Exercise Can Ease Psychosis in Young People

That is the title of this article I am reviewing today. "'Exercise has been shown to significantly reduce symptoms of first-episode psychosis in young people, according to a new study at the University of Manchester in the U.K. 'This was only a pilot study, but the improvements, particularly in psychiatric symptoms, were dramatic,” said lead author and doctoral student Joseph Firth. “Personalized exercise at local leisure centers seems to be a cost-effective and successful way to help these young people recover.'  When young people are diagnosed with psychosis, the long-term prospects are typically poor with high rates of relapse, unemployment, and premature death.  Many patients also experience rapid, unwanted weight gain due to the antipsychotics they are prescribed.'"If it can help then for sure they should do it.  I walk for exercise I do not know if there is any benefit other than I do not gain weight and even lost a lot by walking.
The article goes on to say: "'Although exercise has been found to be an effective treatment for people with long-term schizophrenia, there have been no studies showing its effects on psychiatric symptoms in young adults with early psychosis, until now. For the study, the researchers recruited 31 people ages 18-35 who had been referred to local mental health centers for treatment.  With the participants help, the researchers designed personalized exercise routines which were carried out under supervision for 10 weeks at local recreation centers. 'Establishing an exercise regime for people with psychosis is likely to be much more effective when they are younger, and in the earliest stages of treatment. Getting people into a routine early on also helps set habits for life, which can make a huge difference to their long-term physical and mental health,' Firth said.'"My illness came on when I was already twenty seven.  To have it younger and go through relapses and everything would be hard and if exercise helps that would be great.  The reason I do not see any difference in me is I do not suffer from symptoms by last relapses was in 1994 because they had lowered my medicine. I am lucky in my illness because I do not have problems with my mental illness.
The article ends: "'The study participants actually exceeded the target amounts of exercise, achieving 107 minutes of vigorous exercise training each week for 10-weeks. This compares favorably with exercise programs in healthy populations as well as in schizophrenia. 'Personalizing exercise training to the activities which patients find most motivating helps them stick to their program,' said Firth.
At the end of the 10-week period, the participants completed a variety of standardized mental and physical health tests. The researchers compared their results to those of a control group of seven people being treated by mental health services without an exercise program. The findings showed that the exercise group experienced a 27 percent reduction in psychiatric symptoms on the standardized tests, much better than the control group. Their brain function also improved, and they achieved a slight reduction in body weight — going against expected weight gain from normal treatment.
'By reaching people early on, exercise can provide a healthy and empowering add-on treatment for young people with psychosis. This could massively improve their social functioning and mental health, hopefully preventing long-term disability from ever arising,' Firth said.'" I do know that when I take a day off from work the day is long and my aunt who is retired tells me the same thing so anything I believe that can improve the lives of those who suffer from this illness is great. I used to work out in the fitness center where I live there I would lift weight also.  Although now that we have new mangement they want to charge to workout I will not pay so I just walk now.

Cognitive Dysfunction Often First Sign of Schizophrenia

That is the title of this article I am reviewing today. "'People with schizophrenia  suffer not only from symptoms of psychosis, such as hallucinations and delusions, but neurocognitive deficits as well such as poor memory and attention. Now a new study led by psychologists at Beth Israel Deaconess Medical Center (BIDMC) found that certain neurocognitive symptoms tend to manifest first and are typically evident in the early, high-risk stage of the disorder called the prodromal phase.

The findings suggest that these deficits may serve as early warning signs of schizophrenia, as well as potential targets for intervention that could help curb the onset of the psychotic disorder and significantly improve cognitive function. 'To our knowledge, this is the largest and most definitive study of cognition in the high-risk period before onset of for psychosis/schizophrenia,' said corresponding author Larry J. Seidman, Ph.D., a psychologist at BIDMC and professor of psychology at Harvard Medical School.'" That is the hardest losing attention span and memory.  It makes it hard to hold down a job and make some money.
The article goes on to say: "'This is part of a paradigm shift in the way we are focusing on the earlier, prodromal phase of the disorder in an effort to identify those most likely to develop psychosis.”\'
For the study, the researchers gathered neurocognitive functioning data from participants at eight university-based, outpatient programs in the United States and Canada over the course of four years. They compared 689 males and females deemed at clinical high risk (CHR) of developing psychosis to 264 male and female healthy controls (HC). The findings show that the high-risk group performed significantly worse than the control group on all measures, which involved tests of executive and visuospatial abilities, attention and working memory, verbal abilities, and declarative memory.
Among the high-risk participants only, those who would later go on to develop psychosis performed significantly worse than their high-risk peers who did not develop psychosis during the study.

