Links for Keyword: Schizophrenia

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Cheryl Platzman Weinstock Sometimes a psychiatric crisis can be triggered by something small. For Alexia Phillips, 21, it was a heated argument with a close family member in February 2017. She remembers the fight blew up before she left the house to go to classes at Queens College in Flushing, New York. By midday, Phillips, then a sophomore, says she began to cry loudly and uncontrollably. "It really triggered me. I just got really angry really fast...I was crying so much I couldn't breathe and couldn't talk. I didn't know how to handle it," she says. As she would come to understand later, Phillips was experiencing symptoms of her underlying borderline personality disorder, anxiety and depression. But at the time, all she knew was she felt too overwhelmed to go home, or to go to class. She also didn't want anyone to see her like that. Finally, she went to her college counseling center for the first time and asked for help. Minutes later, Phillips' counselor, a college public safety officer and a paramedic trained to deal with psychiatric crises, calmly and unobtrusively escorted her to the back of the college through a quiet hallway door that led out to a parked ambulance sent from Zucker Hillside Hospital. She was ferried — without the lights or sirens — to be assessed at the hospital's special program for college students. This kind of response to a student crisis is unusual. In a lot of colleges, if staff think the student who's having a crisis may be unsafe, they have little choice but to call 911. Many schools lack resources to address serious crises and students are left to navigate the health care system on their own. © 2018 npr

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: 25802 - Posted: 12.20.2018

By Benedict Carey For the past two decades, scientists have been exploring the genetics of schizophrenia, autism and other brain disorders, looking for a path toward causation. If the biological roots of such ailments could be identified, treatments might follow, or at least tests that could reveal a person’s risk level. In the 1990s, researchers focused on genes that might possibly be responsible for mental distress, but then hit a wall. Choosing so-called candidate genes up front proved to be fruitless. In the 2000s, using new techniques to sample the entire genome, scientists hit many walls: Hundreds of common gene variants seemed to contribute some risk, but no subset stood out. Even considered together, all of those potential contributing genes — some 360 have been identified for schizophrenia — offered nothing close to a test for added risk. The inherited predisposition was real; but the intricate mechanisms by which all those genes somehow led to symptoms such as psychosis or mania were a complete mystery. Now, using more advanced tools, brain scientists have begun to fill out the picture. In a series of 11 papers, published in Science and related journals, a consortium of researchers has produced the most richly detailed model of the brain’s genetic landscape to date, one that incorporates not only genes but also gene regulators, cellular data and developmental information across the human life span. The work is a testament to how far brain biology has come, and how much further it has to go, toward producing anything of practical value to doctors or patients, experts said. © 2018 The New York Times Company

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 4: Development of the Brain
Link ID: 25789 - Posted: 12.15.2018

By Pam Belluck CHARLOTTE, N.C. — Steve Singer, who has bipolar and borderline personality disorders, knows when he’s on the verge of a mental health crisis. The female voice he hears incessantly in his head suddenly shuts up, and the hula hoop he gyrates while walking to the grocery store stops easing his anxieties. That’s when he gets to a hospital. Usually, talking briefly with a nurse or social worker calms him enough to return home. But this year a hospital placed him on a locked ward, took his phone, and had an armed guard watch him for 20 hours before a social worker spoke with him and released him. “I get the heebie-jeebies thinking about it,” said Mr. Singer, 60. “They didn’t help me, they hurt me.” Deeply upset, he turned to something he’d never known existed: He completed a psychiatric advance directive, a legal document declaring what treatment he does and doesn’t want. Increasingly, patients, advocates and doctors believe such directives (called PADs) could help transform the mental health system by allowing patients to shape their care even when they lose touch with reality. Hospitals must put them in patients’ medical records and doctors are expected to follow them unless they document that specific preferences aren’t in the patients’ best medical interest. As the pendulum has swung from institutionalization to outpatient care, psychiatric directives also offer a middle path by allowing patients to designate family members to speak for them when they’re too sick to do so themselves. But some doctors and hospitals are wary that the documents could tie their hands and discourage treatment they consider warranted. Some worry the directives won’t be updated to reflect medical advances. Others question whether people with serious psychiatric conditions are ever capable of lucidly completing such directives. “A decision based on erroneous information on a PAD, that can happen,” said Dr. Katayoun Tabrizi, a forensic psychiatrist at Duke. “This is not a cookbook.” © 2018 The New York Times Company

