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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Netch on January 16, 2009, at 9:02:52
"Jan. 15, 2009 -- The largest study ever to track bipolar disorder and schizophrenia within families offers evidence that the two psychiatric disorders share a common genetic cause.
For more than a century the psychiatric community has debated whether schizophrenia and bipolar disorder were two distinct disorders or were more connected.
Over the course of their illnesses, many patients experience similarities in certain symptoms characteristic of both, such as manic mood swings in bipolar disorder and psychosis in schizophrenia.
Recent genetic studies suggest a common genetic cause for the two conditions. But earlier studies in families have not supported this conclusion, finding no increase in bipolar disorder in family members of schizophrenics and vice versa.
Family Links: Bipolar Disorder, Schizophrenia
In an effort to help settle the question, researchers in Sweden linked a comprehensive national health registry to equally comprehensive hospital discharge records.Three decades of registry and hospital data (1973 to 2004) involving 9 million Swedes from 2 million families were analyzed to determine risk for schizophrenia and bipolar disorder among biological and nonbiological relatives of patients with one or both of the disorders.
Close to 36,000 people with schizophrenia and 40,500 people with a diagnosis of bipolar disorder were identified.
The analysis revealed that:
First-degree relatives (parents, siblings, or offspring) of people with either schizophrenia or bipolar disorder were at increased risk for both of these conditions.
If a sibling had schizophrenia, full siblings were nine times more likely than the general population to have schizophrenia and four times more likely to have bipolar disorder.
If a sibling had bipolar disorder, they were eight times more likely to have bipolar disorder and four times more likely to have schizophrenia.
Half siblings who shared the same mother were 3.6 times more likely to have schizophrenia if their half sibling had schizophrenia and 4.5 times more likely to have bipolar disorder if their half sibling had bipolar disorder. Half siblings who shared the same father had a 2.7-fold increase in schizophrenia risk and a 2.4-fold increase in bipolar disorder.
Adopted children with a biological parent with one of the disorders had a significant increase in risk for the other.
Shared and non-shared environmental factors also contributed to risk, but they were less important influences than genetics.The findings appear in the Jan. 17 issue of the journal The Lancet.
'Time to Rethink Disorders'
"It is time that we rethink the way we view these disorders," study co-author Christina Hultman, PhD, tells WebMD. "And it is clear that we need more genetic studies to help us better understand this shared risk."In an editorial accompanying the study, Cardiff University dean of medicine Michael Owen, MD, PhD, suggested that the earlier family studies were far too small to show the genetic link between schizophrenia and bipolar disorder.
In an interview with WebMD, Owen called the latest research very strong, with major implications for how patients are managed.
"When someone receives a diagnosis of schizophrenia it is easy for clinicians to overlook mood disorder and other symptoms that don't fit with that diagnosis," he says. "The same is true for psychotic symptoms that may occur in people labeled with a diagnosis of bipolar disorder."
He adds that it is important for clinicians to recognize that symptoms can, and often do, change over time.
"Most patients don't fit neatly into categories, and the more questions you ask the more likely you are to find a combination of psychotic and mood symptoms," he says.
John H. Krystal, MD, of Yale University Medical Center and the VA Connecticut Healthcare System, agrees.
He tells WebMD that psychiatry has long struggled with "a gray zone" of patients who do not neatly fit into the categories of bipolar disorder and schizophrenia.
He adds that the new research could have major implications for the development of new treatments for the psychiatric disorders."
Posted by Trans-Human on January 16, 2009, at 9:37:22
In reply to Gene link: schizophrenia + Bipolar Disorder?, posted by Netch on January 16, 2009, at 9:02:52
Still no definite link then or categorical genetic cause.
Posted by Netch on January 16, 2009, at 10:55:09
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Trans-Human on January 16, 2009, at 9:37:22
Hopefully future DNA studies will identify the genes involved.
/Netch
Posted by Trans-Human on January 16, 2009, at 15:05:17
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Netch on January 16, 2009, at 10:55:09
> Hopefully future DNA studies will identify the genes involved.
>
> /NetchThe exact cause of Schizophrenia has never been proved to be biological in nature. I doubt that a biological cause will ever be found. If they could isolate a specific abnormality in brain function; which they can't, it still wouldn't categorically prove biological origin or basis; as cause.
There are too many other potentially contributing factors - from psychological causes to environmental.
