In earlier posts ("Too Much Pop Psytchology and "Alzheimer's and Schizophrenia"), I talked about the medical and scientific evidence that exists demonstrating that schizophrenia (and other serious mental illnesses) are diseases of the brain. While these are diseases, many people commonly refer to them as mental health issues or mental health problems.
Issues and problems are terms that, frankly, I fail to understand. After all, we do not call insulin-dependent diabetes a pancreatic issue or a pancreatic problem. Even type II diabetes which has a considerable life style cause, is not referred to as a problem or an issue. Why, then, do we not recognize schizophrenia and other serious mental illnesses as diseases?
Part of the answer can be found in an excellent article in Forbes Magazine on the ever present debate over vaccines entitled "Anti-Vaccine Activists Apparently Immune to Science." After reviewing the numerous studies that debunk the myth that vaccines cause autism, the author, Sally Pipe, concludes "children continue to be at risk because of an urban legend seemingly immune to modern science. The public health is far too valuable to be threatened by such myths."
But, what of schizophrenia? There are many who believe the urban legend that there are no neurological contributions to any mental illness, no genetic marker, no proof of chemical imbalance, no evidence of biological causation. Science tells us the opposite. Rarely a week goes by when there isn't some new announcement about another discovery in the attempt to uncover the mystery that is serious mental illness.
A recent study cited in Psychiatric Times found a relationship between schizophrenia and temporal lobe epilepsy. I doubt if anyone today considers epilepsy to be anything but a disease of the brain. People with schizophrenia have an increased activity of the enzyme phospholipase A2 (PLA2). This increased enzyme activity was also found in both patients with temporal lobe epilepsy with psychosis and those with bipolar disorder with psychosis. The researchers suggested that "increased PLA2 activity is not specific for schizophrenia, but may be more broadly related to the onset of psychiatric symptoms in general."
In another current study reported in Psychiatric Times, researchers at the University of Texas Health Science Center in San Antonio stated that "schizophrenia probably is not caused by mutations in just a few specific genes but rather is caused by the disruption of any number of genes involved in key developmental signalling pathways, such as the immune system pathway."
The implications of their research suggest that by performing a comprehensive analysis of inflammatory molecules involved in schizophrenia and bipolar disorder, it may become possible to identify specific disease signatures, which will provide valuable clues to understanding the progression to a particular disease.
How schizophrenia works at the cellular level is being studied at , among other centres, the University of Pennsylvania. What they found was that "differences in the interactions between various types of nerve cells lead to schizophrenia. Â Specifically, they have found a link between genetic risk factors for the disease and how the brain responds to sound."
A Scientific American article reviewed the recent findings of the North American Prodromal Longitudinal Study involving eight universities and the brain scans of 400 adolescents. Two-thirds of the subjects were high risk for developing schizophrenia. Those at high risk lost grey matter in their prefrontal and temporal cortex. As their symptoms increased, their grey matter loss increased. Brain cells in adolescence are trimmed but in those developing schizophrenia, more cells are trimmed than normal. There is also an increased lack of white matter in the brains of those who were diagnosed with schizophrenia. This lack of white matter cripples the brain circuitry.
Meanwhile, an international team of scientists is developing a blood test to diagnose schizophrenia. So far, they have found 51 biomarkers linked to schizophrenia. The team's examination of postmortem brain tissue of patients with schizophrenia found evidence of abnormal glucose utilization suggesting that Schizophrenia might be considered "diabetes of the brain."
They then looked at the cerebrospinal fluid of newly diagnosed patients with schizophrenia. These patients had not yet been treated with drugs (drug naive) and they found glucose regulation disruptions. Drug treatment with anti-psychotic medication led to normalization of the glucose in half the patients before results were seen in their overt psychotic symptoms.
And these are only some of the studies reported in just the past few months.
Ignoring the science of vaccinations is leading to a resurgence of infectious diseases that had previously been eradicated. Ignoring the science of mental illness does nothing but put extra stress on those with these illnesses and their families who helplessly watch the suffering of their loved ones. Its time to put science back into mental illness and to stop pretending these illnesses are choice, poor parenting or stress.
Follow Marvin Ross on Twitter: www.twitter.com/dysdads
Professor Richard Gray: World Mental Health Day - A Revolution, Simple
Judith S. Beck, Ph.D.: Hope for Patients With Severe Schizophrenia
Robert David Jaffee: Psychotics Don't Premeditate Crimes
Marvin Ross: Mental Health Commission Dabbles in Dysfunction
Studying Successful People With Mental Illness
We should embrace science; the problem in this area is Big Pharma.
Because research in neuroscience continues to advance, you may need to publish a second edition to your excellent book, "Schizophrenia: Medicine's Mystery -- Society's Shame."
Mary Bartram, Director, Mental Health Strategy, Mental Health Commission of Canada
"We recognize that the current draft does not sufficiently reflect the essential role neuroscience, treatment and psychiatry have to play, and we will make sure this is corrected in the final document."
However, exactly how these oversights will be addressed remains unclear.
Will the revised strategy:
>finally endorse the need for all programs training mental health clinicians to require science based education about psychotic disorders?
>support a public education program about psychotic disorders that integrates the current state of science based knowledge about these brain disorders?
>include support for early psychosis intervention programs not just vaguer references to some kind of early intervention?
>acknowledge the vast science based research that demonstrates that a major problem for almost half of the people with psychotic disorders is anosognosia, an inability to understand that they are ill?
>assure Canadians that the MHCC will not support any legal changes that will result in even more psychotic people left to deteriorate in an untreated psychosis?
It’s hard to feel reassured by Ms. Bartram’s statement that “nearly three dozen’’ medical professionals serve on their committees; where were these people when the earlier draft, now discredited by the MHCC itself, was created?
Susan Inman
I pointed out that keeping the draft mental health strategy secret was not conducive to open discussion and that the commission should put it on their website. Unless I missed it, it is still not there.
I was also critical of the commission in my post called Too Much Pop Psychology Not Enough Science in Serious Mental Illness where I pointed out that one member of a commission committee, Prof Neree Saint Amand, has stated that "untreated schizophrenia can be a gift, and that in other cultures, hearing voices is revered as a bridge to the spirit world."
The commission has the resources to significantly increase the understanding that Canadians have of the serious mental illnesses and to lobby for improvements in care. By doing so, they would help to ensure proper care for these ill and vulnerable members of our society many of whom wind up homeless and/or in prison.
The mind boggles that it has taken so long to make a dint in the psychological/sociological/religious/philosophical assumptions and the myths of mental illnesses that abound, when there is no scientific evidence to back them up.
Surely those with the power to change things must face the truth and insist on a mental illness system which takes scientific research into account. Governnments should not wait for a public concensus on the true nature of these diseases, but,in conscience, they must move forward (ahead of the crowd) and integrate scientific research into the mental illness system of care, immediately. And just as we have done with other chronic diseases, we must assiduously do the scientific research to find improved medical treatment and eventually a cure.
It's time for the care for seriously mentally ill citizens to become science-based. The current hodge podge of treatments must be swept aside and replaced by science.
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