First-Episode Psychosis - Academic Re-Entry Promotion Project -- Research Recruitment

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To download the a PDF of the poster, please click here.

Stereotypes of mental disorders differ in competence and warmth

A February 21st posting by Neuroskeptic:

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Fighting "the stigma of mental illness" is big business at the moment. But does "the stigma" really exist?

As I said back in 2010:

There is a stigma of schizophrenia, and there's a stigma of depression, etc. but they're not the same stigma. We're told it's a myth that "the mentally ill are violent" - [but] no-one thinks depressed or anorexic people are violent. They think (roughly) that people with psychosis are. They have other equally silly opinions about each diagnosis, but there's no monolithic "stigma of mental illness".

Now a paper has come out which explores this idea in some detail: Stereotypes of mental disorders differ in competence and warmth. The title says it all : people have stereotypical views of people suffering from different mental disorders, but these stereotypes vary substantially.

To read the entire post, please click here.

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Also see:

Stereotypes of mental disorders differ in competence and warmth

The importance of measuring psychosocial functioning in schizophrenia

The abstract of an article posted on June 24th by Annals of General Psychiatry:

By Sofia Brissos, Andrew Molodynski, Vasco Videira Dias, and Maria Luisa Figueira

Abstract (provisional)

Background

Schizophrenia is among the most disabling of mental illnesses and frequently causes impaired functioning. We explore issues of definition and terminology, and the relationship between social functioning, cognition, and psychopathology considering relevant research findings.

Methods

The present article describes measures of social functioning and outlines their psychometric properties. It considers their usefulness in research and clinical settings. Treatment aims and objectives are explored in the context of cognitive and social functioning. Finally, we identify areas for developing research and refining the measurement of social functioning.

Results

The definition and measurement of social functioning in schizophrenia remains a complex and disputed area. The relationships between symptoms, cognitive functioning and social functioning are complex but we are beginning to understand them better. Scales for measuring functioning in clinical practice must be brief and sensitive to change and the Personal and Social Performance (PSP) scale may offer several advantages in these regards. Brief cognitive assessments focusing upon the domains most commonly affected in schizophrenia, such as verbal memory and executive functions, should be coadministered with measures of functioning.

Conclusions

The use of validated scales for schizophrenia that are sensitive to change over the course of the illness and its treatment, should allow for a better understanding of patients' functional disabilities, enabling better and more comprehensive monitoring and evaluation of both pharmacological and non-pharmacological treatment strategies.

To download the entire article, please click here (PDF).

Also see:

Symptomatic remission in schizophrenia patients: Relationship with social functioning, quality of life, and neurocognitive performance

To download the entire document (PDF), please click here.

Also see:

ONE MIND for RESEARCH

Understanding schizophrenia: researchers uncover new underlying mechanism

A March 28th media release from The Hospital for Sick Children:

TORONTO – A new way of thinking about the fundamental pathobiology of schizophrenia could one day lead to improved therapeutic approaches to treating this disorder. Researchers at The Hospital for Sick Children (SickKids), the University of Toronto and Tufts University School of Medicine have linked proteins and genes that are implicated in schizophrenia in a novel way. The study is published in the March 27 advance online edition of Nature Medicine.

Schizophrenia is a disorder that affects one per cent of Canadians and 24 million people worldwide. A team of researchers led by Dr. Michael Salter [pictured], SickKids Senior Scientist and Professor of Physiology at the University of Toronto, identified a biochemical pathway in the brain that may contribute to the neurobiological basis of schizophrenia.

“This is a paradigm shift in the way that we view the neural mechanisms of schizophrenia,” says Salter, Head of the Program in Neurosciences and Mental Health at SickKids Research Institute. “With our discovery we have brought together in a new way pieces of the schizophrenia puzzle. We hope that the understanding we have put together will lead to new forms of treatment that are more effective than the ones that are currently available.”

The scientists studied in mice two partner proteins, NRG1 and ErbB4, and the effect they have on a key brain receptor known as the N-methyl D-aspartate glutamate receptor (NMDAR). While NRG1 and ErbB4 have been genetically implicated in schizophrenia, the new study finds an unexpected link to NMDARs.

The NMDAR is a major component of synapses -- the highly specialized sites of communication between the brain’s billions of individual nerve cells -- that is critical for many brain functions including learning and memory. Suppressed functioning of NMDARs was suspected in schizophrenia because drugs that block NMDARs cause the hallucinations and disordered think, that occur in schizophrenia.

