Culturally Guided Family Therapy for Schizophrenia Helps Individual and Caregivers

That is the title of this article I am reviewing today. "Schizophrenia is a difficult mental illness that affects about one percent of the population in the United States. The condition is chronic, severe, and disabling often preventing an individual from living independently.  Approximately 60 percent of those suffering from this condition live with a relative. Despite the fact that family interventions have shown to significantly improve outcomes for individuals with schizophrenia, only about seven percent of patients with this illness receive any family therapy.  To address this void, a new culturally-informed treatment strategy focused on caregivers of people with schizophrenia as well as the individual. The protocol utilizes the cultural believes, values, and behaviors of caregivers to help them cope with the stress of caring for a loved one with schizophrenia.  'We wanted to develop a treatment intervention that taps into cultural beliefs and values that we hypothesized would make the treatment more engaging and relatable to many ethnic minorities that do not necessarily embrace the current mental health care system, said Amy Weisman de Mamani, Ph.D., associate professor of psychology at the University of Miami.  'We hoped to develop a treatment that was not only aimed at benefiting patients, but explicitly focused on reducing caregiver distress as well.'"It is a good turnabout from years ago and needed.  When I first was incarcerated at the state hospital they did not like that all I did when I had the chance was talk to my family on the phone.  The doctor their asked my mom to let me go sink or swim on my own.  The did not promote family.
The article goes on to say: "Since the degree of perceived burden and emotions that we experience are tied to one’s cultural view of the world, the project examined the effect of adding culturally based segments to an already established family focused treatment for schizophrenia. For the study, participants undertook a 15-week family-focused, culturally-informed treatment for schizophrenia (CIT-S). The researchers incorporated modules on spirituality, or religion and family collectivism to already established psychoeducational and communication modules.  Sixty percent of the participants were Hispanic, 28 percent Caucasian, eight percent African American, and nearly four percent identified as “Other.” The researchers believe that the treatment is not specific to particular group, but rather may be helpful to all ethnic, racial, and cultural groups.  Study results show that the new treatment markedly reduces caregiver burden, shame, and guilt, implying an improvement in the quality of life for caregivers and patients alike.  The research appears in the journal Psychotherapy of the American Psychological Association." When you have problems sometimes only family can help you solve it. I know it was important very much when I first came back to Denver from Pueblo. If it was not for my brother I would not have found housing I was looking wrong.
The article ends: "'Caring for a patient with severe mental illness can have adverse consequences for the caregiver and ultimately for the patient,' said co-author of the study Giulia Suro, Ph.D.
'These include reduced opportunities to earn an income, socialize, and take care of one’s own personal needs.' The results show that CIT-S and the psychoeducation-only family intervention were equally and highly effective in reducing shame, although CIT-S markedly outperformed family psychoeducation in reducing caregivers’ burden and guilt. In the spirituality module, the study aimed at helping families’ access beliefs and practices that could help cope with the illness, such as prayer, meditation, volunteerism, and attending religious services. Family members that did not subscribe to any particular religious practice or belief participated in parallel exercises that didn’t specifically reference “God” or “religion.” In the family collectivism module, the study assessed and encouraged the ability of family members to develop the perspective that they are part of a unified team working towards common goals. The study is a follow-up of a study in which the authors shared the first findings about the effect of the CIT-S on patient’s psychiatric symptoms, showing that CIT-S is better at reducing patients’ psychiatric symptoms, than the psychoeducation-only intervention." Well it seems so long ago that I was out and meditation was important.  Also talking to my mom about college since she had went years ago. It helped even though I had different problems happening it helped me see I could finish and be successful.

IQ takes a hit with longer lasting psychosis

That is the title of this article I am writing about. Last week I did on how the higher IQ the less chance to develop schizophrenia.  This one is about how we lose IQ by having psychosis longer. "A 10-year-long Scandinavian study has shed light on a small group of schizophrenic patients who suffer a greater decline in IQ over time than most patients.
Researchers at the University of Oslo and Yale have discovered that people who are diagnosed with schizophrenia often have a more positive illness trajectory than was previously thought. However, a subgroup of the study’s patients who experienced repeated psychosis after receiving treatment demonstrated significant deterioration of verbal recall and working memory ability over time. In other words, those who had a longer duration of psychosis after starting treatment saw their IQs drop more than those who experienced a shorter duration of psychosis.
These findings emphasize the need for patients at higher risk to be monitored more closely in order to detect episodes before they manifest themselves, according to secondary author and University of Oslo professor of neuropsychology Kjetil Sundet. He added that the ultimate goal in treating schizophrenic patients is to notice these warning signs before the onset of even the first psychotic episode." It is the longer you have psychosis after starting treatment.  I think we lose some just in having schizophrenia.  I know my IQ when I went to high school and when I started college were different.
The article continues: "So far, this study is the longest lasting of its kind to investigate whether the course of IQ is affected by duration of psychosis before treatment and duration of psychosis after treatment. Researchers found that the overall IQ of all 89 patients studied remained stable over time. But when they divided the sample into subgroups based on duration of untreated psychosis (DUP) and duration after treatment (DAT), they discovered that the length of DUP did not affect cognitive ability, while the length of DAT did correlate with cognitive decline. Patients with the longest DAT performed significantly worse on tests of intellectual ability over time compared to those with the shortest DAT. Some patients in the study saw a slight increase in IQ, which explains the overall consistency in IQ.
Additionally, the group with the longest DAT had a slightly lower baseline IQ at the start of the study than other groups, suggesting that lower IQ may indicate increased risk for a more severe course of illness.
This study was inspired by the Early Treatment and Intervention in Psychosis Study, led by co-primary investigators Svein Friis, professor of psychiatry at University of Oslo, and Thomas McGlashan, professor emeritus of psychiatry at Yale University. The main goal of that project was to find out if an Early Detection and Early Intervention program could reduce duration of untreated psychosis, and if that could improve quality of life outcomes, according to Friis.
'Without [McGlashan], this large-scale study would hardly have been possible,” Sundet said. “He inspired and enabled his colleagues to do this research.'" They need to treat people with psychosis sooner than.  That would explain to me why I lost some IQ.  I was put in jail with my psychoiss was going on and they did not give me medication until I was sentenced and went to the state hospital about six months down the road.
The article ends with: "
Although the results of this study do not provide any causal explanations of the relationship between longer illness duration after treatment and cognitive decline, the authors have offered several possible hypotheses. Because patients with greater intellectual impairments had a lower baseline IQ to begin with, they hypothesized that those patients may have possessed a lower cognitive reserve in general, hindering their ability to inhibit psychotic symptoms.
Alternatively, the researchers have proposed the existence of a distinct subtype of schizophrenia that causes more severe cognitive decline as well as longer psychotic episodes. That hypothesis is based on recent studies on certain patients’ genetic susceptibility to schizophrenia.
Though the findings of this study fall in line with previous schizophrenia-spectrum disorder studies, the study relied largely on human memory for its data, adding an element of uncertainty to the results.
According to Sundet, the general opinion of schizophrenia-spectrum disorders was much bleaker 20 years ago at the beginning of the study, when it was thought that having schizophrenia necessarily meant a major interference with normal life. However, nowadays most patients can live a good life with treatment and medication, and some people suffer only one episode their entire lives, he added.
According to the National Institute of Mental Health, schizophrenia affects 1.1 percent of the U.S. population ages 18 and older. "My memory of numbers is all I have that works great. Remembering anything else and I have to keep reminding myself to remember and that does not been I will. although with numbers I can remember them very well.

Cellular Process Gone Awry Tied to Schizophrenia

That is the title of this article I am writing about.  “Researchers have discovered a molecular process that may contribute to the development of schizophrenia, according to new research published in the journal Molecular Psychiatry.  The research team from Tel Aviv University discovered that a process called autophagy is reduced in the brain of a person with schizophrenia.  Authophagy – a ‘cell-maintenance’ mechanism – clears out the dysfunctional and needless parts of a cell.  When this process is blocked, cells die.  The findings show that patients with schizophrenia have reduced levels of a protein called beclin-1 in the hippocampus (a brain region linked to learning and memory).  Beclin-1 plays an important role in autophagy, the researchers note.  This finding suggests that autophagy may be blocked in the brains of schizophrenic patients.”  Cell maintenance we need that whether or not were schizophrenic.  Both learning and memory we need.  When I went to junior high and high school, I was good at math, but when I went to college my tutor will say “he gets it and as soon as he walks out the door he forgets all we learned.”

