Of course, in this case the issue seems like it's caused by a general deficiency of single protein, maybe that's a good sign for adapting the treatment to humans.
Very strange how HN elevates news about random drug candidates at very early stages of development.
There is a very active landscape of people developing/validating 'biomarkers' for neurological and psychiatric disorders and developing drugs specifically for those populations with the biomarker present; this news is far from extraordinary.
Identifying a biomarker for a psychological condition, particularly one like schizophrenia which is hugely disruptive for individuals affected and has a seemingly random onset around early adulthood, is significant in its own right even if it doesn’t lead to a pharmaceutical intervention. It could help identify new risk factors, potential non-pharmaceutical interventions like life style changes, and maybe even identify people who are at risk of developing schizophrenia and preparing them for its onset before their first hallucination and avoiding a downward spiral.
Disproportionately many geeks have very strong opinions about psychiatry, probably because we have a lot of people who consider themselves neurodivergent, as well as plenty of folks who experiment with drugs.
Given how debilitating schizophrenia can be, and how compromised the current treatments are - hey, you don't mind making uncontrollable strange expressions on your face forever, do you? - things like this give hope, even if it's just a little bit.
It's been awhile since I read about this stuff...is schizophrenia a spectrum disorder like autism? If so, I wonder if there's a point on the spectrum where it's not worth treating it because of possible side effects.
I feel like our society over-pathologizes a lot of stuff and it would be a shame if we "cured" something that doesn't need a cure.
I liked how this blog[0] describes it. Schizophrenia itself isn't a spectrum, but rather you have varying levels of schizophrenia risk genes. They have positive fitness functions (creativity, cognitive flexibility, linguistic skill) until you cross the threshold to schizophrenia.
No but it is a behaviourally defined disorder like autism. Which means it can and has many different causal patterns behind it.
That is there are many different things that can cause the behaviour.
Anyway on your main point, the definition of all psychiatric disorders has requirements of subjective suffering. So if you don't have subjective suffering you don't have the disorder.
Also there's huge overlap in symptoms between bipolar I with psychosis, schizoaffective disorder, and schizophrenia. People sometimes move around between these diagnoses throughout treatment, different doctors have different opinions, patient behavior changes, etc.
I personally think these symptoms come about through many different causes and the labels are somewhat inadequate. They capture a symptom profile rather than a full understanding.
I remember reading in Courtenay Harding's (now very old) book, Recovery from Schizophrenia: Evidence, History, and Hope, that populations with a higher prevalence of bipolar tended to have a lower prevalence of schizophrenia, and vice versa. The implication was that the same thing was being expressed differently in differing contexts. I would be curious if more contemporary studies bore this out.
> In the United States, the voices are harsher, and in Africa and India, more benign, said Tanya Luhrmann, a Stanford professor of anthropology and first author of the article in the British Journal of Psychiatry.
> To this point, some cultures see schizophrenia as friendly, not scary.
That should not be your conclusion from the article.
"the voices" are hardly the only symptom that people with schizophrenia suffer from. A lot of those affected don't have auditory hallucinations at all and are still suffering from one of the (if not the) most debilitating mental disorders out there.
Calling it "friendly" risks trivialising of the very real symptoms.
> The striking difference was that while many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful – and evidence of a sick condition.
> In Accra, Ghana, where the culture accepts that disembodied spirits can talk, few subjects described voices in brain disease terms. When people talked about their voices, 10 of them called the experience predominantly positive; 16 of them reported hearing God audibly. “‘Mostly, the voices are good,’” one participant remarked.
This seems clinically useful. The existence of other symptoms doesn't really change that fact.
> This idea relocates the problem from the individual to “culture” or “society”...
No, one could incorporate this information just fine on an individual level by treating it as less of a scary symptom and more of something to understand.
Well, there's gotta be a line you can draw somewhere between "treating people who actually need it" and "treating people because that's what policy says and we don't care about the individual".
