Schizophrenia and Psychosis

January 18, 2013

In the business of clinical trials, the most valuable commodities are the research subjects. Filling clinical trials is hard, and filling them quickly is even harder. That’s why in 2000 a clinical investigator told the HHS Office of the Inspector General that research sponsors were looking for three things from research sites: “No. 1—rapid enrollment. No. 2 — rapid enrollment. No. 3 — rapid enrollment.”
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Categorized in: Antipsychotics, Blogs, Featured Blogs, Industry, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Schizophrenia/Psychotic Disorders | Tagged as: Antipsychotics, CAFE study, clinical trials, Dan Markingson, Schizophrenia, University of Minnesota

Childhood Psychotic Symptoms Do Not Predict Adult Schizophrenia

January 12, 2013

Researchers from Duke University, the Dunedin (New Zealand) University School of Medicine, and the King’s College (London) Institute of Psychiatry find that in a study of 1037 children followed prospectively from birth to 38 years of age, “childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder.” Results were published online January 12, 2013 by Psychological Medicine.

Categorized in: Adult, Children and Adolescents, Disorders, Featured News, In the News, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Schizophrenia/Psychotic Disorders

Why Paul Steinberg Has It All Wrong (and Should Stop Seeing Patients)

January 1, 2013

(This commentary originally ran on Beyond Meds) In his New York Times op-ed entitled “Our Failed Approach to Schizophrenia“ Paul Steinberg, a psychiatrist in private practice, proposes we all go back to the “golden age” of psychiatry, when patients spent years in institutions …
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Categorized in: Adult, Antipsychotics, Children and Adolescents, Disorders, DSM, Op-Eds, Psychiatric Drugs, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Violence

Top Researchers Debunk “The Myth of Schizophrenia as a Progressive Brain Disease”

December 31, 2012

Robert Zipursky, Thomas Reilly and Robin Murray, prominent researchers from Canada and the U.K., reviewing all recent evidence regarding schizophrenia as a progressive brain disease for Schizophrenia Bulletin, find “the idea that schizophrenia is a progressive brain disease is not supported by the weight of longitudinal neuroimaging and cognitive studies, and it is not consistent with what is now known about the clinical course of schizophrenia. It is important for optimum clinical care that the idea that underlying schizophrenia there exists an intrinsically malignant process be reconsidered. It has contributed to an undue pessimism among mental health professionals and their consequent alienation from sufferers and their representatives, who increasingly advocate for the “recovery model.”

Categorized in: Adult, Children and Adolescents, Disorders, Featured News, In the News, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Uncategorized

The Road to Perdition

December 7, 2012

The recent research scandals out of the University of Minnesota’s Department of Psychiatry may be alarming, but they are not new. Back in the 1990s, when the university was working its way towards a crippling probation by the National Institutes of Health (for yet another episode of misconduct (this time in the Department of Surgery), the Department of Psychiatry hosted two spectacular cases of research wrongdoing, both of which resulted in faculty members being disqualified from conducting research by the FDA.
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Categorized in: Addiction, Antidepressants, Antipsychotics, Blogs, Featured Blogs, Industry, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Schizophrenia/Psychotic Disorders, Substance Abuse/Addiction, Suicide, Uncategorized | Tagged as: Antipsychotics, Barry Garfinkel, CAFE study, Charles Schulz, clinical trials, corruption, fraud, James Halikas, Psychosis, research misconduct, Schizophrenia, Stephen Olson, University of Minnesota

Were Research Subjects Mistreated in the CATIE Study?

November 21, 2012

The suicide of Dan Markingson at the University of Minnesota has brought notoriety to the CAFÉ study and its site investigators, Stephen Olson and Charles Schulz. But the “corrective action” recently issued by the Minnesota Board of Social Work against the CAFÉ study coordinator, Jean Kenney, has raised another disturbing question.
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Categorized in: Antipsychotics, Blogs, Featured Blogs, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Schizophrenia/Psychotic Disorders, Suicide | Tagged as: CAFE study, CATIE study, Dan Markingson, Jean Kenney, mental health, psychiatric medication, Schizophrenia, Stephen Olson, University of Minnesota

Fact-Checking the General Counsel in the Markingson Case

November 19, 2012

Ever since critics began asking questions about the death of Dan Markinson in a clinical trial at the University of Minnesota, the General Counsel for the university, Mark Rotenberg, has responded with a uniform message: the case has already been investigated many times, and no wrongdoing has ever been found. That’s how Rotenberg responded to my article about the case in Mother Jones, and that’s how he responded last week to the news that the Board of Social Work had issued a “corrective action” to the study coordinator for the clinical trial in which Markingson died.
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Categorized in: Blogs, Featured Blogs, Industry, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Suicide | Tagged as: CAFE study, clinical trials, coming off psychiatric drugs, Markingson, mental health, Schizophrenia, Seroquel, University of Minnesota

The University of Minnesota was not Involved? Some Further Thoughts on the “Corrective Action” Against Jean Kenney in the Markingson Case

November 15, 2012

Categorized in: Antipsychotics, Blogs, Featured Blogs, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Schizophrenia/Psychotic Disorders, Suicide | Tagged as: Antipsychotics, CAFE study, clinical trials, Dan Markingson, Jean Kenney, Schizophrenia, Seroquel, University of Minnesota

“Do We Have to Wait Until He Kills Himself or Someone Else Before Anyone Else Does Anything?”

