SCHIZOPHRENIA
Week of November 9, 1998 (Originally aired May 25, 1998)
What is schizophrenia? What's it like to experience its symptoms? Dr. Goodwin and several top researchers and advocates discuss the most recent developments in our understanding of schizophrenia and how to treat it. Psychologist Fred Frese, who himself has schizophrenia, explains that for the schizophrenic, life can be dreamlike. The ability to determine what is true, to control one's actions, to distinguish between internal and external aspects of one's experience -- all can be altered. The ability to communicate with people who do not have schizophrenia may be lost.
Schizophrenia, like other mental illnesses, is biological in nature. Researchers are exploring the interacting roles of various possible causes. According to Dr. Fuller Torrey, an early line of investigation into viruses as far back as the late 1800s was overshadowed by the dominance of Freudian theory until the 70s. Circumstantial evidence, says Torrey, suggests that childhood exposure to viruses with a latency of fifteen to twenty years could trigger development of mental illness in adults. Dramatic technological advances in the study of viral diseases, due partly to AIDS research, have made the search for viruses - and perhaps eventually, vaccines -- a major research approach for both schizophrenia and manic depression.
Dr. Dolores Malaspina explains the theory that brain chemical abnormalities involving the neurotransmitter dopamine underlie psychosis. The theory is supported by the facts that all known medicines that treat psychosis block the dopamine receptor and that people who take medicines that increase brain dopamine in excessive amounts may develop psychosis. An abnormality in the glutamate transmitter, which has a role in memory, may be important as well. Recently, the neurodevelopmental model, which suggests that abnormal brain development may give rise to later schizophrenia, has received more attention. There are probably several different interacting causes, and may in fact be several distinct disorders, each potentially responding to different treatments, said Dr. Malaspina. She recommended seeking out an individualized treatment program as early as possible after diagnosis.
In combination with medications, said Dr. Anthony Lehman, the education and support both of patients and their family members, can control symptoms and allow people with schizophrenia to lead productive lives. A survey of schizophrenic patients he conducted found that less than half are cared for adequately. Compared to dose ranges of medications known to be optimal, one third of patients were taking too little, and one third were taking too much. Dr. Torrey pointed out that the situation is even worse than Dr. Lehman claims, as 50% of people with schizophrenia aren't under any treatment whatsoever. In response to a question about when medications should be changed, Torrey suggested consulting with state and local support groups to find psychiatrists familiar with the patient's condition who can offer a second opinion. Panelists agreed that no single medication is right for all patients.
Since 1971, former First Lady Rosalynn Carter has been a devoted advocate of reducing the common stigma against the mentally ill, which she considers "almost totally based on ignorance and fear." She has sponsored a series of annual symposiums on the issue at the Carter Center. Mrs. Carter talks about her new book, Helping Someone With Mental Illness, which offers current information about research, side effects of medications, and resources pertaining to many mental illnesses.
Harvard's Dr. Jill Bolte Taylor, "the singing scientist", is addressing the shortage of available brains for medical research. She speaks - and sings- to audiences around the country, inviting them to donate their brains to science. Plus, John Hockenberry ponders how much physicians can learn from their patients about dealing with death. Dr. E. Fuller Torrey is a research psychiatrist and executive director of the Stanley Foundation Research Programs, which support research on schizophrenia and bipolar disorder. He was a special assistant to the Director of the National Institute of Mental Health. He is the author of fifteen books and over 200 papers. Additional information about his acclaimed book, Surviving Schizophrenia: A Manual for Families, Consumers & Providers is also available.
Dr. Dolores Malaspina, M.D., is Associate Professor of Clinical Psychiatry, Columbia University, and Research Psychiatrist at New York State Psychiatric Institute. People interested in the Institute's diagnostic and evaluation center for psychotic disorders can call (212) 543-5577 or e-mail dec_pd@columbia.edu. Those interested in inpatient research can call (212) 543-5418, or can e-mail Dr. Malaspina at dm9@columbia.edu.
Dr. Anthony Lehman, Professor of Psychiatry, University of Maryland School of Medicine / Baltimore. He is also Director of the Center for Mental Health Services Research, which studies the delivery of services to people with severe mental illness. Dr. Lehman can be reached at 685 West Baltimore Street, MSTF #300, Baltimore MD 21201.
The Carter Center in Atlanta, Georgia is a non-profit, nonpartisan public policy institute founded by former U.S. President Jimmy Carter and his wife Rosalynn in 1982. The Center is dedicated to fighting disease, hunger, poverty, conflict and oppression through collaborative initiatives in the areas of democratization, and development, global health, and urban revitalization. Click here to find out more about First Lady Rosalynn Carter's advocacy for the mentally ill, and her new book, Helping Someone With Mental Illness. You may also visit the Carter Center on the Web at http://www.emory.edu/CARTER_CENTER/homepage.htm.
Dr. Jill Bolte Taylor specializes in post-mortem research in schizophrenia. To reach her, or find out more about brain donations, call the Harvard Brain Tissue Research Center at (800)-BRAIN BANK. Donations are sought from people with psychiatric and neurological disorders, and those with no disorders at all.
Connie Lieber is President of the National Alliance for Research in Schizophrenia and Depression (NARSAD). NARSAD has awarded $64 million to fund 1,718 grants to 885 scientists in 130 universities and medical research institutions. NARSAD is the largest non-governmental publicly funded organization that distributes funds for brain disorder research. Their newsletter, focusing on the newest developments and treatments, brings a message of hope through research. It also has an annual scientific symposium where young researchers present their NARSAD supported projects. For information, call (516) 829-0091 and (800) 829-8289. Their Web site is at http://www.mhsource.com/narsad.html.
The National Alliance for the Mentally Ill (NAMI) can be contacted at (703) 524-7600. NAMI is a nonprofit grassroots self-help support and advocacy organization of consumers, families, and friends of people with severe mental illnesses, such as schizophrenia, major depression, bipolar disorder, obsessive-compulsive disorder, and anxiety disorders. They have various publications and brochures which describe brain disorders and medications. NAMI has a toll free help line for information and referrals to affiliate groups is 800-950-NAMI (6264) and their Web site is at http://www.nami.org/.