Hitting Where It Hurts: Schizophrenia linked to Alzheimer's Disease

The following articles have special meaning for me considering that my father spent the last ten years of his life with Alzheimer's disease and I spent most of my twenties dealing with schizophrenia.



CHARLIE FIDELMAN, in The Montreal Gazette, of January 6, 2009 reports of a study warning that Dementia could become epidemic, and that Alzheimer's patients are getting younger.

The Alzheimer Society of Canada is warning that the number of Canadians living with Alzheimer's disease or dementia is expected to swell to epidemic proportions within a generation.

About half a million Canadians - 119,700 of them Quebecers - are affected. The new study, made public yesterday, predicts that within 25 years, the number of cases of Alzheimer's or a related dementia will more than double, ranging between one million and 1.3 million people.

Researchers stress that the findings, presented in a report called Rising Tide: The Impact of Dementia on Canadian Society, should be a clear signal that more effective treatment and preparation is needed in order to avoid a meltdown within the Canadian health care system. The initial findings report the first new prevalence data since the 1991 Canadian Study on Health and Aging.

"These new data only reinforce the fact that Alzheimer's disease and related dementias are a rising concern in this country, an epidemic that has the potential to overwhelm the Canadian health-care system," Ray Congdon of the Alzheimer Society said in a statement.

The most common form of dementia, Alzheimer's, affects one in 11 Canadians over 65. A degenerative disease that slowly destroys memory, reasoning and orientation, Alzheimer's affects how people think, remember and communicate.

But Alzheimer's is not just a disease of the elderly.

The new data suggest an increasing number of baby boomers are also being struck. About 71,000 Canadians under the age of 65 are living with Alzheimer's disease or a related dementia. Approximately 50,000 are 59 or younger. In Quebec, more than 17,140 are under age 65.

"It's urgent we come up with better treatment or there will be an epidemic," said cognitive neurologist Howard Chertkow, a McGill University professor and director of the Bloomfield Centre for Research in Aging at the Jewish General Hospital.

The rising number of cases is no hype, Chertkow said, which explains the push to get the topic on the front burner.

Research suggests Alzheimer's begins about 20 years before symptoms appear, Chertkow said. But despite better awareness and detection tools, there's still a gap between the number of people who are affected by dementia and the number that show up at clinics for evaluation and treatment, he said.

"Some people think it's normal for Grandpa to become senile and lose his memory. So why take a person like that to the doctor?"

There is no cure, but researchers have made progress in understanding the disease, its causes, what makes people susceptible and how it can be prevented.

The report set out to evaluate the economic impact the increasing incidence of the disease will have on the economy. That analysis will be made public when the full report is issued this year.

A provincial working group developing strategies on dementia is expected to complete its report next month.

Dementia causes cognitive impairment, resulting in the loss of memory, attention and reason.

According to en.wikipedia.org, higher mental functions are affected first in the process. Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are or others around them). Symptoms of dementia can be classified as either reversible or irreversible, depending upon the etiology of the disease. Less than 10 percent of cases of dementia are due to causes which may presently be reversed with treatment.

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Alzheimer's/Schizophrenia Link Discovered

ScienceDaily (May 9, 2008) — Neuroscientists at Johns Hopkins have discovered that mice lacking an enzyme that contributes to Alzheimer disease exhibit a number of schizophrenia-like behaviors. The finding raises the possibility that this enzyme may participate in the development of schizophrenia and related psychiatric disorders and therefore may provide a new target for developing therapies.

The BACE1 enzyme, for beta-site amyloid precursor protein cleaving enzyme, generates the amyloid proteins that lead to Alzheimer's disease. The research team years ago suspected that removing BACE1 might prevent Alzheimer.

"We knew at the time that in addition to amyloid precursor protein, BACE1 interacts with other proteins but we didn't know how those interactions might affect behavior," says Alena Savonenko, M.D., Ph.D., an assistant professor in neuropathology at Hopkins.

Reporting in the Proceedings of the National Academies of Sciences, the research team describes how mice lacking the BACE1 enzyme show deficits in social recognition among other behaviors classically linked to schizophrenia.

A normal mouse, when introduced to another mouse, shows a lot of interest the first time they meet. If the mice are separated then reintroduced, their interest drops because they remember having met before, a phenomenon the researchers call habituation. If they then introduce a completely different mouse, interest piques again at the newbie.

The researchers introduced mice lacking BACE1 to another mouse. The first time they met, the BACE1 mouse showed interest, the second time meeting the same mouse the BACE1 mouse showed less interest and even less interest the third time. The researchers then introduced the BACE1 mouse to a totally different mouse of a different strain and the BACE1 mouse showed no interest at all. "These mice were totally disinterested, normal mice just don't behave like this," says Savonenko.

Additionally, the researchers found that these BACE1-lacking mice also displayed many other schizophrenia-like traits. Most importantly, according to Savonenko, some of the deficits improved after treatment with the antipsychotic drug clozapine.

Because schizophrenia is a disorder likely caused by many different factors, Savonenko explains that BACE1 might contribute to an increased risk of schizophrenia in certain patients and the BACE1 mice will be a useful animal model. "We never thought we would see one mouse that closely mimics so many of the clinical features of schizophrenia," says Alena Savonenko, M.D., Ph.D., an assistant professor of neuropathology at Hopkins. "This could be a really useful model to study and understand the molecular contributions to the disease."

The research was funded by the National Institutes of Health, the National Institute on Aging, the Alzheimer's Association, the Adler Foundation, the Ilanna Starr Scholar Fund and the Bristol-Myers Squibb Foundation.

