Unlocking the Secrets of Schizophrenia

By Dina Al Qassar, NAMI Intern

Schizophrenia continues to confound the minds of scientists and researchers alike. Affecting 1% of the human population, the culprit behind this illness is still unknown. There has been research investigating the causes of schizophrenia, and although scientists have known that it runs in families there isn’t any evidence indicating that the causes are purely genetic. The belief is that both genetic and environmental factors play equal parts in the development of schizophrenia.

There have been speculations about the causes, including but not limited to: prenatal factors (viral infections during the pregnancy, malnourishment, stress); environment factors (emotional, physical, or sexual abuse); abnormalities in the brain structure (irregularities in the size of the prefrontal and temporal lobes), neurotransmitter imbalances (high levels of dopamine and low levels of serotonin), etc… yet there aren’t any definite links between a single factor and the disease.

Due to the unique nature of schizophrenia it is very hard to find the causes of the illness. Recently however, a significant pattern emerged between schizophrenia and inheritance that was revealed by looking at the way schizophrenia is more prevalent in some families; this spurred the genetic investigation of the matter.

Schizophrenia - schizophrénie

Schizophrenia – schizophrénie (Photo credit: http://www.cihr-irsc.gc.ca)

According to Dr. Francis Collins, the director of the National Institutes of Health (NIH), in his blog post from Jan. 28, “Exploring the Complex Genetics of Schizophrenia,” new developments in DNA sequences technology have allowed scientists to look at the “actual DNA sequence of the protein-coding region of the entire genome for thousands of individuals with schizophrenia.” This would then give further insight into the nature of the genetic variations and if there is a direct relationship between these genetic mutations and the illness.

For the rest of this article CLICK HERE to visit the NAMI National Site.

Enhanced by Zemanta

Abnormal Retinal Blood Vessels with Schizophrenia

s_1451f1From Psychiatric News Alert: The blood vessels in the retina of the eye are abnormal in individuals with schizophrenia, according to the study “Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging” in the American Journal of Psychiatry. The senior researcher was Richie Poulton, Ph.D., codirector of the National Centre for Lifecourse Research at the University of Otago in Dunedin, New Zealand. The cohort included more than 1,000 individuals who were followed from birth to adulthood. At age 38, the subjects underwent retinal imaging. The researchers compared the retinal imaging results of 27 individuals who had developed schizophrenia with those of individuals who had not and found that the former had microvascular abnormalities reflective of insufficient brain oxygen supply.

s_1451f2These findings have both research and clinical implications, the researchers said. For example, “Longitudinal and high-risk studies can determine whether retinal vessel caliber in juveniles predicts risk of developing psychosis or accompanies the progression of schizophrenia….” And if that is indeed the case, then retinal imaging might eventually be used to track youth at high risk of developing psychosis, since it is noninvasive and available in many primary care, optometry, and ophthalmology centers, and could foster intervention earlier than is now the case.

For an in-depth review of the latest knowledge on the causes of and treatments for schizophrenia, see Essentials of Schizophrenia from American Psychiatric Publishing.

What are Hallucinations?

People experience hallucinations when one or more senses cause them to misinterpret reality. Although the person may be aware that the hallucination is not real, they appear as if it were really happening. This can affect any or all senses:

  • Visual. Visual hallucinations involve seeing things that aren’t there. The hallucinations may be of objects, visual patterns, people, and/or lights. For example, you might see a person who is not in the room or flashing lights that no one else can see.
  • Olfactory. Olfactory hallucinations involve your sense of smell. You might smell an unpleasant odor when waking up in the middle of the night or feel that your body smells bad when it doesn’t. This type of hallucination can also include scents you find enjoyable, like the smell of flowers.
  • Auditory. Auditory hallucinations are among the most common. You might hear someone speaking to you or telling you to do certain things. The voice may be angry, neutral, or warm. Other examples of this type of hallucination include hearing sounds, like someone walking in the attic, or repeated clicking or tapping noises.
  • Tactile. Tactile hallucinations involve the feeling of touch or movement in your body. For example, you might feel that bugs are crawling on your skin or that your internal organs are moving around. You might also feel the imagined touch of someone’s hands on your body.
  • Gustatory. Gustatory hallucination is the sensation of tasting something that isn’t really there, typically an unpleasant flavor. Can be a symptom of certain types of epilepsy, or schizophrenia.

What is Paranoia?

The term “paranoia” is frequently used in association with certain mental illnesses, but is not always fully understood. In paranoia, an individual mistakenly interprets “others” actions and motives as being of a threatening nature. It can establish itself through a personality disorder and is also associated with schizophrenia, in which the individual becomes socially detached and in some cases shows little expression or emotion.

As well as unusual ideas and peculiar behavior, people with paranoia may also experience related “delusions” that are out of keeping with their normal culture and activities.

