Category Archives: Schizophrenia

Brain Cells Recreated From Skin Cells to Study Schizophrenia Safely

A safe means of studying schizophrenia has been achieved, thanks to a science team combining the talents of The Salk Institute for Biological Studies and a range of other institutions.

They have found a method of recreating a patient’s brain cells in a Petri dish.

Goal

It is the pursuit of understanding what exactly underpins schizophrenia that they are chasing, and brings the researchers closer to understanding what it is that biologically underpins the ailment. It is believed that the new findings will have repercussions for the advancement of research beyond schizophrenia, and will go on to aid investigation into other mysterious illness such as bi-polar disorder and even autism.

Hopeful

They researches are hopeful that the pursuit of individualised treatment is now a step closer. The study itself has yet to be released, yet Gong Chen who is an associate professor at Penn State, an author of the study has detailed how they have done it.

Method

First the scientists took skin cell samples from patients suffering from schizophrenia, and through use of molecular biology techniques they managed to reprogram the cells back into a stem cell state.

The cells now no longer have a specific function i.e. they are (pluripotent stem cells iPSCs.)

According to Chen, “During development, such stem cells differentiate into many diverse, specialized cell types, such as a muscle cell, a brain cell, or a blood cell.”

Once these were generated they were cultured towards becoming neurons (brain cells.)From this point the cells were compared against the actual brain cells of healthy individuals. It was found that yes in fact, the generated neurons were distinct to the schizophrenic patient, as in they were unable to forge as many connections with each other.

Cell Communication

Another study author Kristen Brennand, then proceeded to test antipsychotic drug’s ability to get the cells communicating effectively. The drugs he selected were those which are most frequently prescribed.  He stated, “Now, for the very first time, we have a model system that allows us to study how antipsychotic drugs work in live, genetically identical neurons from patients with known clinical outcomes, and we can start correlating pharmacological effects with symptoms,”

Electrophysiology Techniques

Chen made his contribution to the study in his use of electrophysiology techniques which tested the function of the generated neurons. He feels that the new method is advancement towards individualised medicine, in that it is patient specific. He said, “What’s so exciting about this approach is that we can examine patient-derived neurons that are perhaps equivalent to a particular patient’s own neural cells. Obviously, we don’t want to remove someone’s brain cells to experiment on, so recreating the patient’s brain cells in a Petri dish is the next best thing.”

He feels that through the use of this method it can be figured out exactly how any drug will affect that particular patient’s brain cells. This removes the need for the patient to first take the drug, leading to a lessening in side effects experienced. He said that the patient can now be their own guinea pig effectively without direct experimentation on their person.

Rabies

It is felt now that from growing these schizophrenic brain cells in a dish it can be determined just how much the persons environment affects the condition that is believed to affect as much as one percent of the population.  It allows for the environment to be removed from the equation and a focus put onto the underlying biology. One of the more interesting parts of the study was when one of the researchers used a modified form of the rabies virus to highlight the neuron connections.

Study suggests “L-lysine may be of benefit to patients in alleviating some of the negative and cognitive effects of schizophrenia.”

A small study just published has shown that sufferers from schizophrenia who are in receipt of the all natural L-lysine in conjunction with their medication did find a reduction in their symptoms.

The debilitation caused by the condition, reduces many of the functions of humans which others take for granted, these include cognitive problems and an inability to cope in certain social situations, poor concentration, and problems with memory. It is a disorder which is assumed to affect as many as 1 in every 200 persons.

Whilst the bulk of patients do manage to see some relief from their symptoms through antipsychotic drugs, they do on the main part still suffer from negative symptoms and cognitive problems.

Small Study

The small study that has been conducted took 10 patients with the debilitation and gave them either a small dosage of L-lysine or a placebo for 28 consecutive days. All of the subjects had been on a regular does of antipsychotics for at least three months. Each had not had a psychotic episode for at least two months prior to the beginning of the study.

Before they began a test was carried out on their blood lysine levels as well as tests on the severity of their ailment. Their functional ability was tested using the Wisconsin Card Sorting and Trail Making tests (Along with others) at the start, after four, and after eight weeks.

Response to L-lysine

It was found that eight of the subjects showed a response to the L-lysine treatment, this was demonstrated by an increase of lysine in their blood. It was found amongst these eight, that the treatment was beneficial in that there was a general trend amongst them through taking on the symptomatic and cognitive tests that there was an improvement.