Geneticists have conceded that no one Gene is the cause of Schizophrenia & they have been looking at how multiple genetic factors may combine to produce the condition. Despite stories of how they may have found this or that; & very loose anecdotal evidence - nothing ever does get found.
Does it not strike anyone else as odd - considering the vast amount of resources & time that has gone into this - that the chemical imbalance theory is still a theory & genetic cause is as elusive as it always has been?
A document which is well worth reading -
Recent Advances in Understanding Mental Illness and Psychotic Experiences:
A report by The British Psychological Society Division of Clinical Psychology.The full document can be read here -
http://www.freedom-center.org/pdf/britishpsychologicalsocietyrecentadvances.pdf
Posted by seldomseen on January 16, 2009, at 18:17:14
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Trans-Human on January 16, 2009, at 15:05:17
"Geneticists have conceded that no one Gene is the cause of Schizophrenia & they have been looking at how multiple genetic factors may combine to produce the condition. Despite stories of how they may have found this or that; & very loose anecdotal evidence - nothing ever does get found.
Does it not strike anyone else as odd - considering the vast amount of resources & time that has gone into this - that the chemical imbalance theory is still a theory & genetic cause is as elusive as it always has been?"
No, this doesn't strike me as odd at all. Well, no more odd than the fact that we still haven't cured cancer. What we have learned about cancer is that there a multiple types of cancer, that no one gene causes all types, and in some, no genetic basis for it exists at all - it mainly environmental.
Now also consider that cancer is a very simple disease. It's just a bunch of abnormally dividing cells. Yet, even to this day, we know surprisingly little about it in real, applicable, clinical terms, despite the fact that volumes upon volumes of literature is devoted to describing it. Compared to the brain, a dividing cell is almost puerile.
When one compares the billions of dollars and hours spent describing cancer to the trickle of funds and effort devoted to mental illness, it's perhaps even less of an oddity that we don't know that much about it.
To me, lack of evidence is proof of only lack of evidence.
Seldom
Posted by linkadge on January 16, 2009, at 18:24:13
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Trans-Human on January 16, 2009, at 15:05:17
I would have to argue with some of the comments made above. It is true that, at this point in time, no conclusive biological casue of schizophrenia has been found. I would also agree that there is probably not one single gene responsable for the disease. This does not imply that, in the future, we will be able to discover the gene or genes responsable for certain subtypes of the disorder.
>I doubt that a biological cause will ever be >found. If they could isolate a specific >abnormality in brain function; which they can't, >it still wouldn't categorically prove biological >origin or basis; as cause.
I would have to disagree with the above. It is quite possible that they can, and will, locate the gene or genes responsable for certain subtypes of bipolar or schizohprenia. The fairly recent discovery, for instance, that Huntington's disease is a 100% genetic disorder is a good example of how specific genes can be identified as the cause of certain neurological disorders.
There have been some recent discoveries relating bipolar disorder to specific genes which regulate calcium, sodium and protein kinase function homeostasis is impressive and promising.
>Geneticists have conceded that no one Gene is >the cause of Schizophrenia & they have been >looking at how multiple genetic factors may >combine to produce the condition.
They have conceded that no one gene is responsable for the entire category of schizophrenia. This does not imply that a single gene or genes is not responsible for different subtypes of the disorder.
>Does it not strike anyone else as odd - >considering the vast amount of resources & time >that has gone into this - that the chemical >imbalance theory is still a theory & genetic >cause is as elusive as it always has been?
I think we have made some substantial progress in the understanding of mental disorders in the past 20 years. The reason we have not located a single gene is because we are not dealing with a single disorder.
Linkadge
Posted by Trans-Human on January 16, 2009, at 19:07:13
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by linkadge on January 16, 2009, at 18:24:13
Reasonable, balanced & intelligent replies; & it may well be that I'm proved wrong. However, it may be that the best scientists will ever be able to come up with is susceptibility.
To my understanding - People can be driven mad. Environmental stresses, severe trauma, certain social circumstances & inter personal relationships can have the potential for causing a "mental episode" - of course these in turn cause bio chemical changes. I don't think it is as simple to say that one over the other causes mental illness, although some may be more susceptible to go "over the edge" than others; due to physical make up. I would think it is complex & involves multiple factors which could well be different in every case; which is reason why bio medicine has not as yet come up with any concrete answers; & why we may have to eventually look outside of the box to reach any kind of definite conclusion.
