Saturday, 21 November 2015

Schizophrenia

Homer's interpretation of the famous painting: 'The Meme"
Next week I'm giving a presentation to my peers, entitled: 'The Genetics of Schizophrenia'. The topic itself is fascinating to me and not only because of the scientific content. As you may know, there is a large heritable component to schizophrenia and as much as 80% of the liability contributing to the disorder is genetic. Schizophrenia segregates in my family. My mother has been afflicted with paranoid schizophrenia throughout most of her adult life. This has, and continues to have, a profound impact on her life. She has been sectioned on four occasions. The last time, two years ago, she spent 10 months in a secure mental health unit. I was aware of my mother's diagnosis from a relatively early age. My father, when alive, managed my mother's condition with skill and compassion. Only once during his watch was my mother incarcerated and that was when she was first diagnosed. 

Behavioural conditions are hard to define from a genetic perspective. Many interacting genes are involved and there is usually an environmental component or trigger. Furthermore, our response to environmental ‘factors’ is very much conditioned by our genetic makeup –thus adding another layer of complexity to an already labyrinthine situation. And then, there are epigenetic phenomena to contend with.......  

We are in our infancy concerning the genetic factors involved although several hundred genes have been implicated in schizophrenia. Furthermore, epigenetic changes are also involved. When I was at 'Big school' I was taught the 'Central Dogma Theory'. Basically, this states that genetic information flows in one direction only, from DNA, to RNA, to protein. This means that genetic changes are inviolate from environmental influence. To think otherwise was heretical and akin to the discarded theory of Lamarckism. I've added a link if you would like to know more about this fascinating pre-evolutionary theory. However, relatively recently it has been shown that environmental factors can influence gene expression by a mechanism called 'epigenetic transformation'. Thus, environmental insults can change gene expression, not by mutation within the gene, but by altering DNA conformation or by adding methyl groups to gene promoters. Thus, genes are ‘switched off or on’ according to environmental whim (not really). Clearly, the foetus, and especially the early gestational foetus, is highly responsive to environment changes mediated through the mother. Apart from this 'direct' influence, environmental changes can result in epigenetic changes which alter gene expression in the developing foetus. These changes can have profound affects on the developing baby which often continue to take hold throughout adult life. Moreover, once a ‘genetic imprint’ is achieved, it can be passed down the generations. Many of these changes we would consider maladaptive, especially when they are the consequence of extreme maternal stress or distress. Epigenetic changes, from an evolutionary perspective, are actually adaptive and enable organisms to cope with situations, which otherwise, might result in foetal demise.      

Being mad is not all bad news. It has been recognised for a long time that mental illness is associated with creativity and dare I say it, 'genius'. Aristotle, the famed ancient Greek philosopher of the 4th century BC had this to say: "Why is it that all those who have become preeminent in politics or poetry or art are clearly melancholics." But it is only in the past couple of years that we have been able to place this anecdotal observation on a firm scientific footing. Genetic factors predisposing to schizophrenia have been found to be enriched in folk of an 'artistic bent' compared to non-histrionic folk. And conversely, scientists have less of these predisposing factors compared to the general population. Make of this data, what you will.     

Schizophrenics, especially when in the throes of acute florid episodes are subject to delusions. During such periods my mother has several very strong delusions and often recurrent delusions. One delusion stands out. She believes that scientists are conducting experiments on her mind, remotely. When my mother is well all the delusions melt away, except one. We were chatting last week and during the conversation she casually announced: 'The Scientists' had been conducting experiments on her the previous night. Generally I don't comment. This delusion has been persistent for many years and no matter what I say, it remains undiminished. However, on this occasion I pointed out the obvious, as I've done many times, previously. She looked me straight in the eye and said: "But my dear Flaxen (not my real name) you would say that, wouldn't you? You are the 'Head Scientist' supervising the experiments".........             Arse




14 comments:

  1. This is really interesting Saxon thank you so much for sharing it, as you know my partner is Schizophrenia, no history in his family however, and his is believed to be caused by childhood trauma. I shall send him the link for your piece which I think he will find informative and illuminating. :D

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    1. Yes, hopefully new research into this life destroying condition can help to design better targeted drugs.,

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    2. He has had many drugs over his 30 year diagnosis period. Many of the really efficacious ones have awful side effects, the most damaging for him is weight gain, as he has been anorexic in his youth and weight gain sends him lower and lower. His current tablet for controlling the voices is Sertraline he takes up to 12 50mg tablets a day and his weight gain has been frightening, He is hungry all the time and this medication doesn't do more than dull the background noise. I don't think anyone who has not suffered this illness can truly understand how stressful it is for the sufferer.

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    3. PS having just read back my comment to him today, he pointed out that actually the drug is Quetiapine, although he does also take the other one and an opiate the name of which escapes me, but in order to not up the dose of Quetiapine further the dose of Opiate has been increased to improve stability. It's all very confusing.

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  2. Fascinating stuff. I don't think I know any one who is Schizophrenic, but do know a couple of folks that are Bi-polar, and others with severe depression. Mental illness are shite, and anything that helps shine a light onto their causes and successful treatment has to be good.

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  3. "......."But my dear Flaxen (not my real name) you would say that, wouldn't you? You are the 'Head Scientist' supervising the experiments"......... ....."

    Not only does she understand the Not-Quite-Meritocratic hierarchical construct of 'Science', and 'Experimentation', she has placed you at the pinnacle. That mother is proud of her son!
    Were you not in the least tempted to retort, "How am I doin' as the boss? Is there room for improvement?"

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    1. I thinks she wants me to stop the electric shock treatment.

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  4. Nu?
    A
    You knew from and early age yer mam was a Schizophrenic.
    B
    You know it has a significant heritable component.

    Yet you contributed to the gene pool. Is that not irresponsible? The Tutor has certain genetically determined 'predispositions' and accordingly, did not cause to be created potentially-also-affected crotch-fruit. In his case, the bad genes are poor teeth and thin hair, but still, he's thoughtful. His sister went and did procreate and her male spawn are already bald and missing teeth - and they are only in their thirties.

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    1. Yep, the biological prerogative will out. My empirical risk for schizophrenia is 12%. As for the 'fruits of my lions' the risk is no more than 1% ie population risk. None of us come out unscathed. I do have schizotype thought processes- a curse and a blessing. Useful for writing crap on the internet but not desirable during departmental meetings. I know I should try harder to rein it all in. But frankly, I'm having so much fun.

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    2. Oh, I forgot to add, The Tutor is much to selfish to have rug-rats anyway. And I thought it was biological imperative, not perogative.

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    3. Prerogative: a right or privilege exclusive to a particular individual or class.

      http://manningupsmart.com/tag/biological-prerogative/

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    4. Prerogative is optional
      Imperative is not
      That is what I meant. And apologies for that comment. I seem to have an 'r' and an 'o' left over. My typographical and phonetic-spelling-based-on-mispronunciation errors are a result of the furious pace with which I type when in the grip of my muses.

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