The viral hypothesis for schizophrenia has persisted for decades, initially supported by observed increases in psychoses subsequent to the influenza pandemic of the early twentieth century, and then ...later by evidence of elevated viral antibody titres particularly in schizophrenia patient populations. Several research studies have also focused on maternal infections during the second trimester of pregnancy and their long-term effects on fetal brain development, ultimately leading to schizophrenia. No specific virus has been implicated although a handful have received increasing attention. The current pandemic spreading the SARS CoV-2 corona virus world-wide is now showing anecdotal evidence of psychoses newly developing post viral exposure, implicating neuronal inflammation in crucial areas of the brain that could initiate psychotic symptoms. Time will tell if epidemiological data will, similar to the 1918 influenza pandemic, show that schizophrenia spectrum disorders increase after serious viral infections.
Publishing science and scholarly work has long required review by colleagues before appearing in print. Peer review is one of the most important and basic tools for science worth communicating. ...Currently it seems to be in a crisis, and as a journal editor, I question why, and call for re-allocating time for this important function in academia.
To provide a summary of the most up-to-date thoughts about treatment for schizophrenia at different stages of illness.
The use of Coordinated Specialty Care clinics has arisen as the standard for ...early on in the treatment of psychosis, providing the notion that recovery is possible. New medications that do not depend on postsynaptic dopamine receptor blockade are soon becoming available.
A focus should be made by clinicians to personalize treatment plans for each patient who has the possibility of being diagnosed with a primary psychosis and the plan should be to predict outcomes based on biological markers that include genetic vulnerability, early psychosocial combined with pharmacological treatments as needed and then a plan to determine or maintain treatments going forward into the future. It is important to individualize treatment by stage of illness, as well as characteristics of the individual patient. Research is ongoing to advance knowledge for interventions at each stage from the premorbid period through to chronicity.
Research on schizophrenia has been pursued for over a century. While the ability to view the brain and also the entire human genome advanced dramatically during this time and particularly in recent ...years, it is still unclear whether these advances helped to understand the nature of schizophrenia. What appears, however, to be the case is that early detection and treatment of people who are at high risk for developing schizophrenia due to various clinical signs, lead to better outcomes and recovery in many cases. Medications have also dramatically improved and have not been associated with the side-effects of earlier treatments, although they still are not without new sets of adverse effects. Over the years it was shown that structural brain abnormalities were present in the brains of people with chronic schizophrenia and that these observations were present early in the onset of illness. It was then shown these were not static and changed over the years of illness. At the same time it was shown that the brain centers for perceiving and speaking language appeared particularly abnormal in patients with schizophrenia and that these abnormalities could underlie the misperceptions and experiences of auditory hallucinations so characteristic of this illness. In a separate set of investigations that began with family, then twin and adoption studies, it was shown that schizophrenia is inherited, but in a complex manner. At present many genetic studies now find that genes, whose variants can lead to a high risk for schizophrenia, are ones specifically involving brain development and functioning. At present, although still speculative, it can be concluded that the progressive changes in brain structure, particularly related to language processing, take place in genetically vulnerable people and put them ultimately at high risk for developing schizophrenia in a trajectory for a lifelong illness. It is hoped that in the future these brain changes can be prevented by intervening early on the processes of brain growth and plasticity, thus arresting the illness before it begins.
Women have historically faced many barriers to professional achievement that have not been suffered by most men; and those women who chose psychiatry as a profession are not exceptions, despite ...psychiatry having a reputation for attracting more women members than many of the other fields of medicine. While a couple of generations ago, blatant discrimination against women was accepted, whether it was because men were thought to traditionally be the family bread winners and women in charge of household stability, or because their appearances and personalities generated a stereotype of what a leader is meant not to “look like”. However, more recently, women have been raising awareness that these views can no longer be tolerated and are calling for change that requires equal opportunities for leadership roles and academic success. The ways in which change can occur include: developing mentorship programs, requiring all faculty, particularly anyone in a leadership role, to be trained in ways in which implicit bias occurs and how to remedy it, providing networking opportunities, and practicing transparent non-biased hiring practices. These will reduce not only the male/ female gap in academic success, but similarly that which exists between racial, ethnic and gender minorities and those who are not thought of as such.
•One in six children globally are growing up where acts of political violence and armed conflict are occurring.•The war in Ukraine puts an estimated 7.5 million children at extreme mental and ...physical health risk.•The consequences for mental health are very diverse, so interventions must be tailored to specific cultural contexts.
The news from Ukraine is currently full of heart-wrenching stories accompanied by graphic images of civilian casualties and massacres that are telecast world-wide on a daily basis. It is hard to fathom the magnitude of the devastation and disruption to regular lives and everyday routines that war brings with it, the witnessing of countless deaths, the associated trauma of living in perpetual fear, and the daily experience of many families and orphans who are crowded into basement bomb shelters now for months on end. These issues make us contemplate the mental health consequences, among other lasting effects, of this costly war in Ukraine, and wars in other countries not so widely featured in Western news. Despite people of all ages being affected by war, children are especially vulnerable. This commentary outlines some of the epidemiology of the consequences of war, the mental health sequelae specifically, and the complexity of providing culturally and contextually relevant interventions that meet the needs of children.
Kraepelin originally defined dementia praecox as a progressive brain disease, although this concept has received various degrees of acceptance and rejection over the years since his famous published ...textbooks appeared. This article places an historical perspective on the current renewal of Kraepelin's concept in brain imaging literature that supports progressive brain change in schizophrenia from its earliest stages through its chronic course. It is concluded that a great deal of future research is needed focusing on the longitudinal course of change, the extent to the regions of change within each individual and the underlying mechanism and implications of brain change through functional and neurochemical imaging, combined with structural studies in the same individuals.
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