The relationship between schizophrenia and autism

It wasn’t so long ago that most psychiatric and developmental disorders were described and treated as distinct entities. Eventually, the psychiatric community came to understand that there is often overlap or co-morbidity between the various disorders. Recent advances take our understanding even beyond this.

When it comes to autism and schizophrenia for example, scientists have found that the same set of genes may play an important role in the development of both disorders. Besides this, the brains of schizophrenics and autistics seem to function similarly, and people diagnosed with schizophrenia in late adolescence or early adulthood were often diagnosed with autism in childhood or displayed autism-like behavior.

Some researchers will go as far as to claim that autism and schizophrenia are practically the same condition, and have even adopted a new label that subsumes both disorders, called “multiplex developmental disorder“. This way of looking at it renders schizophrenia and autism as distinct disorders largely obsolete. There is so much controversy concerning this, although it is increasingly clear that autism and schizophrenia have a common origin.

According to the University of Washington and Seattle Children’s Hospital, Seattle, Washington in Revisiting the relationship between autism and schizophrenia: toward an integrated neurobiology:

Schizophrenia and autism have been linked since their earliest descriptions. Both are disorders of cerebral specialization originating in the embryonic period. Genetic, molecular, and cytologic research highlights a variety of shared contributory mechanisms that may lead to patterns of abnormal connectivity arising from altered development and topology. Overt behavioral pathology likely emerges during or after neurosensitive periods in which resource demands overwhelm system resources and the individual’s ability to compensate using interregional activation fails. We are at the threshold of being able to chart autism and schizophrenia from the inside out. In so doing, the door is opened to the consideration of new therapeutics that are developed based upon molecular, synaptic, and systems targets common to both disorders.

You can read more about it here: Psychiatric Times – Autism and Schizophrenia

Vegetarians and mental disorders

One of the most common features on this site are posts about the health benefits of a vegetarian diet. In general, vegetarians are healthier than meat-eaters, though people who eat a Mediterranean or Paleo diet and minimize meat are about as healthy as vegetarians.

Truth be told, vegetarianism isn’t always associated with positive health outcomes. In fact, when it comes to mental health, vegetarianism may be more strongly correlated with mental disorders than meat-eating. According to Vegetarian diet and mental disorders: results from a representative community survey:

Results

Vegetarians displayed elevated prevalence rates for depressive disorders, anxiety disorders and somatoform disorders. Due to the matching procedure, the findings cannot be explained by socio-demographic characteristics of vegetarians (e.g. higher rates of females, predominant residency in urban areas, high proportion of singles). The analysis of the respective ages at adoption of a vegetarian diet and onset of a mental disorder showed that the adoption of the vegetarian diet tends to follow the onset of mental disorders.

Conclusions

In Western cultures vegetarian diet is associated with an elevated risk of mental disorders. However, there was no evidence for a causal role of vegetarian diet in the etiology of mental disorders.

None of this means that you are at a greater risk of developing a mental disorder if you are a vegetarian(the study showed that people became vegetarian after showing symptoms of a mental disorder). It shows just a correlation between mental disorders and vegetarianism. Further studies may find no such correlation.

But assuming this is true, why is it so? Vegetarians may just be more sensitive in general, and to animal suffering in particular. In this way, we are like artists. In some studies, creativity is also linked with mental disorders. If you remember my post, The Vegan Brain is Different After all!, it wasn’t that big of a surprise that the brains of vegetarians seem to be wired a little differently from the brains of meat-eaters. Although vegetarians may generally be more prone to mental disorders, vegetarians tend to have higher IQs, on average.

People who enjoy torturing or killing animals or other people are also very likely to have serious mental disorders, but of a completely different kind. It is depressing to even think about such people, and is obviously even more depressing for animal-loving vegetarians.

Music therapy and schizophrenia

“All art constantly aspires towards the condition of music” – Walter Pater

Can you imagine life without music? There’s scarcely anything in this world that can improve our mood as much as beautiful, uplifting music. Of course, depressing music can do the opposite. But can music be used as a form of medicine to help treat mental disorders like schizophrenia? Before we explore this complex, fascinating issue, let’s make sure we all know what schizophrenia is. According to the Mayo Clinic:

Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behavior.

Contrary to some popular belief, schizophrenia isn’t split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking.

Schizophrenia is a chronic condition, requiring lifelong treatment.

Can music therapy help treat this disorder? According to the University of Bergen, Bergen, Norway, in Music therapy for people with schizophrenia and schizophrenia-like disorders:

AUTHORS’ CONCLUSIONS:

Music therapy as an addition to standard care helps people with schizophrenia to improve their global state, mental state (including negative symptoms) and social functioning if a sufficient number of music therapy sessions are provided by qualified music therapists. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcomes measures in relation to music therapy.

It looks like there may be some promise here. I know nothing about music therapy, but if it truly does work, I wonder if music therapist/composers will write music unique to each patient depending on what the patient responds to? Or is this what they already do?

Related articles:

• Properly Diagnosing Schizophrenia
• Schizophrenia and Poverty, Crime and Violence

Is schizophrenia caused by a virus?

I’ve long been intrigued by the idea that a virus, in conjunction with certain genetic abnormalities may play a role in the development of schizophrenia and other mental illnesses.

