Link Between Schizophrenia and Autoimmune Disease

From Psychiatric News Alert: New data show that individuals with schizophrenia are at increased risk of developing autoimmune diseases, according to a study reported in AJP in Advance. The study, “A Nationwide Study on the Risk of Autoimmune Diseases in Individuals With a Personal or Family History of Schizophrenia and Related Psychosis,” led by Michael Benros, M.D., Ph.D., of Denmark’s Aarhus University and the Mental Health Center Copenhagen, suggests that “The increased risk of subsequent autoimmune diseases in individuals with schizophrenia may involve neuropsychiatric manifestations from the undiagnosed autoimmune disease, medical treatment or lifestyle associated with schizophrenia, or common etiological mechanisms, such as infections and shared genetic factors.”

Benros and colleagues noted that prior research has shown an increased risk of schizophrenia in those with autoimmune diseases, but that theirs is the first study to investigate the link between schizophrenia and subsequent development of an autoimmune disease “and to consider the effect of infections, a possible risk factor for both schizophrenia and autoimmune diseases.” They analyzed data from Danish nationwide registers that included 3.8 million people from which they identified 39,364 with “schizophrenia-like psychosis” and 142,328 with autoimmune disease. They found that “individuals with schizophrenia had an elevated risk of subsequent autoimmune diseases, with an incidence rate ratio of 1.53.” Their analysis also found that “For individuals with schizophrenia as well as hospital contacts for infections, the combined risk of autoimmune diseases was 2.70.”

To read more about research on links between schizophrenia and infections, see the Psychiatric News articles Immune System Protein Could Give Clue to Late-Onset Schizophrenia” and “Psychiatrist Hunts for Evidence of Infection Theory of Schizophrenia.”

What is Depersonalization?

Depersonalization is a dreamlike feeling of being disengaged from your surroundings, where things seem “less real” than they should.

People who suffer from severe depersonalization say it feels as if they are watching themselves act from a distance without a sense of complete control. Although it is, itself, harmless, the experience can be extremely disturbing.

The condition is thought to be caused by an imbalance of brain chemicals. As with other dissociative disorders, the feelings are usually triggered by life-threating or traumatic events, such as extreme violence and war.

Depersonalization is also a common symptom in many different mental disorders such as Schizophrenia, Depression, Anxiety, multiple personality disorder, PTSD and Bipolar disorder. Its symptoms include:

    • Feeling as if you are watching yourself as an observer
    • Feeling you are not in control of your actions
    • Feeling disconnected from your body
    • Feeling like you are in a dream
    • Feeling everything around you isn’t real

Cognitive Behavioral Therapy is helpful, however there are no medications approved to treat depersonalization.

More detailed information at: Medical News Today

Schizophrenia–Single Mutation Might Damage Brain Pathway

Schizophrenia is characterized by a broad range of behaviors that profoundly disruption in the lives of people suffering from the condition, as well as in the lives of the people around them. It strikes without regard to gender, race, social class or culture. Throughout history, the disorder has been a source of bewilderment. Those suffering from the illness once were thought to be possessed by demons and were feared, tormented, exiled or locked up forever.

We’ve come a long way since then, but still have a long way to go. One aspect of schizophrenia is that it can be either inherited or appear in a family with no history of the condition. Now, a new discovery is changing the way scientists think about non-inherited schizophrenia–according to researchers at the University of Washington, rather than individual gene mutations being responsible for schizophrenia on their own, it appears more likely that a gene mutation damages an entire neural pathway, which creates a ripple effect across networks as the brain develops.

So what is now known as by one diagnosis — schizophrenia — might actually be many different conditions. According to Mary-Claire King, Ph.D., a University of Washington grantee working on the project:

“Processes critical for the brain’s development can be revealed by the mutations that disrupt them. Mutations can lead to loss of integrity of a whole pathway, not just of a single gene.”

The new research supports the relatively new model of schizophrenia as a neurodevelopmental disorder in which psychosis is a late, potentially preventable stage. In the study, researchers were able to trace back spontaneous gene mutations to where and when they likely caused brain damage. They found some individuals might develop the precursors for schizophrenia even before birth, because their brains produced damaged neurons as a developing fetus.

Previous research had already found a connection between gene mutations and non-inherited schizophrenia that could be traced to genes involved in brain development. The new research supports earlier studies that had implicated the prefrontal cortex in schizophrenia. The prefrontal cortex pulls information from other brain regions to coordinate functions such as thinking, planning, attention span, memory and problem-solving. Problems with these functions are early signs of the condition.

The Onset of Schizophrenia

The onset of schizophrenia in most people is a gradual deterioration that occurs in early adulthood — usually in a person’s early 20s. Loved ones and friends may spot early warning signs long before the primary symptoms of schizophrenia occur. During this initial pre-onset phase, a person may seem without goals in their life, becoming increasingly eccentric and unmotivated. They may isolate themselves and remove themselves from family situations and friends. They may stop engaging in other activities that they also used to enjoy, such as hobbies or volunteering.

