Is Anosognosia Real? First Microscopic Study of the Brain Says Yes

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There are now 20 studies of the brains of individuals with schizophrenia using neuroimaging techniques to determine whether the brains of individuals with anosognosia (poor insight) are different from the brains of individuals who do not have anosognosia (good insight).

Of the 20 studies, 18 reported clear differences and two did not. Two of the positive studies were done on individuals who had never been treated with antipsychotic drugs, so the observed differences clearly were not a drug effect. Thus, using neuroimaging techniques, it is apparent that the brains of individuals with anosognosia are different from the brains of individuals who do not have anosognosia.

Neuroimaging techniques, such as magnetic resonance imaging (MRI) are rather gross measures of the brain. Such studies are done on people who are alive and are like the pictures from an airliner at 20,000 feet; you can see the contours and major features of the land but not the small details.

We now have some of those details. For the first time, a report was recently published on postmortem research on the brains of people with schizophrenia – some of whom had had anosognosia and some did not – looking at their brain cells under a microscope. The research was carried out by a highly experienced Russian group that does neuropathological research under the leadership of Dr. Natalya Uranova at the Mental Health Research Center in Moscow .*

In this research, anosognosia was assessed after death by examining the person’s medical records. Indication of anosognosia included the person’s explicit denial of illness, refusal to take medication, failure to follow treatment plans, and multiple re-admissions. The brains of 24 individuals with schizophrenia were assessed. Nine of them did not have anosognosia (they had good insight and awareness of illness), and 15 exhibited symptoms of anosognosia (fair or poor insight and awareness of illness). The brain areas examined were two parts of the inferior parietal lobule, a brain area known to be involved in insight.

The results of the study showed a 21% reduction in glial cells (specifically obligodendroglia) in the brains of the individuals with anosognosia (fair or poor insight). Those with anosognosia differed statistically from the normal control brains (p=0.04) and at the borderline statistically from those without anosognosia (p=0.055). The brains of the individuals without anosognosia (good insight) did not differ from the normal controls.

Summary: This is the first study that has assessed microscopically the brains of people who have died with schizophrenia, some of whom had anosognosia and some of whom did not. Those with anosognosia had fewer glial (obligodendroglial) cells. Such research is continuing.

–Treatment Advocacy Center

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Thousands of Doctors Practicing Despite Errors, Misconduct

A USA TODAY investigation shows that thousands of doctors who have been banned by hospitals or other medical facilities aren’t punished by the state medical boards that license doctors.

Dr. Greggory Phillips was a familiar figure when he appeared before the Texas Medical Board in 2011 on charges that he’d wrongly prescribed the painkillers that killed Jennifer Chaney.

The family practitioner already had faced an array of sanctions for mismanaging medications — and for abusing drugs himself. Over a decade, board members had fined him thousands of dollars, restricted his prescription powers, and placed his medical license on probation with special monitoring of his practice.

They also let him keep practicing medicine.

by Peter Eisler and Barbara Hansen, USA Today

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A Glut of Antidepressants

Over the past two decades, the use of antidepressants has skyrocketed. One in 10 Americans now takes an antidepressant medication; among women in their 40s and 50s, the figure is one in four.

Experts have offered numerous reasons. Depression is common, and economic struggles have added to our stress and anxiety. Television ads promote antidepressants, and insurance plans usually cover them, even while limiting talk therapy. But a recent study suggests another explanation: that the condition is being overdiagnosed on a remarkable scale.

The study, published in April in the journal Psychotherapy and Psychosomatics, found that nearly two-thirds of a sample of more than 5,000 patients who had been given a diagnosis of depression within the previous 12 months did not meet the criteria for major depressive episode as described by the psychiatrists’ bible, the Diagnostic and Statistical Manual of Mental Disorders (or D.S.M.).

….Ironically, while many patients in the United States are inappropriately diagnosed with depression, many who actually have it suffer without treatment. Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University Medical Center, noted that from the time they develop major depression, it takes Americans eight years on average to seek care.

Diagnosing depression is an inherently subjective task, said Dr. Jeffrey Lieberman, the president of the American Psychiatric Association.

By Roni Caryn Rabin, The New York Times

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Boston: Searching for Candidate Genetic Defects for Schizophrenia Using the Latest Genetic Technology

Boston VA Healthcare Systems and Amgen

Research study volunteers needed!!!

Volunteers: 

We are looking for families with THREE or more members diagnosed with schizophrenia or related disorders to participate in this research study. We are interested in interviewing the individuals who have been diagnosed with schizophrenia as well as several healthy family members.

Purpose: 

The purpose of this study is to learn more about the role of genes in causing schizophrenia.

Involvement: 

Structured clinical interview, neurological testing, and a blood draw

Study participation may take one or two visits, but we will work with your schedule.

Locations: 

The study will take place in Boston at the Brockton or Jamaica Plain Veterans Affairs Hospital.

We will assist with travel when possible. If these locations are not convenient, home visits are also an option.

Compensation: 

You may receive $130 upon completion of this study.

Contact: 

To learn more about this study or volunteer to participate, please contact us and we will be happy to answer any questions!

