Another gene linked to increased risk of mental illness

A team of researchers from Shanghai Jiao Tong University have been looking into the links between genetics and schizophrenia. They studied 12,229 people in Shanghai: 5,772 had no mental-health problems, 4,187 had schizophrenia, 1,135 had bipolar disorder and 1,135 had depression. The study found that variations in the BCL9 gene led to a greater risk of schizophrenia and were also associated with bipolar disorder and depression.

Li, Junyan ... [et al] - Common variants in the BCL9 gene conferring risk of schizophrenia Archives of General Psychiatry 2011; 68(3): 232-241

Schizophrenia and shrinking brains

Schizophrenia is associated with a decrease in the volume of people's brains. Researchers from the University of Iowa in Iowa City looked further into this topic in a study of 211 schizophrenia patients who underwent regular brain scans over a period of just over seven years. The study examined four factors: how long people had been ill; how severe their illness was; whether they used illegal drugs and whether they had been treated with antipsychotic drugs. Being ill for longer and being treated with antipsychotic drugs were both linked to loss of brain tissue. Higher doses of antipsychotics were linked to overall brain tissue loss, reduced grey matter and progressive declines in white matter. However, illness severity and substance abuse had little or no association with brain tissue changes.

Schizophrenia and shrinking brains

Brain scans could be used to help people at risk of developing schizophrenia so that they can be offered help before they become unwell. Schizophrenia is known to run in families and researchers from Edinburgh University compared 146 people with a family history of the illness, but who had suffered no symptoms themselves, with 36 healthy controls. All the participants were between 16 and 25 at the start of the study and were not taking anti-psychotic medication; they had brain scans every 18 months over a 10-year period. The study found that the participants who later went on to develop schizophrenia suffered from an acceleration of brain shrinkage before they became unwell. It is known that accelerated brain shrinkage occurs in people with bipolar disorder, or manic-depression, and schizophrenia, but until now it was not known whether these changes occurred before people became ill, as a result of their illness or as a side effect of their medication. The loss of brain tissue occurred in areas of the brain associated with personality, decision making and social behaviour.

Schizophrenia and impulsivity

Being over-impulsive is one of the hallmarks of schizophrenia and can lead to violence, drug abuse and suicide. However, it is not really known what happens in the brains of people suffering from schizophrenia that makes them more impulsive. Researchers from the Universite de la Mediterranee in Marseilles studied this issue by comparing 26 people with schizophrenia with 30 healthy controls. The participants filled out a questionnaire about their impulsiveness, took a 'Go/No go' test - in which not reacting to things is as important as reacting to them - and had MRI brain scans. The patients with schizophrenia were more impulsive than the controls and a region of their brains called the right ventrolateral prefrontal cortex was less efficient at processing 'inhibitory control.'

Kaladjian, A. ... [et al] - Impulsivity and neural correlates of response inhibition in schizophrenia Psychological Medicine (2011), 41, 291–299

Schizophrenia and caeliac disease

People with schizophrenia are more likely to suffer from caeliac disease than the rest of the population. Scientists don't know why but a team of researchers from John Hopkins University in Baltimore looked into the prevalence of antibodies associated with gliadin, transglutinamase and endomysium - which are associated with caeliac disease - in a study of 2,301 people 1,401 of whom had schizophrenia. The researchers found that 23.1% of the schizophrenia patients had moderate-high levels of gliadin antibodies compard to 3.1% of the unaffected people. 5.4% of the schizophrenia patients had high levels of transglutaminase antibodies compared to 0.8% of the unaffected people.

Cascella, Nicola G. ... [et al] - Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population Schizophrenia Bulletin 37 (1), 94–100, 2011

Charting the path from childhood delusions to mental illness

Although only around 1% of people suffer from full-blown schizophrenia or psychosis hallucinations or delusional beliefs - psychotic-like experiences (PLEs) - are more common and some psychologists think they are a risk factor for developing mental illness. One study found that 11-year-olds who reported a PLE were 16 times more likely to be diagnosed with schizophrenia when they were 26. For most people PLEs decline as they grow up but in a few people they persist, or even get worse. A team of researchers from the Institute of Psychiatry, King's College London looked into this is in a study of 409 teenagers who were studied four times at six-month intervals. They found that the teenagers whose PLEs were persistent suffered frequent victimization and higher levels of depression and anxiety. Those whose PLEs increased were more likely to smoke and use cannabis and cocaine.

Mackie, C. J., Castellanos-Ryan, N. and Conrod, P.J. - Developmental trajectories of psychotic-like

experiences across adolescence: impact of victimization and substance use Psychological Medicine (2011), 41, 47–58

Schizophrenia, metabolic syndrome and quality of life

Metabolic syndrome is a collection of factors that can add to people's risk of developing heart disease and other health problems and includes having a pot belly, high cholesterol, being overweight, having high blood pressure and having difficulty controlling one's blood sugar. People with schizophrenia are prone to developing metabolic syndrome, partly because the drugs they take make them put on weight. A team of Spanish researchers looked at the effects of metabolic syndrome on quality of life in a study of 136 people with schizophrenia, of whom 49 had metabolic syndrome. They found that the older people were, the longer they had been ill and the longer they had taken antipsychotics the more likely they were to have metabolic syndrome. Metabolic syndrome was also associated with a lower quality of life and mobility problems. Quality of life was negatively affected most strongly by age but also by metabolic syndrome and mobility problems.