'Currently, when mental health professionals assess people coming in for evaluation, we don’t know who will eventually develop schizophrenia,' said Seidman. 'Our group’s focus is on identifying early warning signs and then developing interventions to improve a person’s chances for not getting it, making it milder or delaying it.'" Even if they can make it milder that would help.  I remember not understanding what was going on with me when I first had a breakdown.
The article ends: "Impaired working memory (the ability to hold information like a phone number in mind for a short time while it’s in use) and declarative memory (the ability to recall things learned in the last few minutes) turned out to be the key neurocognitive functions that are impaired in the high-risk, prodromal phase prior to the onset of full-blown psychosis. These findings, said Seidman, confirm the experiences of many people with schizophrenia who report sudden difficulties reading, concentrating or remembering things in the earliest days of the disorder. These cognitive deficits are the most difficult symptoms to treat and are responsible for keeping roughly 80 percent of people with schizophrenia out of work or school. New focus on the prodromal period and the growing promise of early intervention is giving patients and their families more realistic hope that better outcomes are possible, added Seidman. 'People can hear voices and still function pretty well, but they basically cannot function at all when their cognition is impaired,' he said. 'We are also testing a number of cognitive remediation and enhancement treatments to determine their role in the evolution of the illness. There’s more evidence suggesting that early intervention reduces the number of people who transition to schizophrenia.' The study is published in the journal JAMA Psychiatry.'" See I would like to know how and why my memory works so good.  Although before this illness I never had a phone book I remembered everyone's phone number I still am pretty good with numbers although I do not know about other things if there is something I want to remember I just repeat the phrase or number to myself and that works.

Genes Tied to Smaller Brain Area in Those At Risk for Psychosis

That is the title of this article I am reviewing today. "Scientists in Switzerland have uncovered a link between certain genes and the size of important brain structures in individuals with a heightened risk of schizophrenia psychosis. The findings are published in the scientific journal Translational Psychiatry. Schizophrenia is a severely debilitating mental disorder characterized by hallucinations, delusions and cognitive decline. The condition has been linked to a variety of biological, social, and environmental factors as well as to changes in brain structure. For example, the hippocampus in the temporal lobe is usually smaller in people with schizophrenia compared to those without the disorder. Researchers have been unsure whether these changes to the brain structure are a result of the disorder and/or its prescribed medications, or whether these changes were already present before the onset of symptoms. For the study, a research team at the University of Basel examined the brain structures of individuals who were at risk of developing psychosis as well as those of patients who were experiencing the onset of psychotic symptoms for the first time."  I do not understand what they could have found because everyone with the schizophrenia have different ways the mental illness affects some are lower functioning some are higher functioning.
The article goes on to say: "Initially, scientists from the Adult Psychiatric Clinic of the University Psychiatric Clinics (UPK) and the Transfaculty Research Platform Molecular and Cognitive Neurosciences (MCN) observed no notable differences between the hippocampi of individuals at high risk and those of patients. Next, in collaboration with scientists from the Transfaculty Research Platform, the Basel researchers investigated whether any known schizophrenia risk genes were associated with the hippocampus structure. They did, in fact, find a connection. The researchers found that the greater the number of risk genes a person possessed, the smaller the volume of their hippocampus. This was true regardless of whether they were a high-risk study participant or a patient."  There have been other studies with the hippocampus  I wrote about them a couple of years ago.
The article ends: "'This discovery suggests that a group of risk genes is connected with a reduction in the size of a critical region of the brain before the disorder manifests itself. The findings offer a greater understanding of neurobiological factors contributing to schizophrenia. It is well-known that none of the wider risk factors (e.g. genes, environment, unfavorable social situation) can be used to predict the onset of psychosis in any specific person. However, the discovery may be of use for the treatment of schizophrenia. 'It is quite possible that individuals with smaller hippocampi will react differently to therapy compared to those with normally developed hippocampi,' said lead researcher Dr. Stefan Borgwardt of the Neuropsychiatry and Brain Imaging Unit. The scientists are planning more studies to further confirm the therapeutic potential of this new finding.'"  They do these studies but we get no answers.  Like I would like to know why I have this disease since it does not run in my family.

New Approach Advised to Treat Schizophrenia

That is the title of this article I am writing about. "More than two million people in the United States have a diagnosis of schizophrenia, and the treatment for most of them mainly involves strong doses of antipsychotic drugs that blunt hallucinations and delusions but can come with unbearable side effects, like severe weight gain or debilitating tremors.  Now, results of a landmark government-funded study call that approach into question. The findings, from by far the most rigorous trial to date conducted in the United States, concluded that schizophrenia patients who received a program intended to keep dosages of antipsychotic medication as low as possible and emphasize one-on-one talk therapy and family support made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.Its findings have already trickled out to government agencies: On Friday, the Centers for Medicare & Medicaid Services published in its influential guidelines a strong endorsement of the combined-therapy approach. Mental health reform bills now being circulated in Congress “mention the study by name,” said Dr. Robert K. Heinssen, the director of services and intervention research at the National Institute of Mental Health, who oversaw the research. In 2014, Congress awarded $25 million in block grants to the states to be set aside for early-intervention mental health programs. So far, 32 states have begun using those grants to fund combined-treatment services, Dr. Heinssen said. Experts said the findings could help set a new standard of care in an area of medicine that many consider woefully inadequate: the management of so-called first episode psychosis, that first break with reality in which patients (usually people in their late teens or early 20s) become afraid and deeply suspicious. The sooner people started the combined treatment after that first episode, the better they did, the study found. The average time between the first episode and receiving medical care — for those who do get it — is currently about a year and half." I wish they would have kept my medicine low dose maybe I would not be fighting all this weight.
The article goes on to say: "'As for medications, I have had every side effect out there, from chills and shakes to lockjaw and lactation,' said a participant in the trial, Maggie, 20, who asked that her last name be omitted. She did well in the trial and is now attending nursing school. Doctors praised the study results. 'I’m very favorably impressed they were able to pull this study off so successfully, and it clearly shows the importance of early intervention,' said Dr. William T. Carpenter, a professor of psychiatry at the University of Maryland School of Medicine, who was not involved in the study. Dr. Mary E. Olson, an assistant professor of psychiatry at the University of Massachusetts Medical School, who has worked to promote approaches to psychosis that are less reliant on drugs, said the combined treatment had a lot in common with Open Dialogue, a Finnish program developed in the 1980s. 'These are zeitgeist ideas, and I think it’s thrilling that this trial got such good results,' Dr. Olson said. In the new study, doctors used the medications as part of a package of treatments and worked to keep the doses as low as possible minimizing their bad effects. The sprawling research team, led by Dr. John M. Kane, chairman of the psychiatry department at Hofstra North Shore-LIJ School of Medicine, randomly assigned 34 community care clinics in 21 states to provide either treatment as usual, or the combined package. The team trained staff members at the selected clinics to deliver that package, and it included three elements in addition to the medication. First, help with work or school such as assistance in deciding which classes or opportunities are most appropriate, given a person’s symptoms. Second, education for family members to increase their understanding of the disorder. And finally, one-on-one talk therapy in which the person with the diagnosis learns tools to build social relationships, reduce substance use and help manage the symptoms, which include mood problems as well as hallucinations and delusions." If some one would have explained a mental illness to me when I first was ill it would have been a great help.
The article ends: "For example, some patients can learn to defuse the voices in their head — depending on the severity of the episode — by ignoring them or talking back. The team recruited 404 people with first-episode psychosis, mostly diagnosed in their late teens or 20s. About half got the combined approach and half received treatment as usual. Clinicians monitored both groups using standardized checklists that rate symptom severity and quality of life, like whether a person is working, and how well he or she is getting along with family members. The group that started on the combined treatment scored, on average, more poorly on both measures at the beginning of the trial. Over two years, both groups showed steady improvement. But by the end, those who had been in the combined program had more symptom relief, and were functioning better as well.The researchers expect to have lowered average doses in the combined program but had not yet finished analyzing that data. 'One way to think about it is, if you look at the people who did the best — those we caught earliest after their first episode — their improvement by the end was easily noticeable by friends and family,' Dr. Kane said. The gains for those in typical treatment were apparent to doctors, but much less obvious. Dr. Kenneth Duckworth, medical director for the National Alliance on Mental Illness, an advocacy group, called the findings “a game-changer for the field” in the way it combines multiple, individualized therapies, suited to the stage of the psychosis. The study, begun in 2009, almost collapsed under the weight of its ambition. The original proposal called for two parallel trials, each including hundreds of first-episode patients. But that plan was changed due in part to recruiting problems, said people familiar with the project. 'It’s been a long haul,” Dr. Heinssen added, “but it’s worth noting that it usually takes about 17 years for a new discovery to make it into clinical practice; or that’s the number people throw around. But this process only took seven years.'
Correction:
 October 23, 2015 
An article on Tuesday about a study of the treatment of first-episode schizophrenia referred incorrectly to the conclusions of the study. Though it studied a program intended to reduce medication dosages, the researchers do not yet know for sure if dosages were lowered or by how much. Therefore, the study did not conclude “that schizophrenia patients who received smaller doses of antipsychotic medication and a bigger emphasis on one-on-one talk therapy and family support made greater strides in recovery.” (The study did conclude that the alternative treatment program as a whole led to better outcomes.) The article also erroneously attributed a statement to Dr. Robert K. Heinssen, who oversaw the research. It was scientists familiar with the project — not Dr. Heinssen — who said that the study’s original proposal, calling for two nearly identical trials, was changed in part because of recruiting problems. (Dr. Heinssen said that one trial was redirected, but did not say why.) And because of an editing error, the article misidentified the institution where Dr. Heinssen is director of services and intervention research. It the National Institute of Mental Health, not the Centers for Medicare & Medicaid." I just hope there is something new that can especially with the face cramping and other side effects from the medication.

