Police enter wired world of schizophrenia via 3D device

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“You’re a loser.” “Pathetic!” “You shouldn’t be here”… The voices bombard you, words running angrily over the top of each other, bursting in from every direction.

It is not often police will put up with this kind of abuse. But officers taking part in a unique mental health training program in NSW are doing just that, using a 3D machine that simulates the experience of a person with schizophrenia in the midst of a paranoid psychotic episode.

As part of an intensive four-day training course, officers experience what it is like to be a person with schizophrenia who is trying to do everyday activities, like catching a bus, while experiencing auditory and visual hallucinations.

When the Herald tried the machine – 3D goggles and earphones hooked up to a computer program – it was nauseating and disorienting. People faded in an out of view, there was constant colour and movement, and innocent faces turned into sinister plotters in a matter of seconds. It was disturbing despite knowing that unlike a real psychotic episode it could be turned off at any time.

Constable Katrina Shaw, 26, said the machine, which is loaned to the police by pharmaceutical research company Janssen-Cilag Australia, gave her an insight into a “whole different world”.

Reported by AMY CORDEROY
The Sydney Morning Herald

http://www.smh.com.au/technology/technology-news/police-enter-wired-world-of-schizophrenia-via-3d-device-20100528-wldu.html

Submitted by Anna

Scientists Identify Brain Region That May Give Rise to Schizophrenia

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Schizophrenia is as mysterious as it is devastating. No one knows just what happens within the brain to cause the disease’s characteristic hallucinations, delusions and cognitive deficits. Now researchers have identified a small region in the hippocampus where an early increase in activity—before symptoms become marked—might represent the beginning of the disease process. The results could lead to new targets for drug treatment and new ideas for strategies to prevent the disease.

Schizophrenia is often preceded by a “prodromal” phase, when individuals begin to exhibit symptoms but fall short of the criteria for a psychiatric diagnosis. They might, for instance, withdraw socially, or hear their names in the sound of the wind rather than an outright hallucination. Some studies suggest that treatment—including medication—during these early stages may delay the onset of full schizophrenia, reduce its severity or prevent it altogether.

But not all prodromal individuals go on to develop the disease—just 35 percent within 2.5 years, says Thomas McGlashan, a professor of psychiatry at Yale University who works with such patients. In the face of this uncertainty, most clinicians believe the risks of side effects from treatment outweigh potential benefits and have adopted a conservative wait-and-see approach. “For the ‘false positives,’ which might be the majority, you’d be unnecessarily giving powerful agents that can have severe side effects,” McGlashan says.

To investigate why the prodromal phase progresses to schizophrenia in only one out of three patients, researchers from Columbia University used a high-resolution variant of functional magnetic resonance imaging (fMRI) to compare the brains of 18 people with established schizophrenia with 18 healthy controls. In the disease group, they found increased blood flow, suggesting higher levels of activity, in the orbitofrontal cortex and in a small section—the CA1 subfield—of the hippocampus. In the dorsolateral prefrontal cortex, meanwhile, blood flow decreased.

Reported by Carl Sherman
The DANA Foundation

http://www.dana.org/news/features/detail.aspx?id=23754

September 2009 issue of Archives of General Psychiatry

Submitted by Anna

Greater Clinical Risk Following Rapid Antidepressant Withdrawal

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n patients with major depressive disorder, panic disorder, or bipolar disorder, the risk for illness recurrence is far greater following abrupt or rapid, vs gradual, discontinuation of clinically effective antidepressant treatment, according to a study published online May 17 in the American Journal of Psychiatry.

“Our findings of greater clinical risk following rapid versus gradual discontinuation of antidepressants is one of several similar findings that we have reported over the years,” Ross J. Baldessarini, MD, from Harvard Medical School, Boston, and McLean Hospital, Belmont, Massachusetts, told Medscape Psychiatry.

“We found this phenomenon first with discontinuing lithium in bipolar disorder patients and later with antipsychotic drugs in schizophrenia patients. Similar risks also are well known in rapidly stopping sedative-anxiolytics and anticonvulsants (both of which can lead to epileptic-like seizures),” he added.

According to Dr. Baldessarini, it was not easy to obtain data on effects of discontinuing the use of antidepressants rapidly vs gradually because single studies involving both conditions had virtually been unknown. “To my knowledge, our report is the first to involve such a comparison with antidepressants of various types,” he said.

Reported by Megan Brooks
Medscape Medical News

http://www.medscape.com/viewarticle/722646

The study was supported in part by the National Institutes of Health. Dr. Baldessarini and several coauthors report being consultants or receiving research support from several pharmaceutical companies that make antidepressant medications.

Am J Psychiatry. Published online May 17, 2010

Submitted by Anna

Hidden Cost of Schizophrenia

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ScienceDaily (Feb. 1, 2010) — People being treated for schizophrenia are more likely than the general population to have encounters with the criminal justice system in the US. A study published in the open access journal BMC Psychiatry has shown that schizophrenia patients’ involvement with the criminal justice system is primarily driven by their being victims of crime and that the average annual per-patient cost of involvement with the criminal justice system was $1429.