It had been suspected that NRG1 and ErbB4 might suppress generally NMDAR function but the present study found this was not the case. Rather, the researchers discovered that NRG1 and ErbB4 work together through inhibiting another protein, Src. The link to NMDARs is that Src normally increases NMDAR function under circumstances when this is needed such as in learning and memory. The researchers found that by blocking Src, NRG1 and ErbB4 selectively prevented that critical boost in NMDAR function.

The researchers also studied the responses of nerve cells during brain activity that mimicked normal brain oscillations known as theta rhythm. Theta rhythm activity, which is critical for learning and memory, is impaired in individuals with schizophrenia. The researchers determined that by acting through Src, NRG1 and ErbB4 greatly reduced the nerve cell responses to theta rhythm activity.

The findings suggest new approaches to schizophrenia treatment by reversing the effects of NRG1 and ErbB4 through enhancing the Src boost of NMDARs. “The tricky part is that all of these proteins are involved in other functions of the body; we can’t randomly enhance or inhibit them as this would lead to side effects,” says Salter. “The key will be to develop clever ways to target the proteins in the context of the synapse.”

This study is funded by supported by the Canadian Institutes of Health Research, the Deafness Research Foundation, Howard Hughes Medical Institute and SickKids Foundation.


About The Hospital for Sick Children

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.

About SickKids Research & Learning Tower

SickKids Research & Learning Tower will bring together researchers from different scientific disciplines and a variety of clinical perspectives, to accelerate discoveries, new knowledge and their application to child health — a different concept from traditional research building designs. The Tower will physically connect SickKids science, discovery and learning activities to its clinical operations. Designed by award-winning architects Diamond + Schmitt Inc. and HDR Inc. with a goal to achieve LEED® Gold Certification for sustainable design, the Tower will create an architectural landmark as the eastern gateway to Toronto’s Discovery District. SickKids Research & Learning Tower is funded by a grant from the Canada Foundation for Innovation and community support for the ongoing fundraising campaign. For more information, please visit www.buildsickkids.com.

For more information, please contact:

Matet Nebres
Manager, Media Relations
Communications and Public Affairs
The Hospital for Sick Children
Phone: 416-813-6380
Fax: 416-813-5328
email: matet.nebres@sickkids.ca

Suzanne Gold
Communications Specialist - Media Relations
Communications and Public Affairs
The Hospital for Sick Children
Phone: 416-813-7654 ext. 2059
Fax: 416-813-5328
email: suzanne.gold@sickkids.ca

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Schizophrenia, “Just the Facts” 6. Moving ahead with the schizophrenia concept: From the elephant to the mouse

The abstract of an article published in the April 2011 issue of Schizophrenia Research:

By Matcheri S. Keshavan, Henry A. Nasrallah, and Rajiv Tandon

Abstract

The current construct of schizophrenia as a unitary disease is far from satisfactory, and is in need of reconceptualization. The first five papers in our “facts” series reviewed what is known about schizophrenia to date, and a limited number of key facts appear to stand out. Schizophrenia is characterized by persistent cognitive deficits, positive and negative symptoms typically beginning in youth, substantive heritability, and brain structural, functional and neurochemical alterations including dopaminergic dysregulation. Several pathophysiological models have been proposed with differing interpretations of the illness, like the fabled six blind Indian men groping different parts of an elephant coming up with different conclusions. However, accumulating knowledge is integrating the several extant models of schizophrenia etiopathogenesis into unifying constructs; we discuss an example, involving a neurodevelopmental imbalance in excitatory/inhibitory neural systems leading to impaired neural plasticity. This imbalance, which may be proximal to clinical manifestations, could result from a variety of genetic, epigenetic and environmental causes, as well as pathophysiological processes such as inflammation and oxidative stress. Such efforts to “connect the dots” (and visualizing the elephant) are still limited by the substantial clinical, pathological, and etiological heterogeneity of schizophrenia and its blurred boundaries with several other psychiatric disorders leading to a “fuzzy cluster” of overlapping syndromes, thereby reducing the content, discriminant and predictive validity of a unitary construct of this illness. The way ahead involves several key directions: a) choosing valid phenotype definitions increasingly derived from translational neuroscience; b) addressing clinical heterogeneity by a cross-diagnostic dimensional and a staging approach to psychopathology; c) addressing pathophysiological heterogeneity by elucidating independent families of “extended” intermediate phenotypes and pathophysiological processes (e.g. altered excitatory/inhibitory, salience or executive circuitries, oxidative stress systems) that traverse structural, functional, neurochemical and molecular domains; d) resolving etiologic heterogeneity by mapping genomic and environmental factors and their interactions to syndromal and specific pathophysiological signatures; e) separating causal factors from consequences and compensatory phenomena; and f) formulating or reformulating hypotheses that can be refuted/tested, perhaps in the mouse or other experimental models. These steps will likely lead to the current entity of schizophrenia being usefully deconstructed and reconfigured into phenotypically overlapping, but etiopathologically unique and empirically testable component entities (similar to mental retardation, epilepsy or cancer syndromes). The mouse may be the way to rescue the trapped elephant!

