“Schizophrenia Breakthrough” – Or a Case of Ignoring the Most Important Evidence?

Last week, the headlines blared: “Schizophrenia breakthrough as genetic study reveals link to brain changes!”  We heard that our best hope for treating “schizophrenia” is to understand it at a genetic level, and that this new breakthrough would get us really started on that mission, as it showed how a genetic variation could lead to the more intense pruning of brain connections, which is often seen in those diagnosed with schizophrenia.  “For the first time, the origin of schizophrenia is no longer a complete black box,” said one (while admitting that “it’s still early days”).  The acting director of the National Institute of Mental Health (NIMH) described the study as “a crucial turning point in the fight against mental illness.” But is all this hype justified?
Full Article

Categorized In:

And Now for Something Completely the Same:  The Latest, Greatest Breakthrough in Understanding the Biogenetic Cause of Schizophrenia

Another scientific study that ostensibly identifies a biological cause of schizophrenia has appeared and is being widely reported. So, we finally have the elusive breakthrough to understanding the biological basis of schizophrenia. Or do we? A close look at the source of all this hyperbolic language raises serious questions about such enthusiasm.
Full Article

Categorized In:

Madness and the Family: What Helps, and What Makes Things Worse?

Families are often very important for people encountering severe mental and emotional difficulties. But how can family members really know what is helpful, and what is likely to make things worse for the person having problems? Similarly, for those who want to help families, how can they know what will really be helpful for those families, and what will make things worse?
Full Article

Categorized In:

Experts Decry Dangerous Use of Antipsychotics in Children

In a featured article for Psychiatric Services, psychiatrists from Dartmouth raise the alarm on the increasing numbers of children prescribed dangerous antipsychotic drugs. Despite the fact that data on the safety of long-term use of these drugs in this vulnerable population “do not exist,” the rate of children and adolescents being prescribed antipsychotic drugs have continued to increase over the past fifteen years.

More →

Categorized In:

Letters to the Editor: “The Treatment of Choice”

Readers respond to the New York Times article, “The Treatment of Choice,” about innovative programs for psychosis and schizophrenia that involve patients and their families in treatment decisions. “Narratives of success counter a drumbeat of faulty links of mental illness and violence, inaccuracies which serve only to further stigmatize and isolate individuals with psychiatric illness.”

Article → More →

Categorized In:

“Cannabis for Schizophrenia – Does it Work?”

The German news agency DW features a video report on whether cannabidiol, an active substance derived from marijuana, can help relieve the symptoms of schizophrenia.

Video → More →

Categorized In:

The Recovery After an Initial Schizophrenia Episode (RAISE) Study: Notes from the Trenches

I was a psychiatrist who participated in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). Although I welcomed the positive headlines that heralded the study’s results, the reports left me with mixed feelings. What happened to render the notion that talking to people about their experiences and helping them find jobs or go back to school is something novel?
Full Article

Categorized In:

Why Mainstream Psychiatry Fears a Balanced Understanding of Psychosis

Many people are now familiar with the BPS report, Understanding Psychosis and Schizophrenia, and they have appreciated how it integrates both science and a humanistic understanding to convey a fresh and progressive approach to difficult and extreme experiences. But it has come under attack by psychiatrists, using arguments that are often quite slick, and sound reasonable to the uninformed. But they are wrong, and the better we can articulate how and why they are wrong, the better we can advocate for a more humane and skillful response to people having the experiences that are called “psychosis.”
Full Article

Categorized In:

RAISE Study Out Of Sync With Media Reports

Writing on his 1 Boring Old Man blog, Dr. Mickey Nardo reflects on the media frenzy around the RAISE study and asks why the prescription data has not been released. He adds skepticism about the political motives of the potentially overblown results, which he sees as a clear push for increased mental health funding.

Article → More →

Categorized In:

Landmark Schizophrenia Study Recommends More Therapy

Results of a large government-funded study call into question current drug-only approaches to treating people diagnosed with schizophrenia.  The study, which the New York Times called “by far the most rigorous trial to date conducted in the United States,” found that patients who received increased drug counseling along with individual talk therapy, family training, and support for employment and education experienced a greater reduction in symptoms, were more likely to resume work and school, and reported a higher quality of life than those receiving current standard treatments.

More →

Categorized In:

Slow Psychiatry: Integrating Need-Adapted Approaches with Drug-Centered Pharmacology

For the past four years, I have been deconstructing my views of my profession. My focus has been primarily in two areas: the efficacy and safety of the drugs I prescribe and the so-called “alternative” approaches (in this I include many things such as Open Dialogue, Hearing Voices groups, and Intentional Peer Support to name a few). I have shared much of this in the blogs I wrote during this time. I am also interested in how we can improve and reform the public mental health system since this is not only where I work but where most people seek services and help. I wonder where – if anywhere – psychiatrists fit in to a reformed system.
Full Article

Categorized In:

“My Ego Strength is Too Developed for Me to Ever Become Psychotic!”