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 4: Development of the Brain
Link ID: 25749 - Posted: 12.04.2018

By Lisa Sanders, M.D. “Something’s wrong,” the 27-year-old woman said to her new husband. “I think you need to take me to the hospital.” It was the day after their wedding. The woman’s husband and her best friend were car fanatics, and so the newlyweds had wanted to commemorate their union with pictures at a drift track in rural Toutle, Wash. The best friend would “drift cookies,” circling the couple in a tight, controlled skid. As another friend took pictures, the two embraced, wreathed by smoke and dust and barely contained chaos as the red Mustang fishtailed around them. In the photos, the couple look happy. But as they loaded up the car to go home, the young woman started to feel strange. She’d been a little jittery all day. She noticed she couldn’t stop talking. She figured it was just the excitement of the wedding’s aftermath. But suddenly her excitement felt out of control. Her heart, which was racing since she got up that morning, went into overdrive. It pounded so hard that it hurt her throat and chest. She couldn’t think. Her hands took on a life of their own — they opened and closed incessantly. Her new husband was confused and worried. They drove to a hospital a couple of towns over. It was a panic attack, they were told. Since the birth of the couple’s daughter a year before, the young woman had struggled with postpartum depression and anxiety. She’d just married and had these crazy pictures taken; it was no wonder she was panicking. The young woman accepted the diagnosis, but she couldn’t help feeling that this was different from the anxiety she sometimes experienced. She was given a medication to take if she had more symptoms and sent home. The pills didn’t seem to help. The next day she felt her heart pounding in her throat and the same spacy-headed jitters from the day before. She tried the medicine again but after that, her memory is just fragments. © 2018 The New York Times Company

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: 25719 - Posted: 11.26.2018

By Benedict Carey Nothing humbles history’s great thinkers more quickly than reading their declarations on the causes of madness. Over the centuries, mental illness has been attributed to everything from a “badness of spirit” (Aristotle) and a “humoral imbalance” (Galen) to autoerotic fixation (Freud) and the weakness of the hierarchical state of the ego (Jung). The arrival of biological psychiatry, in the past few decades, was expected to clarify matters, by detailing how abnormalities in the brain gave rise to all variety of mental distress. But that goal hasn’t been achieved — nor is it likely to be, in this lifetime. Still, the futility of the effort promises to inspire a change in the culture of behavioral science in the coming decades. The way forward will require a closer collaboration between scientists and the individuals they’re trying to understand, a mutual endeavor based on a shared appreciation of where the science stands, and why it hasn’t progressed further. “There has to be far more give and take between researchers and the people suffering with these disorders,” said Dr. Steven Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute of M.I.T. and Harvard. “The research cannot happen without them, and they need to be convinced it’s promising.” The course of Science Times coincides almost exactly with the tear-down and rebuilding of psychiatry. Over the past 40 years, the field remade itself from the inside out, radically altering how researchers and the public talked about the root causes of persistent mental distress. The blueprint for reassembly was the revision in 1980 of psychiatry’s field guide, the Diagnostic and Statistical Manual of Mental Disorders, which effectively excluded psychological explanations. Gone was the rich Freudian language about hidden conflicts, along with the empty theories about incorrect or insufficient “mothering.” Depression became a cluster of symptoms and behaviors; so did obsessive-compulsive disorder, bipolar disorder, schizophrenia, autism and the rest. © 2018 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: 25703 - Posted: 11.20.2018