Keywords: Schizophrenia, Models, Heterogeneity, Etiology, Pathophysiology, Phenotype, Treatment, Biology

Posting of the abstract is for the purposes of research into schizophrenia.

Metabolome in schizophrenia and other psychotic disorders: a general population-based study

A provisional abstract posted on March 23 by Genome Medicine:

By Matej Oresic, Jing Tang, Tuulikki Seppanen-Laakso, Ismo Mattila, Suoma E Saarni, Samuli I Saarni, Jouko Lonnqvist, Marko Sysi-Aho, Tuulia Hyotylainen, Jonna Perala and Jaana Suvisaari

Abstract (provisional)

Background

Persons with schizophrenia and other psychotic disorders have a high prevalence of obesity, impaired glucose tolerance, and lipid abnormalities, particularly hypertriglyceridemia and low HDL. More detailed molecular information on the metabolic abnormalities may reveal clues about the pathophysiology of these changes, as well as about disease specificity.

Methods

We applied comprehensive metabolomics in serum samples from a general population-based study in Finland. The study included all persons with DSM-IV primary psychotic disorder (schizophrenia n=45, other nonaffective psychosis (ONAP) n=57, affective psychosis n=37) and controls matched by age, sex, and region of residence. Two analytical platforms for metabolomics were applied to all serum samples: (1) global lipidomics platform based on Ultra Performance Liquid Chromatography coupled to mass spectrometry, which covers molecular lipids such as phospholipids and neutral lipids and (2) platform for small polar metabolites based on two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GCxGC-TOFMS).

Results

Compared with their matched controls, persons with schizophrenia had significantly higher metabolite levels in six lipid clusters containing mainly saturated triglycerides and in two small-molecule clusters containing, among other metabolites, (1) branched chain amino acids phenylalanine and tyrosine and (2) proline, glutamic, lactic and pyruvic acids. Among these, serum glutamic acid was elevated in all psychoses (P=0.0020) as compared to controls, while proline [moleculecular structure illustrated] upregulation (P=0.000023) was specific to schizophrenia. After adjusting for medication and metabolic comorbidity in linear mixed models, schizophrenia remained independently associated with higher levels in seven of these eight clusters (P<0.05 in each cluster). The metabolic abnormalities were less pronounced in persons with ONAP or affective psychosis. Conclusions

Our findings suggest that specific metabolic abnormalities related to glucoregulatory processes and proline metabolism are specifically associated with schizophrenia and reflect two different disease-related pathways. Metabolomics may become a powerful tool in psychiatric research to investigate disease susceptibility, clinical course, and treatment response, sensitive to both genetic and environmental variation.


The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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

Combating schizophrenia

Nature, one of the most prestigious science journals in the world, devotes its November 11th edition to schizophrenia:

Research has revealed daunting complexities in the psychiatric condition, but also new routes towards diagnosis and treatment.

A special collection of articles focuses on the challenges of schizophrenia, from spotting early symptoms during adolescence to changing the stigma associated with the disease.

Editorial

Combating schizophrenia
Research has revealed daunting complexities in the psychiatric condition, but also new routes towards diagnosis and treatment.

News

China tackles surge in mental illness
Psychological examinations added to selection procedure for government officials.

Features

The making of a troubled mind
Schizophrenia appears during adolescence. But where does one begin and the other end?

The drug deadlock
The biology is too complicated. Pharma companies are quitting. Where are schizophrenia drugs going to come from?

Comment

Short-lived campaigns are not enough
The stigma of mental illness will be reduced only if region-specific awareness initiatives become a permanent fixture of health and social services, argues Norman Sartorius.

Cognitive remediation therapy needs funding
More rigorous studies should be done on the effects of a therapy that seems to improve the everyday functioning of people with schizophrenia, says Til Wykes.

In retrospect: The five lives of the psychiatry manual
Roy Richard Grinker describes the military origins of the key reference work for diagnosing mental illness.

Audio

Nature podcast (24:36, Rethinking schizophrenia)
Thomas Insel, director of the National Institute of Mental Health, and Til Wykes, psychiatrist at Kings College London, talk about the symptoms, causes and best treatments for schizophrenia.

Perspectives

Rethinking schizophrenia
Thomas Insel, director of the National Institute of Mental Health, calls for schizophrenia to be emphasized as a neurodevelopmental disorder in which psychosis is a late — and potentially curable — stage.

From maps to mechanisms through neuroimaging of schizophrenia
Andreas Meyer-Lindenberg, director of the Central Institute of Mental Health, Mannheim, explains how neuroimagng and other systems-level techniques can help develop future treatment.

The environment and schizophrenia
Jim van Os, Gunter Kenis and Bart Rutten review our knowledge of the environmental factors that influence schizophrenia risk, and the major challenges that will be involved in teasing them out.

Image credit: The cover artwork is by Rodger Casier and NARSAD Artworks, a non-profit organization that showcases artists with mental illness. Proceeds from the art go to the research-funding body NARSAD.

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.

Review of Mental Health Research (U.K.)

To download the entire publication, please click here.

Also see:

Mental health research is 'incredibly underfunded'

Landmark MRC review of mental health research calls for change

Gene linked to schizophrenia: Canadian study

An article posted on April 13th by AFP:

MONTREAL — People with a specific mutated gene may be prone to schizophrenia, according to a Canadian study published Monday in a US scientific journal.

The study led by University of Montreal researchers found new mutations in the so-called "SHANK3 gene" in [schizophrenia] patients.

"That these new mutations occur in schizophrenia is rather unexpected and may explain why the identification of the genes linked to this disease has been so difficult," senior author Guy Rouleau [pictured] said in a statement.

"Our findings show that a significant number of schizophrenia cases are the result of new genetic mutations in the SHANK3 gene," he said in the study published in the US Proceedings of the National Academy of Science.

Schizophrenia is a mental disorder that affects about one percent of people worldwide. It is most commonly manifested as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking.

It often leads to significant social or occupational dysfunction.

SHANK3 proteins are involved in maintaining the physical structure of nerve cells, and mutations in the gene result in specific abnormalities in cell shapes.

These deformations have been observed in schizophrenia patients.

Lead study author Julie Gauthier said the SHANK3 gene had "previously been linked to autism," which suggests "a molecular genetic link between these two neurodevelopmental disorders."

It also means that SHANK3 "may have a role in other brain disorders," she said.

Posting of this article is for the purposes of research into schizophrenia.

Antipsychotic medication research study

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Blood test for schizophrenia could be ready this year

A January 20th media release from the American Chemical Society:

A blood test for diagnosing schizophrenia — the most serious form of mental illness — could be available this year, according to an article in the current issue of Chemical & Engineering News, ACS' weekly newsmagazine. The disorder, with symptoms that can include hallucinations and delusional thoughts, affects more than two million people in the United States and millions more worldwide.

C&EN Senior Editor Celia Henry Arnaud mentions the test as one part of a much broader discussion of how scientists are using non-brain cells to study schizophrenia in an attempt to speed the identification of biomarkers of the disease and develop new diagnostic tests. She notes that schizophrenia does not just involve the brain, but also abnormal levels of certain proteins that appear in other parts of the body. The article highlights groundbreaking research by a group of scientists in the United Kingdom indicating that 40 percent of the chemical changes in the brains of schizophrenia patients also occur in other body parts. The U.K. scientists are studying these biomarkers in the skin, immune cells, and blood of patients to provide a real-time picture of the disease. Most previous studies, in contrast, were done with brain tissue taken from patients after death, the article notes.

The scientists have already identified several schizophrenia biomarkers in the blood and are working with a company that plans to launch a blood test for diagnosing schizophrenia in 2010. The test could help confirm diagnoses made on the basis of psychiatric evaluations and allow earlier diagnosis so that patients can be treated earlier.

###

ARTICLE FOR IMMEDIATE RELEASE
"A Systemic Look at Schizophrenia"

This story is available at http://pubs.acs.org/cen/science/88/8803sci1.html

Contact
Michael Bernstein
Email: m_bernstein@acs.org
Phone: 202-872-6042

Also see:

Expression Profiling of Fibroblasts Identifies Cell Cycle Abnormalities in Schizophrenia

Photograph courtesy of the American Chemical Society.

Industry-Academic Consortium Set Up to Bolster Schizophrenia and Depression R&D

An article posted today by Genetic Engineering and Biotechnology News:

A newly established international industry-academic consortium is to receive funding from the Innovative Medicines Initiative (IMI) to develop new models and methods for the discovery of treatments for schizophrenia and depression. Led by H. Lundbeck and Kings College London, the NEWMEDS (novel methods leading to new medications in depression and schizophrenia) project plans on partnering with major academic institutions in Europe and Israel as well as global pharma companies like AstraZeneca, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutica, Novartis, Orion, Pfizer, Roche, Servier, and Wyeth.

The research will focus on developing new animal models for the identification of treatments for schizophrenia. It will also examine how genetic variations influence drug response. Additionally, the project aims to develop new approaches that will allow shorter and more efficient clinical trials.

The consortium believes there are currently a number of major bottlenecks preventing the translation of knowledge and research findings relating to schizophrenia and depression to the clinic. These include a lack of accurate animal models for drug discovery, a scarcity of tools and tests in healthy volunteers to provide early efficacy data, and the reliance in clinical trials on symptom-based diagnostic and statistical manual categories.

“While the biology of psychiatry has made remarkable progress, we have been slow in converting that into innovative and new medications,” points out Shitij Kapur, M.D. (pictured), at King’s College London’s Institute of Psychiatry. “This is a joint challenge for academia and industry. NEWMEDS is a joint response. It is not only scientifically innovative, but it is also an innovation in creating a cluster of nearly 50 scientists from both sides to work together to achieve a common goal of better, safer, and more effective medicines more quickly.”

Tine Bryan Stensbl, M.D., divisional director for discovery pharmacology research at Lundbeck, adds, “NEWMEDS embodies a novel collaborative effort where companies join forces and together with academia answer scientific questions in a precompetitive environment that will form the basis of tomorrow’s medicines. This joint effort will provide novel insights that undoubtedly will be to the benefit of the patients suffering from schizophrenia and depression.”

The IMI, which will provide funding to NEWMEDS, is public-private partnership between the pharma industry’s European Federation of Pharmaceutical Industries and Associations and the EU. The initiative’s goal is to promote and support Europe’s position in drug discovery and development. The IMI’s overall funding scheme has a budget of €2 billion, half of which will be provided by the EU’s Seventh Framework Programme and half by EFPIA member companies.

I thank John Devlin for bringing this article to my attention.

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Recovery After Psychosis (RAP): A Compassion Focused Programme for Individuals Residing in High Security Settings

The abstract of an article published online on September 21st by the journal Behavioural and Cognitive Psychotherapy:

By Heather Laithwaite (1,3), Martin O’Hanlona (1), Padraig Collinsa (1), Patrick Doylea (1), Lucy Abrahama (1), Shauneen Portera (1), and Andrew Gumleya (2)

(1) The State Hospital, Carstairs, Scotland

(2) University of Glasgow, Scotland

(3) Reprint requests to Heather Laithwaite, Rowanbank Clinic, Balornock, Glasgow G21 3UL, Scotland. E-mail: heather.laithwaite@ggc.scot.nhs.uk


Background:

The aim of the study was to evaluate the effectiveness of a recovery group intervention based on compassionate mind training, for individuals with psychosis. In particular, the objective was to improve depression, to develop compassion towards self, and to promote help seeking.

Method:

A within-subjects design was used. Participants were assessed at the start of group, mid-group (5 weeks), the end of the programme and at 6 week follow-up. Three group programmes were run over the course of a year. Nineteen participants commenced the intervention and 18 completed the programme.

Results:

Significant improvements were found on the Social Comparison Scale; the Beck Depression Inventory; Other As Shamer Scale; the Rosenberg Self-Esteem Inventory and the General Psychopathology Scale from the Positive and Negative Syndrome Scale.

Conclusions:

The results provide initial indications of the effectiveness of a group intervention based on the principles of compassionate focused therapy for this population. The findings of this study, alongside implications of further research are discussed.

