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Schizophrenia News Watch – interesting newsbites from around the globe

by Staff Member on April 28, 2014

With this new posting on “Schizophrenia News Watch” – we are initiating a periodic summary of interesting schizophrenia-related news from around the globe. In these postings we will provide short summaries and links to schizophrenia-related news, videos and presentations from around the world.

Closer than ever to a cure for Schizophrenia: This is a good radio interview with Cyndi Wickert, a schizophrenia-focused professor and researcher that now resides and works in Australia, but who grew up in upstate New York. Cindy has a brother who has schizophrenia.

Professor Wickert has made important contributions to the conceptualization of schizophrenia as a neurodevelopmental disorder and is best known for her pioneering work on brain-derived neurotropic factor (BDNF) and the estrogen receptor. She is Macquarie Group Foundation Chair of Schizophrenia Research, a joint position between NeuRA, UNSW and Schizophrenia Research Institute.

Click here to listen to the full interview: Cyndi Wickert Interview on ABC

Metformin May Help Combat Antipsychotic-Induced Weight Gain – We have reported in the past (6 years ago in this report – “Antipsychotic Drug-induced weight gain stopped with metformin” about the benefits of metformin for people taking anti-psychotic medications. Here is yet another report on this well-proven, and inexpensive medicine (its been available as a generic medication for many years all around the world). In this new news it is reported that:

“Despite its modest ability to attenuate weight gain, metformin may be an important addition for patients at risk for weight gain associated with antipsychotics and related consequences.

In a new meta-analysis, researchers have found the drug metformin appears to be the most effective pharmacological option for countering weight gain related to the use of antipsychotic medications. Metformin is an antihyperglycemic agent that improves glucose tolerance in patients with type 2 diabetes.”

Read the full story here: Metformin May Help Combat Antipsychotic-Induced Weight Gain

More about Metformin on Wikipedia: Metformin

Cognitive Behavioral Therapy (CBT) for Psychosis (Schizophrenia) – Lessons from History and Hopes for the Future

CBT for schizophrenia is the most-recommended psychological approach to improving outcomes in people who have schizophrenia. In the UK / England it is recommended by the National Health Service for everyone who has schizophrenia, and for front-line treatment starting as soon as the person is identified as suffering from schizophrenia. We’ve covered it many times in the past – and you can read some of those news stories and interviews here:

Free CBT for Schizophrenia Therapists Manual Available

Cognitive Behavioral Therapy and Schizophrenia – An interview with Experts

Cognitive Behavioral Therapy Approaches to Schizophrenia

List of CBT for schizophrenia providers in the USA

Web Software that teaches CBT for Schizophrenia (Copingtutor.com) – associated with founder of Schiz.com.

In this new overview on CBT for schizophrenia, out of Australia, it suggests:

“Evidence from the first randomised controlled trials of CBT for psychosis were promising, demonstrating significant improvement in target symptoms after brief intervention. A series of clinical manuals were developed showing how to apply CBT approaches to psychotic symptoms, followed in the early 2000s by positive meta-analyses (e.g., Gould, et al., 2001). More recently, CBT targeting psychosis has begun to be routinely delivered in a range of settings (individual, group, first episode, acute phase etc). The sense of therapeutic nihilism has lifted, with optimism reinforced by the inclusion of CBT for psychosis by the UK National Institute for Health and Clinical Excellence (NICE) guidelines (www.nice.org.uk/nicemedia/pdf/CG82NICEGuideline.pdf)”

“Today, the role of psychological intervention in the management of psychotic symptoms is an established component of treatment. ”

The overview also provides a good summary of some of the CBT working approaches for people with schizophrenia – something that every family could benefit from knowing. While these suggestions are for psychotherapists – we think that many families could benefit from knowing them also. Here is a brief look at these suggestions:

CBT suggestions (to clinicians) for working with psychotic symptoms
Take your time and don’t panic if you feel treatment is stagnating. Engagement and the development of trust take more time when working with people who have schizophrenia than when working with other conditions. Conduct a thorough personal history. Themes often emerge that link development to the context of delusions or hallucinations. For example, the authors have often observed a history of childhood bullying and other forms of ostracism, the internalisation of a low social rank and later paranoia and derogatory, malevolent hallucinations. As best you can, maintain neutrality in the style of a detached, uninvested scientist. It is counterproductive to prematurely challenge a belief. Your role is to gather evidence and assess it collaboratively. Accept that strong convictions are common and are not reserved for those experiencing psychosis. Remember the golden rule – no distress, no psychological treatment. Only aim to modify what is required to reduce distress and for functioning to increase. The aim is not to remove all forms of delusional thinking necessarily. Before commencing CBT, consider the function of the symptoms and the ramifications of symptom modification – e.g., a delusion may be protective of a person’s self respect. If they no longer believe they have special powers, they may conclude they’re worthless and be at risk. We all attempt to cope with stressful situations, even if this coping is ineffective or destructive. If possible, maximise the individual’s current coping style and offer additional strategies. Test reaction to hypothetical contradiction, as this can often indicate whether the person will benefit from cognitive approaches – e.g., if the person believes they have a chip in their brain that empowers them to control others, you may ask: what would you think if we x-rayed your brain and the chip wasn’t there? If the response indicates that clear disconfirmatory evidence would not alter conviction, you may reconsider your approach or even the utility of cognitive therapy.