Sometimes, that line is whether or not the state is somehow involved through social services or the criminal justice system.
I have some primary care providers in the family and I've asked them since I often have differing opinions. I've asked if some people with bipolar and schizophrenia refuse specific medical treatment and just go on with their life. I've gotten the answer that many of them have learned to recognize what is happening and ride it out well enough that they can live with it. I'm sure it's highly dependent on the severity and the person.
I've noticed something similar with people on say heavy doses if hallucinogens. Some people just ride it out knowing it's the mind playing tricks on them, others hopelessly panic or make irreversible decisions.
This seems to be mainly about the so called negative symptoms, not positive symptoms (like hallucinations or delusions). While it is often hard to argue with people about their positive symptoms in schizophrenia or in mania, pretty much nobody who has negative symptoms wants to have them. The fact that antipsychotics do little about the negative symptoms is probably the biggest pain of schizophrenia sufferers - and they are aware of that.
Also, and this depends on the jurisdiction, but people can be forced to take psychiatric medication against their will. Or even forced to go through a treatment like ECT, for example when presenting with strong and dangerous mania. BTW, ECT has an extremely unfair popular opinion, it's one of the best treatments in all of psychiatry. It could even be that it is impossible to get a response from the patient, for example if they are catatonic and don't budge within a reasonable time - you just inject them with benzodiazepines, as this is a serious condition if left to last a long time.
People do try psylocybin, or ketamine, or frankly just about anything. Esketamine even has regulatory approval as a tretment. Research is sometimes posted here on HN. But nothing seems to be as effective as ECT, it truly is the king of affective disorders.
BTW, and not many people know this, it is a procedure performed under full anesthesia, including muscle blockers. From the outside it looks very calm, and from the inside the patient's experience is pretty much identical to taking a nap.
It is not risk free, precisely because of the anesthesia, so in most areas one can only get it if they try enough other treatments - like 2 or 3 or something like that, ideally from different classes of drugs. But definitely do consider this if you're suffering and nothing seems to help (enough).
My great friend, when we were 20, shot himself in the head while we were doing shrooms. This is not an uncommon occurrence. Thousands of incidents of self harm happen every year in the US alone because of these drugs.
I would advise anyone against this. Don't believe the weird hype (that mostly all comes from a few small clicks of people looking to profit off this drug) about mushrooms being some spiritual, mental catch all. If you have any sort of mental illness you probably should avoid. Don't play Russian roulette with your sanity.
Depressed people killing themselves as soon as they start to get treatment is a known phenomenon. The energy that comes from treating depression gives them just enough oomph to get to the 'finish line.' It's quite possible they were thinking about it and never told anyone and everyone thinks it's a complete surprise caused by the drug, plenty of people have suicidal ideation or depression while giving zero indication or clues to anyone close to them that would be the case.
Even outside a drug. Breakup happens this can be a result.
Maybe if guns weren’t so accessible people wouldn’t be so quick to use them on themselves in those moments. There’s a statistic out there where a gun in the home is most likely to harm you.
"Leave them alone" is easy to type into a comment textbox but is much more difficult when it's a neighbor, or a family member, or someone else you have to interact with at a regular interval.
I highly recommend the book Hidden Valley Road for anyone curious about how difficult schizophrenia is for families and the researchers trying to find treatments.
Drug has only been tested in mice.
Of course, in this case the issue seems like it's caused by a general deficiency of single protein, maybe that's a good sign for adapting the treatment to humans.
Inmiced above. Thanks!
Very strange how HN elevates news about random drug candidates at very early stages of development.
There is a very active landscape of people developing/validating 'biomarkers' for neurological and psychiatric disorders and developing drugs specifically for those populations with the biomarker present; this news is far from extraordinary.
The real news is when these reach FDA approval.
