Tuesday, September 29, 2015

Belief That Mental Illness Can Be Contagious Contributes To Isolation

That is the title of this article I am writing about. "Many illnesses are contagious. You'd do well to avoid your neighbor's sneeze, for example, and to wash your hands after tending to your sick child. But what about mental illness? The idea that anxiety, autism or major depression could be transmitted through contact may sound crazy — and it probably is. There's a lot we don't know about the origins of mental illness, but the mechanisms identified so far point in other directions. Nonetheless, we do know that people's emotions can be affected by the emotions of those around them — a phenomenon known as "emotional contagion" — and that specific symptoms of mental disorders, such as binge eating, can sometimes spread among peers. We also know that many people hold scientifically unfounded views about transmission. For instance, some people believe that organ transplant recipients can acquire the personal characteristics of their donors, a view for which there's no serious scientific support. So, could it be that some people believe psychiatric disorders can be contagious? And, if so, does this belief have consequences for their willingness to interact with people diagnosed with those disorders?" Well what people believe.  I have worked for over six years and no one has caught schizophrenia from me.  I know some people can catch colds from someone else in the family or school or work but not a mental illness.
The article goes on to say: "A recent paper by Jessecae Marsh and Lindzi Shanks, published in the journal Memory & Cognition, suggests the answers are "yes" and "yes." Many of their participants agreed that mental disorders can be communicated from one person to another, and individuals' views about the communicability of a disorder strongly predicted their willingness to interact with a person having that disorder. In their first study, Marsh and Shanks presented 45 undergraduate participants with 12 different mental disorders that ranged from alcohol abuse and ADD to schizophrenia and generalized anxiety disorder. For each one, participants were asked to rate how likely they thought it would be for someone to catch the disorder through close contact with a person who had it, with ratings on a scale from 0 percent probability to 100 percent probability. Ratings varied strongly across disorders, with the highest average estimated transmission rates for alcohol abuse (56.0%), anorexia (35.7%), major depressive disorder (32.2%), and hypochondria (30.6%). The disorders with the lowest estimated transmission rates were Tourette's disorder (4.2%), autism (5.3%), schizophrenia (7.4%), and bipolar disorder (11.2%). Participants answered a variety of additional questions, including how willing they would be to interact with someone with each disorder. For example, they rated their agreement with statements like, "I would be willing to work with a person with anorexia," or "I think someone with schizophrenia is dangerous." The study's central result was this: People's willingness to interact with someone with a given disorder was best predicted by their belief as about the communicability of that disorder, with other beliefs — about, for instance, the disorder's psychological basis and the extent to which an individual can control the symptoms she displays — playing a much smaller role. A second experiment helped establish that this predictive relationship was actually causal: It was indeed beliefs about communicability that caused different attitudes towards personal interaction. " I believe this when I was looking for an apartment me and my sister went to look at one when I told the landlady that I had a mental illness she stopped talking to me and started talking to my sister.  Like I was not there.  Of course she did not give me the apartment but played it off that there was another reason.  It is illegal to discriminate against people with disability.
The article ends: "But how, exactly, did people think the transmission of mental illness from one person to another actually occurred? A follow-up study with 122 undergraduates probed more deeply into people's beliefs about the mechanisms involved. Diseases like chicken pox and the flu were overwhelmingly thought to be transmitted through physical contact on a relatively short timescale (e.g., being sneezed on or touching the same object). But the most common mechanisms of transmission for mental illness involved social interactions and were generally believed to operate on a much longer timescale — closer to years than to minutes. Not surprisingly, though, the responses participants provided were pretty light on specifics. For instance, one participant explained that generalized anxiety disorder can be transmitted because "the person's anxiety will rub off." For alcohol abuse, a participant explained: "If you hang out with someone that drinks all the time, you will soon be drinking a lot as well." People who suffer from mental illness face a variety of challenges, often including stigma and social isolation. The findings from these new studies help identify one factor that may contribute to both: people's beliefs about the transmission of mental illness from one person to another. The thing is, these beliefs about transmission are almost certainly false. This may seem disheartening, but it also makes room for a sliver of hope: the hope that a small bit of education could go a long way."Some how we have to get rid of stigma and these beliefs. They only see what is on TV and they do not interact with people that have mental illness to find out we our not contagious and really would not wish this disease on anyone.

