Saturday, October 30, 2010

Province Hosts First Atlantic Mental Health Summit


An October 29th media release from the Nova Scotia Department of Health:
Health representatives from the Atlantic provinces gathered in Halifax this week for the first Atlantic Mental Health Summit.

They have been discussing ways the provinces can work together and raise the profile of mental health issues at all levels of government. During the summit they have also heard from national and international experts.

Health Minister Maureen MacDonald [pictured] offered to lead the summit at the Atlantic health minister's meeting in January.

"The great thing about a summit like this is we gather from all walks of life, social workers, practitioners and experts to share ideas and best practices," said Ms. MacDonald during her opening remarks. "The knowledge that is shared here will help us make the right decisions for our province's mental health strategy, as we work to provide better care, sooner."

Delegates are participating in sessions and workshops to discuss mental health and homelessness, child and youth mental health, mental health promotion and prevention, public policy and a national strategy.

One in three Canadians experience mental illness in their lifetimes, and many more are directly or indirectly affected through their relationships with friends, family and co-workers.

The province announced the 12 members of the Mental Health Strategy Advisory Committee in September to help fulfill a commitment to revamp mental health and addiction services.

The summit ends today, Oct. 29.


FOR BROADCAST USE:

Health representatives from the Atlantic provinces are meeting in Halifax this week to discuss ways to work together and raise the profile of mental health at all levels of government.

Health Minister Maureen MacDonald offered to lead the summit at the Atlantic health minister's meeting in January. She says it's a perfect opportunity to share new ideas and best practices in mental health care.

-30-

Media Contact:

Nicole Brooks
Department of Health
902-424-2608
E-mail: brooksnl@gov.ns.ca

Two representatives from the Schizophrenia Society of Nova Scotia participated in the Atlantic Mental Health Summit. They were Stephen Ayer, Executive Director, and Cecilia McRae, President.

To view the Atlantic Mental Health Summit agenda, please click here (PDF).

Photo credit

Friday, October 29, 2010

Open Groups - Bayers Road Community Mental Health


The list below is up-to-date as of August 10th, 2010.


Please click on the image to magnify it.

For further information, call Bayers Road Community Mental Health at (902) 454-1400.

New mental health curriculum guide targets high schools


An October 26th posting by the Dalhousie University Medical School:
By Margo Wheaton

Dealing with a mental health disorder can be overwhelming, especially for adolescents. At a time when fitting in feels crucial, it can be hard for a teen to admit how down she is or how alone he feels.

Although it’s estimated that mental health problems affect one in five young people in Canada, early diagnosis and treatment of conditions such as depression, bipolar disorder, schizophrenia, bulimia and anxiety disorders remains elusive. As a result, many young people aren’t receiving the help they need.



Dr. Stan Kutcher [pictured], a professor in the Department of Psychiatry at Dalhousie University's Faculty of Medicine and the holder of the Sun Life Financial Chair in Adolescent Mental Health, has a group that has been working to change that.

Through a partnership with the Canadian Mental Health Association, Kutcher and his team at the IWK Health Centre have developed the Mental Health and High School Curriculum Guide, an innovative learning resource for secondary school teachers. The guide represents a component of the first expert-reviewed comprehensive school-based mental health program in the country and combines collaborative learning strategies with interactive multimedia tools.

The goal? To increase mental health awareness and literacy in students, teachers, and families.

According to Kutcher, who is this year’s recipient of the J.M. Cleghorn Award for Excellence in Leadership in Clinical Research, early identification of mental disorders in adolescents is key: “The data is very clear. We know that early identification and early effective treatment has profound short and long term positive outcomes not only in terms of the disorder but in terms of secondary prevention.”

He notes that identifying mental disorders in adolescence can help prevent substance abuse and social-vocational problems and stresses that failure to identify and treat mental illness in teenagers can have dire consequences: “Jail has become the new mental hospital for kids. We have to intervene earlier.”

By equipping schools with the most current resources in mental health and education along with the tools to facilitate dialogue in the classroom, teachers and students alike will be in a better position to see mental health problems for what they are and know there’s no shame in seeking help.

The curriculum guide, which consists of lesson plans, student-friendly activities and audiovisual resources, has already been successfully field-tested at Forest Heights Community School and will be further evaluated in two Digby schools early in the new year. A national launch of the program will take place in the next few months.

The curriculum resource is part of a larger framework called Pathways to Care, a collaborative, inter-disciplinary approach to adolescent mental health that’s been developed by the Sun Life team as part of its mission to disseminate the most current scientific information available. Other resources include a number of creative, interactive and user-friendly materials specifically for parents, siblings, healthcare providers and, of course, for teens themselves.