It is very difficult to figure out what is going on when it comes to the development of schizophrenia, since the brain and genetics are so very complicated. Let’s take a sneak peek anyway to see if any progress is being made. According to the University of Minnesota Medical School in The viral theory of schizophrenia revisited: abnormal placental gene expression and structural changes with lack of evidence for H1N1 viral presence in placentae of infected mice or brains of exposed offspring:

Abstract

Researchers have long noted an excess of patients with schizophrenia were born during the months of January and March. This winter birth effect has been hypothesized to result either from various causes such as vitamin D deficiency (McGrath, 1999; McGrath et al., 2010), or from maternal infection during pregnancy. Infection with a number of viruses during pregnancy including influenza, and rubella are known to increase the risk of schizophrenia in the offspring (Brown, 2006). Animal models using influenza virus or Poly I:C, a viral mimic, have been able to replicate many of the brain morphological, genetic, and behavioral deficits of schizophrenia (Meyer et al., 2006, 2008a, 2009; Bitanihirwe et al., 2010; Meyer and Feldon, 2010; Short et al., 2010). Using a murine model of prenatal viral infection, our laboratory has shown that viral infection on embryonic days 9, 16, and 18 leads to abnormal expression of brain genes and brain structural abnormalities in the exposed offspring (Fatemi et al., 2005, 2008a,b, 2009a,b). The purpose of the current study was to examine gene expression and morphological changes in the placenta, hippocampus, and prefrontal cortex as a result of viral infection on embryonic day 7 of pregnancy. Pregnant mice were either infected with influenza virus [A/WSN/33 strain (H1N1)] or sham-infected with vehicle solution. At E16, placentas were harvested and prepared for either microarray analysis or for light microscopy. We observed significant, upregulation of 77 genes and significant downregulation of 93 genes in placentas. In brains of exposed offspring following E7 infection, there were changes in gene expression in prefrontal cortex (6 upregulated and 24 downregulated at P0; 5 upregulated and 14 downregulated at P56) and hippocampus (4 upregulated and 6 downregulated at P0; 6 upregulated and 13 downregulated at P56). QRT-PCR verified the direction and magnitude of change for a number of genes associated with hypoxia, inflammation, schizophrenia, and autism. Placentas from infected mice showed a number of morphological abnormalities including presence of thrombi and increased presence of immune cells. Additionally, we searched for presence of H1N1 viral-specific genes for M1/M2, NA, and NS1 in placentas of infected mice and brains of exposed offspring and found none. Our results demonstrate that prenatal viral infection disrupts structure and gene expression of the placenta, hippocampus, and prefrontal cortex potentially explaining deleterious effects in the exposed offspring without evidence for presence of viral RNAs in the target tissues.

If you would like to read some more, read this: The Insanity Virus

When it comes to puzzles, nothing beats the brain. It looks like this viral theory of schizophrenia has some support, though it looks like everyone has this virus to some degree.

Exercise and schizophrenia

Let’s have some fun today. Come with me deep into the human brain and have a look at what exercise can do for those suffering from schizophrenia. We’ve already explored how it may be beneficial for those with OCD(obsessive compulsive disorder), but I think it would be more interesting to see what exercise can do for those with a more “serious” mental condition.

Here is a list of the common symptoms of schizophrenia:

1) Characteristic symptoms: Two or more of the following, each present for much of the time during a one-month period (or less, if symptoms remitted with treatment).
Delusions
Hallucinations
Disorganized speech, which is a manifestation of formal thought disorder
Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation)
If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other, only that symptom is required above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.
2) Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care, are markedly below the level achieved prior to the onset.
3) Significant duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if symptoms remitted with treatment).

Source

Based on some of these symptoms, it looks like it may be difficult to motivate some people with schizophrenia to adopt a regular exercise regimen. There is a vast spectrum of severity of symptoms of this condition, with evidence that schizophrenia is correlated with some brain abnormalities(though this is not used to diagnose it).

According to the Department of Psychiatry, The Saarland University Hospital, Homburg, Germany:

Hippocampal volume is lower than expected in patients with schizophrenia; however, whether this represents a fixed deficit is uncertain. Exercise is a stimulus to hippocampal plasticity.

The results and conclusion of their research:

RESULTS:

Following exercise training, relative hippocampal volume increased significantly in patients (12%) and healthy subjects (16%), with no change in the nonexercise group of patients (-1%). Changes in hippocampal volume in the exercise group were correlated with improvements in aerobic fitness measured by change in maximum oxygen consumption (r = 0.71; P = .003). In the schizophrenia exercise group (but not the controls), change in hippocampal volume was associated with a 35% increase in the N-acetylaspartate to creatine ratio in the hippocampus. Finally, improvement in test scores for short-term memory in the combined exercise and nonexercise schizophrenia group was correlated with change in hippocampal volume (r = 0.51; P < .05).
CONCLUSION:

These results indicate that in both healthy subjects and patients with schizophrenia hippocampal volume is plastic in response to aerobic exercise.

While this study looked at the brain plasticity of schizophrenics, it didn’t monitor any improvements in living with their condition. Luckily, other researchers have explored if exercise can improve the lives of schizophrenics.

After examining many studies in the scientific literature, the Schizophrenia Bulletin reports that:

Although studies included in this review are small and used various measures of physical and mental health, results indicated that regular exercise programs are possible in this population and that they can have healthful effects on both the physical and mental health and well being of individuals with schizophrenia. Larger randomized studies are required before any definitive conclusions can be drawn.

Although it can’t “cure” schizophrenia, it looks like exercise should be included in the treatment of schizophrenia and other mental conditions whenever possible. I don’t think there is anything that provides nearly as many benefits to health as exercise. Healthy body, healthy mind.