Feeling Better

It was even noted in the study that three of the participants actually noticed a difference in themselves of a positive nature. It was found however that given the small scale of the research, there was a benefit found through use of the placebo also. Another problem being, that there was an increased knowledge of the tests themselves by the subjects over the eight weeks, meaning that scores would have been better anyway.

Starting Place

Dr Wass a lead author of the study said, “This study is a starting place for further research into the beneficial effects of L-lysine as part of the treatment of patients with schizophrenia. It was an extremely low dose, and a small sized trial, which limited the conclusions we could draw.”

Background

L-lysine is an amino acid known as ‘the inner salt,’ and a connective tissue protein that is seen as being very important for the body. Whilst it has long been used in the maintenance of a healthy body, useful for the skin etc, this is the first time that its benefits have been observed in this fashion.

Trustworthy Conclusion

The facts of the matter being that this study was so small, and did indeed demonstrate that there was little difference when reconciling the affects of the placebo, versus the effects of L-lysine. As a result it may be the case that it will be a long time before doctors actively prescribe L-lysine as a medication form for schizophrenia.

Reasoning

Whilst the researchers did not go so far as to explain why there was a relief from symptoms of schizophrenia from the use of L-lysine, it is possible that there is an explanation. Amino acids serve to reduce the level of nitric oxide in the brain, which is a determinant of enhanced memory and social function.

This information was acquired by Swedish scientists who noted after experimenting with rats that when they treated rats that showed symptoms of schizophrenia with drugs designed to reduce these levels, they regained normal brain function.

New Drug Approved for Schizophrenia Treatment in Teens

This month the FDA has made a decision relating to the use of new drug INVEGA tablets for adolescent users. Now those between 12-17 years-of-age can use the medication if they are suffering from schizophrenia.

It took a six week trial’s success however, before the new decision was effected, the trial conducted into the efficacy of INVEGA to deal with schizophrenia in adolescents.

These tablets are what are called an atypical antipsychotic, with this drug first being accepted as an adult medication in 2006.

Not Yet Known

Schizophrenia leads to false beliefs and delusions, unusual behaviours, and disorganised thinking, it often starts to show itself in adolescence. Whilst 1% of adults have the condition, the number of teens and adolescents with the condition is not yet known.

Very Serious

Husseini Manji, M.D., F.R.C.P.C., who works for Johnson and Johnson the drug manufacturer, said, “Although rare, schizophrenia in adolescents is a very serious and disabling brain condition that affects every aspect of an adolescent’s life and has significant consequences,”

Unfortunately schizophrenia is a lifelong disease, but early detection and treatment can deal with it, successfully treating it over time. Often when it presents itself in adolescents it is dealt with by a range of means. There is individualised therapy given, other methods and specialised programs developed for the patient.

It was a double blind trial that led to the FDA decision. It was conducted in many different countries with similar results regarding effectiveness, although there were still a number of side effects of use as demonstrated by the double blind trial.

Risk Factors

Five main risk factors have been determined by scientists which serve as predictors as to whether the teen is likely to suffer from schizophrenia either in these formative years or later in their lives.

There are of course levels of schizophrenia which will never develop into full blown versions of the condition, but the risk factors that have been uncovered mainly pertain to the schizophrenia becoming full blown.

1.       The key factors are where there is a genetic likelihood. This will be determined by a family history of the ailment. In this case the genetic likelihood stands to be examined in particular if there is a general decline in the mental condition of the youth.

2.       If there is a higher level of unusual thought than could possibly by ascertained to be normal. These thoughts are particularly relevant to the ailment if the thoughts themselves do not make sense.

3.       If there is what can be regarded as an increase in general suspicion otherwise known as a deep sense of paranoia (a belief that people out to get the youth etc.)

4.       If the youth is demonstrating an inability to deal with the social environment. A change can be noted in the child, if they are increasingly avoiding friends or anything social.

5.       Also a major risk at play on the development of full blown schizophrenia is if the youth is taking any substances, whether those substances are alcohol or controlled substances. If the abuse is current, or if the abuse was in the youth’s past, then there is a direct risk of development of the ailment.

Successful Predictors

It was noted that any of these risks will indeed manifest a much greater likelihood that the condition will develop. It was also noted that of the individuals that took part in the study, eight out of each ten were likely to develop the condition in later life if they were showing at least two of these symptomatic risk factors.

Breakthrough

These risk factors are seen as something of a breakthrough, in that it can now be more readily identified if a person is at risk. The scientists involved say that it is as easily gauged, once these parameters are put in place, as say it is to predict if a person is likely to contract a heart ailment.

Normal Life

So too as a result of the arrival of this knowledge, there is hope that more cases of schizophrenia can be prevented. It has been found through observance of treated persons that the earlier the condition is caught and treated then the less severe the ailment will be, and the more capable the person will be of living a normal life.

291 teenagers were taken as subjects in the study, all of which were considered to be at a heightened risk based on a diagnosis. The study took place over an elongated period (Two and a half years) to observe if the condition manifested. Before commencing all of the youths had been diagnosed with prodromal syndrome for schizophrenia. By this diagnosis it is observed that they already were presenting some of the symptoms i.e. paranoia or unusual thoughts.

Veterans Representing Mental Health Issues Have High Substance Abuse Levels

Veterans of wars who are suffering from mental health issues such as schizophrenia are far more likely than other sufferers to have a substance addiction, according to a new study.

The study was led by Ismene Petrakis MD. She and her researchers at Yale University of Medicine have sifted through data provided by the Department of Veterans Affairs to determine their findings.

The information relates to veterans of the Iraq and Afghanistan wars, who were observed and diagnosed with Post Traumatic Stress Disorder and other disorders psychiatric in origin.

One Million

A massive 1,001,996 of the veteran patients who had data pertaining to their state, had already been diagnosed with either one or more of six different mental disorders.

Of this million persons more than a quarter of a million individuals had a substance abuse issue. Those with either bipolar disorder or schizophrenia were found to have the highest prevalence of substance abuse.

Program Planning

Ismene believes that her findings may be beneficial in defining program planning, and for bettering the understanding of the needs of these veterans.

Different Eras

She spoke also of the different eras these soldiers fought in and believes that there are different needs based on these different eras also. She points to the recent conflicts, where it seems conclusive from the data that their mental disorders are in need of services that would address a co-morbid substance use disorder.

New Work could Facilitate Identification of Disruptions

There is optimism amongst researchers that Bilingual Neurons could now reveal the secrets of brain disease. University of Montreal and McGill Universities have made a new discovery. It is that of ‘cellular bilingualism.’ This is the allowing of just a single neuron to use more than one method (normally two hence the ‘bi’) of communication in the exchange of information.

“Our work could facilitate the identification of mechanisms that disrupt the function of dopaminergic, serotonergic and cholinergic neurons in diseases such as schizophrenia, Parkinson’s and depression,” was stated in writing recently by Dr. Louis-Eric Trudeau of the University of Montreal’s Department of Pharmacology and Dr. Salah El Mestikawy, who is pertaining to a researcher role at the Douglas Mental Health University Institute. She is also a professor at McGill’s Department of Psychiatry.

With much of the details of their research now published in the Nature Reviews Neuroscience Journal, there is definite cause for the optimism they are showing. The results of their research and papers show how a large deal of the neurons of the brain find it possible to control function in the activity of the cerebral through using two chemical messengers.

This simultaneous process is synonymous with neurotransmitters. The name they have attributed to this messaging system is ‘contransmission.’ Detailed in the results of Dr. Trudeau is how; ‘The neurons in the nervous system both in the brain and in the peripheral nervous system are typically classified by the main transmitter they use.” The doctor detailed how different neurons use different chemicals to aid the ‘contransmission’ process with for example; dopaminergic neurons using dopamine as a transmitter. This means of communication is used in many areas such as in learning and motivation.

Where the research sees benefit towards the identifications that will assist in uncovering the reasons behind brain disease is, where there is a breakdown in the process or a ‘malfunction.’ They have found that this breakdown is evident in mental illnesses such as Parkinson’s disease or in Schizophrenia. The researchers have found that the information is being relayed in two ways, but in the diseased brain the information is transmitting not on a simultaneous basis. Depending on the chemical being used by the neuron the time scale under which the information is delivered is different.