By educating the most important people in a child’s life about mental health, the model cuts across sectors and emphasizes the importance of community connections as a gateway to early detection and treatment.

Kutcher notes that “what we’re doing in the schools here is really cutting edge” and is very appreciative of support from the Provincial Department of Education, the Schools Plus Program, school boards, schools, educators and others without whom the work could not be successful. He points out that the Mental Health Commission of Canada has identified school mental health as a national priority and he envisions it as a major area of investment and development over the next decade.

“We’re now developing national and international linkages in school mental health and I think that we’re well positioned to take a leadership role. I’m hopeful that the province will continue to work very closely with us as we move that agenda forward.”


Media enquiries:

Allison Gerrard, Dalhousie Medical School, (902) 494.1789 / (902) 222.1917, allison.gerrard@dal.ca

Photo credit

Wednesday, October 27, 2010

Compelling new report shows why mental health ‘must be at the heart of public health’



Please click on the image to magnify it.

An October 26th media release from the Royal College of Psychiatrists (U.K.):
Psychiatrists are today calling on the government to put mental health at the heart of their new public health strategy, which is due to be unveiled later this year.

The Royal College of Psychiatrists (RCPsych) has published a compelling bank of evidence showing why public health strategies cannot afford to ignore mental health. The position statement, No health without public mental health: the case for action, shows that:
  • People with a mental disorder smoke almost half of all tobacco consumed in the UK and account for almost half of all smoking-related deaths.
  • Depression doubles the risk of developing coronary heart disease.
  • People with schizophrenia and bipolar disorder die an average 20 years earlier than the general population, largely owing to physical health problems.
  • People with two or more long-term physical illnesses have a 7 times greater risk of depression.
  • Children from the poorest households have a three-fold greater risk of mental ill health than children from the richest households.
RCPsych President Professor Dinesh Bhugra said: “Historically, government public health strategies have concentrated on physical health and overlooked the importance of both mental illness and mental well-being. But there is no health without mental health. There is vast evidence to show that mental illness is associated with a greater risk of physical illness – and physical illness in turn increases the risk of mental illness. It’s clear that strategies to improve the health of the nation will only be effective if they address mental health and wellbeing as well.”

In the position statement, the RCPsych calls on the Coalition government to make a series of important policy changes, including:
  • Tackling substance addiction through a minimum alcohol pricing policy and an evidence-based addictions policy.
  • Prioritising mental health within smoking cessation programmes.
  • Targeting public mental health interventions for people at higher risk, for example children in care and those who are unemployed or homeless.
  • Promoting the importance of mental health and well-being in older age.
Professor Bhugra said: “Earlier this month, a study revealed that mental illness costs the economy £105 billion a year in England alone, and is the single largest source of burden of disease. Including mental health at the heart of the public health agenda will improve people’s lifestyles and reduce health-risk behaviours, thereby both preventing physical illness and reducing the burden of mental illness on society.”

He continued: “Our new position statement makes clear recommendations for political action and policy change. I hope that the evidence we present today can persuade government at all levels, as well as wider society, of the need for action and the benefits it will bring.”

Responding the launch of this new report, Care Service Minister, Paul Burstow MP, said "The Government is clear that there is no health without mental health. That is why we will publish both a public health White Paper and mental health strategy that will break new ground. If the right action is taken early in people's lives, it’s possible to make a big difference. The right support at the right time can help people realise their potential, cope with adversity and hold down a job. This is good for the individual and good for society too."


For further information, please contact Liz Fox or Deborah Hart in the Communications Department.
Telephone: 020 7235 2351 Extensions. 6298 or 6127
E-mail: efox@rcpsych.ac.uk or dhart@rcpsych.ac.uk


Note to editors:

The new position statement, No health without public mental health: the case for change, was published on 26 October by the Royal College of Psychiatrists.

Saturday, October 16, 2010

NIMH Head Urges More Emphasis on Mental Illness as Brain Disorder


An article published in the October 15th edition of Psychiatric News:
By Aaron Levin

To catch up with other medical disciplines that have sharply reduced morbidity and mortality, psychiatry must evolve into “clinical neuroscience” and reconceptualize its understanding of the roots of mental disorders.

Research progress on psychiatric disorders must follow the cues of cardiology and oncology, taking major steps forward to find the causes of psychopathology and develop cures for mental illness, stated the director of the National Institute of Mental Health (NIMH).

