate converts.” As Bergner, a contributing writer for The New York Times Magazine, emphasizes in his moving narrative, the chief claim contained in that bestseller of yesteryear — that mental illnesses are diseases for which there exist chemical cures — ended up gaining a lot of traction. But Bergner himself has long harbored reservations about such biological reductionism.

Doctors Gave Her Antipsychotics. She Decided to Live With Her Voices.

By Daniel Bergner Caroline Mazel-Carlton began hearing voices when she was in day care. Mornings, by the time she was in middle school, a bowl of oatmeal awaited her for breakfast next to a white saucer of colorful pills. Her voices remained vibrant. They weren’t within her head; they spoke and screamed from outside her skull. They belonged to beings she could not see. The voice who had been with her longest warned of catastrophes coming for her family in Zionsville, a town north of Indianapolis, calamities tied in some unspecified way to TV images from the gulf war: fighter planes, flashes in the sky, explosions on the ground, luminous and all-consuming. A woman’s voice castigated her at school, telling her that her clothes smelled and that she had better keep her hand down, no matter that she knew the answers to the teacher’s questions. Another voice tracked her every move, its tone faintly mocking. “She’s getting out of bed now; oh, she’s walking down the hall now.” Her mix of psychotropic pills shifted, expanded: antipsychotics, mood stabilizers, an antidepressant, a benzodiazepine for anxiety, a stimulant for attention deficit. The pileup of drugs was typical; people hearing voices or having other hallucinations rarely wind up on just one medication. Multiple chemicals are prescribed, often more than one similar antipsychotic simultaneously, in an attempt to quell the psyche. This article is adapted from “The Mind and the Moon: My Brother’s Story, the Science of Our Brains, and the Search for Our Psyches,” published this month by Ecco. At most, for Mazel-Carlton, the antipsychotics sometimes succeeded in reducing her voices to a wall of sound. This could feel more assaultive than hearing them separately. The antipsychotics caused obesity — 50 pounds of new weight — and the feeling that she was losing control of her forearms and her neck. Her hands quivered and seemed to want to flap-paddle the air. To the isolation caused by the difference of her mind, the drugs added isolation from severe side effects. Her agitation and self-disgust, her terror of being barely human, drove her to twist clusters of her hair around her fingers, to yank hard. Patches of bare scalp crept into view. Classmates taunted, asking why she shook and was going bald, calling her “fat-ass” and “crackhead.” © 2022 The New York Times Company

Is the Immune System to Blame for Schizophrenia?

Diana Kwon Susannah Cahalan was 24 years old when her world turned upside down. Cahalan was living a busy life as a news reporter at the New York Post when she suddenly began experiencing sensitivity to light, numbness in her limbs, and an unsettling feeling that something was not quite right in her body and her brain. One day at work, she found herself inexplicably going from crying hysterically to skipping giddily down a hall. After a seizure landed her in the hospital, her condition rapidly worsened. She started having delusions and hallucinations, believing that her father was a murderer, that she was being secretly recorded, and that she could age people using her mind. In a matter of weeks, walking, speaking, and swallowing became difficult. She eventually became immobile and unresponsive, lying in her hospital bed in a catatonic state. Despite her worsening condition, dozens of specialists from various fields—psychiatry, neurology, internal medicine—couldn’t figure out what was wrong. Numerous blood tests and brain scans failed to generate answers. To many who saw her, Cahalan’s condition looked indistinguishable from mental illnesses such as bipolar disorder or schizophrenia, in which people can experience delusions and hallucinations that make it difficult for them to distinguish what’s real and what’s not. It wasn’t until a neurologist asked Cahalan to draw a clock that the problem became clear. Cahalan had drawn all the numbers on just one side of the clock face, indicating that there was a problem in the functioning of one half of her brain. A brain biopsy confirmed what the doctor had suspected. Cahalan had anti-NMDAR encephalitis, a rare autoimmune disease in which the body produces antibodies that attack the NMDA receptor, a protein found throughout the brain. The condition had only been discovered in the early 2000s, just a few years prior to Cahalan’s diagnosis, by neurologist Josep Dalmau, then at the University of Pennsylvania. This diagnosis was much-needed good news for sufferers of the mysterious condition—their disease was treatable. After receiving immunotherapy, Cahalan was able to fully recover. © 1986–2022 The Scientist.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 28289 - Posted: 04.20.2022