Identifying a biomarker for a psychological condition, particularly one like schizophrenia which is hugely disruptive for individuals affected and has a seemingly random onset around early adulthood, is significant in its own right even if it doesn’t lead to a pharmaceutical intervention. It could help identify new risk factors, potential non-pharmaceutical interventions like life style changes, and maybe even identify people who are at risk of developing schizophrenia and preparing them for its onset before their first hallucination and avoiding a downward spiral.
Disproportionately many geeks have very strong opinions about psychiatry, probably because we have a lot of people who consider themselves neurodivergent, as well as plenty of folks who experiment with drugs.
Given how debilitating schizophrenia can be, and how compromised the current treatments are - hey, you don't mind making uncontrollable strange expressions on your face forever, do you? - things like this give hope, even if it's just a little bit.
It's been awhile since I read about this stuff...is schizophrenia a spectrum disorder like autism? If so, I wonder if there's a point on the spectrum where it's not worth treating it because of possible side effects.
I feel like our society over-pathologizes a lot of stuff and it would be a shame if we "cured" something that doesn't need a cure.
I liked how this blog[0] describes it. Schizophrenia itself isn't a spectrum, but rather you have varying levels of schizophrenia risk genes. They have positive fitness functions (creativity, cognitive flexibility, linguistic skill) until you cross the threshold to schizophrenia.
[0] https://www.psychiatrymargins.com/p/schizophrenia-is-the-pri...
No but it is a behaviourally defined disorder like autism. Which means it can and has many different causal patterns behind it.
That is there are many different things that can cause the behaviour.
Anyway on your main point, the definition of all psychiatric disorders has requirements of subjective suffering. So if you don't have subjective suffering you don't have the disorder.
> is schizophrenia a spectrum disorder like autism?
I'm a non expert but I believe some people are starting to see it that way. See: https://www.google.com/search?q=schizophrenia+spectrum+disor...
Also there's huge overlap in symptoms between bipolar I with psychosis, schizoaffective disorder, and schizophrenia. People sometimes move around between these diagnoses throughout treatment, different doctors have different opinions, patient behavior changes, etc.
I personally think these symptoms come about through many different causes and the labels are somewhat inadequate. They capture a symptom profile rather than a full understanding.
I remember reading in Courtenay Harding's (now very old) book, Recovery from Schizophrenia: Evidence, History, and Hope, that populations with a higher prevalence of bipolar tended to have a lower prevalence of schizophrenia, and vice versa. The implication was that the same thing was being expressed differently in differing contexts. I would be curious if more contemporary studies bore this out.
I believe I've heard that synaptic pruning may be implicated in both.
To this point, some cultures see schizophrenia as friendly, not scary.
https://news.stanford.edu/stories/2014/07/voices-culture-luh...
> In the United States, the voices are harsher, and in Africa and India, more benign, said Tanya Luhrmann, a Stanford professor of anthropology and first author of the article in the British Journal of Psychiatry.
> To this point, some cultures see schizophrenia as friendly, not scary.
That should not be your conclusion from the article.
"the voices" are hardly the only symptom that people with schizophrenia suffer from. A lot of those affected don't have auditory hallucinations at all and are still suffering from one of the (if not the) most debilitating mental disorders out there.
Calling it "friendly" risks trivialising of the very real symptoms.
> The striking difference was that while many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful – and evidence of a sick condition.
> In Accra, Ghana, where the culture accepts that disembodied spirits can talk, few subjects described voices in brain disease terms. When people talked about their voices, 10 of them called the experience predominantly positive; 16 of them reported hearing God audibly. “‘Mostly, the voices are good,’” one participant remarked.
This seems clinically useful. The existence of other symptoms doesn't really change that fact.
This idea relocates the problem from the individual to “culture” or “society,” leaving no solutions for someone suffering from schizophrenia.
I also have a hard time believing that schizophrenia manifests as something like benign quirkiness in some other country.
> I also have a hard time believing…
Well, publish that null result in a journal!
> This idea relocates the problem from the individual to “culture” or “society”...