Tomás Sánchez-Araña Moreno ... [et al] - Quality of life in a sample of schizophrenic patients with and without metabolic syndrome Journal of Psychiatric Intensive Care (2010), 6(2): 101-108

Major review backs family interventions for schizophrenia

People with schizophrenia are more likely to suffer a relapse if they come from families where they experience high levels of criticism and hostility and where family members blame themselves for the sufferer's illness. There are a number of ways in which psychologists and health professionals try to reduce these emotions but their effectiveness has not been proven. A team of researchers led by Fiona Pharaoh from Oxford and Buckinghamshire Mental Health NHS Foundation Trust reviewed 53 trials of these techniques involving a total of 4,708 patients. They found that family interventions led to a reduction in relapses, significantly reduced hospital admissions, improved patients' social functioning and encouraged them to take their medication.

Social cognition and schizophrenia

People with schizophrenia often have problems with their cognition, including what psychologists call social cognition - perceiving people's emotions, recognising social cues and working out what other people are thinking. A team of researchers led by Shaun M. Eack from the University of Pittsburgh studied 133 people in an attempt to find out more about this. 70 of the participants were relatives of people with schizophrenia and were therefore thought to be at greater risk of developing the condition themselves while the rest of them were unaffected controls. The 'at-risk' participants were significantly more likely to assign emotions to neutral faces and to assign the faces negative emotions. They also found it harder to ascertain emotions on faces that were expressing different moods. There was no link between other cognition problems and social cognition. The more people attributed meanings to neutral faces the greater their symptoms of developing schizophrenia were

Eack, Shaun M. ... [et al] - Social cognition deficits among individuals at familial high risk for schizophrenia 36 (6), 1081–1088, 2010
Schizophrenia Bulletin

Child sex abuse and schizophrenia risk

Being sexually abused as a child is a risk factor for psychosis and schizophrenia. Researchers from Monash University in Australia studied 7,697 people, 2,759 of whom had - according to police and medical records - been sexuall abused as children. They found that over a 30-year period people who had suffered child abuse had double the rate of psychosis (2.8% vs 1.4%) and nearly treble the rate of schizophrenia (1.9% vs 0.7%). Those who had suffered penetration of an orifice by another person or an object were at an even greater risk of psychosis and schizophrenia - 3.4% and 2.4% respectively.

Cognitive problems and schizophrenia - which comes first?

Cognitive problems are considered to be one of the main features of schizophrenia. However, it is unclear whether the problems are already there before people's first experience of psychosis or whether developing psychosis has a deleterious effect on people's cognition. A team of researchers from the Academic Medical Centre in Amsterdam studied 58 people, 41 of whom were deemed to be at ultra-high risk of developing psychosis while 17 were unaffected controls. Of the ultra-high risk group 17 developed psychosis during the course of the study. The participants' cognitive performance was assessed at the start of the study and again 18 months later. The people who developed psychosis did not perform any worse at the second test than before they became unwell and the ultra-high-risk group actually performed better on the second test. The control group of unaffected people scored significantly better on test of verbal learning, memory and verbal fluency. So this study at least suggests that problems with cognition come before the development of psychosis and not afterwards.

Becker, H.E. ... [et al] - Neurocognitive functioning before and after the first psychotic episode: does psychosis result in cognitive deterioration? Psychological Medicine, October 2010, 40(10), 1599-1606

Extra help boosts schizophrenia victims

Receiving non-medical help as well as antipsychotic drugs could substantially improve outcomes for people suffering from the early stages of schizophrenia. Researchers from the Central South University in Hunan, China studied 1,268 people with early-stage schizophrenia treated between January 2005 and October 2007. 633 of them had extra, non-medical help (psychosocial intervention) while the rest just took drugs. The extra help included instruction for families and caregivers about mental illness, family therapies designed to teach coping and socializing skills, skills training and cognitive therapy. The rates of treatment discontinuation or change were lower in the group getting the extra help (32.8% vs 22.5%). The participants getting extra help also showed greater improvements in insight, social functioning, activities of daily living and quality of life and a higher proportion of them were employed or in education.

You can find out more about this research by clicking on the title of this post.

Vitamin D and schizophrenia

Levels of vitamin D in newborn children's blood could be linked to their risk of developing schizophrenia in later life. A team of researchers, led by John J. McGrath of the Queensland Centre for Mental Health Research, studied blood samples taken from 848 new-born babies, half of whom were later diagnosed with schizophrenia. Those babies who had low or very high levels of vitamin D in their bloodstream were found to be at an increased risk of schizophrenia.