That was the emphatic response from my grad school psychopathology professor 35 years ago, after I’d stated in her class that anyone could become psychotic given sufficient life stressors, losses and trauma. How many current mental health professionals, especially psychiatrists, also believe they have such strong egos that they never could experience extreme states?
Full Article

Categorized In:

Long-Term Social Supports Needed After Onset of Psychosis

New data on the effects of social support after the onset of psychosis suggests that patients with intense social support function better than those without such help, but than once supports are removed the effects eventually diminish.

More →

Categorized In:

Omega-3 Fatty Acids May Help Prevent Transition to Psychosis

“When people with early-stage symptoms took omega-3 supplements for three months, they had much lower rates of progression than those who did not,” according to research out of Australia covered in this month’s issue of the New ScientistMore →

Categorized In:

CBT: Part of the Solution, Part of the Problem, an Illusion, or All of the Above?

Cognitive behavioral therapy or CBT has been pretty heavily criticized by a number of Mad in America (MIA) bloggers and commenters in the past few years. In a way that isn’t surprising, because most MIA bloggers are looking for radical change, and CBT often appears to be part of the establishment, especially within the therapy world. But while I’m all for criticizing what’s wrong with CBT, especially with bad CBT, I think there’s also a danger in getting so caught up in pointing out real or imagined flaws that we fail to notice where CBT can be part of the solution, helping us move toward more humanistic and effective methods of helping.
Full Article

Categorized In:

Eight Unanswered Questions about Psychiatric Research in Minnesota

The wait has been exhausting, but it is possible that a flicker of light may finally shine on the dark recent history of psychiatric research at the University of Minnesota. Given these upcoming investigations of psychiatric research at the University of Minnesota, the time is right to look back at some of the disturbing, unanswered questions that have emerged over the past several years.
Full Article

Categorized In:

Listening for the Person within “Madness”

As we struggle to invent a humane approach to the extreme states that get called “psychosis” or “madness” or “schizophrenia,” it may be helpful to investigate some of the better approaches developed in the past. While these approaches are not without their flaws, they are often surprisingly insightful. (It can also of course be depressing to notice how truths once more widely known were so easily “forgotten” as compassionate approaches got ditched in favor of the latest coercive innovations.)
Full Article

Categorized In:

Is This Depression? Or Melancholy? Or…

We live in a culture bombarded by media and sped up by rapid-fire social interactions. It’s definitely useful to grab hold of a simple, short, sound-bite term, to quickly describe what we are feeling or suffering. “Depression” is such a word – it evokes and encapsulates, conjures the images of that ugly pit of despair that can drive so many to madness and suicide. Yet at the same time the words we use, strangely, become like those pens deposited in medical offices and waiting rooms around the world: ready at hand, easily found, familiar — and tied to associations, marketing and meanings we were only dimly aware were shaping how we think.
Full Article

Categorized In:

Understanding Psychosis and Schizophrenia? What About Black People?

In many respects it is difficult to fault the report Understanding Psychosis and Schizophrenia, recently published by the British Psychological Society (BPS) and the Division of Clinical Psychology (DCP)[i]; indeed, as recent posts on Mad in America have observed, there is much to admire in it. Whilst not overtly attacking biomedical interpretations of psychosis, it rightly draws attention to the limitations and problems of this model, and points instead to the importance of contexts of adversity, oppression and abuse in understanding psychosis. But the report makes only scant, fleeting references to the role of cultural differences and the complex relationships that are apparent between such differences and individual experiences of psychosis.
Full Article

Categorized In:

When Homosexuality Came Out
(of the DSM)

With a diagnosis of schizophrenia, if internalized, comes the erosion of personhood, lowered self-esteem, shattered dreams, and a sense of disenchantment. The psychiatrist Richard Warner has even suggested that those who reject the diagnosis of severe mental illness may have better outcomes as they retain the right to construct their own narrative of personhood and define what really matters for them. Despite public education campaigns (or perhaps because of them), the stigma of mental illness is as enduring as it was 50 years ago.
Full Article

Categorized In:

Why “Stabilizing” People is Entirely the Wrong Idea

If human beings were meant to be entirely stable entities, then “stabilizing” them would be an entirely good thing; a target for mental health treatment that all could agree on. But it’s way more complex than that: healthy humans are constantly moving and changing. They have a complex mix of stability and instability that is hard to pin down. All this relates to one of my favorite subjects, the intersection of creativity and madness.
Full Article

Categorized In:

From Protesting to Taking Over: Using Education to Change Mental Health Care

As we develop critical awareness about the mental health “treatments” that don’t work and that often make things much worse, the question inevitably comes up, what can those who want to be helpful be doing instead? I believe that one key to successful change is going to be making effective training in alternatives widely available, so that those working in the field who hear our protests and criticisms with an open mind will be able to get support in then transitioning to doing things differently.
Full Article

Categorized In:

Are You Ready for Multiple Lawsuits By Victims of Psychiatric Misconduct?

Professor Leigh Turner of the University of Minnesota Center for Bioethics blasts the Board of Regents for ignoring psychiatric research abuse.
Full Article

Categorized In:

CAFÉ Study: Real Science or Marketing Exercise?

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

Categorized In:

Investigate the Markingson Suicide? Not So Fast, Says University President

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

Categorized In: