Wednesday, January 23, 2013

Schizophrenia is not a progressive brain disease

A December 4, 2012, posting by the Nova Scotia Early Psychosis Program:
Young people who experience a first episode of psychosis often receive a diagnosis of schizophrenia.

Historically there has been the view that schizophrenia is a progressive, deteriorating condition and many clinicians were taught that point of view in their training.

When the field of Early Psychosis began to develop in the 1990s, a major theme was to discard the pessimistic attitude that clinicians held toward the possibility of significant recovery in psychotic disorders and replace it with a more balanced positive approach. The specialized Early Psychosis services that are now widely available are based on this attitude of realistic optimism.

As well, people with lived experience of psychosis, and their families, have increasingly insisted and demonstrated that recovery in schizophrenia is a realistic and attainable goal.

Yet studies of brain structure and function continue to produce data suggesting that there may be progressive changes associated with a diagnosis of schizophrenia.

In an article published in the Schizophrenia Bulletin journal in November 2012, Dr. Robert Zipursky (pictured) a leader in psychosis reseach in Canada, along with eminent colleagues in the UK, reviews the current evidence related to the question of whether or not a diagnosis of Schizophrenia indicates the person has a progress brain disease.

The article reviews all the recent evidence from brain scans, as well as other sources of data, and concludes that “schizophrenia is not a malignant disease that inevitably deteriorates over time, but one from which most people can achieve a significant degree of recovery”.

The authors strongly urge clinicians to provide young people and their families with this up-to-date information so that the old myths regarding negative outcomes for people receiving a diagnosis of schizophrenia can be laid to rest.

For a free copy of the full article click here.

Tuesday, January 22, 2013

Flawed reasoning

A letter to the editor published in today's edition of The Chronicle Herald:
There is a flaw in John Roswell’s reasoning when he writes (Jan. 17), “I believe that most people who have experienced psychosis would agree with me that people should be held responsible for their criminal acts, no matter what their state of mind was when they committed the crime.”

It is the accused who ultimately determines whether or not to proceed with a defence of not criminally responsible on account of mental disorder. Therefore, if the accused, once found fit to stand trial, believes that psychosis, for example, is the reason they should be found not criminally responsible, they will instruct their defence counsel to present this argument in court.

With regard to better access to mental health services, many people experiencing psychosis have lost contact with reality to such an extent that they do not believe they are ill. Therefore, they do not seek treatment for their mental disorder, despite the efforts of family and friends to assist them. This is one reason why the Nova Scotia legislature passed the Involuntary Psychiatric Treatment Act in December 2005.

Stephen W. Ayer, Executive Director, Schizophrenia Society of Nova Scotia

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