Researchers identify new genetic link to schizophrenia

By Lenny Bernstein Researchers have found variations in a small number of genes that appear to dramatically increase the likelihood of developing schizophrenia in some people. The interplay of a wide array of other genes is implicated for most people with schizophrenia, a severe brain disorder characterized by hallucinations, delusions and inability to function. But for some who possess mutations in the 10 genes identified in the new study, published Wednesday in the journal Nature, the likelihood of developing the disease can be 10, 20 and even 50 times greater. The discovery could one day lead to advances in diagnosis of, and therapy for, the disease, according to the lead author of the study, Tarjinder Singh, of the Broad Institute at MIT and Harvard, which led an effort that involved years of work by dozens of research institutions worldwide. “This is the biological clue that leads to better therapies,” Singh said in an interview. “But the key thing is, we haven’t had any meaningful clues for the longest time.” Ken Duckworth, chief medical officer for the National Alliance on Mental Illness, a nationwide advocacy group, said the study is an important development in the neuroscience that underlies schizophrenia. But he said it is difficult to predict how soon such basic research would pay off for people living with the disease. “This is a big step forward for science that may pay a long-term return for people with schizophrenia and the people who live with them,” Duckworth said. But, he said, “if this is a 17-inning game and they’ve gotten us from the first to the second inning, how does this help someone today?” Less than 1 percent of the U.S. population is believed to have schizophrenia, which is generally treated with an array of powerful antipsychotic medications. The disease reduces life expectancy by about 15 years, according to the new research. Scientists have long recognized a hereditary component to the disease, along with other factors such as environment. The work of isolating these genes could not have been accomplished even 10 or 15 years ago, Singh said, before the sequencing of the human genome and the spread of technology that allows such genetic detective work to be conducted in laboratories around the world. © 1996-2022 The Washington Post

COVID and schizophrenia: Why this deadly mix can deepen understanding of the brain

April Dembosky Most of the time, the voices in Keris Myrick's head don't bother her. They stay in the background or say nice things. But sometimes they get loud and mean – like when a deadly pandemic descended on the world and shut down society as we know it. "It's when things go really, really fast and they seem overwhelmingly disastrous. That's when it happens," says Myrick, who was diagnosed with schizophrenia 25 years ago. "The attacking voices were calling me stupid ... I literally had a meltdown right here in my house. Just lost it." She was able to calm herself down and quiet the voices, and as the pandemic wore on, she kept them at bay by keeping busy: She works for a foundation, hosts a podcast and wrote a children's book. She was able to manage, but she worried about others like her. "People with schizophrenia were not actually deemed as 'the priority vulnerable population' to be served or to be addressed in the same way as people who had other chronic health conditions and who were over a certain age," Myrick says. "So we kind of got left out." This omission occurred even as new data published in JAMA Psychiatry showed that people with schizophrenia are nearly three times more likely to die from COVID-19 than the general population. Their risk of death from the virus is greater than for people with diabetes, heart disease or any other condition aside from age. "People's initial reaction to this was one of disbelief," says Katlyn Nemani, a New York University School of Medicine neuropsychiatrist and the study's lead author. © 2022 npr

‘Schizophrenia’ Still Carries a Stigma. Will Changing the Name Help?

