Tuesday, August 25, 2015

Smoking Rates Still High Among Mentally Ill

That is the title of this article I am writing about. "Despite a major decline in cigarette smoking in the general adult population, smoking rates in people with mental illness have remained the same for a decade, according to new research published in the American Journal of Preventive Medicine.
In fact, one-third of current adult smokers suffer from some type of mental illness, and so far, anti-smoking efforts have not seemed to affect this particular population.  'Individuals with mental illness represent approximately one-third of the adult smokers in the U.S., and we need to develop alternative tobacco control strategies, including targeted treatments for this vulnerable population,' said Marc L. Steinberg, Ph.D., associate professor of psychiatry at Robert Wood Johnson Medical School and lead author of the study." I know from reading a lot of them have a hard time quitting.  I quit seventeen years ago.  I did so my granddaughter could come and visit in a smoke free house. My ex was supposed to quit but I am the one that ended up quitting it took me  a month with welbutrin there were so many side effects I quit in a month.
The article goes on to say: "'Tobacco control has been relatively successful in helping some groups quit smoking, but the remaining smokers may be the ones who are the hardest to treat. We need to address the health disparities of the remaining smokers, such as those with lower socioeconomic status and mental health problems.'  For the study, researchers analyzed data of New Jersey residents who had been surveyed by the Behavioral Risk Factor Surveillance System. In this system, data was collected from telephone surveys independently conducted in all 50 states that compiled chronic health information from adults aged 18 and older and then pooled by the federal Centers for Disease Control and Prevention (CDC).  The findings show that during the 10-year period examined by researchers at Rutgers Robert Wood Johnson Medical School, smoking prevalence was greater in people suffering with behavioral health conditions, compared to persons with better mental health.'" I hear talk that the new quitting is using e-cigarettes.  To me that is not quitting.  I remember when I had to give up coffee because it made my symptoms come through.  The  first thing my counselor asked it is what did you replace it with and my answer was water. I can now drink coffee now that I am on a different medication.
The article ends with: "'Our research found that while smoking rates have been going down in New Jersey adults without mental health problems, they have remained steady for those with mental health problems,' said Steinberg.  'This suggests that tobacco control strategies are not reaching those with poor mental health, or, if they are, their messages are not translating into successful cessation.'
Steinberg and his colleagues also examined quit attempts by current smokers. They found that those with poor mental health tried to quit just as often as those who were mentally healthy, but tended to relapse and start smoking again.  “Evidence shows that there has been a significant decrease in smoking in adults, and our data indicates that people with mental illness attempt to quit smoking at the same rate as those without mental illness, yet they are not as successful,” said Steinberg."I had to quit the side effects were to much I quit in a month because I did not want to take anymore of that welbutrin. I had a friend who gave me a list of the side effects and I had everyone on that list. I did not even think about smoking I was wondering what would happen next.  Although I am glad that I quit the first time I tried to quit.

Tuesday, August 18, 2015

The Unintended Consequences of Focusing on Recovery in Schizophrenia

That is the title of this article I am writing about. "Much has been said in this blog by my colleague Dr David Laing Dawson and myself on the concept of recovery. Wouldn’t it be wonderful if full recovery was possible but it isn’t. However, I really should clarify that somewhat. Schizophrenia should probably be referred to as a spectrum disorder like autism. When Bleuler first coined the term in 1908, he referred to it as the schizophrenias and said that it was a physical disease process characterized by exacerbations and remissions. No one was ever completely “cured” of schizophrenia — there was always some sort of lasting cognitive weakness or defect that was manifest in behavior. Unfortunately, over the years, it began to be considered to be one disease only.  In a recent article in Psychology Today, University of Toronto medical historian, Edward Shorter, had this to say. In adolescent-onset schizophrenia, some don’t recover at all; others make only a 'social recovery,' and some maybe go on to have a normal life or 'Maybe not'. Shorter then adds that 'The field has made virtually no progress in unpacking chronic severe illness and differentiating out several distinct entities. In no other field of medicine would this be conceivable!' and 'Some involve loss of brain tissue, others don’t. Some have to stay on meds, others don’t. Some get well, others don’t. These are not all the same illness!'" I do pretty well with my medication, others not so well.  A lot of them do not want to hear that I am doing well.  They suffer. It was like that also with A.A. when I went this one guy said I did not believe that you were and alcoholic until you told your story.  They made sure I had me mental illness I was sick in jail for at least six months which made me never want to get sick again.
The article goes on to say: "In fact, it has long been recognized that there are three outcomes to schizophrenia. Roughly a third are treatment resistant and remain very ill, a third can be helped with meds and other treatment modalities to improve sufficiently to lead a reasonable but disabled life, and a third will have one psychotic episode, receive treatment and never have another or any long term deficits.  According to the Treatment Advocacy Center, 10 years after diagnosis, 'one-fourth of those with schizophrenia have recovered completely, one-fourth have improved considerably, and one-fourth have improved modestly. Fifteen percent have not improved, and 10 percent are dead.'
How do you think the families of the majority of those with non recoverable schizophrenia or the individuals themselves will feel when we hold up to them what is achievable by only 25%? And, we tell them that it is achievable. Why can’t I (or my son or daughter) achieve that. Have I done something wrong? Cancer is an interesting analogy. There is not one cancer but many. And each cancer has its own unique characteristics and prognosis." That is the truth when someone is doing better they all want to do the same and why not? I do not know where I fit on their scale because I did have a relapse when my medication was lowered to much that was an old drug called Moban. I am glad I am off it but it took it be discontinued for me to change that is because I never want this disease to come back and lose control again.
The article ends with: "Non melanoma skin cancer (basal cell and squamous cell) have 5 year survivals of 95% and 90%. In contrast, the 5 year survival for pancreatic cancer ranges from 1% for stage IV to 14% from stage 1A. Imagine if we told those with stage IV pancreatic cancer not to worry because 5 year survival is 95%. Ridiculous isn’t it but that is what we tell people with schizophrenia. Don’t worry, you should be able to recover because 25% do.  Now, I’m not saying to abandon hope but rather to be realistic and pushing recovery is not realistic if it is not qualified.  The second problem was mentioned to me by my friend Kathy Mochnacki of Home on the Hill in Richmond Hill Ontario. She pointed out that if you claim that recovery is possible, then why continue doing research. People can recover so no need for it. Of course, scientists know better but they are dependent on funding from governments and other agencies.
So, let’s all inject some scientific reality into a very troubling and serious disease."  There are people that do not have any symptom relief even with medication. It is troubling. I do not know the answer except we do need more research and better medicaion that does not allow you to get diabetes just because you want to be well.

