Schizophrenia News: January 2014

  • In contrast with a recent meta-analysis of studies on cognitive behavioral therapy for schizophrenia treatment: recovery-oriented cognitive therapy (CT-R) is seen as highly successful for treatment of individuals with chronic schizophrenia who have a hard time integrating in the community.

     

    CT-R treats negative symptoms: lack of motivation, anhedonia, and asocial behavior: that are considered the most disabling. 

     

    CT-R is based on research by Paul Grant, Ph.D., a research assistant at the Aaron T. Beck Psychopathology Research Center in the Perelman School of Medicine at the University of Pennsylvanis, and colleagues.

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    The research shows that early emerging neurocognitive deficits lead to disappointing outcomes, in turn leading to defeatist beliefs; the beliefs engender what appear as negative symptoms.  Addressing these beliefs allows patients to achieve self-defined goals.

     

    Specific long-term goals are established: to form friendships, get married, to have children, to work and do other things.  Defeatist views can take the form of "I'm incapable" or "I don't fit in" or "I'm defective."

     

    The key focus is integrating individuals with schizophrenia into the community via a continuity-of-care approach.  A lot of the participants have been in out and of hospitals their whole lives so getting them to articulate modest, realistic goals is helpful.  The therapists look to find their patients' "pockets of motivation" when achieving the goals seems impossible.

     

    Connecting the principles of recovery to the therapeutic approaches of cognitive therapy is one of the major accomplishments, according to Aaron  Beck, M.D., the father of cognitive therapy.

     

    (CBT Addresses Most-Debilitating Symptoms in Chronic Schizophrenia, retrieved on December 1, 2014 from http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1814151)

     

    Transposable elements (TEs) are genetic sequences that can jump from chromosome to chromosome, increasing their own frequency in the genome.  a study of out the RIKEN Brain Science Institute in Japan suggests these "jumping genes" may play a role in the development of schizophrenia.

     

    Though schizophrenia runs in families, identifying genes with a key role in the development of the illness has proven hard.

     

    Researchers have recently revealed that human neural precursor cells are particularly rich in a common TE called L1.  They found higher levels of L1 correlated with the occurrence of brain disorders, including Rett syndrome (a disorder relat4ed to autism) and Louis-Bar syndrome.

     

    Tadafumi Kato, Kazuya Iwamoto and their RIKEN colleagues examined the brain tissue of deceased schizophrenia patients and found a 1.1-fold increase in L1, as compared with healthy controls.  Major depression and other mental illnesses were also linked with elevated L1.

     

    The team hasn't established a causal relationship between TEs and schizophrenia.  The next step is to determine if possible what role, if any the jumping genes play.

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    (Schizophrenia's Jumping Genetics, retrieved on January 21, 2014 from http://www.the-scientist.com/?articles.view/articleNo/38789/title/Schizophrenia-s-Jumping-Genetics/)

     

    Individuals with severe psychotic disorders have a greater risk for smoking, heavy alcohol use, and other drug use than that documented in individuals with mild mental illness, according to a large study.

     

    Researchers assessed 9142 patients in the Genomic Psychiatry Cohort with a diagnosis of schizophrenia, bipolar disorder with psychotic features, or schizoaffective disorder.

     

    Relative to that for 10,195 mentally healthy controls, drug or heavy alcohol use was elevated nearly fourfold after accounting for age, gender and race.  The increased risk was present across all diagnoses. 

     

    The rates of heavy drinking (>four drinks/day) were 28% in schizophrenia patients versus 8% in controls.  Also, 74% versus 33% reported ever smoking, 43% versus 18% used marijuana more than 21 times per year, and 35% versus 12% had used recreational drugs more than 10 times.

     

    The highest risk was for daily smoking.  The researchers note "Most of the mortality seen in severe psychiatric illness is due to smoking-related disorders."

     

    (Substance use 'dramatically' high in severe psychosis, retrieved on January 21, 2014 from http://www.medwirenews.com/47/105246/Psychiatry/Substance_use...)

     

Published On: January 27, 2014