Schizophrenia Research: Latest Findings
Schizophrenia research is ongoing, and new developments are consistently being made. For some people with schizophrenia, findings can introduce new interventions that may significantly affect their lives at critical points, possibly improving schizophrenia symptoms and functioning. Researchers suggest that genetic and environmental factors play a role in the development of schizophrenia and look to examine the ways such factors might be mitigated with interventions. Other research might focus on prevention, brain changes in particular stages of the illness, or psychotic symptoms. This article covers the latest findings in schizophrenia research.
Schizophrenia research and news
Considered the official journal of the Schizophrenia International Research Society (SIRS), the Schizophrenia Research journal gathers findings from multiple studies in one place, featuring various clinical trials, systematic reviews, and meta-analyses. For example, one recent study focused on the relationship between negative symptoms and motivation toward monetary rewards. The study in question looked at both bipolar disorder and schizophrenia and suggested that negative symptoms were linked with lower motivation for goal-oriented, monetary rewards.
Early psychosis research
A global network of researchers called Accelerating Medicines Partnership Schizophrenia (AMP SCZ), which was launched in 2020, is presently working to study young, at-risk people for schizophrenia. Mount Sinai has announced that this network of researchers is entering a new phase of testing preventive measures and interventions for addressing schizophrenia symptoms. According to Mount Sinai, "MP SCZ is gathering details on biomarkers that could predict which individuals are at risk for developing psychosis." The participants, who are between 12 and 30, are spread across 13 countries. In June 2023, Mount Sinai researchers from around the world presented findings on "new psychosis risk biotypes, cannabidiol as a novel treatment for psychosis, and new clinical interventions for early-stage mental illness."
First episode psychosis
One recent study involving 404 persons aged 15 to 40 years old with non-affective first episode psychosis (FEP) participated in a program called the Recovery After Initial Schizophrenia-Early Treatment Program. The program notes that early intervention services have been shown to improve symptoms and functioning in FEP, but research hasn't yet examined these services' impact on cognitive functioning. To test their theory, participants were put in either community care (CC) or an early intervention program called NAVIGATE for a period of two years.
Intervention results
The program's findings suggest that early intervention programs may not be as significant in improving cognitive functioning for older FEP patients but showed effectiveness in improving working memory in younger FEP patients. Participants aged 15 to 19 in the early intervention program indicated significant improvement in working memory. Moreover, improvements in cognitive functioning noted in the first year correlated with reduced symptom severity. The study concluded that "interventions targeting cognition may be required to enhance cognitive functioning in most FEP patients."
Differences in brain structure
A structural and functional MRI study sought to examine progressive changes in the brain throughout the illness course. The study had 115 participants with different stages of schizophrenia, divided according to how long they've had the illness (five, 15, and 25 years). These three groups were matched with a control group of 230 people without schizophrenia or another mental disorder.
All groups were evaluated using two structural and functional MRI analysis methods, and each group of patients with schizophrenia was compared with the control groups. These methods indicated that brain abnormalities become present at different stages of the illness. The researchers noted that "individual functional abnormalities occur in limited brain areas initially, functional connectivity and gray matter density abnormalities ensue later in wider brain areas, and structural connectivity abnormalities involving almost all white matter tracts emerge in the third decade of the course in schizophrenia."
Cognitive symptoms
The cognitive impairment associated with schizophrenia symptoms has been a source of interest for researchers. Current findings suggest that cognitive impairment seems to be distinct from positive and negative symptoms. Using a five-factor model (positive, negative, disorganized, excited, and depressed), the Positive and Negative Syndrome Scale (PANSS) is often used to assess the structure of symptoms. Research indicates the disorganized factor is associated with more cognitive impairment.
Schizophrenia research: Latest findings on mental health services
A cross-sectional observational study assessed how diagnosed schizophrenia patients had their first contact with mental health services. The study included 150 schizophrenia patients between 12 and 60 years old and found that faith healers were the most common "pathway to care," and factors such as family members' education and socioeconomic background influence the choice and perception of psychiatric care. The researchers suggest that "while planning mental health services, emphasis should be made on collaboration between psychiatric and nonpsychiatric services."
Healthcare providers
A systematic review of the role of primary care physicians in managing schizophrenia in low- and middle-income countries suggests that appropriate training of primary care physicians to address schizophrenia may reduce the treatment gap and introduce interventions for improving quality of life. The review indicates a need for more integrated care of various professionals who encounter individuals at risk for schizophrenia.
Safeguarding your mental health
Speaking to a therapist may be helpful when struggling with daily life challenges. A therapist can help clients manage stress and find ways to navigate symptoms. If in-person sessions are inconvenient or not easy to reach, online therapy can be an convenient way to receive therapy. Online therapy through platforms like BetterHelp can be a convenient and easy-to-use option for some people grappling with schizophrenia symptoms across the spectrum. Clients can choose between phone, video, or in-app messaging sessions and obtain resources like support groups and worksheets.
Online therapy for schizophrenia
Online therapy can also be effective for treating schizophrenia. Online treatment methods are similar to those conducted in person and often have similar outcomes. Schizophrenia patients can have their symptoms addressed in either an online or in-person format, whichever is most convenient to the individual. However, those experiencing acute psychosis may need to seek in-person care.
Takeaway
What are the latest findings in schizophrenia research?
Research into schizophrenia spectrum disorders has continued to increase in recent years, much of which could lead to new tools and new treatments for managing symptoms. For example, a new study found that paranoia - a common symptom of schizophrenia - has a visual component that might one day allow professionals to test for schizophrenia with an eye test. Another piece of new research found that sensory regions of the brain were more closely connected to the thalamus - the brain’s information relay station - and more weakly connected to the cortex, giving researchers and clinicians another potential biomarker to use as a diagnostic tool.