“We're in the middle of a revolution,” said Thomas Insel, M.D. [pictured] “We have the chance to change the world—not tomorrow, but by staying on course.”

NIMH has laid out that course over the last few years by shifting its grants in directions that it hopes will produce “disruptive innovations,” said Insel in the inaugural lecture of the George Washington Institute for Neuroscience at George Washington University in Washington, D.C., in September.

The new institute is a multidisciplinary center that promotes research and training in the mechanisms of normal and pathological brain function.

Neuropsychiatric illnesses are the leading cause of years lost to disability or death from noncommunicable causes, noted Insel.

Progress Lags in Psychiatric Illness

Advances in research and changes in practice have cut deaths from heart disease by 63 percent since 1965, but similar progress has not happened for mental illness, he pointed out.

“We have to move the agenda,” he said. “Diagnosis still comes by observation, illness is detected late, prediction is poor, etiology is often unknown, prevention is not well developed, treatment is by trial and error, and there are no cures and no vaccines.”

Prevalence and mortality have not decreased, and the culture surrounding them is sunk in low expectations. “This is the only area of medicine where people don't talk about cure and prevention,” he said.

The burden of mental disorders is magnified by its relatively high prevalence (approximately 6 percent) and the fact that these illnesses are chronic disorders and usually begin early in life.

He suggested three main areas on which neuroscience research needs to concentrate to tackle the large public-health problem that mental illness presents: a renewed emphasis on psychiatric disorders as brain disorders, an increasing recognition of the role of child and adolescent development, and achievement of advances in understanding the genetic basis of mental illness risk factors.

Field May Shift to Clinical Neuroscience

Brain lesions may be the realm of neurology, but psychiatric illness is defined by the physiology of neural circuits in the brain, said Insel. A different approach and different training may be needed to understand and treat those illnesses. In 10 years, he suggested, psychiatry might be better termed “clinical neuroscience.”

He cited the example of Area 25 in the subgenual cingulate, a region that becomes overactive in depression, but where activity declines when depression is treated with an SSRI. Imaging studies show brain changes—but only in treatment responders. Deep brain stimulation (DBS) near Area 25 also turns down activity, he noted, and the research on DBS shows how knowledge gleaned from brain mapping, circuitry, and imaging can converge to improve understanding of disease and its treatment.

Second, mental disorders are also developmental disorders, he pointed out. Many begin before age 15, while normal brain development continues until age 25.

The cortex in patients with attention-deficit/hyperactivity disorder (ADHD) seems to take longer to mature. Individuals with the disorder “end up at the same point but two or three years late,” he said. “So is ADHD a disease of attention and behavior in children, or is it one of cortical maturation? The challenge is to see what is going wrong in the organ of interest.”

Third, while genetics are another key component of mental illness, Insel acknowledged that understanding how hundreds of variations map onto brain pathways is a complex challenge. Many variants express only in the human brain and only during development. Many other genes that contribute to mental illness have not yet been identified.

“We need to move from description to mechanism and to approach all of these problems from many levels: molecular, cellular, systemic, individual, and social,” he said.

Learning which early variations in brain structure, circuitry, and function foretell later disorder might lead to interventions that can prevent the development of frank illness.

Eventually, the foundation of brain circuitry, development, and genetics will support a better understanding of pathophysiology, prevention, and personalized medicine, all leading to Insel's goal of a comprehensive public-health approach to psychiatric disorders.

The George Washington Institute for Neuroscience has scheduled a dozen more lectures by other neuroscience researchers between now and next May.

Information about the George Washington Institute for Neuroscience is posted at www.gwumc.edu/neuroscience.

Photograph by David Hathcox

Friday, October 15, 2010

York study finds schizophrenia and superior verbal intelligence can co-exist


An October 15th media release from York University:
A study released yesterday by York University researchers has found that schizophrenia patients with superior verbal abilities are like similarly-gifted healthy people in many ways, but still have trouble functioning in the community.

The study is the first to confirm the existence of small numbers of schizophrenia patients with superior levels of verbal ability, defined as a vocabulary score in the upper five-to-ten per cent of the general population.

Researchers investigated the cognitive performance, life skills and community independence of verbally gifted schizophrenia patients, comparing their abilities in these areas to those of verbally gifted healthy people. They found no significant differences between the two groups except in the ability to function independently in the community.