Tuesday, September 22, 2015

Drug to treat flat affect in schizophrenia shows promise

That is the title of this article I am writing about.  "AMSTERDAM – Patients with schizophrenia given the investigational drug cariprazine showed statistical improvements in negative symptoms such as apathy and withdrawal, compared with those given risperidone, results from a phase III clinical trial have shown. The data were presented at the annual congress of the European College of Neuropsychopharmacology.  Both drugs are antipsychotics, but risperidone is a dopaminergic antagonist, and cariprazine is a D2 and D3 receptor partial agonist, tending toward the D3 receptor. Currently, no drugs are on the market with a specific indication for treating the negative symptoms of schizophrenia, although several second-generation antipsychotics reduce negative symptoms as well as positive and general symptoms of schizophrenia. Several pharmacotherapies are available to treat the positive symptoms of the illness.  In this multicenter, international, double-blind study, 230 adults with schizophrenia were randomly assigned to receive cariprazine and 231 were assigned risperidone for 26 weeks, reported Dr. György Németh, one of the study’s lead authors and chief medical officer of the study’s sponsor, Gedeon Richter." I do know from what I read that this drug is welcome by both people with schizophrenia and bipolar disorder.  They say no drug on the market treats both.
The article goes on to say: "People included in the study had been stable for at least 6 months prior to screening, and for a subsequent 4 weeks prior to randomization. Those with a score of at least 24 or greater on the Negative Factor Scale of the Positive and Negative Syndrome Scale (PANSS-NFS) and a score of at least 4 on two of the three core negative symptoms, along with positive factor scores on the PANSS of at least 19 or more were considered for inclusion in the study. At baseline, both groups had similar PANSS scores: Negative factor scores in the study drug arm were 27.7 and 27.5 in controls. Positive factor scores were also similar: 8.8 in the study arm and 8.6 in controls.
Study participants also were measured at baseline on the Personal and Social Performance Scale. Scores were 48.8 in the study drug arm and 48.1 in the risperidone arm.  After a 2-week period of cross-titration and washout of previous medications, patients were treated with the target dose of 4.5 mg daily of their assigned drug for 24 weeks." This is from the makers of Geodon that is what I take now and for me it has been a wonder drug.  I have no symptoms either positive or negative. If this helps people able to not withdrawal from society it would be great.
The article ends: "In the 77.4% of enrollees in both cohorts who completed the trial, those treated with cariprazine had the most improvement in both negative symptoms and personal and social performance, compared with the control group. At 26 weeks, the overall change from baseline in the study group for negative factor symptoms was –2.39, compared with –0.53 in controls (95% confidence interval; P = .002). Personal and social performance scores changed at 26 weeks from baseline by 2.71 in the study group and 6.56 in controls (95% CI; P less than .001).
Discontinuation rates were low, and the most common side effects were insomnia and headache (about 10% for each), mostly in the risperidone arm.  Dr. David Pickar, who was not involved in the study, said in an interview that when treating patients with schizophrenia “improvement in negative symptoms occurs a fair amount with improvements in positive symptoms. The problem is the persistence of negative symptoms,” said Dr. Pickar of the department of psychiatry at Johns Hopkins University, Baltimore, and former branch chief of intramural experimental therapeutics at the National Institute of Mental Health.  This trial was sponsored by Gedeon Richter."They do need a drug that gets rid of all negative symptoms. I personally would like to read that all people with schizophrenia are doing well working if they would like and be able to not suffer with negative symptoms.