A purely bio chemical basis to Schizophrenia & other mental illness is not supported by the genuine & astounding recoveries made by people under the care of certain practitioners; including Jung, John Weir Perry, Loren Mosher & others - who all had over 85% full recovery rates; with patients classed as having severe "mental illness". How do these well documented; proved; albeit generally ignored cases, tally up with a purely "orthodox bio medical disease model"? If these conditions had a sole Genetic cause - how were the results of these practitioners obtained using purely psychological means?
Posted by linkadge on January 16, 2009, at 21:25:43
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Trans-Human on January 16, 2009, at 19:07:13
I do agree that severe stress can cause many forms of mental illness. In many people with schizophrenia however, doctors nor family can identify any significant form of environmental trigger. Because many forms of mental illness resemble normal responces to environmental stress, people sometimes have a hard time believing that there is anything infact a thing as mental illness.
When the brain is under severe stress it can release all sorts of chemicals that can produce behavioral states resembling schizohprenia. For instance, stress increases PKC which supresses prefrontal and higher cortex functioning and can lead to impulsivity and distractability. In addition, severe stress can release endogenious compounds that bind to the same receptors as phenycyclidine. PCP interacts with NDMA receptors in a way that can produce a state remarkably similar to disorganized schizophrenia. Severe stress can also dramatically increase conceptrations of PEA which is similar in action to the amphetamines. There are a number of other compounds released during stress such as isatin (decreases the binding of gaba to gaba receptors) as well as tryptamine (which binds to the same receptors as LSD).
There have been a number of recent studies, however, suggesting that there is a progressive loss of grey matter in schizohprenia. This is interesting because some of the genes associated with *certain forms* of schizophrenia are responsable for the production and maintainance of myelin.
If stress is not too severe or prolonged, it doesn't tend to induce structural changes to the brain. This is why, some people can have psychotic breaks and just go back to normal. The healthy brain has a capacity to repair itself after certain forms of neurological insult.
In genuine mental illness however, there could be a reduced capacity for the brain to repair itself after stressfull events. There could be an initial decreased cellular resiliance. There may be impairments in the brain's capacity to undergo normal maintainance too. This is like what happens in MS, where, for whatever reason, the brain just starts to loose its remyleinating capacity. Many cases of schizophrenia start out as other mood disorders like anxiety disorders or depression. This could be an early indicator of the types of brain changes that are occuring.
Some of the mood stabilizers like lithium and valproate may be working by enhancing cellular resiliance and boosting the level of cetain neurotrophic factors. Early studies suggest they may be preventing the atrophy associated with the disorders.
(Some studies indiciate that bipolar is associated with significant reductions in DHA content. DHA like valproate inhibits GSK-3b, PKC and induces the neuroprotective protein BCL-2. PKC expression modifies the way the brain utilizes and responces to calcium. DHA is also critical for the maintainance of grey matter. Perhaps divalproex is just ameleorating the signal transduction deficits that result from severe DHA deficiancy. Then again, there are genes that code for the conversion of short chain omega-3's to DHA. Some studies like alchoholism, for instance, with a gene that impairs this process. Not to go on a tangent.)
I guess what I am trying to say that even though we do not have solid conclusive results at this point, I don't doubt that some cases of mental illness are associated with real and significant brain changes.
Nobody would doubt that parkinsons is an actually a brain disesase. Some forms of Parkinsons have been conclusively linked to genes, other forms are associated with exposure to neurotoxins. Perhaps mood disorders are like parkionsons of the limbic system. There could be many causes, but to say that search for particulalr causes is futile may not be entirely acurate.
>including Jung, John Weir Perry, Loren Mosher & >others - who all had over 85% full recovery >rates;Yes and modern studies claim that prozac works in 85% of depressed patients. That doesn't mean I believe that either.
Linkadge
Posted by Trans-Human on January 16, 2009, at 22:32:34
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by linkadge on January 16, 2009, at 21:25:43
> Yes and modern studies claim that prozac works in 85% of depressed patients. That doesn't mean I believe that either.
>
>
> LinkadgeWhich studies are those? As far as I am aware the most recent studies into anti depressants show they are ineffective in the majority of cases & no better than a placebo.
Thank you for your reply - but I admit that I am not up, at depth, on the technical terms & intricacies of the scientific jargon regarding present understandings of brain function. I am however largely aware of the present level lack of definition as to what is exactly going on in mental illness.