From Google Dictionary: [noun] a mental condition characterized by delusions of persecution, unwarranted jealousy, or exaggerated self-importance, typically elaborated into an organized system. It may be an aspect of chronic personality disorder, of drug abuse, or of a serious condition such as schizophrenia in which the person loses touch with reality.

Paranoid schizophrenia is a subtype of schizophrenia in which the patient has delusions (false beliefs) that a person or some individuals are plotting against him or her, or members of his or her family. An individual with paranoid schizophrenia may spend a disproportionate amount of time thinking up ways of protecting themselves from their persecutors. Interestingly, a person with paranoid schizophrenia typically has fewer problems with memory, dulled emotions and concentration compared to those with other subtypes; which allows them to think and function more successfully. Even so, paranoid schizophrenia is a chronic (long-term, lifelong) condition which may eventually lead to complications, including suicidal thoughts and behavior.

People with paranoid personality disorder are generally characterized by having a long-standing pattern of pervasive distrust and suspiciousness of others.  A person with paranoid personality disorder will nearly always believe that other people’s motives are suspect or even malevolent. Paranoid personality disorder generally isn’t diagnosed when another psychotic disorder, such as schizophrenia, has already been diagnosed in the person. Paranoid personality disorder is more prevalent in males than females. Like most personality disorders, paranoid personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in the 40s or 50s.

Four Mental Illness Recovery Patterns Identified in Study

A two-year study of patients with schizophrenia, schizoaffective disorder, bipolar disorder, or affective psychosis reveals four recovery trajectories and the factors that affect those outcomes. Generally speaking, those four trajectories are:

  • Stable with a high level of recovery
  • Stable with a lower level of recovery
  • Fluctuating high-level recovery
  • Fluctuating low-level recovery

Of the factors that affect recovery, having access to good-quality mental health care—defined as including satisfying relationships with clinicians, responsiveness to needs, satisfaction with psychiatric medications, receipt of services at needed levels, support in managing deficits in resources and strains, and care for general medical conditions—may facilitate or improve recovery trajectories.

These results are promising, because all too often, serious mental illness is seen as incurable, permanent, and progressively deteriorating. The reality is that as many as 60% to 70% of patients can achieve a measurable level of recovery. Carla Green Ph.D., M.P.H., and colleagues of the Center for Health Research at Kaiser Permanente Northwest, in Portland, Ore., reported the findings in their report, “Recovery From Serious Mental Illness: Trajectories, Characteristics, and the Role of Mental Health Care” in the December Psychiatric Services.

“Few demographic or diagnostic factors differentiated clusters at baseline. Consistent predictors of trajectories included psychiatric symptoms, physical health, resources and strains, and use of psychiatric medications.” 

The most consistent predictors of recovery were psychiatric symptoms and changes in those symptoms. Those in turn are dependent on good-quality care, which includes satisfaction with their clinicians and with the medications they are taking. “Providing such care has the potential to change recovery trajectories over time.”

Lack of Psychiatric Treatment for Former Prisoners with Schizophrenia Increases Chance of Later Violent Offenses

A study that tracked released prisoners convicted of violent crimes found that mental health treatment affected rates of subsequent violence among those with schizophrenia. Most of the 967 prisoners in the study had no psychosis at about nine months after their release. However, 94 were diagnosed with schizophrenia, 29 with a delusional disorder, and 102 with drug-induced psychosis.

After adjusting for demographic factors, psychiatric comorbidities, and substance use, former prisoners whose schizophrenia was untreated during or after imprisonment were found to be three times more likely to be violent after their release than were prisoners who received psychosis treatment or those without psychosis, wrote Robert Keers, Ph.D., of Queen Mary University of London, and colleagues, online today in AJP in AdvanceThe presence of persecutory delusions appeared to explain at least part of that association, they said.

“Our findings are consistent with those in studies of treatment compliance in psychosis that report that nonadherence to medication is associated with increased risk of violence. They are also in line with findings from studies of first-episode patients that suggest that the risk of violence is higher at first presentation than following treatment.”

The fact that a prisoner was untreated for psychosis should be considered a risk factor for violent recidivism, they concluded. To read more about early detection and treatment of schizophrenia, see the Psychiatric News column “Early Detection of Schizophrenia: The Time Is Now.” Also see the book Essentials of Schizophrenia from American Psychiatric Publishing.

Participation Opportunity for Schizophrenia Caregiver

Adler Weiner Research, an independent marketing research firm, is inviting caregivers of patients that have schizophrenia to participate in an exclusive research event that will take place in Irvine on November 18th and 19th.

If you are currently the caregiver for a family member that has schizophrenia, Adler Weiner Research would like to talk to you!

If you attend this research event, Adler Weiner says you will receive $125 for 90 minutes of your time. Adler Weiner’s research is sponsored by a medical company that is only interested in discussing the life experiences of living with an managing this health condition.

If you are interested in participating, please email awrecruiting@awrla.com or call (310) 471-1379. Mention the topic if you need to leave a message. Space is limited so act fast.