People with schizophrenia sometimes hear voices others do not hear; believe that others are broadcasting their thoughts; or become convinced others are plotting to harm them. They may also lose motivation for activities and relationships, stop taking care of themselves, and lose the ability to experience or express emotions.
University of Iowa research is aiming to improve treatment for schizophrenia with a two-year $1.6 million grant from the National Institute of Mental Health. Tom Wassink, MD, the study's principal investigator and psychiatrist at University of Iowa Children's Hospital, talks about the grant:
Who is likely to develop schizophrenia?
Schizophrenia can occur in just about anybody, so we don't know what distinguishes one person from another in terms of who's going to develop it. The typical age of onset is somewhere in the late teens to early twenties, so you know, anybody in that age range might be at risk.
Are there variations of the disease?
That's a difficult question to answer. Schizophrenia can certainly look quite a bit different from one person to the next. Some people may have more of what we think of as the psychotic symptoms—hallucinations, delusions or false fixed belief. Other people may be more of what we would term a negative—have a difficult time expressing or feeling emotions and don't have motivation to participate in life in a certain way. These are very different symptoms, but they all go under schizophrenia. Whether it's actually a collection of different disorders lumped under that term, or whether there's some other way to conceive of it, we're not really sure. We know that it looks different from one person to the next; whether they're different disease or not is still unclear.
How many people are affected with schizophrenia?
Across the world, the rate of schizophrenia or the incidence is about one percent—a little less than one percent—and it doesn't change much from one geographic region to another, or one ethnicity to another. It's a pretty consistent rate of disease for schizophrenia.
Do we know what causes schizophrenia?
We don't know exactly what causes it, but we are pretty sure it's primarily determined by genetic factors. Studies done in twins and in families where we track how the disease moves through a family or if it's concordant in identical versus non-identical twins tells us that the most significant influence in terms of who's going to develop it or not is due to genetic factors. There is some room in there for the environment to have an influence, but that influence is pretty small and we don't really know what specific environmental factors might be involved.
What is the current treatment for schizophrenia?
There's a wide range of treatment. The primary one most people are aware of, and that certainly is at the center of helping people with schizophrenia, is medication. You know, medications have been used for decades to help people with schizophrenia. Newer medications have come along in the past 10 or 15 years.
As we look across the full range of medications, they all are about equally effective in helping people with schizophrenia. The sad thing is that there are probably a quarter to even one-third of people with the disease who just won't be helped very much by medications at all.
In addition to medication, social assistance can provide more structured living settings and supportive care for people with schizophrenia. There are people here at The University and elsewhere doing straightforward or basic types of therapy to help people with schizophrenia cope with the kind of disturbed thoughts they have.
What will your study look at regarding schizophrenia?
As I mentioned, we believe that the primary determinants of who develops schizophrenia are in the realm of genetics. This study will look at a large range of genetic variations, using the most sophisticated technology currently available, to identify some specific genetic factors that influence the risk of developing disease. We're using something called a microarray chip that can look at more than million points of variation in the human genome at once. We're going to be looking at that in a sample of over 1,000 people who have been brought into our study over the past 20 years, primary through the work of Dr. Nancy Andreasen, here at The University of Iowa.
Will the study call for participants or continue with data already gathered?
This study is going to be looking primarily at data already gathered. As I mentioned, we've brought in over a thousand people over the past 20 years and they've been studied in detail—looking at how they think, their signs and symptoms, how those progress over time, doing brain imaging scans—so we're going to match that with the genetic data generated from the collected DNA.
What is the desired result of this research study?
What we really hope to do is identify genetic factors such as specific genetic variants and mutations—what influences the risk of developing disease.
Then tie those genetic factors to things like:
- Do they predict or help us understand who is going to do well versus who is going to do poorly
- Do they help us understand who's going to respond to specific medications versus who's not
If we can identify genetic factors that influence those things, we can do a better job predicting who is going to do well, and we might be able to target treatment more finely for these patients. |