By Moises Velasquez-Manoff The man was 23 when the delusions came on. He became convinced that his thoughts were leaking out of his head and that other people could hear them. When he watched television, he thought the actors were signaling him, trying to communicate. He became irritable and anxious and couldn’t sleep. Dr. Tsuyoshi Miyaoka, a psychiatrist treating him at the Shimane University School of Medicine in Japan, eventually diagnosed paranoid schizophrenia. He then prescribed a series of antipsychotic drugs. None helped. The man’s symptoms were, in medical parlance, “treatment resistant.” A year later, the man’s condition worsened. He developed fatigue, fever and shortness of breath, and it turned out he had a cancer of the blood called acute myeloid leukemia. He’d need a bone-marrow transplant to survive. After the procedure came the miracle. The man’s delusions and paranoia almost completely disappeared. His schizophrenia seemingly vanished. Years later, “he is completely off all medication and shows no psychiatric symptoms,” Dr. Miyaoka told me in an email. Somehow the transplant cured the man’s schizophrenia. A bone-marrow transplant essentially reboots the immune system. Chemotherapy kills off your old white blood cells, and new ones sprout from the donor’s transplanted blood stem cells. It’s unwise to extrapolate too much from a single case study, and it’s possible it was the drugs the man took as part of the transplant procedure that helped him. But his recovery suggests that his immune system was somehow driving his psychiatric symptoms. At first glance, the idea seems bizarre — what does the immune system have to do with the brain? — but it jibes with a growing body of literature suggesting that the immune system is involved in psychiatric disorders from depression to bipolar disorder. © 2018 The New York Times Company

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: 25512 - Posted: 10.01.2018

Luke Watkin was in year eight at school and alone in a corridor when he first heard a strange noise. "I heard what sounded like a train brake, followed by a metal on metal noise. "It was just something completely out of the ordinary. It was a bit of a shock to the system, something I just couldn't understand or really process. "My experience at the time was quite terrifying." It was his first experience of the mental health condition, psychosis. Luke was 12 years old. He said it went on from noises to hearing words, hearing his name, to eventually hearing whole sentences "of it almost trying to talk to me". The main symptoms of psychosis are hallucinations and delusions and it can be caused by a specific mental health condition, such as schizophrenia, bipolar disorder or severe depression. It can also be triggered by traumatic experiences, stress, drugs, alcohol, as a side-effect of prescribed mediation or a physical condition such as a brain tumour. While it is not as common as depression - affecting fewer than one in every hundred - experts say it is important to recognise symptoms of psychosis early because early treatment can be more effective. People with psychosis have a higher than average risk of self-harm and suicide. The charity Rethink Mental Illness has surveyed 4,000 people and found more than half believe they wouldn't be able to identify the early symptoms. They are concerned that a general lack of awareness leads to young people not getting help early on - especially as the first episode of psychosis is most likely to happen between the ages of 18 and 24. More subtle early warning signs include withdrawing from friends, expressing strange beliefs, sudden changes in mood and confused thoughts. © 2018 BBC

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: 25462 - Posted: 09.18.2018

By Alan Jasanoff Disorders of the mind have meant different things to different people at different times. In Plato’s “Phaedrus,” Socrates extols divinely inspired madness in mystics, lovers, poets and prophets; he describes these disturbances as gifts of the gods, rather than maladies. Premodern Europeans more commonly despised the insane, but barely distinguished them from others their society rejected; madmen were imprisoned alongside beggars, blasphemers and prostitutes. Some modern cultures have notions of mental disorder that seem almost as strange to us; syndromes with names like latah, amok and zar defy traditional classifications of Western psychiatry and often call for spiritual rather than medical responses. Our own culture’s conception of the varieties of mental illness took shape first from a deck of cards curated by the pioneering German psychiatrist Emil Kraepelin over a century ago. Each of the cards contained an abstract of a patient’s medical history, and by grouping them according to similarities he observed among the cases, Kraepelin delineated for the first time some of the major categories physicians now use to diagnose psychiatric diseases. Since the 1980s, Kraepelin’s characterizations of psychosis, mania and depression have been virtually codified in the Diagnostic and Statistical Manual of Mental Disorders, the clinician’s bible for evaluating patients. Kraepelin was a staunch critic of psychoanalysis and passionate advocate for understanding mental phenomena in strictly biological terms — attitudes now also ascendant in psychiatric biomedicine. © 2018 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: 25461 - Posted: 09.18.2018

By Nicholas Bakalar Children whose families move homes frequently may be at increased risk for serious psychiatric illness. Researchers followed 1,440,383 children from birth to age 29, including data on residential moves. They found 4,537 cases of psychosis, symptoms of which can include hallucinations and delusions. The more often children under 19 moved, the greater their risk for psychosis. The largest effect was among 16- to 19-year-olds. For them, two or three moves more than tripled the risk for psychosis, and four or more nearly quadrupled the risk. After age 20, there was no association between moving and illness. The study, in JAMA Psychiatry, controlled for sex, foreign background, parental death, parental history of severe mental illness, income and mother’s age at birth, but had no data for bullying or physical or sexual abuse. “Moving once or twice over the course of a childhood won’t have much effect,” said the lead author, James B. Kirkbride, an associate professor at University College London. “But moving once a year for four or five years — it would seem that those kids would face a risk. So we’d want to build a social network for those children who are moving frequently, particularly in late adolescence, when forming friendships can be vital for lifelong resistance to psychotic illness.” © 2018 The New York Times Company

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 4: Development of the Brain
Link ID: 25364 - Posted: 08.23.2018

Ina Jaffe The antipsychotic drug Seroquel was approved by the FDA years ago to help people with schizophrenia, bipolar disorder and other serious mental illnesses. But too frequently the drug is also given to people who have Alzheimer's disease or other forms of dementia. The problem with that? Seroquel can be deadly for dementia patients, according to the FDA. Now some researchers have conducted an experiment that convinced some of the general practice doctors who prescribe Seroquel most frequently to cut back. All the scientists did was have Medicare send letters — three of them over the course of six months — to the roughly 5,000 general practitioners who prescribe Seroquel the most. The letters (attached to this document) had two elements: First there was a peer comparison aspect. The doctors who got the letters were told that they wrote a lot more prescriptions for Seroquel than the average for their state — in some cases as many as 8 times more. The Centers for Medicare and Medicaid Services which regulates Medicare, was a partner in the study and sent the letters. So the in addition to peer pressure, they contained a government warning: "You have been flagged as a markedly unusual prescriber, subject to review by the Center for Program Integrity." Researchers then tracked the physicians' prescribing habits for two years. © 2018 npr

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 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 25303 - Posted: 08.07.2018

Olga Khazan For people with bipolar disorder, manic episodes can be euphoric, but they can also be terrifying. In the throes of mania, some people feel like they are superhuman. They start new projects and stay up all night to work on them. In the worst cases, they cease thinking coherently: They might attempt to walk into the sea or fly off the roof. Though medications can help manage the symptoms, no pill is perfect, and all of them have side effects. Bipolar disorder appears to be at least partly genetic, but environmental factors also play a role, perhaps by switching different genes on and off, which might spark manic episodes. And the thing that might be switching on some of these genes, according to a new study, is rather surprising: a category of preservatives in beef jerky called nitrates. For the study, recently published in the journal Molecular Psychiatry, researchers asked people being treated for psychiatric disorders at the Sheppard Pratt Health System in Baltimore whether they had ever eaten dry cured meat, undercooked meat, or undercooked fish. Those who had eaten cured meats—which include jerky and meat sticks—were three and a half times more likely to be in the group that was hospitalized for mania compared with the control group. Meanwhile, cured meats were not significantly associated with other types of psychiatric disorders, such as major depression, and none of the other foods participants were asked about was significantly correlated with mania.