CBT suggestions (to clinicians) for working with psychotic symptoms

Take your time and don’t panic if you feel treatment is stagnating. Engagement and the development of trust take more time when working with people who have schizophrenia than when working with other conditions.
Conduct a thorough personal history. Themes often emerge that link development to the context of delusions or hallucinations. For example, the authors have often observed a history of childhood bullying and other forms of ostracism, the internalisation of a low social rank and later paranoia and derogatory, malevolent hallucinations.
As best you can, maintain neutrality in the style of a detached, uninvested scientist. It is counterproductive to prematurely challenge a belief. Your role is to gather evidence and assess it collaboratively.
Accept that strong convictions are common and are not reserved for those experiencing psychosis.
Remember the golden rule – no distress, no psychological treatment. Only aim to modify what is required to reduce distress and for functioning to increase. The aim is not to remove all forms of delusional thinking necessarily.
Before commencing CBT, consider the function of the symptoms and the ramifications of symptom modification – e.g., a delusion may be protective of a person’s self respect. If they no longer believe they have special powers, they may conclude they’re worthless and be at risk.
We all attempt to cope with stressful situations, even if this coping is ineffective or destructive. If possible, maximise the individual’s current coping style and offer additional strategies.
Test reaction to hypothetical contradiction, as this can often indicate whether the person will benefit from cognitive approaches – e.g., if the person believes they have a chip in their brain that empowers them to control others, you may ask: what would you think if we x-rayed your brain and the chip wasn’t there? If the response indicates that clear disconfirmatory evidence would not alter conviction, you may reconsider your approach or even the utility of cognitive therapy.

Read the full story: Cognitive Behavioral Therapy (CBT) for Psychosis – Lessons from History and Hopes for the Future

People who Experience Adderall Euphoria Less Likely to Develop ADHD, Schizophrenia – People with a genetic variant that results in euphoria-like feelings after taking d-amphetamine (the active ingredient in Adderall) have a reduced risk for developing attention deficit hyperactivity disorder (ADHD) and schizophrenia, according to scientists from the University of Chicago.

The findings, published in the journal Proceedings of the National Academy of Sciences, add to the long-standing evidence that dopamine — the neurotransmitter responsible for the euphoric feeling of amphetamine — is related to schizophrenia and ADHD

read full story: here

Brain Region linked to Schizophrenia – Researchers have identified a region of the brain which is sensitive to small changes in memory. The results provide a clue as to why this area is often found to be abnormal in people suffering with schizophrenia.

The region of the brain identified as having a link to schizophrenia is the hippocampus (the memory center in the brain), in particular a specific area called CA2.With is region scientists believe that it plays a key role in memory formation.

On bitopertin and sharing data from clinical trials
“one wonders, why didn’t a brand new bitopertin study (ClinicalTrials.gov identifier NCT00616798), with a solid design and impressive action on negative symptoms get any attention – from the media, psychiatrist gurus, patient’s advocates, anyone? The study, which just came out in the flagship psychiatric journal (JAMA Psychiatry) generated no press/media coverage that I am aware off.

Actually, this rather surprising silent treatment is not an accident.

It turns out that this study has been preempted by a press announcement that Roche made this last January stating that bitopertin did not hold up to its promise following its Phase III testing. Meaning that… the just published JAMA Psychiatry study — the very study which generated enough enthusiasm to justify the seemingly well-deserved promotion bitopertin received further down the pipeline — is old, outdated news.

To summarize: on one hand, great positive results from a just published study, which, as it turns out, are actually quite old. On the other hand, negative results in Phase III testing, according to a news conference, but no publications to date.

The result: bitopertin is at the center of what is essentially a skewed and likely misleading state of affairs – at least from the point of view of official scientific validation via publication in peer reviewed journals.”

Read the full story here: On bitopertin and sharing data from clinical trials (PLOS blogs)

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