Tuesday, August 11, 2015

Brain Training App Improves Memory of People With Schizophrenia

That is the title of this article I am writing about today. "A new brain training iPad game developed by researchers at the University of Cambridge may improve the memory of patients with schizophrenia, according to new research. While the psychotic symptoms of schizophrenia are reasonably treated by current medications, patients are still left with debilitating cognitive impairments, including in their memory, and so are frequently unable to return to school or work, the researchers said.  They added that while there are no medications to improve cognitive function for people with schizophrenia, there is increasing evidence that computer-assisted training can help them overcome some of their symptoms, with better outcomes in daily functioning and their lives.
In a study published in the Philosophical Transactions of the Royal Society B, a team of researchers led by Professor Barbara Sahakian from the Department of Psychiatry at Cambridge describe how they developed and tested Wizard, an iPad game aimed at improving episodic memory.
Episodic memory is the type of memory required when you have to remember where you parked your car in a multi-story parking garage after going shopping for several hours or where you left your keys several hours ago, for example. It is one of the facets of cognitive functioning affected in patients with schizophrenia, the researchers said.  The game is the result of a nine-month collaboration between psychologists, neuroscientists, a professional game developer, and people with schizophrenia. It is intended to be fun, attention-grabbing, motivating and easy to understand, while at the same time improving the player’s episodic memory."I would love to try it the last game I tried for memory was posit.  It does work if you use it everyday  like I did and I could see the improvement each day.  It is hard for some people as a coworker with schizophrenia just said it is repeating and you just have to remember where the things are.  That gets your memory working.
The article goes on to say: "The memory task was woven into a narrative in which the player is allowed to choose their own character and name. The game rewards progress with additional in-game activities to provide the user with a sense of progression independent of the cognitive training process, the researchers explain.  For the study, the researchers recruited 22 people diagnosed with schizophrenia. They were then randomly assigned to either the cognitive training group or a control group. Those in the training group played the memory game for a total of eight hours over a four-week period, while those in the control group continued their treatment as usual. At the end of the four weeks, the researchers tested all participants’ episodic memory using the Cambridge Neuropsychological Test Automated Battery (CANTAB) PAL, as well as their level of enjoyment and motivation, and their score on the Global Assessment of Functioning (GAF) scale, which doctors use to rate the social, occupational, and psychological functioning of adults. The researchers found that the patients who had played the memory game made significantly fewer errors and needed significantly fewer attempts to remember the location of different patterns in the CANTAB PAL test relative to the control group. In addition, patients in the cognitive training group saw an increase in their score on the GAF scale. Those in the training group indicated that they enjoyed the game and were motivated to continue playing across the eight hours of cognitive training. In fact, the researchers found that those who were most motivated also performed best at the game. This is important, as lack of motivation is another common facet of schizophrenia." This one sounds a lot better than the one I was doing. If they can stay motivated that is great.  That is most of the battle having someone keep playing the brain game for a long time to get results.
The article ends with: "'We need a way of treating the cognitive symptoms of schizophrenia, such as problems with episodic memory, but slow progress is being made towards developing a drug treatment,' Sahakian said. “So this proof-of-concept study is important because it demonstrates that the memory game can help where drugs have so far failed. Because the game is interesting, even those patients with a general lack of motivation are spurred on to continue the training.”
In April 2015, the researchers began a collaboration with the team behind the brain training app Peak to produce scientifically-tested cognitive training modules. The collaboration has resulted in the launch of the Cambridge University & Peak Advanced Training Plan, a memory game available within Peak’s iOS app, designed to train visual and episodic memory while promoting learning.
The training module is based on the Wizard memory game, developed by Sahakian and colleague Tom Piercy at the Department of Psychiatry at the University of Cambridge. Rights to the game were licensed to Peak by Cambridge Enterprise, the university’s commercialization company.
'This new app will allow the Wizard memory game to become widely available, inexpensively,' Sahakian said. 'State-of-the-art neuroscience at the University of Cambridge, combined with the innovative approach at Peak, will help bring the games industry to a new level and promote the benefits of cognitive enhancement.'
The game is built for four weeks of training and is priced at $14.99/£10.99."It is not bad priced if it works and it sounds like it does. Also keeps people wanting to continue that is great. Only four weeks of training that sounds even better if it helps your memory.

