A review of the literature from 2001 to 2011 on child abuse, neglect, and psychiatric disorders finds that early life stress subtypes can predict the development of psychopathology subtypes in adults. Physical & sexual abuse and unspecified neglect were associated with mood & anxiety disorders. Emotional abuse was associated with personality disorders and schizophrenia, and physical neglect with personality disorders. The research appears in the December issue of the Journal of Nervous and Mental Disease.
I really valued the massive Melbourne Hearing Voices conference last week. The theme of reconciliation between voice hearers and mental health workers was a powerful one. This emphasis on creating understanding conversations at the conference was encouraged with dialogues between people on specific subjects – medication, spirituality, psychological approaches to voices etc. – rather than keynotes. It seemed a move away from presentations of competing knowledges, toward a more dialogical conference; a respectful exchange of different viewpoints, feelings and values. When you have a range of views in a presentation it’s less easy to adopt a “good guys vs. bad guys” mentality; you start to see the complexities in more relief. The surprise for me was that I liked it. Full Article →
Modern “civilized” cultures do not have a good relationship with the wild. It seems we are always doing everything possible to shut it out of our lives, or to kill or tame it to the point where it is unrecognizable. Yet that which is wild is always still lurking, somewhere over the edge of our boundaries and frontiers, and also inside people, both inside the “others” we might approach warily on the street, and even inside our family members and ourselves. Full Article →
Allen Frances adds to his catalog of DSM-5 mistakes with the return of the controversial – and ultimately rejected – “Psychosis Risk Disorder”, under a new name; “Attenuated Psychosis Syndrome.” Under the new name, insurance companies can be billed for an ‘Other Specified Schizophrenia Spectrum Disorder/Other Psychotic Disorder.’ “It makes absolutely no sense to pin the misleading and stigmatizing label ‘Other Specified Schizophrenia Spectrum Disorder’ on someone who, in typical settings, will have only about a 10% chance of ever becoming psychotic,” says Frances, “And certainly it makes no sense to follow this misdiagnosis with an unproven and potentially very harmful antipsychotic treatment. Preventing psychosis would be a great idea if we could really do it; but there is no reason to think we can. And reaching beyond our grasp is likely to harm those we hoped to help.”
For a scathing, 11-minute overview of the death of Dan Markingson at the University of Minnesota, and new allegations of coercion into psychiatric clinical trials, you can’t do much better than this excellent investigative report by Jeff Baillon. Full Article →
A 48-year longitudinal study of 244 subjects, published in Schizophrenia Research, finds that those with schizophrenia-spectrum diagnoses had had the worst social functioning scores at the age of 10–13 years. Although most of the patients who went on to schizophrenia diagnoses had a parent who was hospitalized with the condition, this risk did not affect the correlation between social functioning and psychiatric outcome.
E. Fuller Torrey has a new book. While I was not thrilled to support the Treatment Advocacy Center, I was curious as to what he had to say. Where Torrey has clarity, I contend there is much that we still do not understand. I worry that a perspective that suggests the answers are clear cuts us off from inquiry into alternate approaches. Full Article →
Researchers (including Jim van Os) find, in a three-year cohort study of 1272 people at possible genetic risk of psychosis, that “most transitions (to psychosis) can be attributed to powerful environmental effects that become detectable when analysed against elevated background genetic risk, indicating gene-environment interaction.” The authors conclude “Environmental risk associated with transition to psychotic disorder is semi-ubiquitous regardless of genetic high risk status.”
Research in the Harvard Review of Psychiatry looks at Oxytocin – a hormone thought to play a role in evaluating and responding to social stimuli – for its possible role in psychiatric disorders. “The evidence suggests a role of oxytocin in the pathophysiology of some psychiatric disorders, particularly those characterized by impairments in social functioning,” according to the authors, ““However, the preliminary nature of the currently available data precludes a clear understanding of the exact nature of this role.”
Britain’s The Independent tells the story of Lloyd Dres, a 44-year-old former stock trader, who has been trying to make sense of the “paranoid schizophrenia” label he has found himself with. “It makes me worry because I don’t know my own mind,” he said.