You can find out more about this research by clicking on the title of this post.

Do antipsychotics rot your brain?

Post mortems have shown that people with schizophrenia have changes in their brains compared to people without the condition. A number of studies have shown that their brains are smaller, that they have less grey matter and larger ventricles (gaps) with more cerebrospinal fluid. But there is a debate as to whether these changes are due to the effects of schizophrenia or the antipsychotics used to treat it. Researchers from University College London and Lincoln Memorial University in Tennessee reviewed 26 MRI (magnetic resonance imaging) studies into this issue and found that 14 of them showed a decline in global brain or grey-matter volume over the course of drug treatment. Three studies of patients with long-term schizophrenia but who had not taken drugs showed no differences in brain volume. The researchers concluded that 'antipsychotics may contribute to the genesis of some of the abnormalities usually attributed to schizophrenia.'

Moncrieff, J. and Leo, J. - A systematic review of the effects of antipsychotic drugs on brain volume Psychological Medicine September 2010, 40(9), 1409-1422

Drug company pays out in diabetes cases

Anglo-Swedish drug company AstraZeneca is to pay out £125m to people who developed diabetes after taking its schizophrenia and bipolar drug Seroquel. Seroquel had worldwide sales of $4.9bn last year, representing 15% of AstraZeneca's total revenue. The payment settles 17,500 claims against the company.

You can find out more about this story by clicking on the link in the title of this post.

Deleted genes and schizophrenia

Researchers from Emory University in Atlanta have been looking into the links between genetics and schizophrenia among Ashkenazi (from Germany and Europe) Jews. They compared people with and without schizophrenia and analyzed their genetic makeup. A deleted gene on the 3rd chromosome was linked to a seventeen-fold increase in the risk of schizophrenia.

You can find out more about this research by clicking on the title of this post.

Flower arranging and schizophrenia

Schizophrenia can affect people as much from the losses - of memory and cognition - it causes as from the delusions and hallucinations it inflicts upon them. The severity of these losses predicts quality of life, social functioning and how independent people remain so anything that could restore them would have a very beneficial effect. Researchers from the National Institute of Floricultural Science in Japan have been testing out whether flower arranging can help improve cognition in people with schizophrenia. They carried out a small study comparing people who went to flower-arranging classes with a control group. The study found that the group who had done flower arranging had a better working memory and were better at copying complex figures than the other group. This was a very small-scale study though and will need to be replicated in a much larger group of patients to really prove flower-arranging's effectiveness.

Schizophrenics at greater risk in hospital

People with schizophrenia are already known to suffer from worse health than the rest of the population and now a new study from the Johns Hopkins Bloomberg School of Public Health suggests that they may also be more at risk when they go into hospital for treatment. The researchers used data from 2002-2007 which covered 269,387 hospitalizations of people with schizophrenia and 37,092,651 hospitalizations of unaffected people. They found that patients with schizophrenia were more likely to have complications such as pressure sores, infections, blood infections, respiratory failure or pneumonia after surgery, deep vein thrombosis or pulmonary embolism. The researchers put the disparity down to the difficulties people with schizophrenia have in communicating with other people, the fact that nurses and doctors might ignore them if they complained and put this down to their mental-health problem, and the side effects of the drugs that people take for their schizophrenia.

You can find out more about this research by clicking on the link in the title of this post.

Aspirin for schizophrenia

Aspirin could have a role in the treatment of schizophrenia. Nobody really knows what causes schizophrenia but previous studies have shown that anti-inflammatory drugs such as celexicob can have some effect, suggesting that inflammation plays a role in the process. Aspirin is an anti-inflammatory and researchers from the University Medical Centre, Utrecht, studied 80 patients over 3 months, half of whom were given an aspirin and half of whom took a placebo. The participants continued to take their antipsychotic medication and were given other drugs to prevent the stomach problems sometimes caused by taking aspirin. After three months the patients who had been given the aspirin showed a significant reduction in their schizophrenia symptoms.

You can find out more about this research at

http://psychcentral.com/news/2010/06/16/can-aspirin-treat-schizophrenia/14621.html

Cannabis and schizophrenia - new evidence to add to the debate

Much ink has been spilt and many trees sacrificed debating the links between smoking cannabis and schizophrenia. Researchers from Stony Brook University in New York have added to the debate with a long-term study following 229 patients for ten years after they were first admitted to a psychiatric hospital. They compared the patients' use of marijuana - both recently and over their lifetimes - with how old they were when their symptoms started and how severe those symptoms currently were. Two-thirds of the participants had smoked cannabis at some point in their lives. The people who had used cannabis before being hospitalised had worse symptoms of psychosis than those who hadn't and were admitted at a younger age. Patients whose symptoms had become worse said they were smoking more cannabis next time they were interviewed and people who started smoking more cannabis developed worse symptoms.

You can find out more about this research at

http://uk.reuters.com/article/idUKTRE65150620100602?feedType=RSS&feedName=healthNews