Warning signs that may indicate someone is heading toward an episode of schizophrenia include:

  • Social isolation and withdrawal
  • Irrational, bizarre or odd statements or beliefs
  • Increased paranoia or questioning others’ motivations
  • Becoming more emotionless
  • Hostility or suspiciousness
  • Increasing reliance on drugs or alcohol (in an attempt to self-medicate)
  • Lack of motivation
  • Speaking in a strange manner unlike themselves
  • Inappropriate laughter
  • Insomnia or oversleeping
  • Deterioration in their personal appearance and hygiene

While there is no guarantee that one or more of these symptoms will lead to schizophrenia, a number of them occurring together should be cause for concern, especially if it appears that the individual is getting worse over time. This is the ideal time to act to help the person — even if it turns out not to be schizophrenia.

For further information, go to PsychCentral.com.

Related articles

Mental Illness Awareness Week 2013

It’s Time to Make a Difference

During much of the past year, Americans have engaged in a dialogue about mental illness, sparked by the tragedies in Aurora, Colo. and Newtown, Conn. Most people living with mental illness are not violent, but when violence does occur, the spotlight falls on holes in the mental health care system.

This year, the spotlight has had special intensity, including proposals by the President of the United States, congressional hearings and interest among state and local elected officials. During Mental Illness Awareness Week (MIAW) is Oct. 6-12, 2013, every community should pause to consider whether a true awakening has occurred, including greater investment in mental health care.

It’s time to make a difference.

Mental illness does not discriminate. It can strike anyone at any time. Fortunately recovery is possible. Treatment works, but only if a person can get it.

One in four American adults experience a mental health problem in any given year. One in five young people ages 13 to 18 also experience mental illness. In fact, one-half of all mental illness begins by the age of 14—three-quarters by age 24.

Unfortunately, there are long delays−sometimes decades−between the first appearance of symptoms and when people get help. Less than one-third of adults and less than one-half of children with a diagnosed illness receive treatment.

Local NAMI affiliates stand ready to help in their areas. For residents in the Los Angeles South Bay, NAMI South Bay offers resources, classes, support groups and helpful information, beginning with the information available on this site. For affiliates in other areas, the national organization keeps an updated and interactive page you can find by CLICKING HERE or clicking on NAMI’s Affiliates-by-State map:

Key issues that affect access to mental health care include expansion of state Medicaid coverage for uninsured persons, mental health insurance parity and state spending on direct services. Spending money can involve difficult choices, but when it comes to mental health care, lack of coverage or cuts too often results in simply shifting costs to hospital emergency rooms, schools, police, courts, jails and broken families

When it comes to mental health care, we need to focus on “sooner” rather than simply “later.” As part of this year’s dialogue on mental illness, the challenge has been made not to fix the mental health care system but to build it anew—with much greater emphasis on early screening, diagnosis and treatment. This includes the need for effective school-based and school-linked mental health services. It also includes family education and support who too often are overwhelmed as caregivers.

During MIAW,  these are issues to talk about. Even more fundamentally, everyone should take care to know the nature of mental illness and the symptoms of different conditions such as major depression, bipolar disorder and schizophrenia. Information about specific diagnoses and treatment options is available at www.nami.org.

No one should have to confront mental illness alone. Know where to find help in case it’s ever needed. Most people start with their primary care doctor. Many start by confiding in a close family member of friend.

Don’t be afraid to speak up. The U.S. Surgeon General has reported that stigma is a major barrier to people seeking help when they need it.  That’s why MIAW is so important.  The more people know, the better they can help themselves or their loved ones to get the support they need.

CBS 60 Minute Show – “Untreated Mental Illness an Imminent Danger”

Please CLICK HERE to visit CBS’s site to view the segment on mental illness that appeared last night on the 60 minute show. Correspondent Steve Kroft interviewed two experts on the subject—Jeffrey Lieberman, M.D., president of APA and chair of psychiatry at Columbia University, and E. Fuller Torrey, M.D., executive director of the Stanley Medical Research Institute. Dr. Torrey Fuller, a nationally known psychiatrist, frequent contributor on national television shows, NAMI award winner, and one of the founders of the Treatment Advocacy Center provides comment on mental illness and recent tragic events involving persons with a mental illness. The segment is also available through YouTube, embedded below:

Several major points emerged from the segment, including:

  • That schizophrenia is a brain illness. Lieberman documented this knowledge with brain images showing changes in the brains of people with schizophrenia. He also explained that the illness, which “usually emerges in late adolescence and early adulthood, affecting perception and judgment,” may cause a person to hear voices, among other symptoms.
  • There are effective treatments for the hallucinations that individuals with schizophrenia experience, but not all of those individuals have access to such treatments.
  • The vast majority of individuals with schizophrenia do not commit violence. They are the ones who suffer the most from their illness. And the tragic fact is that many people with serious mental illness are not receiving treatment in the community and end up in jails and prisons.