If for example glutamate is being used for the transmission of the message along with dopamine then the glutamate message will take longer to get the message to where it is needed.

The same process was found in the brain by the research team when neurons use serotonin (Of particular importance to depression sufferers) and acetylcholine. These chemicals are used in the transmission of information pertaining to controlling aggression, food intake, mood and impulsive actions. They have uncovered that there is an imbalance here when Parkinson’s disease is present along with the addiction to drugs.

“We know very little about the role of ‘contransmission’ in disease, and the regulation of behaviour, however,” it was warned b y Dr. Trudeau. The doctor vowed; “That will have to be the subject of future studies.”

Scientists discover genes involved in Schizophrenia affect brain signalling

In a new study which appears in the Proceedings of the National Academy of Scientists, Scientists from the Center for Applied Genomics at The Children’s Hospital of Philadelphia have identified a number of gene sequences, including some that are involved in brain signalling, that increase the risk of developing schizophrenia.

“When we compared the genomes of patients with schizophrenia to those of healthy subjects, we found variations in genes that regulate brain functions, several of which are already known to be perturbed in patients with this disorder,” said study leader Hakon Hakonarson, M.D., Ph.D., who is also the Director of the Center.

“Although much research remains to be done, detecting genes on specific pathways is a first step to identifying more specific targets for improved drug treatments” said Dr Hakonarson.

Hakonarson and his colleagues analysed the DNA of over 1,735 adults who had been diagnosed with Schizophrenia and compared their DNA to the DNA from 3,458 adults without Schizophrenia. They not only found copy number variations in genes involved in brain function and brain development, they also found some that overlapped with other disorders including Autism and ADHD.

“Although different brain regions may be affected in these different neuropsychiatric disorders, these overlaps suggest that there may be common features in their underlying pathogenesis,” said Hakonarson.

“These genes affect synaptic function, so deletions or duplications in those genes may alter how brain circuits are formed.”

Schizophrenia is a serious psychiatric disorder that affects roughly one to one and half percent of the population. The symptoms can include hallucinations, delusions, disorganised speech, and abnormal thought processes and behaviours, as well as other symptoms.

As Schizophrenia has a tendency to run in families, scientists already know there is a genetic link but that doesn’t mean that if you do have someone in your family that has Schizophrenia that you will too, neither does it mean that if you don’t, you won’t, so there are other factors involved too.

At the moment people with Schizophrenia are usually prescribed anti-psychotic medication, some of which can carry unpleasant side effects. The researchers believe that future studies into copy number variations in the genetic code will enable greater understanding of what is happening in the brain of a person with Schizophrenia and may allow researchers to develop better drugs that are more effective and with fewer side effects.

DSM IV Schizophrenia Diagnosis

Schizophrenia is a serious mental disorder characterised by hallucinations and delusions that affects roughly one percent of individuals around the world. If you have a close family member with Schizophrenia then the risk rises to around ten percent but if that family member is an identical twin then the other twin has a fifty percent chance of developing Schizophrenia.

No one knows what causes Schizophrenia but we now know that genetics certainly do play a part as it does tend to run in families. Other causes that have been implicated include maternal stress in the very early stages of pregnancy, biological, environmental and social factors. Scientists now believe that Schizophrenia may be a whole range of different disorders as opposed to just one which would explain why there are so many variations and potential triggers.

There are no diagnostic tests that will identify Schizophrenia so a diagnosis is made according to the symptoms that are present.

The DSM-1V criteria for Schizophrenia

Two or more of the following symptoms have to have been present for more than one month coinciding with reduced social or personal or occupational functioning that has been present for six months. These symptoms must not be a result of drug abuse or any other medical condition or medication and Schizoaffective and Mood Disorder have been ruled out.

•    Hallucinations (the most common type of hallucinations in Schizophrenia are auditory hallucinations where the individual may hear voices but hallucinations can affect any of the senses for example sight, hearing, taste, touch and smell)
•    Delusions (holding bizarre ideas and beliefs which are evidently false)
•    Disorganised Speech (speech may be rambling and incoherent)
•    Disorganised or Catatonic Behaviour
•    Negative Symptoms (a flattening of the emotions, apathy, social withdrawal etc.)

If another disorder is present, an additional diagnosis of Schizophrenia may be made if delusions or hallucinations are also present and have been for at least one month.