November 14, 2012

In the “agreement for corrective action” against CAFE study coordinator Jean Kenney last week, the Board of Social Work cited Kenney’s failure to respond to “alarming voicemail messages” from family members of Dan Markingson. Presumably, the Board is referring to a message left by his mother, Mary Weiss, which warned, “Do we have to wait until he kills himself or someone else before anyone else does anything?” The failure of Kenney and Stephen Olson to take the warnings of Mary Weiss seriously has been one of the most disturbing aspects of this case. In a deposition for the lawsuit filed by Weiss, Kenney was questioned about her response. Here is an excerpt. (The initial questions come from Gale Pearson, an attorney for Mary Weiss.)

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Categorized in: Antipsychotics, Blogs, Featured Blogs, Industry, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Suicide | Tagged as: Antipsychotics, AstraZeneca, CAFE study, clinical trials, Dan Markingson, Jean Kenney, Psychosis, Schizophrenia, University of Minnesota

Jim Gottstein Talks with Gary Null About Drugging Children

October 4, 2012

Categorized in: Antipsychotics, Bipolar, Children and Adolescents, Disorders, Mood Stabilizers, Psychiatric Drugs, Schizophrenia and Psychosis, Videos

Pressuring Parents to Drug Children

October 4, 2012

Jim Gottstein on Pressuring Parents to Drug Children

Categorized in: Antipsychotics, Bipolar, Children and Adolescents, Disorders, Psychiatric Drugs, Schizophrenia and Psychosis, Videos

Off-Label Antipsychotic Use Among Children Soaring

September 11, 2012

Researchers from Philadelphia and Baltimore find, in a study of Medicaid records for 50 states and the District of Columbia, that antipsychotic prescribing to Medicaid-enrolled children increased 62% from 2002 to 2007. Although proportionally more youth with bipolar disorder, schizophrenia or autism received antipsychotics, by 2007 youth with ADHD accounted for 50 percent of the total antipsychotic use. The authors express concern about the need for efficacy data, in light of safety concerns.

Categorized in: ADHD, Antipsychotics, Autism, Bipolar, Children and Adolescents, Disorders, Featured News, In the News, Industry, Psychiatric Drugs, Research, Schizophrenia and Psychosis

Changes in “Schizophrenia” Incidence Over Four Decades

August 25, 2012

Danish and Australian researchers find, in a review of the Danish Psychiatric Central Research Register, that the incidence rate of early-onset schizophrenia diagnoses has increased significantly in the period from 1971 to 2010, and that the higher incidence of the diagnosis in males seen earlier in the period has reversed. The authors draw no conclusions as to whether the changes over the time period reflect changes in the diagnostic system, increased awareness of early psychosis, or changes in the actual incidence of the disorder.

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Categorized in: Children and Adolescents, Disorders, Documents, Featured News, In the News, Schizophrenia and Psychosis

Perceived Social Status Impacts Early Psychosis

July 5, 2012

Writing in the British Journal of Clinical Psychology, London researchers find that perceptions of lower social rank and inferiority amongst 24 individuals with early psychosis impact on feelings of satisfaction with and feelings of exclusion from peer groups, possibly resulting in lost friendships and on clinical course and recovery.

Categorized in: Adult, Children and Adolescents, Disorders, In the News, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders

Brain Imaging Shows Trauma-Related Differences in DID

July 3, 2012

Dissociative Identity Disorder (DID) has a complicated and controversial history. In this study, published in PLoS 1, researchers from London and the Netherlands explore whether DID is a purely “socioculteral (e.g,, iatrogenic)” illness, finding “important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID.”

Categorized in: Adult, Children and Adolescents, Disorders, In the News, Research, Schizophrenia and Psychosis

Antipsychotics Aren’t Helpful to Children

June 18, 2012

Researchers from London, writing in European Psychiatry, reviewed “all RCTs involving children and young people with a diagnosis of childhood onset schizophrenia comparing any antipsychotic drug with another antipsychotic or placebo.” They found that “there is little conclusive evidence regarding the effects of antipsychotic medication for those with early onset schizophrenia. Some benefits were identified in using the atypical antipsychotic clozapine but the benefits were offset by an increased risk of serious adverse effects.”