The facts still remain that there is no definite genetic cause; nor any proof beyond weak anecdotal; that chemical imbalance & brain dysfunction is to blame.
Despite the advances in neurology; still too little is known about brain function; & how it's myriad parts & systems combine to produce overall function.
The biological basis for Schizophrenia is not established - & yet you speak as if it is a done deal - far from it my friend.
Don't get me wrong. I sincerely hope that neurological research & studies in brain function carry on & increase. Neurological scientific research is what is needed; on one level to help assist those afflicted. For some a chemical solution is the best one; & God knows how that needs to be improved. But people would be wise to also look towards balance with these matters & also more phenomenological; metaphysical; & esoteric perspectives.
It may appear that you are on an opposite end to the spectrum to me in regards to our perspectives on this. I do believe in the great work that was done by Jung & those who have carried on his tradition; & I think it shameful; to say the last; that his ideas have not been universally accepted & implemented. I have studied, researched, read & experienced enough to know the genuine nature of his work; & it is by no means an over statement to say that he was the greatest mind of the last century & by far the greatest psychiatrist to have ever lived. But it is OK with me to agree to disagree.
Time will tell; & history will judge these things accordingly.
Posted by Trans-Human on January 16, 2009, at 22:41:42
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by linkadge on January 16, 2009, at 21:25:43
There could be many causes, but to say that search for particulalr causes is futile may not be entirely acurate.
>
I concede that it is maybe not futile. But expounding theories as fact & moulding "mental illness" to a scientific reductionist perspective; at the exclusion of other paradigms which have shown great results - is IMO - too narrow a view.
Posted by linkadge on January 17, 2009, at 8:13:16
In reply to Re: Gene link: schizophrenia + Bipolar Disorder? » linkadge, posted by Trans-Human on January 16, 2009, at 22:32:34
>Which studies are those? As far as I am aware >the most recent studies into anti depressants >show they are ineffective in the majority of >cases & no better than a placebo.
But thats exactly what I am getting at. Early studies claimed on thing, but the reality is totally different. Just because Jung claimed that he had a 95% sucess rate or whatever, doesn't mean it is true.
Linkadge
Posted by Trans-Human on January 17, 2009, at 8:23:51
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by linkadge on January 16, 2009, at 21:25:43
> There have been a number of recent studies, however, suggesting that there is a progressive loss of grey matter in schizohprenia. This is interesting because some of the genes associated with *certain forms* of schizophrenia are responsable for the production and maintainance of myelin.
>I do not think that there has been enough in the way of unbiased study & research into these matters. It is also very difficult to obtain accurate data on these subjects - for certain reasons which I will outline here -
In many studies of the brains of people with "Schizophrenia" - they have been treated with medications. There is a lot of evidence for the way psychiatric drugs alter brain structure & function. Lets have it right - anti psychotics work by altering the brain - it's chemical make up & operation. It is a lie to say these types of drugs correct any kind of chemical imbalance - they work in very crude ways; & it is more accurate to say they cause chemical imbalance & brain abnormality.
Those classed as having "Schizophrenia" & who are never treated with medication, & who never have any other kind of treatment also show signs of brain abnormalities & damage. However - these findings need to be balanced with the groups of people who have had effective & comprehensive psychological help. Outlined in the Diabasis & Soteria Projects (To name two). The only way to gain a half accurate picture is to make comparisons between all three groups.
I would strongly assume & conclude that the best prognosis & those having best overall brain function is made by those having had "comprehensive psychological help in a therapeutic environment", followed by med treated, & those faring most poorly are those with no treatment.
In my own life - from an orthodox psychiatric perspective - I am classed as suffering from "paranoid schizophrenia", & have been for 20 years. On two occasions I was able to successfully stop all psychiatric medication for long periods of time.
After being placed on high doses of meds 10 odd years ago - I came off the meds after a year & then returned to a very minimal dose; which I have been on since. Over this time; overall functioning has improved. I would consider that my IQ is higher now than it ever was - & I have an above normal intelligence. I also know a number of people in my life, & on-line who have been diagnosed with "schizophrenia" & are living full lives, completely med free - without psychotic symptoms.How are these things possible from the perspective of the idea that "Schizophrenia" is a progressive & incurable brain disease? It doesn't make sense to see it that way. Current understandings around mental illness & Schizophrenia; acknowledge the very real realities of recovery & remission.
http://www.freedom-center.org/pdf/britishpsychologicalsocietyrecentadvances.pdf
> In genuine mental illness however, there could be a reduced capacity for the brain to repair itself after stressfull events.Could be? - or maybe not. Cutting edge understandings in brain function are acknowledging & realising the incredible capacity for the brain to regenerate & it's plasticity; even in severe mental illness.
http://en.wikipedia.org/wiki/Neuroplasticity
Or Google the term Neuroplasticity & Brain Plasticity.