“Impaired cognitive performance is widely regarded as a core feature of schizophrenia and a major cause of disability in daily life,” says the study’s lead author, Walter Heinrichs (right), a psychology professor in York’s Faculty of Health. “We’re seeing that this is not necessarily the case with these exceptional patients. They resemble similarly-gifted healthy people in most aspects of cognition as well as in daily living skills, but they still can’t function normally in the community.”

Researchers tested 151 patients, ranging in age from 21 to 65, alongside healthy people with no history of medical or mental illness. Twenty-five of these patients scored in the superior range. Heinrichs notes that the large number of patients tested meant it was possible to compare the gifted group with more typical schizophrenia patients, and with verbally gifted and average healthy people.

The gifted and more typical patient groups differed on virtually every comparison except the severity of their psychotic symptoms. The gifted group was significantly more independent than typical patients, but experienced equivalent levels of symptoms like delusions, hallucinations, apathy and lack of motivation.

It was also noted that neither verbally-superior patients nor verbally-superior healthy subjects performed at superior levels on all cognitive tasks. Instead, oral reading, visual abstract reasoning, working memory, word fluency, learning and attention scores for both groups ranged between average and high-average levels.

“The discovery of verbally gifted patients is important because they offer a window on the schizophrenic brain when it is relatively free of the abnormalities underlying cognitive impairment,” Heinrichs says. “These patients also demonstrate that cognitive ability cannot be the only determinant of community adjustment in this severe form of mental illness.”

Heinrichs worked alongside York graduate students Ashley Miles and Narmeen Ammari, and psychologists Stephanie McDermid Vaz and Joel Goldberg, a York psychology professor.

The study, “Cognitive, Clinical, and Functional Characteristics of Verbally Superior Schizophrenia Patients,” is published in the journal Neuropsychology.

Posting of this media release is for the purposes of research into schizophrenia and psychosis.

Friday, October 8, 2010

Retired businessman living with paranoid schizophrenia to discuss his struggle


An article posted yesterday by The News of Cumberland County (New Jersey, USA).
Special to The News

VINELAND - Robin Cunningham [pictured], a retired businessman living with paranoid schizophrenia, will discuss his struggle with the disease at a community education forum sponsored by the Cumberland County Guidance Center, on Tuesday, Oct. 26, from 7 to 9 p.m., at Chestnut Assembly of God, 2554 E. Chestnut Ave., Vineland.

In this free public forum, "Hope & Mental Illness: A Personal Story," Cunningham will recount his long struggle with paranoid schizophrenia and give an intimate look at the world through the eyes of a person living with this disease.

After receiving his MBA, Cunningham began a challenging business career. Within three years, he advanced to the level of vice president and thereafter he served as a senior corporate executive officer with several international industry-leading corporations, or their subsidiaries, as well as a major Wall Street investment banking firm and a highly profitable commercial bank.

Cunningham's accomplishments are unusual given that at the age of 13 he was diagnosed with schizophrenia, in a time when the prognosis for individuals with this disease was dismal and the associated stigma was devastating.

Cunningham's life experience has provided him with intriguing insights into the human condition. Since his retirement, he has devoted himself to writing, public speaking and advocacy for the mentally ill. Numerous articles have been written about him and by him, including more than 100 expert blogs he prepared for www.schizophreniaconnection.com.

He currently serves on the New Jersey Governor's Council on Mental Health Stigma, the NAMI New Jersey Board of Trustees, and the Governing Board of Greater Trenton Behavioral Healthcare.

Among others, he has appeared on Voices in the Family (WHYY) and in the BBC documentary "Voices in My Head."

In addition to his presentation, Cunningham will be answering questions from the audience.

Call Jennifer Gardner at (856) 825-6810, ext. 206, by Tuesday, Oct. 19, if you plan to attend.

For more information, call Mary Sauceda at (856) 825-6810, ext. 256.

Thursday, October 7, 2010

Rules-Based Medicine, Inc. announces commercial release of VeriPsych™, diagnostic aid for recent onset schizophrenia


An October 6th media release form Rules-Based Medicine, Inc.:
Announcement coincides with Mental Illness Awareness Week, October 3 – 9, 2010

AUSTIN, Texas — October 6, 2010 /PRNewswire/ — Rules-Based Medicine, Inc. (RBM), today announced the widespread commercial availability of VeriPsych™, the first and only blood-based diagnostic test to aid in confirming the diagnosis of recent onset schizophrenia, a potentially devastating and costly mental illness that affects about 24 million people worldwide. VeriPsych is an innovative molecular diagnostic tool designed to complement the healthcare provider’s clinical impression.

