Research in the Journal of Clinical Psychiatry finds, in a study of 18,154 subjects diagnosed with schizophrenia, that “The highest suicide-related mortality was seen among subjects recently diagnosed with schizophrenia. Among all potential baseline risk factors for completed suicide examined, the variables most associated with completed suicide were history of suicide attempts and usage of antidepressant medication.”
In England, childhood sexual abuse (CSA) has become big news. The increasing understanding of the level of childhood sexual abuse and how this produces mental anguish has of course reached the psychosis arena, and encouraged academic study. Whilst the majority of psychiatrists continue to privilege a biological explanation of psychosis, more and more workers recognise abuse as at least a trigger if not a cause of psychosis. It’s important to develop thinking points for teams struggling with, or more generally avoiding, the CSA/psychosis link. Full Article →
A very gifted and compassionate friend recently said that she feels enslaved to Abilify – that she has tried to taper off it several times but always ends up slipping into an extreme state, no matter how slow she tapers. She said this repeated experience makes her feel like a slave, because she has to go back on the drug to stop the very intense extreme state induced whenever she tries to stop taking it. I have another friend who for years felt painfully anguished until he found his way free of heroin. He stopped using, went through withdrawal and was finally free. Most people who try withdrawing from antipsychotics face professional caregivers who discourage them from doing it. On the other hand, when people detox from heroin, everyone encourages them to go through it, no matter how extreme their behavior or how much pain they go through. Full Article →
After a well-publicized stint in treatment for a diagnosis of schizophrenia, actress Amanda Bynes and her family have announced that she never had a mental illness and that her behavior was the result of marijuana abuse. ”Amanda currently is on zero medication,” according to the family’s attorney. “She’s devoted to living her life as healthy as possible. She’s never had a history of abusing alcohol or hard drugs, and she’s proud to say she’s been marijuana-free for the past nine months.” Discuss →
A voice can be cruel or a voice can be kind, but what it says is only rarely meaningless and irrelevant. A voice may reassure us about our fears. A voice may try to correct our thoughts or actions. A voice may warn us about possible dangers, or remind us of trauma we’ve experienced in the past, possibly as a way to warn us about someone who might be threatening. Hearing voices, then, is not a “hallucination.” It’s an important and relevant experience. Full Article →
Research in Schizophrenia Research finds that 57 out of 7189 schizophrenia patients admitted between 1989 and 2013 died suddenly and unexpectedly during hospitalization; a rate significantly above that of the general population. Cardiovascular, respiratory and neurological abnormalities were implicated in most cases, however 6 cases (11.8% remained unexplained. Discuss →
Analysis of 221 joint crisis plans for people with diagnoses of psychotic disorders and at least one psychiatric admission in the past two years, in England’s CRIMSON randomized controlled trial, finds that “Most service users requested full involvement in decisions about their care, clear and consistent treatment plans, access to familiar clinicians who knew them well, and to be treated with respect and compassion. Some service users requested hospitalisation, but the majority preferred alternatives. The most frequently preferred intervention was care by a home treatment team.” The researchers conclude that “Joint crisis planning (JCP) resulted in service users making choices that were clinically reasonable. The technique employed by JCPs appeared to empower service users by engaging them in a productive dialogue with their clinicians.” Discuss →
A study of 650 immigrant and racial & ethnic minority young adults in the United States finds that psychotic symptoms are significantly correlated with racial discrimination, even after adjusting for anxiety and depression symptoms. The study was published by Social Psychiatry and Psychiatric Epidemiology. Discuss →
Research involving 184 people with schizophrenia or schizoaffective diagnoses, and 447 people without diagnoses, finds strong positive correlations between childhood maltreatment and self-reported psychotic symptoms regardless of diagnostic status. ”Although patients scored significantly higher than controls on both history of childhood maltreatment and self-reported symptoms, the strength of the relationship did not differ between groups. These data provide strong support for etiological continuity between subclinical psychotic symptoms and psychotic disorders,” the study, published yesterday by Schizophrenia Research, concludes. Discuss →
Novelist Jenni Fagan writes in the New York Times of being gestated in a psychiatric hospital, told she may have inherited schizophrenia, growing up in public care and foster homes, and ultimately deciding that “pleasure is the ultimate rebellion, and so I am taking it, in the small moments, holding my child, feeling ill but still seeing friends for dinner, going to work. I don’t need to understand everything. I just need to offer myself empathy when I feel terror, or the closeness of death, or the sadness of this world, or when I wake in the middle of the night.” (more…)
Martin Harrow’s study tracing the effects of antipsychotics on 139 schizophrenia (SZ) and mood-disordered patients over 20 years, just published in Psychological Medicine, finds that “At each follow-up assessment over the 20 years, a surprisingly high percentage of SZ treated with antipsychotics longitudinally had psychotic activity. More than 70% of SZ continuously prescribed antipsychotics experienced psychotic activity at four or more of six follow-up assessments over 20 years. Longitudinally, SZ not prescribed antipsychotics showed significantly less psychotic activity than those prescribed antipsychotics . . . the condition of the majority of SZ prescribed antipsychotics for multiple years would raise questions as to how many of them are truly in remission.”