By Karen Brown For decades, Linda Larson has been trying to distance herself from the diagnosis she was given as a teenager: schizophrenia. She accepts that she has the mental disorder but deeply resents the term’s stigma. People hear it and think, “violent, amoral, unhygienic,” she said. Ms. Larson, 74, is part of a group trying to remove that association — by changing the name of the illness. The idea is that replacing the term “schizophrenia” with something less frightening and more descriptive will not only change how the public perceives people with the diagnosis, but also how these people see themselves. Ms. Larson is a member of the Consumer Advisory Board of the Massachusetts Mental Health Center, which is associated with Beth Israel Deaconess Medical Center in Boston. The group has been working with psychiatrists at Harvard to build momentum for a name change, most recently through a national survey published in the journal Schizophrenia Research. “That term over time has become so associated with hopelessness, with dangerousness, with volatile and erratic behavior, that doctors are afraid to use that term with people and their family members,” said Dr. Raquelle Mesholam-Gately, a Harvard psychologist and the lead author of the new paper. “And people who have the condition don’t want to be associated with that name.” As a result, she said, clinicians often avoid making such a devastating diagnosis and many patients and their families don’t seek treatment until after the illness has wreaked considerable damage. Dr. Mesholam-Gately and her team asked about 1,200 people connected to schizophrenia — including those with the disorder, their family members, mental health providers, researchers and government officials — whether it should be called something else. The survey proposed nine alternative names, based partly on the experience of people diagnosed with schizophrenia. Among them: altered perception disorder, attunement disorder, disconnectivity syndrome, integration disorder and psychosis spectrum disorder. © 2021 The New York Times Company

Prenatal exposure to antipsychotic medication does not increase odds of autism, ADHD

by Peter Hess Children born to mothers who take antipsychotic medications during pregnancy do not have elevated odds of autism or attention deficit hyperactivity disorder (ADHD), nor are they more likely to be born preterm or underweight, according to a study released this past Monday in JAMA Internal Medicine. Some women with schizophrenia, Tourette syndrome or bipolar disorder take antipsychotic drugs, such as aripiprazole, haloperidol or risperidone. Clinicians have long debated whether women should discontinue these medications during pregnancy out of concern for the drugs’ effects on the developing fetus. But children born to mothers who take antipsychotics during pregnancy and to those who do not take them have similar outcomes, the new work shows. “Our findings do not support a recommendation for women to discontinue their regular antipsychotic treatment during pregnancy,” says senior investigator Kenneth Man, research fellow at the University College London School of Pharmacy in the United Kingdom. Prescribing antipsychotics during pregnancy can help prevent potentially dangerous psychotic episodes and ensure that an expectant mother can take care of herself, says Mady Hornig, associate professor of epidemiology at Columbia University, who was not involved in the study. “We certainly don’t want to be cavalier about the use of any medication during pregnancy, but one also wants to balance out the implications of not treating.” © 2021 Simons Foundation

Challenges of Bipolar Disorder in Young People

By Jane E. Brody I was doing research and interviews on bipolar disorder when notices appeared in my Brooklyn neighborhood about a 21-year-old man who had been missing for a week. He was described as “bipolar” and “may be experiencing a manic episode.” It took me back nearly seven decades when the state police in Texas called my father to say they had found his brother, my favorite uncle, wandering on a highway. How he got there from Brooklyn we never learned. He had apparently suffered a psychotic break and ended up in a New York State mental hospital that administered electric shock treatments but did little else to help him re-enter society effectively. Not until decades later did he receive a correct diagnosis of manic depression, now known as bipolar disorder. Characterized by extreme shifts in mood, “manic-depressive illness” was officially recognized by the American Psychiatric Association in 1952. But it would be many years before an effective treatment, the drug lithium, which acts on the brain to help stabilize debilitating episodes of severe mania and depression, was available to help my brilliant uncle resume a reasonably normal life. Bipolar disorder typically runs in families, with different members experiencing symptoms to a greater or lesser degree. If a parent has the disorder, a child’s risk can rise to 10 percent. My uncle’s only child displayed some minor behavioral characteristics of bipolar disorder, like very rapid speech and frenetic activity, but was able to complete two advanced degrees, marry, be a parent and succeed in an intellectually demanding career. Bipolar disorder is most often diagnosed in the later teen years or young adulthood, affecting some 4 percent of people at some point in their lives. But in recent decades, diagnosis of the disorder has soared in children and adolescents, although some experts believe the condition is overdiagnosed or overtreated with potent psychiatric drugs. © 2021 The New York Times Company

Could mitochondria be the key to a healthy brain?

