Schizophrenia and Psychosis

In a 1992 essay, British psychiatric genetic researcher Michael Owen wondered whether schizophrenia molecular genetic research would become the “graveyard of molecular geneticists.”1 Owen predicted that if major schizophrenia genes existed, they would be found within five years of that date. He was optimistic, believing that “talk of graveyards is premature.”2 Owen now believes that genes for schizophrenia and other disorders have been found, and was subsequently knighted for his work. Despite massively improved technology, however, decades of molecular genetic gene finding attempts have failed to provide consistently replicated evidence of specific genes that play a role in causing the major psychiatric disorders.

Sir Robin Murray, a professor at the Institute of Psychiatry, Psychology, and Neuroscience in London, states that he ignored social factors that contribute to ‘schizophrenia’ for too long. He also reports that he neglected the negative effects antipsychotic medication has on the brain.

A new study in the journal Translational Psychiatry, an influential journal in biological psychiatry published by Nature, challenges the state of the research on antipsychotic drugs.

The Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and Schizophrenia. The central theme of the paper is that the condition known as psychosis is better understood as a response to adverse life events rather than as a symptom of neurological pathology. The paper was wide-ranging and insightful and, predictably, drew support from most of us on this side of the issue and criticism from psychiatry.  Section 12 of the paper is headed "Medication" and under the subheading "Key Points" you'll find this quote: "[Antipsychotic] drugs appear to have a general rather than a specific effect: there is little evidence that they are correcting an underlying biochemical abnormality."

When children do things like recoil in fear from monsters and ghosts in their darkened bedroom at night, it’s easy to see the “out of touch with reality” aspect of their experience as being closely related to the faculty that gives them their ability to play – their imagination. We help children through such challenging experiences by being with them, and by playing together, doing things like creating scary images together and then figuring out how to cope with them or laugh at them. In the process we help them explore how to create a world view that works to at least some extent and has room for joy and originality - when their imagination helps them (and maybe others) see the world in new ways.

Researchers investigate the first-person experiences of people who disagreed with their psychiatric diagnosis of psychosis.

Researchers detect disparity between white and African American patients diagnosed with schizophrenia when symptoms of a mood disorder are present.

The authors outline reasons for renaming schizophrenia and the way a change can reform practice.

Understanding schizophrenia as a non-enigmatic, understandable human experience goes against a history of institutional “othering” that has sustained psychiatric legitimacy and further marginalized service-users.

“Overall, this study showed that the information and awareness campaign had almost no significant effects on the general public's attitudes toward people affected by either schizophrenia or depression,” the researchers, led by German medical sociologist Anna Makowski, wrote. “One could assume that deeply rooted convictions cannot be modified by rather time-limited and general activities targeted at the public.”

There is a lack of consensus in the definition of ‘relapse’ across randomized controlled trials of antipsychotic maintenance treatment for schizophrenia and psychosis.

Anthropologists study Parachute NYC to identify challenges and opportunities for implementing peer support and Open Dialogue practices.

Researchers from the City College of New York and Columbia University published a study this month testing the hypothesis that people diagnosed with schizophrenia treated long-term with antipsychotic drugs have worse outcomes than patients with no exposure to these drugs. They concluded that there is not a sufficient evidence base for the standard practice of long-term use of antipsychotic medications.

Study finds that 74% of patients with a psychotic disorder off antipsychotics at end of 10 years are in remission.

Patients who recover from a single episode of psychosis are often prescribed antipsychotics long-term, despite a lack of evidence for this practice

Psychiatrist outlines varying roles in Open Dialogue model, fostering service-user and family agency through meaningful conversations with a team of providers.

Research by five U.K. universities across multiple sites for up to two years divided 288 young adults (14-35 years) deemed at risk for psychosis...

We are profoundly social beings living not as isolated individuals but as integral members of interdependent social systems—our nuclear family system, and the broader social systems of extended family, peers, our community and the broader society. Therefore, psychosis and other forms of human distress often deemed “mental illness” are best seen not so much as something intrinsically “wrong” or “diseased” within the particular individual who is most exhibiting that distress, but rather as systemic problems that are merely being channeled through this individual.

An article on contributory injustice describes the clinical and ethical imperative that clinicians listen to service users experiences.

In a commentary piece, Ben Alderson-Day and Nev Jones discuss the AVATAR therapy research for psychosis and propose further questions.

While most treatments have had "statistically significant" success in clinical trials, no common psychiatric or psychological treatments improve the negative symptoms of schizophrenia at levels that are "clinically meaningful."

A new study explores how “psychosis” and “schizophrenia” are viewed within the Māori community in New Zealand.

In this month’s issue of Psychological Medicine, researchers from King’s College London found evidence for associations between different types of childhood adversity and specific symptoms associated with psychosis. As current categorical approaches to psychosis and schizophrenia diagnoses come under increasing scrutiny, this study adds support to sociological and psychological theories and treatments.

A pathbreaking new study out of Finland suggests that early intervention programs for youth experiencing psychotic-like symptoms may see the greatest improvement when treatment works within the home rather than in a hospital setting. The research, to be published in next month’s issue of Psychiatry Research, found greater improvement in functioning, depression, and hopelessness among teens in a new need-adapted Family and Community oriented Integrative Treatment Model (FCTM) program.

Sociocultural context, language, and sense-making process are among concepts that can help hearers and providers better understand the phenomenon of hearing voices