According to a report prepared by Colorado University and released to the Denver Post, half of the children on government insurance in Colorado who are prescribed antipsychotics do not have a diagnosed psychotic illness listed on their Medicaid claims. ”Few studies have examined side effects on children, and that the drugs have been linked to weight gain, diabetes and growth of breasts in boys,” the article states. “Foster parents and therapists say heavily medicated children are detached from reality — as though ‘walking in a cloud.’ They also contend that the use of the drugs has been fueled by pharmaceutical firms pursuing big profits with the help of willing doctors.”
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 →
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 →
Hello from another fellow Virginian. First, I want to extend my deepest condolences for the horrific tragedy that befell your family last year, and for the loss of your precious son Gus. I think I know, at least in part, how agonizing it is when our loved ones cannot access helpful supports, and how it feels to watch in horror as they spiral downward into darkness and despair. We all agree that our mental health systems are broken. Those of us who have been down the hellish road of struggling with our mental health and have found recovery have developed a new vision that will take us forwards, not backwards. Please give us the opportunity to share that new vision with you. Full Article →
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.”
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.”
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.”
Children who lose a parent before the age of 3 are 84% more likely to experience psychosis as adults, according to research published in the British Journal of Psychiatry. In a dose-dependent relationship, the increased risk for children aged 3 to 7 drops to 47%, and 32% for children aged 7 to 13. Data was drawn from nearly 947,000 children born in Sweden between 1973 and 1985.
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.”
I received the following question from a reader regarding the controversial CAFÉ – Comparisons of Atypicals in First Episode of Psychosis – study. (This was the study in which Dan Markingson committed suicide.) “It appears that there was no head-to-head with a control group taking a placebo pill. Nor was there a control group featuring ‘old’ types of ‘antipsychotic’. If that was the case then it is very poor study . . . what on earth can you hope to show from the data?” I started to write a response, but the subject is complex, and my response became the following article. Full Article →
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.”