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: 25234 - Posted: 07.21.2018

Bruce Bower England’s King George III descended into mental chaos, or what at the time was called madness, in 1789. Physicians could not say whether he would recover or if a replacement should assume the throne. That political crisis jump-started the study of human heredity. Using archival records, science historian Theodore M. Porter describes how the king’s deteriorating condition invigorated research at England’s insane asylums into the inheritance of madness. Well before DNA’s discovery, heredity started out as a science of record keeping and statistical calculations. In the 1800s, largely forgotten doctors in both Europe and North America meticulously collected family histories of madness, intellectual disability and crime among the growing numbers of people consigned to asylums, schools for “feebleminded” children and prisons. Some physicians who specialized in madness, known as alienists, saw severe mental deficits as a disease caused by modern life’s pressures. But most alienists regarded heredity, the transmission of a presumed biological factor among family members, as the true culprit. Asylum directors launched efforts to track down all sick relatives of patients. The increasing number of people institutionalized for mental deficits fueled the view that individuals from susceptible families should be discouraged from reproducing. © Society for Science & the Public 2000 - 2018

Related chapters from BN: Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 4: Development of the Brain
Link ID: 25163 - Posted: 07.02.2018

By Emily Willingham Analysis of a Million-Plus Genomes Points to Blurring Lines Among Brain Disorders Brain scan of a 23-year-old schizophrenic man experiencing a hallucination. Credit: Getty Images Is lower academic achievement in early life tied to the same gene changes as an increased risk for Alzheimer’s in older age? That is one of dozens of possible deductions to be drawn from the largest genomic study of brain conditions ever conducted, research that obscures what often have been considered clear diagnostic borders. According to the findings, published June 22 in Science, conditions such as schizophrenia, major depressive disorder (MDD) and bipolar disorder share a suite of overlapping genetic variants rather than having distinct genetic signatures. In addition to the genetic links between educational attainment and Alzheimer’s risk, the results link neuroticism to anorexia nervosa, anxiety disorders, MDD and obsessive-compulsive disorder (OCD). Neurological disorders like Parkinson’s and multiple sclerosis, however, have few variants in common with each other or with psychiatric conditions. This mother lode of findings comes after a six-year delving into genomes representing more than a million people, a quest for unusual genetic signals that track with one or more of 42 disorders and traits. © 2018 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 4: Development of the Brain
Link ID: 25127 - Posted: 06.22.2018

By The Editorial Board When President Trump mused that the mass shooting at a high school in Parkland, Fla., in February might have been prevented if the United States had more mental institutions, he revived a not-quite-dormant debate: Should the country bring back asylums? Psychiatric facilities are unlikely to prevent crimes similar to the Parkland shooting because people are typically not committed until after a serious incident. Still, a string of news articles, editorials and policy forums have noted that plenty of mental health experts agree with the president’s broader point. The question of whether to open mental institutions tends to divide the people who provide, use and support mental health services — let’s call them the mental health community — into two camps. There are just 14 or so psychiatric beds per every 100,000 people in the United States, a 95 percent decline from the 1950s. One camp says this profound shortage is a chief reason that so many people suffering from mental health conditions have ended up in jail, on the streets or worse. The other argues that large psychiatric institutions are morally repugnant, and that the problem is not the lack of such facilities but how little has been done to fill the void since they were shut down. Neither side wants to return to the era of “insane asylums,” the warehouselike hospitals that closed en masse between the 1960s and 1980s. Nor does anyone disagree that the “system” that replaced them is a colossal failure. Nearly 10 times as many people suffering from serious mental illnesses are being kept in jails and prisons as are receiving treatment in psychiatric hospitals. What’s more, both sides broadly agree that mental institutions alone would not be the solution. “Bring back the asylums” sounds catchy, but here are some more useful slogans to help steer the conversation: © 2018 The New York Times Company

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: 25056 - Posted: 06.04.2018