Story Source: The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BioMed Central, via EurekAlert!, a service of AAAS.

Reference: Haya Ascher-Svanum, Allen W. Nyhuis, Douglas E. Faries, Daniel E. Ball and Bruce J. Kinon. Involvement in the US criminal justice system and cost implications for persons treated for schizophrenia. BMC Psychiatry, (in press).

http://www.sciencedaily.com/releases/2010/01/100127211855.htm

Submitted by Anna

Survey: People uncaring to mentally ill

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WASHINGTON, May 26 (UPI) — Twenty-two percent of U.S. adults say people show caring and sympathy to those with mental illness, a government survey indicates.

The national survey by the Substance Abuse and Mental Health Services Administration of the estimated 9.8 million U.S. adults living with serious mental illness, found the prevalence of serious mental illness is highest in the 18-25 age group.

The HealthStyles Survey, by SAMHSA and Porter Novelli, indicates 72 percent of young adults ages 18-24 say a person with mental illness would improve if given treatment and support. However, only 33 percent say a person can eventually recover from mental illness.

Forty percent of the survey respondents say a person with mental illness can succeed at work and 65 percent say treatment can help people with mental illness.

SAMHSA and The Advertising Council are beginning a national public service announcement campaign aimed at encouraging, educating and inspiring young adults to support friends and family experiencing a mental health problem.

“We know that people can recover from mental health problems,” Kathleen Sebelius, secretary of Health and Human Services, says in a statement. “Today we are getting the word out that support from friends and family can make a difference in helping people overcome these illnesses.”

No survey details were provided.

Reported by UPI

Submitted by Anna

The Quest for Better Schizophrenia Treatment, Serendipity and Science

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In the early 1950s, a chance discovery helped transform schizophrenia from mystical affliction to medical disorder. French psychiatrists discovered that chlorpromazine, a drug used to make surgical patients less anxious, also relieved the symptoms of psychosis. The subsequent discovery that chlorpromazine targeted a brain messenger molecule called dopamine kicked off a large research effort into dopamine dysfunction in schizophrenia…….Read on!

Reorted by By Hakon Heimer
The DANA Foundation

http://www.dana.org/news/publications/detail.aspx?id=14412

Submitted by Anna

NIMH director: time to rethink mental illness

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* Mental disorders are the No. 1 cause of disability for people ages 15-45 in the developed world.

* There are 33,000 suicides every year in the US—twice as many suicides as homicides.

* The life expectancy of people with serious mental illnesses like schizophrenia, 56, is 25 years earlier than the population at large.

* There are three times as many people with serious mental illness in jails and prisons than in hospitals.

These statistics define where we are in the field, said Thomas Insel, director of the National Institute of Mental Health and a member of the Dana Alliance for Brain Initiatives. But the field will be transformed in coming decades, he argues, as what we learn from genetics, brain science, and behavior come together to change how we diagnose, treat, and think about mental illness.

Insel wrote a commentary on the topic in this week’s issue of JAMA; yesterday he elaborated on his ideas during a media briefing discussing the special issue, which focuses on mental illness.

For example, advances in genetics have led to the discovery of structural variations in the genome. In mental illnesses like schizophrenia, autism, bipolar disorder, OCD, and ADHD, researchers have found hundreds of common variations—deletions or duplications in the genetic code—that have “completely changed the way we think about genetics in psychiatric disease,” he said.

These variations—all associated with neurodevelopmental genes—“could not be associated with a single illness even in the same family,” said Insel; the same variation could indicate schizophrenia for one person, and autism for another. But they could point to a more general risk for mental illness.

Discoveries about brain circuitry also may change how we may view disorders. Much mental illness is associated with the developing brain—the age of onset peaks in the teen years, when the brain’s grey matter is undergoing a “pruning effect” and becoming more efficient. Some disorders might be described as “poor pruning.”

For example, it may be that people likely to develop schizophrenia lose too many synapses during this period, Insel suggested. He hopes that by 2020, we can detect schizophrenia before psychosis begins. “We are going to shift the curve and get earlier in diagnosis and treatment,” intervening when people have risk factors but before they have symptoms.

This may lead to a change in the way diseases are defined. “We have been locked into presentation,” said Insel, citing the way the DSM characterizes diseases by symptoms, not underlying causes. “Most of medicine has moved beyond that. We want to add all the things we can’t see,” like genetics and imaging.

In a decade, predicts Insel, “We will have entirely different names and ways of thinking about disorders.”

Reported by Johanna Goldberg
Dana press web blog

Reference: Thomas R. Insel; Philip S. Wang
Rethinking Mental Illness JAMA, May 19, 2010; 303: 1970 – 1971.

submitted by Anna