From now through the end of May, NARSAD, a brain and behavior research fund, is hosting free public forums around the country to showcase mental health research. On Saturday, local researchers will convene at the Indiana University School of Medicine for a "Healthy Minds Across America" gathering.
Among those speaking will be Dr. Alan Breier, chief of the psychotic disorders program at the medical school, who specializes in schizophrenia.
For more information or to register, call (800) 829-8289. In advance of the event, Breier discussed schizophrenia, a mental disorder in which a person may have delusions, hallucinations, or other forms of impaired thinking.
Question: How has our understanding of schizophrenia changed in recent years?
Answer: There have been substantial advances in the neuroscience. We're getting a better handle on the brain processes that have gone awry to cause this devastating illness.
Q: What do we know?
A: The basic problem with schizophrenia involves the wiring in the cortex of the brain. Schizophrenia is hereditary. We reason that some genetic abnormality affects the genes that form the cortex, early in fetal development. But the illness manifests in the teens and early 20s.
Q: Why does it take so long?
A: When you look carefully, you may find hints of problems as early as the grade school years -- school performance complications or not being as social. We're trying to identify people who are at early risk to develop novel treatments that could hopefully change the course of illness. Our Prevention and Recovery from Early Psychosis Center is focused on detection, training and research.
Q: What is the center's approach to treatment?
A: Our approach is, let's start early. We know that people who are at this early phase rarely get to treatment promptly.
The symptoms emerge and this adds to the downward course -- unemployment, dropping out of school, substance abuse problems, incarceration, social isolation. People with schizophrenia frequently die 10 to 15 years earlier. They have high rates of smoking, metabolic disease, high rates of suicide.
Q: Does a person need both pharmacological and non-pharmacological treatments?
A: Both. We need the introduction of pharmacological treatments as early as possible in the illness. The longer you wait, the poorer the outcome.
There are some interesting behavioral treatments; one is called cognitive remediation, where you're basically exercising the cortex. It's done with a computer program where the individual basically interacts with a computer program that is creating a variety of tasks that are exercising the brain. After a 10-week course, cognitive function improves.
Q: What more can we do?
A: The most important thing we can do in schizophrenia is develop a new group of pharmacological treatments. The treatments we have today are effective in quelling the voices, in quelling the delusional beliefs. The treatments we have right now, I'd rate as a "B".
We need treatments we could rate as an "A" that would change the long-term nature of the illness.