Symptoms and Sub Categories of Schizophrenia

The symptoms of Schizophrenia are classified into positive and negative symptoms. The positive symptoms can be described as behaviour that is in addition to what you would normally expect such as hallucinations and delusions. Negative symptoms can be described as behaviour that is missing from what you would normally expect such as lack of emotion, lack of facial expressions, and an inability to function effectively.

There are five different sub categories of Schizophrenia and the type of Schizophrenia diagnosed will depend on which type most suits the symptoms. For example:

•    Paranoid Schizophrenia – feelings of persecution or that someone or something is out to get you
•    Disorganized Schizophrenia – speech and behaviour that is disorganized and chaotic, there may be inappropriate social responses
•    Catatonic Schizophrenia – disturbances affecting movement, echolalia and echopraxia may be present
•    Undifferentiated Schizophrenia – where the symptoms don’t clearly fit in with any other category
•    Residual Schizophrenia – currently no positive symptoms but a past history of Schizophrenia. This is the long term state of Schizophrenia.

What is the prognosis?

Although Schizophrenia is a distressing disorder, most people can and do lead very fulfilling lives. Around a quarter of people with Schizophrenia will go on to make a full recovery, about half will have periods of remission but will still need support and the remaining quarter will require long term treatment and support.

Is Schizophrenia like Bipolar Disorder?

Both Schizophrenia and Bipolar are mental disorders and although there can be similarities between them they are two separate conditions.

It is disturbing that despite awareness campaigns about mental health issues, surveys have shown that many members of the general public are still unaware of the differences between Schizophrenia and Bipolar and often mistakenly believe they are the same thing. They are not.

What is Bipolar Disorder?

Bipolar disorder or manic depression as it is often called is a mental disorder characterised by extreme highs (episodes of mania) and extreme lows (episodes of depression). These mood swings are the defining feature of Bipolar.

When an individual is experiencing a manic episode they usually have bundles of energy, will often need very little sleep, they may speak faster and appear to think faster than other people and they could have unrealistic ideas about what they can achieve.

Once the manic episode is over the person with bipolar will tend to sink into a depressed state where they experience low moods, apathy and disinterest, they may sleep a lot, talk little and withdraw socially.

However, no two individuals will experience Bipolar in the same way and the symptoms and severity of the symptoms will vary significantly from person to person.
Fortunately, most people with Bipolar can function normally with appropriate medication and support.

What is Schizophrenia?

Schizophrenia is characterised by positive symptoms which include hallucinations and delusions as well as negative symptoms such as flattening of the emotions and speech. The type of symptoms and the way they are manifested will be different for each person. Consequently there are 5 sub categories of Schizophrenia.

Paranoid Schizophrenia – feelings of persecution
Disorganised Schizophrenia – disorders of speech and behaviour
Catatonic Schizophrenia – disorders of movement
Undifferentiated Schizophrenia – doesn’t clearly fit with any other sub type
Residual Schizophrenia – no more positive symptoms. This is the long term state of schizophrenia

So what can you expect with regard to symptoms? Hallucinations can be defined as seeing, hearing, tasting, feeling, and smelling something that isn’t really there. As far as Schizophrenia is concerned, the most common type of hallucinations are auditory hallucinations. The individual might hear voices which can take the form of a single voice talking to them, often in a critical manner, or they may hear a running commentary or even conversations between two or more voices.

Delusions can be described as having a belief in something that isn’t real and sticking to that belief despite being shown evidence to the contrary. For example, the individual may have delusions of grandeur such as believing believe they are famous, are a secret spy, that they can fly, that they have special magical powers and so on. Or, they may have delusions of persecution where they think that family members, neighbours, aliens or the government are plotting against them, spying on them or following them.

Treatment for schizophrenia consists of anti-psychotic medication and some form of psychotherapy.  Anti-psychotic medication is generally very successful at treating psychosis but treating the so called negative symptoms can prove more challenging.

Fortunately around fifty percent of people diagnosed with schizophrenia will be able to function most of the time and will experience periods of remission. A quarter of people diagnosed will actually go on to make a full recovery; however, the remaining quarter will require long term help and treatment.

Interestingly, there is a growing amount of evidence that supplementing with Fish Oil that has a very high content of the Omega 3 fatty acid EPA helps to alleviate the symptoms of both Bipolar disorder and Schizophrenia.