By Diana Kwon Long before the earliest animals swam through the water-covered surface of Earth’s ancient past, one of the most important encounters in the history of life took place. A primitive bacterium was engulfed by our oldest ancestor — a solo, free-floating cell. The two fused to form a mutually beneficial relationship that has lasted more than a billion years, with the latter providing a safe, comfortable home and the former becoming a powerhouse, fueling the processes necessary to maintain life. That’s the best hypothesis to date for how the cellular components, or organelles, known as mitochondria came to be. Today, trillions of these bacterial descendants live within our bodies, churning out ATP, the molecular energy source that sustains our cells. Despite being inextricably integrated into the machinery of the human body, mitochondria also carry remnants of their bacterial past, such as their own set of DNA. The DNA that constitutes the human genome is contained within the nucleus of our cells. But mitochondria possess their own set of circular DNA, which is likely a remnant of their ancient bacterial past. These features make mitochondria both a critical element of our cells and a potential source of problems. Like the DNA inside the nuclei of our cells that makes up the human genome, mitochondrial DNA can harbor mutations. Age, stress and other factors may disrupt mitochondria’s many functions. On top of that, mitochondrial injury can release molecules that, due to their similarities to those made by bacteria, can be mistaken by our immune system as foreign invaders, triggering a harmful inflammatory response against our own cells. © 2021 Annual Reviews, Inc

Psychiatry Confronts Its Racist Past, and Tries to Make Amends

By Judith Warner Dr. Benjamin Rush, the 18th-century doctor who is often called the “father” of American psychiatry, held the racist belief that Black skin was the result of a mild form of leprosy. He called the condition “negritude.” His onetime apprentice, Dr. Samuel Cartwright, spread the falsehood throughout the antebellum South that enslaved people who experienced an unyielding desire to be free were in the grip of a mental illness he called “drapetomania,” or “the disease causing Negroes to run away.” In the late 20th century, psychiatry’s rank and file became a receptive audience for drug makers who were willing to tap into racist fears about urban crime and social unrest. (“Assaultive and belligerent?” read an ad that featured a Black man with a raised fist that appeared in the “Archives of General Psychiatry” in 1974. “Cooperation often begins with Haldol.”) Now the American Psychiatric Association, which featured Rush’s image on its logo until 2015, is confronting that painful history and trying to make amends. In January, the 176-year-old group issued its first-ever apology for its racist past. Acknowledging “appalling past actions” on the part of the profession, its governing board committed the association to “identifying, understanding, and rectifying our past injustices,” and pledged to institute “anti-racist practices” aimed at ending the inequities of the past in care, research, education and leadership. This weekend, the A.P.A. is devoting its annual meeting to the theme of equity. Over the course of the three-day virtual gathering of as many as 10,000 participants, the group will present the results of its yearlong effort to educate its 37,000 mostly white members about the psychologically toxic effects of racism, both in their profession and in the lives of their patients. © 2021 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 1: Introduction: Scope and Outlook
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 1: Cells and Structures: The Anatomy of the Nervous System
Link ID: 27797 - Posted: 05.01.2021

Mice That Hear Imaginary Sounds May Help Explain Hallucinations In People

Jon Hamilton A study of mice that hear imaginary sounds could help explain human disorders like schizophrenia, which produce hallucinations. D-Keine/Getty Images A technique that induces imaginary sounds in both mice and people could help scientists understand the brain circuits involved in schizophrenia and other disorders that cause hallucinations. The technique appears to offer "a way to study psychotic disorders in animals," says Adam Kepecs, a professor of neuroscience and psychiatry at Washington University School of Medicine in St. Louis. It also shows how levels of the brain chemical dopamine determine the likelihood that a mouse or a person will perceive something that isn't really there, Kepecs and a team report in this week's issue of the journal Science. Until now, scientists have had no good way to study precisely how hallucinations occur in the brain. "This study is valuable because it will allow us to use mice and dig into the cellular, molecular, physiological details," says Eleanor Simpson, a researcher at the New York State Psychiatric Institute. That's important, Simpson says, because it could lead to better treatments for disorders like schizophrenia. "We have drugs that treat hallucinations but they're not very good," she says. "They don't work for everybody and they have a lot of terrible side effects which prevent people from using them." The study came about because "a mouse can't tell you when it's hallucinating," Kepecs © 2021 npr