Psychosis Seldom Leads to Violence

That is the title of this article I am writing about.  "The hallucinations and delusions associated with psychosis seldom foreshadow acts of violence, according to new research led by the University of California, Berkeley.  The findings, published in the online journal Clinical Psychological Science, challenge the media-fueled stereotype of psychosis-induced aggression.  For the study, researchers conducted a meticulous review of 305 violent incidents by mental health patients in the United States, and discovered that only 12 percent of these were preceded by psychosis.  Numerous studies have shown that violence and murder are more likely to be sparked by anger, access to firearms, and substance abuse. The new study is the first to analyze the regularity of psychosis-induced violence among the mentally ill.  'High-profile mass shootings capture public attention and increase vigilance of people with mental illness. But our findings clearly show that psychosis rarely leads directly to violence,' said study lead author Dr. Jennifer Skeem, a clinical psychologist and associate dean of research at University of California, Berkeley’s School of Social Welfare. " People with mental illness are usually the subjects of violence happening to them. My mental illness had some violence although I was drunk on tequila or it would have never happen at all.
The article goes on to say: "Skeem and fellow researchers at the University of Virginia and Columbia University focused on the most violent patients tracked in the MacArthur Violence Risk Assessment study, a major 1998 analysis of more than 1,100 offenders who had been discharged from psychiatric facilities. Specifically, the researchers focused on 100 high-risk patients, who had been involved in two or more violent incidents in the year after they were discharged from a psychiatric facility. The goal was to establish their mental states at the time they were engaging in acts of violence. 'We wanted to examine the small group of people with repeated violence and see how consistently these violent incidents were caused by hallucinations and delusions,' Skeem said. In addition to reviewing records, they interviewed former patients about what they were thinking and feeling just before they committed acts of violence, and also sought the perspectives of their friends and family members." I have not committed an act of violence in the twenty six years of having a mental illness since that day. There are more regular people who commit violence everyday than people with mental illness.
The article ends: "The findings revealed that psychosis preceded only 12 percent of the violent acts they committed following their release. Furthermore, if psychosis was the basis of one violent incident, it was rarely implicated in subsequent ones. Mental health professionals and advocates assert that high-profile cases perpetuate the stigma of mental illness, and keep people who are suffering from psychiatric disorders from talking about their condition and seeking help. In fact, they say, people with mental illness are more likely to be victims of violence than the perpetrators. 'None of this detracts from the message that people with mental illness need access to psychiatric services,' Skeem said. 'But it’s important to remember that risk factors for violence, such as substance abuse, childhood maltreatment, neighborhood disadvantage, are mostly shared by people with and without mental illness, and that’s what we should be focused on if maximizing public safety is our goal.'" They tell the truth I would never commit a violent act again.  I would not have committed that one if I was not drunk.  I know that is not a good excuse although it happened and I will never let it happen again.
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