Schizophrenia Suicide Risk

Studies have shown that people suffering from Schizophrenia have a higher risk of suicide or attempted suicide than other members of the general public. Depression is a common feature in Schizophrenia and yet it often goes undetected and undiagnosed, mainly because the so called negative symptoms of Schizophrenia can mask an underlying depression. Depression also increases the risk of suicide.

Although figures vary slightly from study to study the overall results indicate that between five and thirteen percent of individuals diagnosed with Schizophrenia will commit suicide. There is no doubt that suicide is a major cause of death in individuals with Schizophrenia.

Most researchers agree that the profile of the Schizophrenic patient most likely to commit suicide is a young, white, single, male who functioned well prior to the onset of the illness and who suffered depression after a psychotic episode and who has a history of substance abuse. However, this doesn’t mean that a person fitting this description is going to commit suicide. Although anyone can commit suicide there are other risk factors to be aware of.

Risk factors for suicide in Schizophrenia

•    Depression
•    Feelings of hopelessness
•    Previous suicide attempts
•    Social isolation
•    Living alone
•    Stress in the family
•    Relationship problems
•    Recent loss or rejection
•    Substance abuse
•    Homelessness
•    Lack of support
•    Hospitalisation
•    Not sticking to treatment plan
•    Fear of mental disintegration

Some researchers have found that individuals who functioned well prior to the onset of Schizophrenia symptoms and who are fully aware of the implications of their disorder and the impact that it is likely to have on their future lives are more at risk.

However, other researchers claim that a full understanding of the nature of Schizophrenia can actually help the individual to cope and does not increase the risk of suicide.

According to the Royal College of Psychiatrists a literature review revealed that the suicide risk in individuals with Schizophrenia was related more to the affective symptoms of Schizophrenia such as depression and feelings of hopelessness and a previous history of suicide attempts or threats of suicide rather than the positive symptoms of hallucinations and delusions.

To reduce the risk of suicide in people with Schizophrenia it’s important to be aware of the risk factors and to seek help as soon as possible if there are any indications or signs that the individual might be having suicidal thoughts.

How Adolescent Schizophrenia Develops

Schizophrenia affects males and females equally; however, it tends to develop earlier in males, usually between the ages of 15 and 25. Schizophrenia can be devastating, especially when it develops at such a young age and it can put a tremendous amount of pressure on family members.  It is important to know what to look for and to seek help as soon as possible if your child is showing signs of Schizophrenia.

Changes in your child’s behaviour may happen slowly over a long period of time so that there is a growing awareness of something wrong, or, symptoms can develop suddenly over a few days or weeks.

The first signs could be a gradual withdrawal from social activities and friends, becoming more shy and talking less, spending a great deal of time alone, appearing fearful or anxious or moody. On the other hand the first signs may involve the youngster expressing bizarre ideas and behaviours.

There is such a wide variation in symptoms and no clear pattern however there are some early warning signs that you can look out for and these include the following:

  • Social withdrawal and a reluctance to take part in social activities, difficulty making friends or unwilling to make friends, social isolation, spending a lot of time alone
  • Bizarre behaviour and thoughts
  • Strange ideas or beliefs that are not based on reality (delusions)
  • Hearing voices or seeing things that are not really there (hallucinations)
  • Lack of emotion and emotional expression
  • Inappropriate social responses such as laughing when hearing bad news
  • Becoming increasingly agitated and anxious
  • Staring into space or sitting in the same position for long periods of time
  • Cannot function effectively at school and difficulty carrying out homework or other tasks
  • Paranoia and feelings of persecution or that someone or something is out to do them harm, suspicious of other people and their intentions
  • Distorted perception of reality
  • Difficulty organising thoughts, confused thinking
  • Aggressive outbursts

The problem with diagnosis is that these symptoms are also present in other conditions and can also occur as a result of substance abuse. It’s absolutely vital to seek help as early as possible for two main reasons.

The first is to obtain an accurate diagnosis so that the right treatment and help can be given, particularly as there is a high suicide risk in people with Schizophrenia. The second is that research has shown that the longer treatment is delayed when the symptoms of Schizophrenia first develop, the poorer the outlook. If you are worried, speak to your doctor.