By Dhruv Khullar I didn’t think our relationship would last, but neither did I think it would end so soon. My patient had struggled with bipolar disorder his entire life, and his illness dominated our years together. He had, in a fit of hopelessness, tried to take his life with a fistful of pills. He had, in an episode of mania, driven his car into a tree. But the reason I now held his death certificate — his sister and mother in tears by his bed — was more pedestrian: a ruptured plaque in his coronary artery. A heart attack. Americans with depression, bipolar disorder or other serious mental illnesses die 15 to 30 years younger than those without mental illness — a disparity larger than for race, ethnicity, geography or socioeconomic status. It’s a gap, unlike many others, that has been growing, but it receives considerably less academic study or public attention. The extraordinary life expectancy gains of the past half-century have left these patients behind, with the result that Americans with serious mental illness live shorter lives than those in many of the world’s poorest countries. National conversations about better mental health care tend to follow a mass shooting or the suicide of a celebrity. These discussions obscure a more rampant killer of millions of Americans with mental illness: chronic disease. © 2018 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: 25037 - Posted: 05.31.2018

By Shawna Williams | Complications during pregnancy can magnify the effect of genetic risk factors for schizophrenia by altering gene expression in the placenta, a new study suggests. The paper appeared yesterday (May 28) in Nature Medicine. “To me the key thing in this paper is the recognition that environmental factors in early development, prenatal factors, are likely to be very important in schizophrenia and just as important as genes,” Allan Brown of Columbia University Medical Center who was not involved in the study tells Scientific American. An international team of researchers analyzed data from nearly 3,000 participants, including people with schizophrenia and healthy controls. The researchers found that, among people with known genetic risk factors, those who were products of a pregnancy complicated by conditions such as preeclampsia or diabetes were at least five times more likely to have the disease than were people born of uncomplicated pregnancies. The researchers also analyzed gene expression in placental tissue from complicated and uncomplicated pregnancies. That assay revealed that genes associated with schizophrenia risk tended to be “turned on” in the placentas from complicated pregnancies, and that higher expression of those genes was associated with inflammation and other signs of stress in the tissue. “We need to create a new risk score for schizophrenia, incorporating not only genes but also placental health,” study coauthor Daniel Weinberger of the Lieber Institute for Brain Research and the Johns Hopkins University School of Medicine tells STAT. “The odds of becoming schizophrenic based on your polygenic risk score is more than 10 times greater with these early-life complications than without them.” © 1986-2018 The Scientist

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 4: Development of the Brain
Link ID: 25032 - Posted: 05.30.2018

By Dana G. Smith About 60 to 70 percent of a person’s risk for schizophrenia depends on their genes. Most of us have some of the schizophrenia-associated genetic variants—single-letter changes in the DNA of genes scattered across our genome—and the more we have, the greater our risk. At the same time, scientists have known that complications during pregnancy, including viral infections in the mother, increase the fetus’s risk for developing schizophrenia by two-fold, but scientists have been unsure why. New research published in Nature Medicine on May 28 reveals how when these two risk factors interact, the likelihood of an individual eventually being diagnosed with schizophrenia goes up at least five-fold compared to someone with a high genetic risk alone. Daniel Weinberger, director of the Lieber Institute for Brain Development in Baltimore and team discovered that roughly a third of the genes associated with schizophrenia are in the placenta. But certain variations in the DNA of these genes only result in schizophrenia if there are complications during pregnancy. The gene variants likely affect how resilient the placenta is to stress from its environment. If the mother or baby experiences a major health complication during pregnancy, the variants could activate these genes in the placenta and induce inflammation or affect the fetus’s development, increasing the risk for schizophrenia later in life. “The placenta is the missing link between maternal risk factors that complicate pregnancies and the development of the fetal brain and the emergence of developmental behavioral disorders,” Weinberger says. © 2018 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 4: Development of the Brain
Link ID: 25029 - Posted: 05.29.2018

Anna Gorman When 47-year-old Edward Vega arrived in jail, he couldn't quiet the voices in his head. He felt paranoid, as though he was losing control. "I knew if I didn't get my medication, I was going to hurt someone," says Vega. He was right. A week after being arrested for alleged drug possession, Vega says, he assaulted a fellow inmate and ended up in isolation, which only made him feel worse. Finally, a doctor prescribed drugs that Vega says helped. He had been taking them on the outside but ran out just before he was arrested. "The medication hasn't totally taken away the voices, but I am able to differentiate reality from fiction," says Vega, who was released three months ago. The number of inmates in California who've been prescribed psychiatric drugs has jumped about 25 percent in five years, according to a recent analysis of state data. These inmates now account for about a fifth of the county jail population across the state. The increase might be a reflection of the growing number of inmates with mental illness, though it also might stem from improved identification of people in need of treatment, say researchers from California Health Policy Strategies, a Sacramento-based consulting firm. Amid a severe shortage of psychiatric beds and community-based treatment throughout the state and nation, jails have become repositories for people in the throes of acute mental health crises. © 2018 npr

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: 24947 - Posted: 05.07.2018

by Amy Ellis Nutt and Dan Keating The first warning came a dozen years ago, when the Food and Drug Administration accused the drug company AstraZeneca of “false or misleading” information about health risks in the marketing material for its blockbuster medication Seroquel, an antipsychotic developed to treat schizophrenia but increasingly prescribed “off label” for insomnia. What followed was an onslaught of litigation by state attorneys general, who charged AstraZeneca with fraudulently promoting Seroquel for unapproved uses, and by individual patients, who claimed that it had failed to alert consumers about some of the drug’s most pernicious side effects. Although the company never admitted wrongdoing, by the end of 2011 it had paid out more than $1 billion to settle many of the cases. Another product might have been derailed, but not Seroquel. Despite generic competition and lingering lawsuits, AstraZeneca’s annual reports show Seroquel remained a blockbuster, with $3.6 billion in sales from 2014 to 2016. In the drug’s titanic success and its strong link to off-label prescribing lies a cautionary tale — about the sometimes conflicting forces within health care, the relationship between medications and marketing, and the limits of regulatory protections. These days, the powerful antipsychotic is used for an expansive array of ills, including insomnia, post-traumatic stress disorder and agitation in patients with dementia. Many of the doctors who turn to it for off-label uses are physicians with minimal training in psychiatry and, medical experts say, too little understanding of the potential downsides. © 1996-2018 The Washington Post

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 24804 - Posted: 03.31.2018

By Daniel S. Barron It was midday when an ambulance brought Rose to the Emergency Department. The triage nurses, with their characteristic knack for brevity, had written “50 year old schizophrenic woman hearing/seeing dead boyfriend.” The medical team had done the standard workup—temperature, blood pressure, EKG, labs to screen for an electrolyte imbalance, drug or toxin that might explain Rose’s condition. Everything seemed normal, making Rose (whose name and narrative details have been changed to protect her privacy) a psychiatry patient. So I made my way to the B wing of the E.D., which serves as a Limbo of sorts between the medical and psychiatric services. The B wing invariably bustles with activity. A long concierge-style counter with three computers faces the center of the room, which is essentially a large rectangle. When seated at one of these computers, you can see into each of the nine patient rooms that wrap around the three outer walls. From this vantage, the B wing becomes an amphitheater, with patients in gurney-sized niches showcasing some emergent medical concern: B7, chest pain; B9, acute shortness of breath. Rose was medically cleared, so her gurney had been downgraded to stage right, to the end of the counter. I entered at stage left and noticed her across the room, feet at the head of the gurney propped on a pillow; her head was at the foot, neck slightly bent over the edge. Her hands were neatly resting on her belly while her thick hair formed a graying river that reached towards the linoleum. In a firm yet conversational tone, Rose said towards the ceiling, “Why would Steven say he isn’t dead? How could anyone be so cruel?” Her mouth moved widely like a Claymation character as she slowly enunciated every syllable, chopping cruel into CRU-EL. She was smiling. I stood quietly, observing the scene as Rose stared intensely upwards. A few seconds later, it occurred to me that she was waiting for the ceiling to reply. “I see,” I muttered, recalling the triage nurses’ note, and went in search of a stool for my interview. © 2018 Scientific American

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: 24765 - Posted: 03.19.2018