Lynn E. DeLisi MD, Study Investigator

Email GeneticsResearchVA@gmail.com or call (774)826-3155

(Please include name, age and preferred method of contact)

 

Distinct Brain Disorders Biologically Linked: Schizophrenia and Autism

Disruption to the gene TOP3B increases susceptibility to schizophrenia and a learning disorder

A team of researchers have shown that schizophrenia and a disorder associated with autism and learning difficulties share a common biological pathway. This is one of the first times that researchers have uncovered genetic evidence for the underlying causes of schizophrenia.

The team found that a disruption of the gene TOP3B, an exceedingly rare occurrence in most parts of the world, is fairly common in a uniquely genetically distinct founder population from North-eastern Finland. In this population, which has grown in relative isolation for several centuries, the disruption of TOP3B is associated with an increased risk of schizophrenia as well as with impairment in intellectual function and learning.

Furthermore, the biochemical investigation of the protein encoded by the TOP3B gene allowed the researchers to gain first insight into the cellular processes that might be disturbed in the affected individuals.

Although the past two decades have revealed a wealth of information about the genetics of disease, we still know little about the biology behind schizophrenia. Many associations between schizophrenia and genetic risk factors have been reported, but only a very few can be considered schizophrenia susceptibility genes. This study uncovers an important biological pathway that appears to underlie schizophrenia and could contribute to the cognitive impairment that is an important component of this disorder.

–Sanger Institute

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Military Suicides Linked to Mental Illness, Not Combat or Deployments

Neither combat experience, number of deployments, nor cumulative days deployed were significantly associated with suicide among current and former U.S. service members, found a study of 151,560 military personnel published today in JAMA. Instead, having depression or bipolar disorder, having alcohol-related problems, and being male are the strongest risk factors for suicide, reported Cynthia LeardMann, M.P.H., of the Naval Health Research Center in San Diego and colleagues.

–Psychiatric News Alert

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Risk of Adult Anxiety Seen in Children’s Stomachaches

Children with chronic stomach pains are at high risk for anxiety disorders in adolescence and young adulthood, a new study has found, suggesting that parents may wish to have their children evaluated at some point for anxiety.

Researchers at Vanderbilt University tracked 332 children with recurring stomachaches that could not be traced to a physical cause — so-called functional abdominal pain — comparing them as they reached young adulthood with 147 children who had never had such stomachaches.

About half the teenagers and young adults who had had functional abdominal pain as children developed an anxiety disorder at some point, compared with 20 percent of the control group, the researchers found. The vulnerability to anxiety persisted into adulthood even if the pain had disappeared, although the risk was highest if the pain continued.

Forty percent of the children with functional abdominal pain went on to experience depression, compared with 16 percent of those who had never had these stomachaches.

By Catherine Saint Louis, The New York Times

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To Get a Leg Up, Start Teaching Mental Health in Junior High

Ever wonder why mental health is not taught in schools? Likely not, if you are of the mainstream mindset. But a majority of the population is affected by mental illness.

Twenty-five percent of individuals exhibit symptoms of various mental health disorders at some point in their lives, diagnosed or not (according to statistics from the National Institute of Mental Health). There are untold family members, mates, close friends, neighbors and colleagues who deal with it — not to mention the effect of depression, anxiety and personality disorders in our workplaces and community.

This information is generally just taught in college level public health or psychology classes, for those perhaps needing to get in one more elective before graduation. Wouldn’t it be better if we started mental health education in junior high?

Some children might start identifying what they are going through at home with an ill parent; others could begin to formulate an entirely new way of being when it comes to the stress and tension they’ll meet with throughout life. Many lives could be potentially changed if young people from junior high on began to learn signs and symptoms.

by Lisa Miles

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Childhood Psychosis Study Reveals Prevention Opportunity

Researchers have published strong evidence from a large sample of adolescents that trauma leads to psychosis. But, in an encouraging finding, the ceasing of trauma (bullying or physical abuse) was associated with a clear reduction in psychotic experiences.

“These findings place new weight on calls for more comprehensive prevention and intervention strategies against childhood trauma in the community, from abuse at home to bullying at school,” say lead study author Ian Kelleher (Royal College of Surgeons in Ireland, Dublin) and team.

“Our findings provide the first direct evidence that this may lead to a reduced incidence of psychotic experiences in the community and ultimately, we hope, a similar reduction in the incidence of psychotic disorders.”

–Magpie Media

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Schizophrenics Likely to Benefit From Brain Discovery and Early Treatment

The discovery of brain impairment in mice could open the door to better treatment options for those suffering from schizophrenia and major depression, according to a new study published in the Proceedings of the National Academy of Sciences.

After studying rodents that have a gene associated with mental illness, neuroscientist Alexander Johnson and his research team from Michigan State University discovered a link between a specific area of the prefrontal cortex, and learning and behavioral deficits.

The finding is a significant step forward in better understanding mental illness. Although there are currently antipsychotic medications that can treat symptoms like hallucinations in schizophrenics, there are really no effective treatments for other symptoms, such as lack of motivation or anhedonia, which is an inability to experience pleasure.

“This study may well suggest that if we start targeting these brain-behavior mechanisms in people with mental illness, it may help to alleviate some of the cognitive and motivational symptoms, which to date remain largely untreated with current drug therapies,” said Johnson, who also serves as assistant professor of psychology at Michigan State University.

–Magpie Media

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