Schizophrenia and Psychosis

ServiceNet, a mental health and human service agency in western Massachusetts, received a three year, two million dollar grant to launch a program designed to support young adults who have recently experienced their first episode of psychosis. The Prevention and Recovery Early Psychosis (PREP) program is funded by the Massachusetts department of mental health and is designed to treat psychosis as a symptom, not an illness, resulting from other illnesses, substance abuse, trauma, or extreme stress.

Researchers recently completed a first of its kind, large-scale international survey of attitudes about mental health and they were surprised by the results. According to their analysis published in this month’s issue of the Journal of Affective Disorders, people in developed countries, like the United States, are more likely to assume that ‘mental illnesses’ are similar to physical illnesses and biological or genetic in origin, but they are also much less likely to think that individuals can overcome these challenges and recover

In the third major verdict of its kind, drug giant Johnson & Johnson was ordered to pay a Maryland man who grew female breasts while taking the antipsychotic Risperdal. The company failed to warn doctors, patients, and regulators of the risk of abnormal breast development in young males and now faces about 5,400 lawsuits involving the drug.

The Washington Examiner reports that the manufacturer of the antipsychotic Abilify is seeking FDA approval for new digitized pills that would alert doctors if patients fail to take their drugs on schedule.

The German news agency DW features a video report on whether cannabidiol, an active substance derived from marijuana, can help relieve the symptoms of schizophrenia.

I was a psychiatrist who participated in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). Although I welcomed the positive headlines that heralded the study's results, the reports left me with mixed feelings. What happened to render the notion that talking to people about their experiences and helping them find jobs or go back to school is something novel?

Robert Neugeboren, who “spent most of his adult life in institutions, often subject to isolation, physical punishment and numbing medication,” was “a celebrity of sorts in the world of the mentally ill: a survivor of the horrors of mistreatment, a case history for those who point to the positive effects of kindness and talk therapy, and, perhaps most of all, the embodiment of the bottomless mystery of the human mind.”

In a Science Update, the National Institute of Mental Health (NIMH) reports that Medicaid services is already taking steps to implement “coordinated specialty care” (CSC) in response to the RAISE study released last week. “The RAISE initiative has shown that coordinated specialty care for first episode psychosis is better than the standard care offered in community clinics. However, covering the cost of coordinated specialty care can be challenging. When Medicaid agrees to pay for effective treatment programs, patients in need benefit.”

I believe that my surges from the unconscious (what some might call “psychotic episodes”) contain an inner wisdom and force that has a tremendous capacity to encourage the healing of intergenerational trauma. This essay explores an energy that is especially potent and accessible during these periods of unconscious spelunking.

Dr. Mickey Nardo adds to the ongoing discussion about the RAISE study results. He writes: “If there is ‘spin’ in the reporting of this study, we need to know about it. I personally think that it’s more important for RAISE to be reported completely and honestly than whether it comes out like they [or I] want it to come out. We don’t need some sanitized version of RAISE to tell us we need to turn our attention to a full bodied approach to the treatment of First Episode psychotic patients. We all already know that. What we do need is to have our confidence restored in our research community – that they will honestly and clearly report their findings whether they are clean as a whistle or an unholy mess.”

Neuroskeptic weighs in on the controversy over the lack of antipsychotic dose data in the RAISE study and the misleading media coverage. He points out that one of the treatment interventions was a computerized medication management system called COMPASS, which recommends doctors use lower doses than they otherwise might.

Last Tuesday, The New York Times and several other outlets (including Mad In America) reported on the highly-touted results of a study on psychosocial treatment for patients diagnosed with schizophrenia. Now, claims made about the study, which the ‘Times called “the most rigorous trial to date,” are coming under increased scrutiny.

Writing on his 1 Boring Old Man blog, Dr. Mickey Nardo reflects on the media frenzy around the RAISE study and asks why the prescription data has not been released. He adds skepticism about the political motives of the potentially overblown results, which he sees as a clear push for increased mental health funding.

A California jury ruled that Johnson & Johnson’s Janssen Pharmaceutical and a psychiatrist were responsible for the death of 25-year-old Leo Liu. During a clinical trial for Risperdal, Liu died of a heart injury that was “further complicated” by the drug and ignored by the study doctors. Janssen was found 70% responsible for Liu’s death and ordered to pay $5.6 million to the family.

Yesterday, the New York Times reported that schizophrenia patients in an experimental treatment program (RAISE) who experienced better outcomes had been on lower doses of antipsychotics than normal. However, the article published in the American Journal of Psychiatry on Tuesday did not divulge any data on the varying antipsychotic drug doses in the different study groups.

Results of a large government-funded study call into question current drug heavy approaches to treating people diagnosed with schizophrenia. The study, which the New York Times called “by far the most rigorous trial to date conducted in the United States,” found that patients who received smaller doses of antipsychotic drugs with individual talk therapy, family training, and support for employment and education had a greater reduction in symptoms as well as increases in quality of life, and participation in work and school than those receiving the current standard of care.

Johnson & Johnson is exposed to personal injury and product liability lawsuits over the failure to warn about Risperdal gynecomastia side effects in boys.

Writing for CounterPunch, Paris Williams writes that when an individual is experiencing what has been termed “psychosis,” it is important to recognize that this may also be the manifestation of a breakdown in their larger social groups, the family, society, and even the species.

Journalist Emma Reynolds profiles Amanda Waegeli, Ron Coleman, Nathan Grixli and Lyn Mahboub about their experiences coming to the Hearing Voices Network (HVN). HVN was established 10 years ago in Australia and provided a support group that encouraged people to listen to their voices rather than trying to block them out. The group now operates in 25 countries.

The University of Minnesota recently announced that it is ending the controversial practice of recruiting study participants from patients involuntarily being held in their psychiatric unit. In a commentary for Minnesota’s Star Tribune, bioethicist and MIA contributor Carl Elliot reports that the university has still not apologized to the patient who spoke out against this practice. Instead, “the university has done its best to discredit him.”

Individuals diagnosed with psychotic disorders have an earlier onset of psychosis if they have previously been exposed to prescription stimulants, according to new research currently in press in the Journal of Psychiatric Research.

The University of Minnesota announced a change to its research ethics policies this month after coming under criticism “following the recruitment of a schizophrenia...

New research published in the July issue of The Journal of Clinical Psychiatry found that the use of mood stabilizers, antipsychotics, antidepressants, and hypnotics during pregnancy is associated with increased health risks to the infant.

New data on the effects of social support after early onset of psychosis suggests that patients with intense social support function better than those without such help, but than once supports are removed the effects diminish.

Antipsychotics are currently the predominant treatment for individuals diagnosed with schizophrenia, but there is an accumulating body of research that links the use of these drugs to structural abnormalities in the brain. A recent meta-analysis suggests that gray matter loss in the brain may depend on the dose and class of the antipsychotic.