No, one could incorporate this information just fine on an individual level by treating it as less of a scary symptom and more of something to understand.
You might be interested in this book: https://en.wikipedia.org/wiki/Doctoring_the_Mind
Well, there's gotta be a line you can draw somewhere between "treating people who actually need it" and "treating people because that's what policy says and we don't care about the individual".
Sometimes, that line is whether or not the state is somehow involved through social services or the criminal justice system.
I have some primary care providers in the family and I've asked them since I often have differing opinions. I've asked if some people with bipolar and schizophrenia refuse specific medical treatment and just go on with their life. I've gotten the answer that many of them have learned to recognize what is happening and ride it out well enough that they can live with it. I'm sure it's highly dependent on the severity and the person.
I've noticed something similar with people on say heavy doses if hallucinogens. Some people just ride it out knowing it's the mind playing tricks on them, others hopelessly panic or make irreversible decisions.
That would be an incredible cure and raises the ethical question of how to get schizophrenic people well enough to understand that they need it.
This seems to be mainly about the so called negative symptoms, not positive symptoms (like hallucinations or delusions). While it is often hard to argue with people about their positive symptoms in schizophrenia or in mania, pretty much nobody who has negative symptoms wants to have them. The fact that antipsychotics do little about the negative symptoms is probably the biggest pain of schizophrenia sufferers - and they are aware of that.
Also, and this depends on the jurisdiction, but people can be forced to take psychiatric medication against their will. Or even forced to go through a treatment like ECT, for example when presenting with strong and dangerous mania. BTW, ECT has an extremely unfair popular opinion, it's one of the best treatments in all of psychiatry. It could even be that it is impossible to get a response from the patient, for example if they are catatonic and don't budge within a reasonable time - you just inject them with benzodiazepines, as this is a serious condition if left to last a long time.
ECT just comes across as a bit barbaric. I'd welcome more research into Psilocybin to achieve system reset.
People do try psylocybin, or ketamine, or frankly just about anything. Esketamine even has regulatory approval as a tretment. Research is sometimes posted here on HN. But nothing seems to be as effective as ECT, it truly is the king of affective disorders.
BTW, and not many people know this, it is a procedure performed under full anesthesia, including muscle blockers. From the outside it looks very calm, and from the inside the patient's experience is pretty much identical to taking a nap.
It is not risk free, precisely because of the anesthesia, so in most areas one can only get it if they try enough other treatments - like 2 or 3 or something like that, ideally from different classes of drugs. But definitely do consider this if you're suffering and nothing seems to help (enough).
My great friend, when we were 20, shot himself in the head while we were doing shrooms. This is not an uncommon occurrence. Thousands of incidents of self harm happen every year in the US alone because of these drugs.
I would advise anyone against this. Don't believe the weird hype (that mostly all comes from a few small clicks of people looking to profit off this drug) about mushrooms being some spiritual, mental catch all. If you have any sort of mental illness you probably should avoid. Don't play Russian roulette with your sanity.
People do that after getting drunk too.
Depressed people killing themselves as soon as they start to get treatment is a known phenomenon. The energy that comes from treating depression gives them just enough oomph to get to the 'finish line.' It's quite possible they were thinking about it and never told anyone and everyone thinks it's a complete surprise caused by the drug, plenty of people have suicidal ideation or depression while giving zero indication or clues to anyone close to them that would be the case.
Even outside a drug. Breakup happens this can be a result.
Maybe if guns weren’t so accessible people wouldn’t be so quick to use them on themselves in those moments. There’s a statistic out there where a gun in the home is most likely to harm you.
You just do your best and leave them alone otherwise.
"Leave them alone" is easy to type into a comment textbox but is much more difficult when it's a neighbor, or a family member, or someone else you have to interact with at a regular interval.
I highly recommend the book Hidden Valley Road for anyone curious about how difficult schizophrenia is for families and the researchers trying to find treatments.