A study published in the Journal of Psychiatric Research finds the strongest association between a history of childhood trauma and the risk of violence in adults with psychotic disorders is for people with a history of sexual abuse. A cumulative effect of trauma in general on risk for violence in psychosis was also found. “There are implications for applying models of violence to psychosis, risk assessment and treatment of people with psychotic disorders as well as informing trauma models and protective factors for children in conflict-affected regions,” the study concludes.
fMRI data from 162 people with schizophrenia diagnoses and 178 people without show hyper connectivity between the amygdala and the visual cortex. “This hyperconnectivity may facilitate retrieval and reactivation of visual memories, arguably the raw material of [visual hallucinations],” say the researchers. ““Hyperconnectivity between the amygdala and visual cortex may reflect the ability of these areas to communicate too efficiently with each other, perhaps resulting in excessive conscious experiences or [visual hallucinations] of negatively charged, threatening images.”
Anthony Gill’s doctoral thesis for the University of Leeds attempts to correct the observation that “There is no available evidence that has produced detailed, valid accounts of how patients themselves construct meaning in their lives, and in particular how medication has affected them,” finding that “the stigma associated with schizophrenia has a negative impact on individual’s lives. People with schizophrenia want and need to be listened to, in order for them to have an improved quality of life. It is clear that their lived experiences should be taken into consideration when implementing policy development in order to reduce the social isolation associated with schizophrenia.”
Although psychotic experiences (PEs) and schizophrenia are thought to share similar etiological risk factors, PEs also co-exist with depression and, according to research from the U.K., are a weak predictor of genetic and environmental risk for schizophrenia. The data, published in Psychological Medicine, indicate that “disentangling aetiological pathways to PEs from those impacting upon co-morbid psychopathology might provide important insights into the aetiology of psychotic disorders.”
Research from Australia asks the question noted above, and answers “subtle, but diverse, structural brain alterations, altered electrophysiological functioning and sleep patterns, minor physical anomalies, neurological soft signs, and sensory alterations. There are markers of infection, inflammation or altered immunological parameters; and there is increased mortality from a range of causes. Risk for schizophrenia is increased with cannabis use, pregnancy and birth complications, prenatal exposure to Toxoplasma gondii, childhood central nervous system viral infections, childhood adversities, urbanicity and immigration (first and second generation), particularly in certain ethnic groups . . . We conclude that while our knowledge of schizophrenia is very substantial, our understanding of it remains limited.”
Subsidiaries of Johnson & Johnson have agreed to pay $5.9 million to settle Montana’s lawsuit over the company’s fraudulent marketing of Risperdal. According to the lawsuit, J&J and its subsidiaries knew that the drug could cause weight gain, diabetes, and vascular complications, but hid the risks. After approval by the FDA for adult schizophrenia and bipolar disorder in adults, the companies promoted the drug for various conditions in both adults and children.
Research from the Netherlands finds, in a nationwide survey of 1929 young adults, that cigarette smoking and cannabis were equally strongly associated with the frequency of psychotic-like experiences (PLEs). Further, though cannabis use was associated with distress from PLEs when cigarette smoking was eliminated as a confound, the inclusion of cigarette smoking rendered the statistical effect of cannabis on distress insignificant.
Prior admissions with stimulant disorder, but not a prior cannabis disorder diagnosis, are a negative prognostic sign in first-episode psychosis according to new research in the British Journal of Psychiatry. “Young people with substance comorbidities may have both the best and worst of outcomes, depending on whether problematic substance use is discontinued,” the authors note.
Treatment by lay health workers is more effective than standard facility-based care at reducing disability and psychotic symptoms in people with schizophrenia diagnoses, according to research published yesterday in The Lancet. Findings from the first randomized trial to test community-based care against standard care in a low-income country “show even more positive outcomes than similar trials of collaborative community-based care in high-income countries.”
An NBC online News article dated October 15, 2010, carried the noteworthy title New blood test may help detect schizophrenia. The article was written by Natasha Allen, a freelance medical journalist. The gist of the article is that there is a new blood test called VeriPsych which “researchers say” is 83% accurate in discriminating people who are “schizophrenic” from people who are not. Full Article →
Research has shown a correlation between schizophrenia and exposure to cat bites or scratches. This has been theorized to be due to the effects of Toxoplasmosis Gondii, a parasite that can cause changes in behavior, including a reduction of fear and an increase in impulsiveness. Popular Science considers research that extends this connection to depression, with speculation on other reasons that cat fellowship may correlate with changes in behavior.