Tuesday, August 4, 2015

Scientists identify schizophrenia's 'Rosetta Stone' gene

That is the title of this article I am writing about today. " Scientists have identified a critical function of what they believe to be schizophrenia's "Rosetta Stone" gene that could hold the key to decoding the function of all genes involved in the disease.
The breakthrough has revealed a vulnerable period in the early stages of the brain's development that researchers hope can be targeted for future efforts in reversing schizophrenia.
In a paper published in the journal Science, neuroscientists from Cardiff University describe having uncovered the previously unknown influence of a gene in ensuring healthy brain development.
The gene is known as 'disrupted in schizophrenia-1' (DISC-1). Past studies have shown that when mutated, the gene is a high risk factor for mental illness including schizophrenia, major clinical depression and bipolar disorder. The aim of this latest study was to determine whether DISC-1's interactions with other proteins, early on in the brain's development, had a bearing on the brain's ability to adapt its structure and function (also known as 'plasticity') later on in adulthood.
Many genes responsible for the creation of synaptic proteins have previously shown to be strongly linked to schizophrenia and other brain disorders, but until now the reasons have not been understood."It would be great if they can reverse schizophrenia and all mental illnesses.  I hope for the people who have not been diagnosed that they do not have to go through the same that I went through and all people who have this disease.
The article goes on to say: " Their experiments in mice revealed that by preventing DISC-1 from binding with these molecules -- using a protein-releasing drug called Tamoxifen at an early stage of the brain's development -- it would lack plasticity once it grows to its adult state, preventing cells (cortical neurons) in the brain's largest region from being able to form synapses.
The ability to form coherent thoughts and to properly perceive the world is damaged as a consequence of this.
Preventing DISC-1 from binding with 'Lis' and 'Nudel' molecules, when the brain was fully formed, showed no effect on its plasticity. However, the researchers were able to pinpoint a seven-day window early on in the brain's development -- one week after birth -- where failure to bind had an irreversible effect on the brain's plasticity later on in life.
'We believe that DISC-1 is schizophrenia's Rosetta Stone gene and could hold the master key to help us unlock our understanding of the role played by all risk genes involved in the disease,' said Professor Fox.
"The potential of what we now know about this gene is immense. We have identified a critical period during brain development that directs us to test whether other schizophrenia risk genes affecting different regions of the brain create their malfunction during their own critical period.
'The challenge ahead lies in finding a way of treating people during this critical period or in finding ways of reversing the problem during adulthood by returning plasticity to the brain. This, we hope, could one day help to prevent the manifestation or recurrence of schizophrenia symptoms altogether.'" It would be great if they can fix schizophrenia before it starts but it would be good also if they can just return the plasticity of the brain once people are diagnosed with a mental illness.
The article ends with: "Professor Jeremy Hall, an academic mental health clinician and director of Cardiff University's Neuroscience and Mental Health Research Institute, said:
"This paper provides strong experimental evidence that subtle changes early on in life can lead to much bigger effects in adulthood. This helps explain how early life events can increase the risk of adult mental health disorders like schizophrenia."
Schizophrenia affects around 1% of the global population and an estimated 635,000 people in the UK will at some stage in their lives be affected by the condition. The projected cost of schizophrenia to society is around £11.8 billion a year.
The symptoms of schizophrenia can be extremely disruptive, and have a large impact on a person's ability to carry out everyday tasks, such as going to work, maintaining relationships and caring for themselves or others."I do not have the problems that most with schizophrenia have. I have paranoid schizophrenia that did not start until age twenty eight I had all the symptoms but did not get fully diagnosed until age twenty nine.  So all I learned in those years stuck with me except math. I saw it as a chance to get out of a rotten life that all I was doing was always being locked up.  I will always wonder if being hit in the head with a barbell at age five had something to do with be ending up with this disease.  I know it was an accident but I will never know how my life could have turned out if I wasn't hit in the head.