Its been an exciting week for psychiatry!
Landmark Studies in Alzheimer’s and Schizophrenia
One of the big studies reported on this week was the success of a drug called Rember in halting decline in Alzheimer’s Disease. What is remarkable is that Rember is a special preparation of a substance known as methylene blue which was first created in the 1890’s. Methylene blue is commonly used in laboratories and was used to treat malaria but has some unusual side effects e.g. turning the sclera blue. What is also remarkable was that in the study, Rember reduced the cognitive decline by 81% over 19 months in 321 patients. However there are still Phase III trials to be completed, so we must see if Rember overcomes this final hurdle – but if so, it should be available by 2012 according to Professor Claude Wischik.
Three massive genetics studies looking at a combined total of over 40,000 people have implicated chromosomes 1, 12, 13, 15, 16 and 22 in schizophrenia. The relationship between genes and schizophrenia is however unlikely to be straightforward. The environment impacts on the way genes are expressed as proteins and it is this intersection which must be examined to make sense of the findings of any genes that are implicated. Additionally localising to the chromosomal level sets the scene for further studies to identify the genes within that part of the chromosome that are involved.
Round-up of Other News
A recent study reported that prison psychiatric inpatients with tattoos are more likely to have antisocial personality disorder. This study was carried out in prison, where there is a higher prevalence of antisocial personality disorder. This provoked lots of responses including points about tattoos being a cultural phenomenon (e.g. depending on fashion) and also different types of tattoos may vary in their significance. Check out the Shrink Rap Blog for a perspective on this study. In some cities in the United States, free courses have been developed for families with members having a mental illness. A study has shown that gossip can help to establish reputation and helps people to trust each other.
Dr Richard Martini, an american Child and Adolescent Psychiatrist has suggested that the new Batman film, The Dark Knight, shouldn’t be watched by children under 10. His argument was that children find it difficult to differentiate between fantasy and reality and that the content was therefore unsuitable.In the city of Chandigarh in India, a recent study was carried out showing that 25% of adolescents have mental health problems. Professor Arun’s study looked at 2000 children in 10 schools across the city. A study involving 3000 children and looking at a variation of the FTO gene, which has been implicated in obesity, has shown that those with the gene were less likely to feel full than those without that variant of the gene.
A novel approach to treating agitation has been developed by the company Alexza. They are now entering Phase III trials for the treatment of acute agitation using an inhalation device which delivers the drug loxapine. The study is recruting people with Bipolar I disorder and acute agitation. At a conference ‘The Brain at War: Neurocognitive Consequences of Combat’, physicist Norbert Schuff has shown some pictures generated using a 7T MRI scanner, showing that veterans returning from combat with PTSD had smaller hippocampi than those without PTSD. However I haven’t seen the data on this and can’t comment further at this point. Psychiatrists in Iowa, USA are preparing for a rise in mental health problems including PTSD following floods in the area. Using medication to augment learning in behavioural therapy is an interesting approach and a meta-analysis of the use of D-cycloserine in exposure therapy has shown benefits for this method.
Dr Niall McLaren is an Australian psychiatrist who is proposing an alternative to the Biopsychosocial model. Although his book ‘Human Madness’ was published last year, he’s recently been lecturing on his theory over in the states. What’s interesting is his assessment of the Biopsychosocial model. McLaren argues that Engel, the originator of the biopsychosocial approach, didn’t actually come up with a model at all. Indeed McLaren argues that there is a theoretical vacuum contained within the biopsychosocial approach. I haven’t read the book yet, but will be getting my copy and will write a review as soon as I’ve done so.
A Finnish study has shown that the risk of Alzheimer’s Disease is increased for single people. A phase II trial of AL-108 in mild cognitive impairment showed an improvement in memory whilst a combination of oral diabetes drugs and insulin results in less amyloid plaques (which accumulate in Alzheimer’s Disease) in the brain. The rate at which the brain atrophies has been associated with cognitive decline and also with the risk of progressing to dementia.
The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor.