Some of the “Other” Common Symptoms in Schizophrenia

Schizophrenia is most easily recognized by the symptoms that define it, such as visual and auditory hallucinations (e.g., “seeing things” and “hearing voices”) and delusions, including paranoia. But other symptoms are also extremely common.

Apathy, for instance, is often observed. If a person is experiencing auditory or visual delusions and paranoia – “psychosis” – they they are less likely to engage in day to day activities because the voices and suspicions are controlling the majority of their life. A Person living with schizophrenia can still experience depression even when they are not having other symptoms, the person will show signs of apathy, which can be attributed to the depression. Excessive doses of antipsychotics can also sometimes contribute to apathy.

Negative Symptoms Associated with Schizophrenia

Between 40% and 50% of people living with schizophrenia who have been treated and are recovering

will show evidence of negative symptoms. Negative symptoms include:

• Emotional flatness or lack of expressiveness.
• Inability to start and follow through with activities.
• Lack of pleasure or interest in life.

One distinction of some people living with schizophrenia is they do not expect enjoyable activities to give them pleasure, which likely causes them to not engage in pleasure-seeking behaviors.

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Reprograming Skin Cells Into Brain Cells

Using skin cells from patients with mental disorders, scientists are creating brain cells that are now providing extraordinary insights into schizophrenia and Parkinson’s disease.

For many poorly understood mental disorders, such as schizophrenia or autism, scientists often wish they could turn back the clock to uncover what has gone wrong in the brain. Now thanks to recent developments in the lab, this is coming true.

Salk Institute for Biological Studies, La Joll...

Salk Institute for Biological Studies, La Jolla, California (Photo credit: Wikipedia)

Researchers are using genetic engineering and growth factors to reprogram the skin cells of patients and grow them into brain cells. In the lab under careful watch, investigators can detect inherent defects in how neurons develop or function, or see what environmental toxins or other factors prod them to misbehave in the Petri dish. With these “diseases in a dish” they can also test the effectiveness of drugs that can right missteps in development, or counter the harm of environmental insults.

“It’s quite amazing that we can replicate a psychiatric disease in a petri dish,” says neuroscientist Fred Gage, a professor of genetics at the Salk Institute of Biological Studies. “This allows us to identify subtle changes in the functioning of neuronal circuits that we never had access to before.”

Stanford study finds auditory hallucinations affected by local culture

FROM STANFORD REPORT, July 16, 2014, Hallucinatory ‘voices’ shaped by local culture, Stanford anthropologist says, by Clifton B. Parker. People suffering from schizophrenia may hear “voices” – auditory hallucinations – differently depending on their cultural context, according to new Stanford research.

Tanya Luhrmann, professor of anthropology, studies how culture affects the experiences of people who experience auditory hallucinations, specifically in India, Ghana and the United States.

In the United States, the voices are harsher, and in Africa and India, more benign, said Tanya Luhrmann, a Stanford professor of anthropologyand first author of the article in the British Journal of Psychiatry.

The experience of hearing voices is complex and varies from person to person, according to Luhrmann. The new research suggests that the voice-hearing experiences are influenced by one’s particular social and cultural environment – and this may have consequences for treatment.

The striking difference was that while many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful – and evidence of a sick condition. The Americans experienced voices as bombardment and as symptoms of a brain disease caused by genes or trauma.

Why the difference? Luhrmann offered an explanation: Europeans and Americans tend to see themselves as individuals motivated by a sense of self identity, whereas outside the West, people imagine the mind and self interwoven with others and defined through relationships.

Luhrmann said the role of culture in understanding psychiatric illnesses in depth has been overlooked.

“The work by anthropologists who work on psychiatric illness teaches us that these illnesses shift in small but important ways in different social worlds. Psychiatric scientists tend not to look at cultural variation. Someone should, because it’s important, and it can teach us something about psychiatric illness,” said Luhrmann, an anthropologist trained in psychology. She is the Watkins University Professor at Stanford.

See the full Stanford News article HERE.

Anderson Cooper’s Empathy Exercise for Schizophrenia

In case you haven’t seen it yet, below is Anderson Cooper’s segment in June 2014 in which he dons earphones and attempts ordinary activities while experiencing voices in an exercise designed by clinical psychologist, Pat Deegan.

Visit Anderson Cooper’s blog by CLICKING HERE to see what he has to say about the experience and to see his interview of Dr. Deegan.

Patricia E. Deegan, Ph.D., is an independent consultant who specializes in researching and lecturing on the topic of recovery and the empowerment of people diagnosed with mental illness. She is an activist in the disability rights movement and has lived her own journey of recovery after being diagnosed with schizophrenia as a teenager. She is the creator of the CommonGround Approach, which includes CommonGround – a web application to support shared decision making in the psychopharmacology consultation, and RECOVERYlibrary – a collection of recovery oriented resources aimed at providing the tools, the hope, and the inspiration to recovery after a diagnosis of mental illness.

You can learn more about Pat Deegan at HER WEBSITE.

38-Year Study Assesses Violence and Premature Mortality in People With Schizophrenia

People with schizophrenia and related disorders have increased rates of suicide, premature mortality, and convictions for violent offenses, according to a report from British and Swedish researchers published in Lancet.

English: Image showing brain areas more active...

English: Image showing brain areas more active in controls than in schizophrenia patients during a working memory task during a fMRI study. Two brain slices are shown. (Photo credit: Wikipedia)

The study compared 24,297 Swedish patients with their unaffected siblings and matched controls from the general population, assessing outcomes from 1972 through 2009. Within five years of diagnosis, 13.9% of male patients and 4.7% of female patients recorded one of those three adverse outcomes. Overall, those adverse outcomes were 7.5 times more likely compared with men in the general population and 11.1 times more likely for women, wrote Seena Fazel, M.D., an honorary consultant forensic psychiatrist in the University of Oxford’s Department of Psychiatry, and colleagues.

The authors assessed adverse outcomes in all three study groups and found that three risk factors present in all three cohorts predicted the adverse outcomes: drug use disorders, criminality, and self-harm. “Schizophrenia and related disorders are associated with substantially increased rates of violent crime, suicide, and premature mortality,” they concluded. “Risk factors for these three outcomes included both those specific to individuals with schizophrenia and related disorders, and those shared with the general population. Therefore, a combination of population-based and targeted strategies might be necessary to reduce the substantial rates of adverse outcomes in patients with schizophrenia and related disorders.”

“[T]he authors suggest that to best manage violence and suicide risk, we should perhaps now turn our attention to those factors evident across populations,” added Eric Elbogen, Ph.D., an associate professor, and Sally Johnson, M.D., a professor of psychiatry at the University of North Carolina, in a related commentary. “In this way, we might not only reduce actual risk in people with schizophrenia, but appropriately place this in the context of violence reduction for society as a whole. The potential to achieve practical, evidence-based, and potentially less stigmatising interventions is one of the most exciting implications of this study.”

To read more research on violence risk in those with schizophrenia, see the Psychiatric News articles, “Antisocial Behavior Raises Violence Risk in Some Psychosis Patients” and “Untreated Schizophrenia Increases Risk for Violence By Inmates.” Also see “Systematic Suicide Risk Assessment for Patients With Schizophrenia: A National Population-Based Study” in Psychiatric Services.

Study on Vets With Schizophrenia, Comorbid Anxiety

FROM Psychiatric News Alert: Veterans with schizophrenia and a comorbid anxiety disorder have increased rates of other disorders, higher psychiatric and medical hospitalization, and increased utilization of outpatient mental health services, according to the study, “Service Utilization Among Veterans With Schizophrenia and a Comorbid Anxiety Disorder,” published in the APA journal Psychiatric Services in Advance.

Researchers from the Department of Veterans Affairs’ Serious Mental Illness Treatment Resource and Evaluation Center in Ann Arbor, Mich., examined diagnostic, utilization, and medication records included in the Veterans Health Administration (VHA) National Psychosis Registry. Relationships between schizophrenia and anxiety disorders were evaluated along demographic and service utilization dimensions.

During Fiscal 2011, 23.8% of 87,006 VHA patients with schizophrenia were diagnosed with a comorbid anxiety disorder; 15.2% of the sample had a posttraumatic stress disorder (PTSD) diagnosis and 8.6% a non-PTSD anxiety disorder. The researchers found that patients without a comorbid anxiety disorder had significantly lower rates of other comorbid mental disorders than did patients with comorbid anxiety disorders. Specifically, 20.6% of patients with no anxiety disorder had depression, compared with 47.7% of those with PTSD and 46.8% of those with non-PTSD anxiety disorders. Only 3.7% of patients with no anxiety disorder had a personality disorder, compared with 11.2% of those with PTSD and 10.8% of those with non-PTSD anxiety.

“Anxiety disorders are common among individuals with schizophrenia within the VHA and appeared in this study to convey additional disability in terms of psychiatric comorbidity and the need for increased psychiatric care,” the researchers pointed out. “Future research should investigate ways to improve detection and enhance treatment provided to this population.”

For more on care of veterans with psychiatric disorders, see the Psychiatric Newsarticles, “APA Calls for Better Training to Treat Chronic Pain, Addiction Among Vets” and “Knowledge of Military Life Facilitates Vets’ MH Care.”

The Difference Between Bipolar Disorder and Schizophrenia

There are numerous mental illnesses that the medical field recognizes today, ranging from anxiety issues to depression and beyond. Two of the most serious problems are schizophrenia and bipolar disorder. They’re also two of the most confusing issues, largely due to the fact that they share a number of similar symptoms. Because of this, it’s often difficult for even professional psychiatrists to make an accurate diagnosis between the two. 

However, there are a few things that can help. First, it’s worth understanding the differences and similarities. For starters, schizophrenia is classified as a psychotic disorder that leads to delusions, hallucinations, and more. Bipolar disorder is a mood disorder, though it may manifest in ways that often seem similar to schizophrenia. 

The source of most confusion comes from the overlapping symptoms. For example, things like mania, depression, suicidal thoughts, social issues, and more are all common in both types of mental illness. The biggest difference lies in hallucinations. While those with bipolar disorder can experience hallucinations, they’re far more common among schizophrenics. And even when they do occur in those with a bipolar disorder, the patient will usually be far more alert and expressive when explaining those hallucinations. 

Many who begin to experience mental illness likely won’t even realize that they are suffering from the symptoms of one of these diseases – at the very least, they won’t be able to identify the specific issue they’re dealing with. Today, most psychiatrists will rely on counseling and on scans of brain activity in order to understand the exact problem. Since schizophrenic patients will show a loss of gray matter in their brain and those with bipolar disorder won’t show that loss, this is the primary method of distinguishing between the two when no other methods are working. 

No matter the problem, there are solutions. Modern medicine has led to numerous treatments that can help patients overcome bipolar disorder and schizophrenia. But the first step is simply figuring out which of the two one is suffering from. To find out more, contact us today.

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