Tuesday, September 15, 2015

Negative Symptoms of Schizophrenia Linked to Worse Outcome

That is the title of this article I am writing about. "Negative symptoms in patients with schizophrenia are associated with an increased likelihood of hospital admission, longer duration of admission, and an increased likelihood of re-admission following discharge, according to a new study by researchers at King’s College London. Negative symptoms include poor motivation, poor eye contact, and a reduction in speech and activity. As a result, people with schizophrenia often appear emotionless, flat, and apathetic. These contrast with the positive symptoms of hallucinations or delusions, which are typically the first targets of treatment.  The study is the largest ever to investigate a relationship between negative symptoms and clinical outcomes, pulling from a sample of more than 7,500 patients."The people with negative symptoms can tell you all this because they suffer everyday with negative symptoms.
The article goes on to say: "'Hospital admissions are the main drivers of cost in the care of patients with schizophrenia — yet they have traditionally been linked to the severity of positive psychotic symptoms,' said Dr. Rashmi Patel from the Department of Psychosis Studies. Our data indicate that negative symptoms are an equally important factor, and suggest that a greater emphasis on assessing and treating these features of schizophrenia may have significant health economic benefits.”
'However, as our findings are drawn from observational data, interventional clinical studies are required to determine whether an effective treatment for negative symptoms would lead to better clinical outcomes.'  For the study, researchers used the Clinical Record Interactive Search (CRIS) application, a text-mining tool, to analyze anonymous patient data on negative symptoms. Natural Language Processing (NLP) was used to detect statements within the clinical records that determined references to specified negative symptoms."I think if you would get rid of the negative symptoms you would find more people with schizophrenia working. I know they are just observing but I read about it everyday.
The article ends with: "Ten negative symptoms were identified, including poor motivation, blunted or flattened mood, poor eye contact, emotional withdrawal, poor rapport, social withdrawal, poverty of speech (excessively short speech with minimal elaborations), inability to speak, apathy, and concrete thinking (the inability to think in abstract terms).  The researchers found that 41 percent of patients exhibited two or more negative symptoms. Negative symptoms across the sample were associated with an increased likelihood of hospital admission, longer duration of admission, and an increased likelihood of re-admission following discharge from hospital.  In fact, patients with two or more negative symptoms were 24 percent more likely to have been admitted to the hospital. In addition, each of their admissions were, on average, an extra 21 days in duration and, when discharged, these individuals had a 58 percent higher risk of re-admission within 12 months.  The most frequently recorded negative symptoms were poor motivation (31 percent), blunted or flattened mood (27 percent), poor eye contact (26 percent), and emotional withdrawal (24 percent). If a person had all those negative symptoms you would think something would have been done by now.  Especially the poor motivation.  It is hard to get anything done when you are fighting just to do it. Everyone needs motivation  and not a flatten mood.

Friday, September 4, 2015

Clinical trial shows first treatment for ‘emotional flatness’ associated with schizophrenia

That is the title of this article I am writing about. "Results of a clinical trial seem to show the first effective treatment for the negative symptoms--withdrawal, lack of emotion, and apathy--associated with schizophrenia.  This work is presented at the European College of Neuropsychopharmacology conference in Amsterdam.  Schizophrenia is one of the most common serious mental health conditions, with around 1 in 100 people experiencing schizophrenia in their lifetime. The main symptoms fall into 3 categories: positive symptoms, such as delusions and hallucinations; negative symptoms, such as lack of drive and social withdrawal; and cognitive symptoms, such as problems with attention and memory. The negative symptoms tend to persist, and don't respond well to current treatment. Effective medicines (antipsychotics) exist for positive symptoms, but negative symptoms and cognitive impairment do not respond well to the available treatments.  Now the results of a new Phase III clinical trial indicate that the negative symptoms may be treatable with a new investigational drug, cariprazine, which binds to the D2 and D3 dopamine receptor with D3 preference. The researchers, all from the Gedeon Richter pharmaceutical company which developed the drug, enrolled 461 men and women in a randomised, double-blind clinical trial, to compare cariprazine against risperidone (which is commonly used to treat schizophrenia). Patients were treated for 26 weeks, with 77.4% of enrolled patients completing the trial. Full details of the trial are given in the abstract."It is the first to show good results.  This is what people have been waiting for now we have to see if there are any side effects that make it not wanted.
The article goes on to say: "The outcomes were measured using a special subscale of the PANSS scale (Positive and Negative Syndrome Scale) which is a standard method used for measuring symptom severity of patients with schizophrenia. After 26 weeks of treatment, it was found that cariprazine treatment group showed a statistically significant improvement in the PANSS-NFS scale relative to risperidone (-1.47; p=0.002). In addition to the effect on predominant negative symptoms of schizophrenia, patients who took cariprazine also performed significantly better on personal and social functioning than those who took risperidone. Full details of the trial are given in the abstract.
According to lead researcher Dr György Németh (Chief Medical Officer, Gedeon Richter): 'The positive symptoms of schizophrenia can be controlled by drugs, but this is the first study ever to show a significant effect of a compound on negative symptom compared to another antipsychotic. It seems that with cariprazine, we may be able to treat both the positive and negative symptoms with a single medication.'" One drug to treat it all what more could you ask for.  I know taking one drug for my mental illness is the best.  Although I never had negative symptoms but hear all the time how it effects those others with schizophrenia.
The article ends: "Commenting, ECNP Executive Committee Member Professor Andreas Meyer-Lindenberg said: 'Treatments for the negative symptoms of schizophrenia are still urgently needed as these are critical predictors for patient's recovery and reintegration. The current results suggest that D3-dopaminergic mechanisms may play a role in both causing and treating emotional flatness, which deserve further confirmation.'  The trial was organised and supported by the Gedeon Richter pharmaceutical company, which developed cariprazine. The researchers report that the most frequent adverse events (incidence ≥5%) across both treatments groups were insomnia, headache, akathisia, worsening of schizophrenia symptoms, anxiety and somnolence. As this drug has not yet completed the approval process, no indication of the costs of the treatment is available." That is a lot of side effects.  It will not work for everyone is what I am thinking.