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 9: Hearing, Balance, Taste, and Smell
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 6: Hearing, Balance, Taste, and Smell
Link ID: 27758 - Posted: 04.03.2021

First Covid, Then Psychosis: ‘The Most Terrifying Thing I’ve Ever Experienced’

By Pam Belluck Ivan Agerton pulled his wife, Emily, into their bedroom closet, telling her not to bring her cellphone. “I believe people are following me,” he said, his eyes flaring with fear. He described the paranoid delusions haunting him: that people in cars driving into their suburban Seattle cul-de-sac were spying on him, that a SWAT officer was crouching in a bush in their yard. It was a drastic change for the 49-year-old Mr. Agerton, a usually unflappable former marine and risk-taking documentary photographer whose most recent adventure involved exploring the Red Sea for two months in a submarine. He was accustomed to stress and said that neither he nor his family had previously experienced mental health issues. But in mid-December, after a mild case of Covid-19, he was seized by a kind of psychosis that turned life into a nightmare. He couldn’t sleep, worried he had somehow done something wrong, suspected ordinary people of sinister motives and eventually was hospitalized in a psychiatric ward twice. “Like a light switch — it happened this fast — this intense paranoia hit me,” Mr. Agerton said in interviews over two months. “It was really single-handedly the most terrifying thing I’ve ever experienced in my life.” Mr. Agerton’s experience reflects a phenomenon doctors are increasingly reporting: psychotic symptoms emerging weeks after coronavirus infection in some people with no previous mental illness. Doctors say such symptoms may be one manifestation of brain-related aftereffects of Covid-19. Along with more common issues like brain fog, memory loss and neurological problems, “new onset” psychosis may result from an immune response, vascular issues or inflammation from the disease process, experts hypothesize. Sporadic cases have occurred with other viruses, and while such extreme symptoms are likely to affect only a small proportion of Covid survivors, cases have emerged worldwide. © 2021 The New York Times Company

Small Number of Covid Patients Develop Severe Psychotic Symptoms

By Pam Belluck Almost immediately, Dr. Hisam Goueli could tell that the patient who came to his psychiatric hospital on Long Island this summer was unusual. The patient, a 42-year-old physical therapist and mother of four young children, had never had psychiatric symptoms or any family history of mental illness. Yet there she was, sitting at a table in a beige-walled room at South Oaks Hospital in Amityville, N.Y., sobbing and saying that she kept seeing her children, ages 2 to 10, being gruesomely murdered and that she herself had crafted plans to kill them. “It was like she was experiencing a movie, like ‘Kill Bill,’” Dr. Goueli, a psychiatrist, said. The patient described one of her children being run over by a truck and another decapitated. “It’s a horrifying thing that here’s this well-accomplished woman and she’s like ‘I love my kids, and I don’t know why I feel this way that I want to decapitate them,’” he said. The only notable thing about her medical history was that the woman, who declined to be interviewed but allowed Dr. Goueli to describe her case, had become infected with the coronavirus in the spring. She had experienced only mild physical symptoms from the virus, but, months later, she heard a voice that first told her to kill herself and then told her to kill her children. At South Oaks, which has an inpatient psychiatric treatment program for Covid-19 patients, Dr. Goueli was unsure whether the coronavirus was connected to the woman’s psychological symptoms. “Maybe this is Covid-related, maybe it’s not,” he recalled thinking. “But then,” he said, “we saw a second case, a third case and a fourth case, and we’re like, ‘There’s something happening.’” Indeed, doctors are reporting similar cases across the country and around the world. A small number of Covid patients who had never experienced mental health problems are developing severe psychotic symptoms weeks after contracting the coronavirus. In interviews and scientific articles, doctors described: A 36-year-old nursing home employee in North Carolina who became so paranoid that she believed her three children would be kidnapped and, to save them, tried to pass them through a fast-food restaurant’s drive-through window. © 2020 The New York Times Company

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