I hope before I die that they find out what really went wrong with me. “The researchers believe that creating drugs that increase beclin-1 levels and trigger autophagy may lead to a new treatment for schizophrenia.  It is all about balance.  Paucity in beclin-1 may lead to decreased autophagy and enhanced cell death.  Our research suggests that normalizing beclin-1 levels in schizophrenia patients could restore balance and prevent harmful brain-cell death, said lead author Illana Gozes, Ph.D., of Tel Aviv University.  When researchers measured beclin-1 in the blood of schizophrenic patients, however, the levels were normal.  They say this suggests that reduced levels of protein are confined to the hippocampus.  They also found that patients with schizophrenia have increased levels of a protein called activity-dependent neuroprotective protein (ADNP) in their white blood cells.”  Hopefully they find out soon what is wrong.  I do know that balance they are on the right track everything has to find a balance.
The article goes on to say: “This protein, discovered by Gozes in 1999, is crucial for function and formation of the brain.  The team notes that previous research had also shown that ADNP is abnormal in the brains of schizophrenics.  They hypothesize that when beclin-1 levels drop and autophagy is slowed down, the body increases ADNP levels to help protect the brain. Therefore, ADNP could be used as a biomarker – meaning a blood test could be used to diagnose schizophrenia.  The investigators hope their research will lead to further knowledge that will help them better understand the mechanisms and treatment of schizophrenia.  We discovered a new pathway that plays a part in schizophrenia.  By identifying and targeting the proteins known to be involved in the pathway, we may be able to diagnose and treat the disease in new and more effective ways, said Gozes.” That is what we need better treatment options and to find out why we developed schizophrenia in the first place.  I do know that environmental factors did play a role in my developing schizophrenia.  How did I get it in the first place?  I would like that answer.

Collaborative Efforts Help Mental Health Patients Quit Smoking

That is the title of this article and blog.  It is not worth it to smoke anymore.  I am glad that I quit fifteen years ago. “Persons with mental illness account for more than one-third of adult smokers in the United States and despite a decline in tobacco use during the past five decades, there has been no change in the smoking rate for patients with poor mental health.  To combat reliance on tobacco in mental health populations, experts agree that mental health services and government-sponsored tobacco control programs must work together to improve education and access to smoking cessation programs.”  It is time to quit that is what I felt when I decided to quit.  I could not have done it before than because I enjoyed it too much.  I always carried cigarettes on me.  When I quit I had four packs on me that I gave to a friend besides the two cartons.

I cannot say that I quit with smoke aid.  The wellbutrin I took to stop smoking just made me so upset that I quit in a month.  I just did not want to take it anymore and I wasn’t craving so I quit. “Historically, mental health care has operated separately from general medical practices where collaborations exist to strongly encourage smoking cessation in typical patient populations, said Jill M. Williams, MD, professor of psychiatry at Rutgers Robert Wood Johnson Medical School.  The result of this disconnect, according to Dr. Williams, has left smokers with disparities to become dominant group of smokers in the United States. This includes smokers with mental illness, as well as other addictions and the very poor. Disparities research indicates we need tailored strategies to effect these remaining populations of smokers, she said.”  I had to ask my doctor when I wanted to quit.  A lot of people with mental illness do not have PCP’s.  I believe you have to have a reason to quit.  It was not that I would die young that made me quit.  It was the reason of having my granddaughter in a smoke free house.  I was not even supposed to quit that was supposed to my ex-wife.  She did not quit.
The article says: “Williams said partnerships between mental health providers and state or county tobacco control programs benefit patients, providers and programs.  For patients, smoking cessation improves their health be reducing the impact of smoking-related illnesses.  This in turn lowers costs in treating those illnesses.  The paradox is that we still pay for the heart disease and cancer that these smokers develop so it makes more sense to help them stop smoking, explained Williams. Likewise, tobacco control programs, already leaders in advocacy, can emphasize the need for smoking cessation programs and policies that focus specifically on underserved populations, including individuals with mental health illness. Ultimately, coordinated efforts can strengthen and expand treatment programs, control healthcare costs, and improve the well-being of individuals with mental illness and other disparate populations, which have limited access to smoking cessation options, said Williams.”  If you can quit why not if it means you will be here longer with your loved ones, I enjoyed every minute I had with my granddaughter when she was a baby that I would not trade to this day for a cigarette.