Tuesday, September 1, 2015

Fish oil pills may help teenagers stave off schizophrenia

That is the title of this article I am writing about. "There may finally be a way to stop people progressing beyond the first signs of schizophrenia – fish oil. When people with early-stage symptoms took omega-3 supplements for three months, they had much lower rates of progression than those who did not, according to one small-scale trial.  People with schizophrenia are usually diagnosed in their teens or 20s, but may experience symptoms for years beforehand, such as minor delusions or paranoid thoughts. Only about a third of people with such symptoms do go on to develop psychosis, however, and antipsychotic drugs can cause nasty side effects, so these are rarely given as a preventative.  Fish oil supplements, which contain polyunsaturated fatty acids like omega-3, may be a benign alternative. These fatty acids may normally help dampen inflammation in the brain and protect neurons from damage, and lower levels in the brain have been implicated in several mental illnesses."That would be great if they work.  I take them for dry eye.  It is good to see there are so many uses for fish oil.
The article goes on to say: "Tests have found that people with schizophrenia have lower levels of these fatty acids in their blood cells, suggesting the same could be true for their brain cells. Fish oil supplements have been investigated as a treatment for adults with schizophrenia, but so far results have been mixed – four trials found no benefit while another four found a small reduction in symptoms. But a study that gave omega-3 fish oil pills to younger people suggests that what matters is catching the condition in time. The trial followed 81 people aged 13 to 25 with early signs of schizophrenia. Roughly half took fish oil pills and half took placebo tablets for three months. A year later, those given fish oils were less likely to have developed psychosis."I can tell because I do not have negative or positive symptoms to see if the fish oil I take help my psychosis.  I do know my diet was not the best when I was growing up. We had fish although I never eat it.  Prison food is not all that great.
The article ends: "New trajectory
That was seven years ago. The researchers have now followed up 71 of the participants and found that just 10 per cent of those given fish oils went on to develop schizophrenia, compared with 40 per cent of the placebo group. “We may have put them on a different trajectory,” says team member Paul Amminger of the University of Melbourne, Australia.  The results are striking, says David Taylor  of the Maudsley Hospital in London. But he cautions that this was a small trial and the results need to be reproduced.  Nigel Barnes of Birmingham and Solihull Mental Health NHS Foundation Trust in the UK agrees that the study needs repeating with a larger group, but says that it’s reasonable for people to give fish oils a try. However, he warns that over-the-counter products may not have the right dose of the right fatty acids to be of use.  Amminger says the best approach for those at risk of developing schizophrenia would probably be to combine fish oil supplements with talking therapies." That is the trouble finding the right fish oil that works.  The final say if it works is a bigger trial I will watch for that trial so I can write if it works.