Researchers continue to search for a common biological basis shared by all psychotic disorders. Large studies, like one that mapped brain networks regulating gene activity, help researchers and clinicians increase the ease of diagnosing schizophrenia while opening up new avenues for research into effective treatments.
What is schizophrenia triggered by?
Scientists are still investigating what mechanism leads to someone developing schizophrenia. A combination of genetic and environmental factors likely play a role. The most significant predictor of whether someone will be diagnosed with schizophrenia is whether they have a family member with the condition. Evidence suggests that genes are likely the schizophrenia risk factor that matters most. Potential environmental triggers include high-stress situations, traumatic exposure, childhood exposure to toxic substances like lead, and substance use.
What makes schizophrenia worse?
Those with schizophrenia often have to prioritize self-care to avoid worsening their symptoms, typically working alongside medical and mental health professionals to develop an effective treatment plan. Many patients learn coping skills to manage and prevent psychotic episodes. They might learn to recognize an episode’s prodrome - early warning signs that indicate psychosis is likely - and take deliberate steps to mitigate the severity of the episode.
Many adults and adolescents with schizophrenia begin focusing on self-care management early in their treatment. Getting enough sleep, eating a healthy diet, and exercising regularly are all known to lower levels of adverse symptoms in those with schizophrenia. Many also prioritize stress management, and high-stress situations are a common trigger for a psychotic episode.
Are schizophrenics aware of their symptoms?
Those with schizophrenia who receive treatment often engage in psychotherapy specifically to recognize and manage their symptoms. However, someone who has not been diagnosed and is not receiving treatment may not be aware of their symptoms. By definition, psychosis refers to a departure from reality. A person experiencing it may not be able to differentiate common symptoms like delusions, hallucinations, or paranoia from rational experiences.
What is the main cause of schizophrenia?
Researchers have not yet developed a complete model of how schizophrenia develops, leading to gaps in understanding regarding which risk factors are most relevant. However, current evidence indicates that genetics likely play the most significant role in determining whether someone will develop schizophrenia. One study shows that genetic risk factors account for 80% of total schizophrenia risk. However, another study of identical twins found that 60% of those diagnosed with schizophrenia also had a twin with the condition. This discovery highlights that, while the genetic risk of schizophrenia is substantial, environmental risk factors still play a significant role. If they didn’t, most or all of the twins in the study would meet the criteria for schizophrenia instead of just over half.
What is the main drug used to treat symptoms of schizophrenia?
Out of all available treatments for schizophrenia, first-line approaches typically include antipsychotic drugs and psychotherapy. Antipsychotics help reduce the frequency and severity of symptoms like visual or auditory hallucinations, delusions, and paranoia. They act on brain cells directly, typically by regulating the action of dopamine or other neurotransmitters. Cells use these neurotransmitters to communicate and determine action potentials, the threshold at which a cell “fires” signals to other cells in the brain.
Stabilizing the neurochemistry within brain tissue reduces the number of psychotic episodes and often completely eliminates symptoms, but the underlying mechanisms are still poorly understood. Clinical drug discovery trials are underway to develop new classes of antipsychotics that are more effective and better tolerated than current drugs.
What is the best lifestyle for schizophrenia?
Likely, the best lifestyle for those with schizophrenia is one based on stress management and self-care. High stress and poor self-care are known triggers for psychotic episodes and can substantially lower overall well-being. Many of those with schizophrenia follow this guidance:
- Eat a healthy diet and drink plenty of water.
- Get regular physical activity.
- Use relaxation strategies like progressive muscle relaxation or mindfulness meditation regularly.
- Work with a professional to learn advanced stress management strategies.
- Adhere to medication regimens and report new or worsening symptoms to healthcare professionals.
- Join a support group to learn new strategies to manage symptoms and support others.
- Stay up-to-date on schizophrenia news and discuss new directions for treatment with healthcare professionals.
What calms a schizophrenic?
Many people with schizophrenia rely on relaxation strategies and stress management techniques to help recognize and prevent psychotic episodes. They might use techniques like diaphragmatic breathing, progressive muscle relaxation, or mindfulness meditation to help them remain calm. If they are experiencing an acute psychotic episode, they may not be able to use their typical strategies. It is not always possible to calm someone experiencing psychosis safely, but you may be able to help by giving the person space, speaking in a calm tone of voice, avoiding challenges to what they communicate, and offering them help in a kind, friendly manner.
What things make schizophrenia worse?
A lack of self-care and high-stress environments typically worsen schizophrenia symptoms. Many people with the condition practice stress management strategies to avoid triggering a psychotic episode. Similarly, many people focus on self-care, like eating healthily, exercising, and getting enough sleep. Avoiding drugs and alcohol is also typically helpful, as substance use is a known trigger for schizophrenia symptoms. Finally, age might worsen the condition, as many older adults experience significantly worse symptoms than their younger counterparts.
What is the most promising treatment for schizophrenia?
The current gold standard for schizophrenia treatments is a combination of antipsychotic medication and psychotherapy. However, some patients do not tolerate antipsychotic medication well, and the psychiatric, neurological, and metabolic effects might make it challenging for some people to take their medication. Furthermore, a patient might have a disease or other medical condition that makes treatment with antipsychotics risky or impossible.
Much of the new research surrounding schizophrenia focuses on personalized medicine that offers a targeted treatment approach. Genetic and laboratory testing can often reveal medications - or combinations of medications - that are likely to be effective and well-tolerated. Research also focuses on non-pharmacological treatments, such as transcranial magnetic stimulation, which uses magnetic pulses to stimulate or inhibit parts of the brain.
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