Kingsley Hall was the first of Laing’s household communities that served as a place where you could live through madness until you could get it together and live independently. It was conceived as an “asylum” from forms of treatment — psychiatric or otherwise — that many were convinced were not helpful, and even contributed to their difficulties. By the time I arrived in London in 1973 to study with Laing there were four or five such places. Getting in wasn’t easy. Full Article →
Phil Hickey of Behaviorism and Mental Health picks apart 60 Minutes‘ segment interviewing E. Fuller Torrey (Untreated mental illness an imminent danger?), and APA President Jeffrey Lieberman’s glowing review of the segment (“… such a good job dealing with a complex and controversial topic.”) Hickey concludes “In fact, they did an extraordinarily biased and one-sided job. Perhaps the most fundamental issue in this regard is the notion that the condition labeled schizophrenia is a brain disease. There is a growing and convincing body of opinion (and research) that challenges this view.”
This blog was prompted by an invitation to do a guest post on the site of one of my favorite bloggers, 1 Boring Old Man. This is my response to the notion that there are certain conditions – Schizophrenia among them – that correspond more directly to biomedical conditions Full Article →
Research from the universities of Cardiff, Cambridge and Bristol finds no evidence of a link between genetic associations with schizophrenia and adolescent psychotic experiences. To the contrary, “individuals who had a higher number of risk alleles for genome-wide hits for schizophrenia showed a decreased risk of psychotic experiences.” Results appear in Schizophrenia Bulletin.
Research drawing on the British national survey finds that, despite the fact that psychotic conditions and mood disorders have historically been approached as separate entities, “mood instability is a prominent feature of psychotic experience and may have a role in its genesis.” Specifically, baseline mood instability predicted roughly a 2.5x greater risk of paranoid ideation and auditory hallucinations over 18 months, as well as mediating a significant portion of the total association of child sexual abuse with psychosis, persecutory ideation, auditory hallucinations.
The death of Master Chef contestant Josh Marks, who committed suicide within 24 hours of receiving a schizophrenia diagnosis, inspires PsychCentral writer Patrick Tracey to ask “Is it time to consign ‘schizophrenia’ to the dustbin of medical terms?”
Researchers from the University of Toronto departments of Psychiatry and Pharmacology, publishing in Progress in Neuro-Psychopharmacology and Biological Psychiatry, propose that various forms of stress, including prenatal and perinatal events, drug abuse, social isolation, and gene mutations can produce a similar effect on the brain – dopamine supersensitivity – which can in turn result in the signs and symptoms of schizophrenia.
Sandra Steingard writes in Community Psychiatrist about Lex Wunderink’s study, published in the August JAMA Psychiatry, which found that people who discontinued medication have much higher rates of functional remission and full recovery. She also notes the work of Martin … Full Article →
Researchers in Spain and the U.K. find a similar pattern of brain volume changes in a group 76 controls and 109 patients with schizophrenia diagnose,s in the first three years following the start of antipsychotic treatment. “However,” the study finds, “patients showed a significant lower progressive decrease in the volume of the caudate nucleus than control subjects, with healthy subjects showing a greater reduction than patients during the follow-up period . . . our findings, showing a lack of brain deterioration in a substantial number of individuals, suggest a less pessimistic and more reassuring perception of the illness.”
The recent incident in the grounds of Washington Capitol, involving a young educated woman, brought shock to many people. It was another opportunity to blame a victim of mental illness and demand further restraint and medical attention for such individuals. Yes, we are lacking dignified, caring, discerning and attentive treatment for those whose spirits are broken. But we certainly don’t suffer from a lack of medical treatment for such individuals. It is time for policy-holders, and our scientific community to ask the ‘heretical’ question; “Could the drugs be the culprit behind the violence?” Full Article →
The hypothesis that psychosis has a toxic effect on the brain is very limited, according to a literature review published in Psychological Medicine. In general, the study notes, research that did not support the hypothesis was larger in size and more adequately designed than studies that support the hypothesis.
Psychiatric Times chronicles the peripatetic progress of “schizophrenia” research, from schizophrenogenic mothers to unspecified genetic lesions and back again via second-trimester embryonic insults, to “Urbanization, migration (especially to a place where the person is very different from the new population), cannabis use (especially in youth), advanced paternal age, childhood abuse/trauma, and social marginalization . . . Nonetheless, the exact neurobiological pathway to pathogenesis and how the various genetic and environmental factors interact still eludes psychiatry.”
When 149 students were randomly assigned to read one of six vignettes depicting a person with either schizophrenia, bipolar disorder, or major depression, with either a genetic or environmental causal attribution, researchers from the Universities of Wyoming and Oregon found that genetic attributions for schizophrenia (but not affective disorders) lead to a greater desire for social distance, due to perceived dangerousness, and a decreased willingness to help.
Chinese researchers find a significant correlation between physical activity and functional outcomes in a six-month prospective longitudinal study of first-episode psychosis. Results are in Schizophrenia Research, published online on September 9, 2013.