Authors on the paper are Savonenko, T. Melnikova, F. Laird, K.-A. Stewart, D. Price and P. Wong, all of Hopkins.

On Clergy and Mental Illness

Mental Illness Often Dismissed By Local Church
see http://www.baylormag.com/story.php?story=006239

Has this happened to you?

With research consistently showing that clergy–not psychologists or other mental health experts–are the most common source of help sought in times of psychological distress, a Baylor University study has found that clergy often deny or dismiss the existence of mental illness.

This is believed to be one of only a few studies to look at the experiences which mentally ill people have when approaching their local church for assistance with their troubles.

In the recent Baylor study of 293 Christians who approached their local church for assistance in response to a personal or family member's diagnosed mental illness, Baylor researchers found that more than 32 percent of these church members were told by their church pastor that they or their loved one did not really have a mental illness. The study found these church members were told the cause of their problem was solely spiritual in nature, such as a personal sin, lack of faith or demonic involvement. Baylor researchers also found that women were more likely than men to have their mental disorders dismissed by the church.

In a subsequent survey, Baylor researchers found the dismissal or denial of the existence of mental illness happened more often in conservative churches, rather than more liberal ones.

All of the participants in both studies were previously diagnosed by a licensed mental health provider as having a serious mental illness, like bipolar disorder and schizophrenia, prior to approaching their local church for assistance.

"The results are troubling because it suggests individuals in the local church are either denying or dismissing a somewhat high percentage of mental health diagnosis," said Dr. Matthew Stanford, BS '88, MA '90, PhD '92, professor of psychology and neuroscience at Baylor, who led the study. "Those whose mental illnesses were dismissed by clergy are not only being told they don't have a mental illness, they are also being told they need to stop taking their medication.
That can be a very dangerous thing."

In addition, Baylor researchers found study participants who were told by their pastors they did not have a mental illness were more likely to attend church more than once a week and described their church as conservative or charismatic. However, the Baylor study also found those whose mental illness was dismissed or denied were less likely to attend church after the fact and their faith in God was weakened.

Dr. Stanford's results were published in 'Mental Health, Religion and Culture'.

see also
http://www.ethicsoup.com/2008/10/demon-or-disorder-clergy-dismiss-mental-illness.html

No doubt there needs to be more academic discussion and public education about the connections between mind and spirit. Are the various so-called mental illnesses only another name for classic spiritual disorders? The heart of the issue for Christians is whether to trust in worldly assistance, which is sometimes all even the church ends up actually offering, or to accept that a combination of prayer and counsel and medicine might be required. We must also not forget that clergy too are human and suffer from various psychological and/or spiritual conditions.

A witness that Jesus does heal through friends, family and... yes...sometimes through doctors!

Richard Alastair

Crazy or Genius?

Back in 2002 it was reported (in ScienceDaily - May 22/02)
that Stanford Researchers had Established a Link Between
Creative Genius And Mental Illness

The report began with saying that for decades, scientists have known that eminently creative individuals have a much higher rate of manic depression, or bipolar disorder, than does the general population, and that few controlled studies have been done to build the link between mental illness and creativity.

Stanford researchers Connie Strong and Terence Ketter, MD, were reported as having taken the first steps toward exploring the relationship.

Using personality and temperament tests, they found healthy artists to be more similar in personality to individuals with manic depression than to healthy people in the general population. "My hunch is that emotional range, having an emotional broadband, is the bipolar patient's advantage," said Strong. "It isn't the only thing going on, but something gives people with manic depression an edge, and I think it's emotional range."

Strong is a research manager in the Department of Psychiatry and Behavioral Science's bipolar disorders clinic and a doctoral candidate at the Pacific Graduate School. She is presenting preliminary results during a poster presentation today (May 21) at the annual meeting of the American Psychiatric Association Meeting in Philadelphia.

The current study is groundbreaking for psychiatric research in that it used separate control groups made up of both healthy, creative people and people from the general population.

Researchers administered standard personality, temperament and creativity tests to 47 people in the healthy control group, 48 patients with successfully treated bipolar disorder and 25 patients successfully treated for depression. She also tested 32 people in a healthy, creative control group. This group was comprised of Stanford graduate students enrolled in prestigious product design, creative writing and fine arts programs, including Stegner Fellows in writing, students in the interdisciplinary Joint Program in Design from the Department of Mechanical Engineering and studio arts master's students from the Department of Art & Art History. All subjects were matched for age, gender, education and socioeconomic status.

Preliminary analysis showed that people in the control group and recovered manic depressives were more open and likely to be moody and neurotic than healthy controls. Moodiness and neuroticism are part of a group of characteristics researchers are calling "negative-affective traits" which also include mild, nonclinical forms of depression and bipolar disorder.

Though the data are preliminary, they provide a roadmap for psychiatric researchers looking to solve the genius/madness paradox depicted in the movie A Beautiful Mind, which tells the story of Nobel Laureate John Nash. The existing data need further review, Strong said. "And, we need to expand this to other groups," he said. How mood influences the performance of artists and genius scientists will be the subject of future research at Stanford. "We need to better understand the emotional side of what they do," Strong said.

The study was funded by grants to Ketter, principal investigator and associate professor of psychiatry and behavioral science at Stanford, from the National Alliance for Research on Schizophrenia and Depression, and Abbott Laboratories.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford.

See original article at http://med.stanford.edu/news_releases/2002/may/creative_gen.html