Jung, after many years of clinical experience concluded:
I have now, after long practical experience, come to hold the view that the psychogenic causation of the disease is more probable than the toxic [physico-chemical] causation. There are a number of mild and ephemeral but manifestly schizophrenic illnesses - quite apart from the even more common latent psychoses - which begin purely psychogenically, run an equally psychological course (aside from certain presumably toxic nuances) and can be completely cured by a purely psychotherapeutic procedure. I have seen this even in severe cases.
I for one am going with Jung on this.
Posted by Trans-Human on January 17, 2009, at 8:30:32
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by linkadge on January 17, 2009, at 8:13:16
> But thats exactly what I am getting at. Early studies claimed on thing, but the reality is totally different. Just because Jung claimed that he had a 95% sucess rate or whatever, doesn't mean it is true.
>
> LinkadgeThe reality is that Jung cured many of his patients who would have been classed as terminally ill by western orthodox psychiatry.
Carl Jung's work; As well as the work of John Weir Perry & Loren Mosher; among others - are all very well documented & established.
If you would like to look at the personal & true account of the curing of a severe case of Schizophrenia - then may I suggest the book Dante's Cure by Daniel Doorman.
Posted by Trans-Human on January 17, 2009, at 9:29:00
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Trans-Human on January 17, 2009, at 8:30:32
Not unrelated to this thread is this -
You may be interested in this lecture with Thomas Campbell. He has written a work entitled "My Big TOE". The TOE refers to a "Theory OF Everything".
He worked in the past with Robert Munroe at the Munroe Institute; for some years. He has more recently been involved with the practicalities of design & installation of the more recent American Missile Defence systems. He trained in applied nuclear physics.
In this lecture he gives a talk about physics, metaphysics, & the nature of consciousness. It is very interesting stuff. All the more so for his obvious intelligence; & solid training in physics.
It takes a while for the lecture to get going; so give it time -
Dr Thomas Campbell - My Big TOE (1 of 18)
http://www.youtube.com/watch?v=MxECb7zcQhQ
The link is to part 1 - the videos are in 18 parts. To view part 2 simply copy the title into the search bar & change the 1 to a 2 ect.
Here is Part 2 -
Dr Thomas Campbell - My Big TOE (2 of 18)
Posted by Phillipa on January 17, 2009, at 13:02:02
In reply to Re: Gene link: schizophrenia + Bipolar Disorder? » Trans-Human, posted by seldomseen on January 16, 2009, at 18:17:14
Seldom didn't read the whole thread but the cancer spoke loud and clear as at first they for instance thought breast cancer was a cancer that ran in family history now they say no not a strong link at all. Yes I feel that it is very scarey and I often wonder if all the hormones we feed cattle etc. Have an impact on cancer. Sorry to interupt the schizoprenia but I feel the same applies. But not reading the other posting as time is limited. I did notice when worked in field in locked unit the symptoms of mania were very similar to that of scizophrenia when patient had stopped meds. Not having read entire thread I'm sure it's already been addressed. Just my comment which is only one. Love Phillipa
Posted by Phillipa on January 17, 2009, at 13:09:11
In reply to Re: Gene link: schizophrenia + Bipolar Disorder? » seldomseen, posted by Phillipa on January 17, 2009, at 13:02:02
I now see the discussion is genes and scizophenia and biological vs genetic. I've seen families of scizophrenics that do quite well on their meds. Clozaril seemed to worked when other didn't. Scizophrenic patients are lovely at least the ones I knew. When properly medicated. Also appeared and said they were happy. Love Phillipa
Posted by Netch on January 19, 2009, at 6:34:39
In reply to Re: Gene link: schizophrenia + Bipolar Disorder?, posted by Trans-Human on January 17, 2009, at 8:30:32
It is very unlikely there is only one gene involved since evolution would have solved that problem long time ago. It is known that the incidence of bipolar and schizophrenia are pretty constant over time. This is a sign that these genes in the right combo provide benifits to homo sapiens and in the wrong combo provides disadvantages.
This is the end of the thread.
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