VeriPsych, based on the simultaneous measurement of 51 different protein and hormone biomarkers with an associated mathematical decision rule, compares the biomarker profile of a patient with suspected schizophrenia to that of patients with a confirmed diagnosis of schizophrenia. VeriPsych was developed by RBM to aid in the confirmation of the diagnosis of recent-onset schizophrenia, as reported in a study published in the May 2010 edition of Biomarker Insights.

“Schizophrenia is commonly associated with an inevitable disabling decline in mental and overall health, but we are understanding more and more that early therapeutic intervention can alter that prognosis,” said Prof. Sabine Bahn, (Sa-bee-neh Baa – hn) Director of the Cambridge Center for Neuropsychiatric Research in the United Kingdom and an RBM collaborator. “Ultimately, clearer and earlier diagnosis may lead to reduced disability, more effective treatment, improved patient outcomes and enhanced quality of life for patients.”

Each year 1.3 million patients in the United States and 2 million patients in Europe present with early signs that could be schizophrenia. Signs of schizophrenia, which include hallucinations, confusion, delusions and cognitive deficits, are often indistinguishable from those of other mental health or central nervous system disorders, presenting frequent diagnostic challenges.

Diagnosis of schizophrenia is typically accomplished through the clinician’s evaluation of symptoms. If left untreated or improperly treated, schizophrenia can lead to worsening patient conditions and ultimately poor outcomes. Neuropsychiatric conditions, including schizophrenia, are a leading cause of disability, accounting for approximately one third of years lost to disability among people aged 15 years and over.

“VeriPsych was developed through targeted research combining RBM’s proprietary multiplexing technology and unique biomarker discovery capabilities, specifically in the area of mental illness,” said RBM Chief Executive Officer Craig Benson. “We believe this test will be useful to mental healthcare providers seeking to confirm diagnostic decisions that can help patients and families living with mental illness. We are pleased to make this announcement during Mental Illness Awareness Week. VeriPsych is an important step in RBM’s ongoing efforts to develop and provide quantitative diagnostic tools for healthcare providers treating patients with neuropsychiatric disorders.”

About VeriPsych

VeriPsych is an objective blood-based molecular diagnostic tool that utilizes a proprietary set of 51 biomarker immunoassays. These biomarkers are associated with specific biochemical pathways, including inflammation, metabolism, and cell-to-cell signaling.

VeriPsych is a Laboratory Developed Test (LDT) that uses a decision rule to evaluate the similarity of a patient's biomarker pattern to that of patients with a medically confirmed diagnosis of schizophrenia. Its intended use is as an aid in the confirmation of the diagnosis of schizophrenia in patients with recent onset of symptoms and without co-morbidities such as diabetes, severe inflammation or autoimmune disease. It is not intended to provide a definitive diagnosis of schizophrenia.

VeriPsych was developed and its performance characteristics were determined by RBM. The test is performed by RBM in compliance with CLIA (Clinical Laboratory Improvement Amendments) regulations.

More information about the test can be found at www.veripsych.com.

About Rules-Based Medicine, Inc.

Rules-Based Medicine's biomarker testing service provides clinical researchers, physicians and healthcare providers with reproducible, quantitative, multiplexed data for hundreds of proteins to advance drug development and patient care. The Company's proprietary Multi Analyte Profiling (MAP) technology offers pre-clinical and clinical researchers broad, cost-effective protein analyses in multiple species from a small sample volume. MAP technology also supports RBM's program for development of molecular diagnostics that aid in the detection of complex diseases and conditions in areas of unmet medical need such as neuropsychiatry, nephrology, immunology and cardiology. RBM's first molecular diagnostic test, VeriPsych™, is a blood-based test that aids in the confirmation of diagnosis of recent-onset schizophrenia by evaluating a proprietary set of 51 protein biomarkers. RBM also offers innovative and proprietary ex vivo testing systems such as TruCulture™, the first fully-closed, reproducible whole blood culture system. More information about RBM may be found at www.rulesbasedmedicine.com.

###

VeriPsych is a trademark of Rules-Based Medicine, Inc.