Dr. Fuller is also the author of Surviving Schizophrenia: A Manual for Families, Consumers and Providers (Harper Perennial). Since its first publication in 1983, Surviving Schizophrenia has become the standard reference book on the disease and has helped thousands of patients, their families and mental health professionals. In clear language, this much–praised and important book describes the nature, causes, symptoms, treatment and course of schizophrenia and also explores living with it from both the patient and the family’s point of view.

The present edition is the Fifth Edition. It is completely updated and includes the latest research findings on what causes schizophrenia, information about the newest drugs for treatment, and answers to the questions most often asked by families, consumers and providers.

How Shootings Stigmatize People Living with Mental Illness

From: NAMI Blog: 

On Sept. 20, CNN.com invited and published the following guest article by NAMI Executive Director Michael J. Fitzpatrick. NAMI also released statements on the Navy Yard tragedy on Sept. 17 and Sept. 19.

When tragedies occur, such as the one at the Navy Yard in Washington, all Americans are deeply affected.

They include the one in four American adults who experience mental health problems. That’s approximately 60 million Americans. Their first reaction is much like that of anyone else: feelings of anger and anguish and wanting to know when such events will ever stop.

But there’s another, secondary impact to this community if a history of mental illness is suspected. Tragically, in the case with the Navy Yard gunman, mental illness appears to be a factor. But in too many cases, people simply assume that it is, no matter how much we caution that it’s best not to attempt to diagnose any medical condition speculatively through the news media.

Unfortunately, stigma surrounds mental illness. It’s most associated with a violent stereotype. The result has always been fear, prejudice and discrimination toward anyone struggling with a mental health problem.

The stereotype endures despite the fact that the U.S. Surgeon General has found that the likelihood of violence from people with mental illness is low. In fact, “the overall contribution of mental disorders to the total level of violence in society is exceptionally small.”

Despite the impact of the Navy Yard tragedy and those of Newtown, Aurora and Virginia Tech on perceptions, a much greater, different reality exists. Many thousands of veterans experience post-traumatic stress disorder. Civilian employees of the military seek help for depression; teachers live with anxiety disorders. Students succeed academically while managing bipolar disorder.

People living with schizophrenia may be psychologists, professors, peer counselors or businesspersons. They are all members of their communities. Few are violent…

CLICK HERE to view this entire article at NAMI Blog.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a blend of two therapies: cognitive therapy (CT) and behavioral therapy. CT was developed by psychotherapist Aaron Beck, M.D. in the 1960’s. CT focuses on a person’s thoughts and beliefs, and how they influence a person’s mood and actions, and aims to change a person’s thinking to be more adaptive and healthy. Behavioral therapy focused on a person’s actions and aims to change unhealthy behavior patterns.

CBT helps a person focus on his or her current problems and how to solve them. Both patient and therapist need to be actively involved in this process. The therapist helps the patient learn how to identify distorted or unhelpful thinking patterns recognize and change inaccurate beliefs, related to others in more positive ways, and change behaviors accordingly.

CBT can be applied and adapted to many conditions, including depression, bipolar disorder, Anxiety disorders, eating disorders, schizophrenia and schizoaffective disorder. For instance, people with bipolar disorder usually need to take medication, such as a mood stabilizer. But CBT is often used as an added treatment. The medication can help stabilize a person’s mood so that he or she is receptive to psychotherapy and can get the most out of it. CBT can help a person cope with bipolar symptoms and learn to recognize when a mood shift is about to occur. CBT also helps a person with bipolar disorder stick with a treatment plan to reduce the chances of relapse (e.g., when symptoms return).

With schizophrenia, the disorder generally requires medication first. But research has shown that CBT, as an add-on to medication, can help a patient cope with schizophrenia, helping patients learn more adaptive and realistic interpretations of events. Patients are also taught various coping techniques for dealing with “voices” or other hallucinations. They learn how to identify what triggers episodes of the illness, which can prevent or reduce the chances of relapse. CBT for schizophrenia also stresses skill-oriented therapies. Patients learn skills to cope with life’s challenges. The therapist teaches social, daily functioning, and problem-solving skills. This can help patients with schizophrenia minimize the types of stress that can lead to outbursts and hospitalizations.

CBT for schizoaffective treatment shares elements of each of the foregoing. Over the past two decades, CBT for schizophrenia and schizoaffective disorder has received considerable attention in the United Kingdom and elsewhere abroad. While this treatment continues to develop in the United States, the results from studies in the United Kingdom and other countries have encouraged therapists in the U.S. to incorporate this treatment into their own practices. In this treatment, often referred to as cognitive behavioral therapy for psychosis (CBT-P).

For more information, see the National Institute for Mental Health Site and NAMI.

From: National Institute of Mental Health and NAMI National.