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

Implementing Evidence-Based Practices for People With Schizophrenia

An abstract published in the July 2009 edition of Schizophrenia Bulletin:

By Robert E. Drake (1,2), Gary R. Bond (3), and Susan M. Essock (4)

1. To whom correspondence should be addressed; Psychiatric Research Center, 2 Whipple Place, Lebanon, NH 03766, tel: 603-448-0263, fax: 603-448-3976, e-mail: Robert.E.Drake@dartmouth.edu
2. Dartmouth Psychiatric Research Center, Dartmouth Medical School, Lebanon, NH
3. Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN
4. Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York, NY
   

Over the last decade, a consensus has emerged regarding a set of evidence-based practices for schizophrenia that address symptom management and psychosocial functioning. Yet, surveys suggest that the great majority of the population of individuals with schizophrenia do not receive evidence-based care. In this article, we review the empirical literature on implementation of evidence-based practices for schizophrenia patients. We first examine lessons learned from implementation studies in general medicine. We then summarize the implementation literature specific to schizophrenia, including medication practices, psychosocial interventions, information technology, and state- and federal-level interventions. We conclude with recommendations for future directions.

Keywords: evidence-based practices / schizophrenia / implementation research

To read the entire article, please click here (free Medscape registration is required).

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

Mental health experts target ‘huge mismatch’ in funding

An article published in yesterday's edition of The Ottawa Citizen:

Stigma is diverting money for research, doctors say

By Tony Spears

The stigma of mental illness is diverting research money from a multibillion-dollar economic problem, Ottawa’s leading mental health experts say.

Mental illness affects one in five Canadians and is the leading cause of workplace disability. According to a Senate report, the Canadian economy takes an $8.1-billion hit from productivity lost to mental illness, and the cost balloons to $33 billion if substance abuse is included.

The World Health Organization did an assessment showing the global burden of mental illness was second only cardiovascular illnesses, said Dr. Zul Merali, head of the Institute of Mental Health Research at the University of Ottawa. Mental illness is the No. 1 reason for workplace disability.

Lacking the “sex appeal” of heart-disease and cancer, mental illness research funding is languishing and accounts for less than five per cent of health research in Canada, Royal Ottawa Mental Health Centre data show.

To read the entire article, please click here.

Genes for Psychosis and Creativity

The abstract of a research report posted online on July 6th by the journal Psychological Science:

Genes for Psychosis and Creativity: A Promoter Polymorphism of the Neuregulin 1 Gene Is Related to Creativity in People With High Intellectual Achievement

By Szabolcs Kéri

Semmelweis University, Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest H1083, Balassa u. 6, Hungary

Abstract

Why are genetic polymorphisms related to severe mental disorders retained in the gene pool of a population? A possible answer is that these genetic variations may have a positive impact on psychological functions. Here, I show that a biologically relevant polymorphism of the promoter region of the neuregulin 1 gene (SNP8NRG243177/rs6994992) is associated with creativity in people with high intellectual and academic performance. Intriguingly, the highest creative achievements and creative-thinking scores were found in people who carried the T/T genotype, which was previously shown to be related to psychosis risk and altered prefrontal activation.

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

Also see:

Genetic link between mental illness, creativity: Study

Recovery from schizophrenia and the recovery model

The abstract of an article published in the July 2009 edition of Current Opinion in Psychiatry:

By Dr. Richard Warner [pictured]

University of Colorado, Boulder, Colorado, USA


Abstract

Purpose of review: The recovery model refers to subjective experiences of optimism, empowerment and interpersonal support, and to a focus on collaborative treatment approaches, finding productive roles for user/consumers, peer support and reducing stigma. The model is influencing service development around the world. This review will assess whether optimism about outcome from serious mental illness and other tenets of the recovery model are borne out by recent research.

Recent findings: Remission of symptoms has been precisely defined, but the definition of 'recovery' is a more diffuse concept that includes such factors as being productive and functioning independently. Recent research and a large, earlier body of data suggest that optimism about outcome from schizophrenia is justified. A substantial proportion of people with the illness will recover completely and many more will regain good social functioning. Outcome is better for people in the developing world. Mortality for people with schizophrenia is increasing but is lower in the developing world. Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process.

Summary: Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.

Keywords
employment, empowerment, outcome, recovery, schizophrenia

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

Photograph courtesy of Colorado Recovery.

Rethinking Mental Disorders

A series edited by Thomas R. Insel published in The Journal of Clinical Investigation:

Mental disorders such as schizophrenia, bipolar illness, depression, and autism are the number one source of medical disability for people 15–44 years of age in the U.S. and Canada. In the past, these disorders have been considered psychological conflicts or chemical imbalances, but, as highlighted in this Review series, recent research indicates they are brain disorders, developmental disorders, and complex genetic disorders.

All papers in the series are free to download by clicking here.

Also see:

Translating scientific opportunity into public health impact: a strategic plan for research on mental illness.