Company Contact:

Christopher Martin
Managing Director, Communications
512-275-2623
512-627-9058 (mobile)
chris.martin@veripsych.com



New Website for Families Marks Mental Illness Awareness Week



An October 6th media release from the Ontario Federation of Community Mental Health and Addiction Programs:

Three key provincial [Ontario] mental health and addictions organizations form partnership to offer families support online

TORONTO, Oct 6 /CNW/ - To mark Mental Illness Awareness Week, the Mood Disorders Association of Ontario, the Ontario Federation of Community Mental Health and Addictions Programs (OFCMHAP) and the Schizophrenia Society of Ontario (SSO) have come together to better meet the needs of families facing addiction and mental health challenges. Together, the three organizations have built an evolving web resource for families - www.familymattersresourcecentre.ca - which addresses the overlapping interests of family members affected by mental illness and/or addictions

"Pooling our resources to create this 'one stop shop' website allows us to get our messages and information out to many more families than if we worked in isolation from each other," says Karen Liberman, Executive Director of the Mood Disorders Association of Ontario.

The website covers a wide range of topics, including events and groups for family members, articles of interest, coping tools and strategies and also treatment and support programs available for their loved ones.

"When a close family friend or family member has a mental health or addiction issue, the first thing people look for is practical information on what they are dealing with and how to get help. This website will help families navigate the complex mental health system by providing them with just that," says Mary Alberti, CEO of the Schizophrenia Society of Ontario.

Mental illness affects one in five Canadians in their lifetime and the remaining four will have a friend, family member or colleague who will experience it. One in 10 Canadians 15 years of age and over are dependent on alcohol and/or illicit drugs, and at least 20% of people with a mental illness also have a substance use problem. Families and friends are an essential and enduring support to people with mental health and addiction issues, but they too need their own supports, and access to timely, accurate and current information.

"Families are at the forefront in coping with addiction and mental illnesses. Their involvement can be crucial to recovery and they need to be supported in taking on that kind of role," says David Kelly, Executive Director of OFCMHAP.

Visit the Family Matters website at www.familymattersresourcecentre.ca

For further information:


For more information, or to arrange interviews, please contact:

Jennifer Foulds, Mood Disorders Association of Ontario, (416) 486-8046 ext. 232; (647) 771-5815 (cell)

David Kelly, Ontario Federation of Community Mental Health and Addiction Programs, (416) 490-8900

Vani Jain, Schizophrenia Society of Ontario, (416) 449-6830 ext. 253

Wednesday, October 6, 2010

Evidence That Familial Liability for Psychosis Is Expressed as Differential Sensitivity to Cannabis


The abstract of a paper posted online on October 4th by the journal Archives of General Psychiatry:

An Analysis of Patient-Sibling and Sibling-Control Pairs

By Genetic Risk and Outcome in Psychosis (GROUP) Investigators

Context

Individual differences in cannabis sensitivity may be associated with genetic risk for psychotic disorder.

Objectives

To demonstrate and replicate, using 2 conceptually different genetic epidemiological designs, that (familial) liability to psychosis is associated with sensitivity to cannabis.

Design, Setting, and Participants

Sibling-control and cross-sibling comparisons using samples of patients with a psychotic disorder (n = 1120), their siblings (n = 1057), and community controls (n = 590) in the Netherlands and Flanders.

Main Outcome Measures

Positive and negative schizotypy using the Structured Interview for Schizotypy–Revised (for siblings and controls) and self-reported positive and negative psychotic experiences using the Community Assessment of Psychic Experiences (for siblings and patients). Cannabis use was assessed as current use (by urinalysis) and lifetime frequency of use (by Composite International Diagnostic Interview).

Results

In the sibling-control comparison, siblings displayed more than 15 times greater sensitivity to positive schizotypy associated with particularly current cannabis use by urinalysis (adjusted B = 0.197, P < .001) than controls (adjusted B = 0.013, P = .86) (P interaction = .04) and a similar difference in sensitivity to its effect on negative schizotypy (siblings: adjusted B = 0.120, P < .001; controls: B = –0.008, P = .87; P interaction = .03). Similarly, siblings exposed to cannabis resembled their patient relative nearly 10 times more closely in the positive psychotic dimension of the Community Assessment of Psychic Experiences (adjusted B = 0.278, P < .001) compared with nonexposed siblings (adjusted B = 0.025, P = .12) (P interaction < .001). No significant effect was apparent for the Community Assessment of Psychic Experiences negative domain, although the association was directionally similar (2 times more resemblance; P interaction = .17). Cross-sibling, cross-trait analyses suggested that the mechanism underlying these findings was moderation (familial risk increasing sensitivity to cannabis) rather than mediation (familial risk increasing use of cannabis).

Conclusions

Genetic risk for psychotic disorder may be expressed in part as sensitivity to the psychotomimetic effect of cannabis. Cannabis use may synergistically combine with preexisting psychosis liability to cause positive and negative symptoms of psychosis.

