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.
Children who reported experiencing frequent nightmares between 2.5 and 9 years of age were significantly more likely to report psychotic experiences at age 12, regardless of sex, family adversity, emotional or behavioral problems, IQ or potential neurological problems, according to research published in the journal Sleep.
Furthering findings that social adversity and urbanicity increase the risk of psychosis, research in Child & Adolescent Psychiatry finds that moving schools, family adversity, and involvement with bullying are linked to a significantly greater risk of psychotic-like experiences in early adolescence. The authors recommend awareness of school changes, helping mobile students establish themselves in new school environments in order to reduce peer difficulties, and routine enquiry regarding bullying experiences in order to reduce psychotic-like experiences in youth.
The U.K.’s National Institute for Health and Care Excellence has issued its new clinical guidelines for “Psychosis and Schizophrenia in Adults: Treatment and Management.” For those considered to be at risk of psychosis, CBT (with or without family intervention), assessment for trauma, and help for anxiety, depression, personality disorder or substance abuse are suggested. For first episode psychosis, the guidelines recommend trauma assessment and informed choice of limited antipsychotics.
In 2004, a patient was given an experimental antipsychotic called bifeprunox and died of hepatorenal failure nine days later. But the sponsor apparently did not investigate the death for three years. In late 2007 the sponsor issued a safety alert and suspended all bifeprunox studies. This is where things get interesting. Full Article →
The traumagenic neurodevelopment model of psychosis, introduced in 2001, highlighted similarities between brain abnormalities found both in people who have been abused and those who are diagnosed with schizophrenia – at the time a radical shift in thinking. This article in Neuropsychiatry by John Read, Roar Fosse, Andrew Moskowitz, and Bruce Perry reviews the research findings since then, and finds that both direct and indirect support for the model has grown.
Recent research has focused on a seemingly high rate of psychiatric disorders in the offspring of older fathers. New research in JAMA Psychiatry, using data drawn from nearly 3 million people (totaling 42.7 million person-years) in the Danish Psychiatric Central Research Register, finds that the offspring of both older and younger parents (below 25 and above 29 years) were at increased risk of mental health diagnoses.
Schizophrenia Bulletin follows the movement change to the name and concept of “Schizophrenia”, revealing that Japan has taken the lead. Japan, to remove the stigma, social and professional consequences, notions of dangerousness and lack of hope that the old name and model conveyed, was the first country to update and revise the schizophrenia concept by embracing the name “Integration Disorder”, and the stress vulnerability model, along with evidence that people “recover and lead a normal life.”
Research from the University of Maryland finds that “Although ‘psychosis-like experiences’ (PLEs) may reflect elevated risk for onset of serious mental illness,” further examination shows that inclusion of a distress scale in screening is more effective in identifying clinical high risk of psychosis. PLEs that are described as neutral of positive, the paper concludes, “do not appear to be relevant for clinical high-risk screening.” The paper appear in Schizophrenia Research.
Cannabis use is associated with an earlier age of psychosis onset, according to an article in Schizophrenia Bulletin, and daily use of high-potency cannabis is associated with an average of 6 years earlier onset than that of non-users.
Noted schizophrenia researchers Robin Murray, Robert Zipursky and Thomas Reilly write in Schizophrenia Bulletin that “mental health professionals need to join with patients and their families in understanding that schizophrenia is not a malignant disease that inevitably deteriorates over time but rather one from which most people can achieve a substantial degree of recovery.”
Research from the U.K. shows that involvement in bullying between the ages of 8 and 11, whether as victim or perpetrator, is linked to an increased risk of psychotic experiences at the age of 18. This finding was based on a longitudinal, community-based study comprised of 4,270 subjects. Results appeared today in Psychological Medicine.
Responding to a letter signed by 175 scholars asking for an inquiry into the death of Dan Markingson at the University of Minnesota, the Faculty Senate voted to investigate clinical research at the university. But the university president says the Markingson case will not be part of the investigation. What is he trying to hide? Full Article →
The Cannabis and Psychosis Awareness Project, a four-year study from Canada that was released on Tuesday, finds that smoking marijuana – particularly heavy use in early adolescence – is associated with a 40% increased risk of psychosis. Youth with a family member identified as having a mental illness are 4x more likely to develop psychosis if they use marijuana, the study says. 50 young Canadians who participated in the study created the video Awareness Strategy for Youth.
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.”
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 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.
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 →
First episode psychosis (FEP) and duration of untreated psychosis (DUP) remain the foci of great numbers of early intervention programs in Western countries. “Untreated” in DUP-anese is synonymous with unmedicated, which often creates a sense of urgency and a myopic fixation on getting these youth started on anti-psychotics and keeping them on. What is the impact of this medical model and its accompanying chemical imbalance narrative on these emerging adults? How often does it set them on a course of regained functioning and restored hope, or does it serve as a gateway into a lifetime of disability and discouragement? Full Article →
It took over twenty years for the state medical board to sanction a Minnesota psychiatrist who was responsible for the deaths and injuries of 46 patients. Today, in the Markingson case, it looks as if history is repeating itself. How many patients die while bureaucrats delay? Full Article →
What would happen if professionals opened their minds about the nature of madness? What new possibilities might be created if they questioned labels such as “schizophrenia” and if they instead showed curiosity about the person underneath the label, and interest … Full Article →