Categorized in: Antipsychotics, Children and Adolescents, Disorders, In the News, Psychiatric Drugs, Research, Schizophrenia and Psychosis

Weak Field Trials Scuttle DSM-5 Diagnoses

May 8, 2012

“Mixed anxiety-depressive disorder,” “attenuated psychosis syndrome,” “obsessive-compulsive personality disorder,” “antisocial personality disorder,” and “nonsuicidal self-injury” were among diagnoses that met with disappointing results in field trials for the new DSM-5. Either low interrater reliability (a lack of sufficient agreement between clinicians), or a lack of sufficient examples of people with a proposed diagnosis in the real world meant that these diagnoses could not be included in this round of the APA’s official list of disorders. One architect of the trials said that a goal of the DSM-5 was to test diagnoses “with real clinicians and real patients,” a goal that may explain why even “major depressive disorder” was found to be surprisingly unreliable, possibly because the previous version of the DSM excluded patients with complicated “psychiatric comorbidities.”

Categorized in: Adult, Anxiety, Anxiety, Children and Adolescents, Depression, Depression, Disorders, DSM, Personality Disorders, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders

DSM-5 Retreats from Some Controversial Diagnoses

May 4, 2012

The APA DSM-5 Development website announced today that “Psychosis Risk” and “Mixed Anxiety Depression” will not be included in the DSM-5 (apart from recommendations for further study), and added criteria to “clarify” the distinction between bereavement and major depressive disorder. Criteria for ADHD have also been tightened. The statement invites “Final Public Comment” through June 15th.

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Categorized in: Adult, Antipsychotics, Children and Adolescents, Depression, Depression, Disorders, DSM, In the News, Psychiatric Drugs, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders

Obstetric Complication, Cannabis Use: Strongest Predictors of Early Psychosis

April 30, 2012

According to data drawn from 608 patients of an early intervention program in Dublin, presented at the 3rd Biennial Schizophrenia International Research Society (SIRS) Conference, obstetric complications followed by cannabis use are the first and second strongest predictors of early onset psychosis after controlling for other factors such as sex, social class of origin, and family history of psychosis.

Categorized in: Adult, Childhood Adversity/Trauma, Children and Adolescents, Disorders, In the News, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders

Review of the Evidence: Childhood Adversity High in Schizophrenia and Other Disorders

April 30, 2012

Researchers from Australia and the UK found that people with a schizophrenia diagnosis almost four times more likely than controls to have a history of childhood adversity. The quality of the evidence in this meta-analysis of the currently available data was found to be very strong (p<0.00001). No difference in rates of childhood adversity were found between schizophrenia and affective psychosis, depression, and personality disorders. Rates of childhood adversity is slightly higher in dissociative disorders and PTSD. Results will appear in Psychological Medicine.

Categorized in: Adult, Anxiety, Childhood Adversity/Trauma, Children and Adolescents, Depression, Disorders, DSM, In the News, Industry, Non-Drug Approaches, Personality Disorders, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Trauma/Distress

Questions About Childhood Trauma And Schizophrenia Settled

April 26, 2012

In the first analysis of 30 years of studies, including 46 studies (selected from 27,000) involving 80,000 subjects, researchers in the U.K. and Australia demonstrate that children with any type of trauma before the age of 16 were three times more likely (in a dose-response relationship) to become psychotic in adulthood. “To have a sophisticated meta-analysis of all the relevant research find that childhood adversities definitely are causal factors for psychosis, which some psychiatrists still think is a biological illness, is very important,” said co-author (with Richard Bentall) John Read.

Categorized in: Adult, Childhood Adversity/Trauma, Children and Adolescents, Disorders, In the News, Industry, Non-Drug Approaches, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Trauma/Distress

Psychotic Symptoms/Childhood Trauma Common in Primary as Well as Psychiatric Care

April 19, 2012

Researchers in Finland reviewed questionnaires filled out by 911 primary and psychiatric care patients over 16 years of age. They found that more than half of the patients in primary care had had at least one psychotic symptom during their lifetime, and nearly 70% had experienced a childhood trauma at least once. Rates were higher in psychiatric care patients. Across both groups, psychotic symptoms correlated in a dose-response relationship with traumatic events, irrespective of age, type of service received, and patient’s functioning. Results will appear in European Psychiatry.

Categorized in: Adult, Childhood Adversity/Trauma, Children and Adolescents, Disorders, In the News, Non-Drug Approaches, Research, Schizophrenia and Psychosis, Schizophrenia/Psychotic Disorders, Trauma/Distress

Labels Initiates Core Social Support, Lose Peripheral Ties

April 10, 2012

Article Abstract:
Although research supports the stigma and labeling perspective, empirical evidence also indicates that a social safety net remains intact for those with mental illness, recalling the classic “sick role” concept. Here, insights from social networks theory are offered as explanation for these discrepant findings. Using data from individuals experiencing their first contact with the mental health treatment system, the effects of diagnosis and symptoms on social networks and stigma experiences are examined. The findings suggest that relative to those with less severe affective disorders, individuals with severe diagnoses and more visible symptoms of mental illness have larger, more broadly functional networks, as well as more supporters who are aware of and sympathetic toward the illness situation. However, those with more severe diagnoses are also vulnerable to rejection and discrimination by acquaintances and strangers. These findings suggest that being formally labeled with a mental illness may present a paradox, simultaneously initiating beneficial social processes within core networks and detrimental ones among peripheral ties.