Author Affiliations:

René S. Kahn MD, PhD, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands; Don H.Linszen MD, PhD, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; Jim van Os MD, PhD, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands, and King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom; Durk Wiersma PhD, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Richard Bruggeman MD, PhD, Department of Psychiatry, University Medical Center Groningen, University of Groningen; Wiepke Cahn MD, PhD, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht; Lieuwe de Haan MD, PhD, Department of Psychiatry, Academic Medical Centre, University of Amsterdam; Lydia Krabbendam PhD, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre; and Inez Myin-Germeys PhD, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre.

Posting of this abstract is for the purposes of research into psychosis and schizophrenia.

Monday, October 4, 2010

Training Faulty Brains to Work Better


An article posted on August 18, 2009, by Newsweek:
New treatments may help people with schizophrenia.

By Sharon Begley

Whenever I speak to educators and interested laypeople about neuroplasticity — the ability of the adult brain to change in function and structure — one of the questions I often get is whether neuroplasticity can be tapped to treat truly devastating brain diseases such as Alzheimer's or schizophrenia. After all, neuroplasticity has been used to treat stroke, depression, dyslexia, and other diseases or injuries of the brain. The jury is still out on Alzheimer's (though since this disease involves massive neuronal death, my bet is that the answer will, sadly, be no). But to my surprise, the answer to schizophrenia might just be yes.

In schizophrenia, which affects about 1.1 percent of American adults, patients suffer from visual and auditory hallucinations, delusions, an absence of emotion, and cognitive deficits. All told, that seemed to be just too much for an approach based on neuroplasticity, which involves retraining the brain, to handle.

But it turns out that at least some of the symptoms of schizophrenia can be lifted with brain training. In a study published in the July [2009] issue of the American Journal of Psychiatry, scientists led by Sophia Vinogradov [pictured] of the University of California, San Francisco, describe what they call "neuroplasticity-based auditory training" to improve memory in people with schizophrenia. Basically, what they did was assign 55 patients with schizophrenia to receive a cognitive-training program developed by Posit Science or to play a computer game that required just as much time and concentration. The Posit program, similar to one the company developed to improve memory in the elderly, emphasizes basic auditory and speech perception; participants used it one hour a day, five days a week, for 10 weeks. The better they got, the harder the program got: it automatically adjusts the level of difficulty to keep the patients' performance at a constant level so they stay engaged.

Fisher and her colleagues found that the brain-trained group showed noticeably bigger improvements in cognition and verbal working memory than the game-playing control group. A better memory would give people with schizophrenia a better chance of doing the little tasks of daily life—remembering what and when to eat, how to dress, how to behave in public—that make them more likely to hold a job and live independently.

The emphasis on auditory training reflects the belief of UCSF's Michael Merzenich, a pioneer in neuroplasticity and cofounder of Posit, that this is the portal to improved memory and, possibly, cognition. The idea is that if you hear more clearly, then your brain makes fewer errors in encoding the information contained in speech. As Michael Green of UCLA put it in an editorial in the American Journal of Psychiatry the Posit Science approach "is unusual in that it rests heavily on neuroplasticity models ... that emphasize the consequences of a poor signal-to-noise ratio" in hearing, "which leads to errors and poor performance as they are fed forward for cognitive … operations."

It's hard to argue with even preliminary success, odd as it seems that merely hearing better could bring about such improvements in memory (and not just memory for heard words; it improves memory for seen words as well). "This emphasis on perceptual processes is a critical insight of the Posit Science approach and a clear distinction from other cognitive-training programs," says Green. The significance of the new study, he says, is that "it addresses cognitive training at a more basic neurobiological level than any previous strategy. We can hope that the dramatic effects they have reported will prove to be replicable and durable and that they will extend to meaningful effects for patients' lives."

Hope is all well and good. But schizophrenia is notable not only for its severity, but for the yawning gap between what's known to be effective and what treatments patients actually receive. Green asks rhetorically, "if cognitive training [for schizophrenia] worked, would we not all know it by now?" In fact, researchers do know it, and some clinicians know it, but by one estimate fewer than 15 percent of schizophrenics get it (or other treatments, rehabilitation and support that would let them live independently). In fact, in a paper earlier this year in Schizophrenia Bulletin, scientists led by Robert S. Kern of the Geffen School of Medicine at the University of California, Los Angeles, were quite upbeat in their assessment of treatments for schizophrenia—none of them the problematic antipsychotic medications that in too many cases are all that people with schizophrenia receive.

Take cognitive-behavior therapy. Its basic premise is that people can be taught to think about their thoughts differently. It is effective in depression (where people are taught to think about their tendency to catastrophize—"I had a bad date; no one will ever love me because I am worthless and unlovable"). But in something as serious as schizophrenia? Yes, Kern and his colleagues find. It turns out that, with cognitive-behavior therapy, patients who hear voices and feel persecuted can learn to see these symptoms as almost normal (in that many people experience them when, say, they are sleep deprived, under extreme stress, drunk or stoned) or as "just" the manifestations of a neurobiological glitch and not real. The approach is surprisingly effective, a 2008 review found.

Similarly, exercises to improve attention, learning and memory, reasoning and problem solving—which 90 percent of people with schizophrenia have problems with—also help, as this study found, and make a meaningful difference in whether the person can live independently and hold a job. The tragedy is that—due to an overburdened medical system, inadequate insurance and an inability to pay, as well as simply ignorance about how to find help—few patients with schizophrenia receive what works. The upside is that even schizophrenia might be treated by approaches that exploit the brain's ability to change in fundamental ways.

Also see:

Changing Your Mind (The Nature of Things)


Dr. Sophia Vinogradov's Lecture on Schizophrenia from Putnam Clubhouse on Vimeo.


Neuroplasticity-Based Cognitive Training in Schizophrenia: An Interim Report on the Effects 6 Months Later


A Randomized, Controlled Trial of Computer-Assisted Cognitive Remediation for Schizophrenia

Saturday, October 2, 2010

Sources of Revenue for Nonprofit Mental Health and Addictions Organizations in Canada

The abstract of an article published in the October 2010 edition of Psychiatric Services:

By Carissa Escober-Doran, B.S.N., M.P.A., Philip Jacobs, D.Phil., C.M.A. and Carolyn Dewa, M.P.H., Ph.D.


Ms. Escober-Doran and Dr. Jacobs are affiliated with the Institute of Health Economics, 10405 Jasper Ave., Suite 1200, Edmonton, Alberta T5J 3N4, Canada (e-mail: escober@ualberta.ca). Dr. Dewa is with the Centre for Addiction and Mental Health, Toronto, Ontario.


OBJECTIVE:

In Canada charitable or nonprofit organizations provide government-contracted mental health and addictions services, and they augment government funding by raising charitable revenues. This study estimated by source the revenues of nonprofit mental health and addictions organizations in Canada.

METHODS:

A list of nonprofit, service-providing organizations in Canada was developed, financial returns to the Canada Revenue Agency (CRA) in 2007 were obtained, and data were analyzed in aggregate.

RESULTS:

Information was obtained from 369 Canadian organizations, which had $915.4 million (Canadian dollars [CAD]) in total revenues: 85% were from the government, 4% were from charitable giving, and 11% were from other sources.

CONCLUSIONS:

The ratio of charitable giving to government funding of mental health care was about 0.55% ($35 million to $6.3 billion CAD). This charitable giving level cannot compensate for the relatively low levels of total government mental health spending identified in government reports.


Posting of this abstract is for the purposes of research into funding of nonprofit mental health organizations.

Friday, October 1, 2010

Laura Burke named a 2010 Champion of Mental Health


From the 2010 Mental Illness Awareness Week website:

Champion - Youth

Laura Burke
Concordia University, Master's in Drama Therapy student



Ms. Burke [pictured above] has made outstanding contributions to the field of mental health in Canada, working to raise awareness, fight biases and stigma, and contribute to community organizations. She has given talks on recovery for the Nova Scotia Early Psychosis Program and acted as a peer support worker at Laing House, a drop-in centre for youth living with mental illness. When at Laing, she also ran a drama group and a writer’s circle, and was constantly inspired by the courage, resilience and determination of the youth she worked with.

In 2008 she recorded an album of her spoken word poetry about her journey through schizophrenia and recovery, and in 2009, she began her role at the Schizophrenia Society of Nova Scotia as a peer support facilitator. Ms. Burke has showed continued dedication to the field of mental health, and has bravely drawn on her own experience with schizophrenia to positively impact her community.

Ms. Burke strongly believes that social inclusion, unconditional acceptance, and the opportunity to use creativity as a force of healing are invaluable, too often overlooked components of recovery. After graduation, Ms. Burke hopes to research and practice drama therapy to improve negative and cognitive symptoms in youth experiencing first episode psychosis.

Also see:

2010 Mental Illness Awareness Week (October 3rd to 9th)

2010 Champions of Mental Health

About the Champions of Mental Health Awards

Superhero - A Visual Poem