NEWS

By LYNN WOOTEN
UNC-CH School of Medicine

CHAPEL HILL -- Researchers at the University of North Carolina at Chapel Hill have begun a new initiative to identify and develop possible treatments for people at high risk for schizophrenia. Scientists hope their study will shed light on factors that may cause schizophrenia and lead to new strategies to prevent schizophrenia from developing in vulnerable people.

Schizophrenia typically begins in late adolescence or early adulthood. The disorder manifests itself through mental and behavioral symptoms such as delusions and hallucinations, the scrambling of thoughts and the erosion of cognitive functions. Both genetic and environmental factors are thought to interact to cause schizophrenia.

The UNC PRIME Research Clinic (PRIME stands for Prevention through Risk Identification, Management and Education) targets adolescents and young adults experiencing basic symptoms. The program’s goal is to help individuals cope with their symptoms so they can continue leading their lives normally and achieve their personal goals.

Research projects aim to evaluate risk factors to predict who will develop psychosis, and to determine if a medication helps treat non-specific symptoms and prevents the development of psychosis. By unveiling identification markers that could predict schizophrenia, researchers could eventually develop a screening strategy for the general population that would help identify people at high risk for schizophrenia before symptoms emerge.

With early identification, treatment can begin right away and significantly enhance the odds of a full recovery.

About one in 100 Americans suffers from schizophrenia, including 70,000 North Carolinians.

"That’s a substantial number," said Dr. Jeffrey Lieberman, vice chairman of the UNC-CH department of psychiatry and director of the university’s Mental Health Clinical Research Center. "It’s not an uncommon disease. And the illness, once it begins, can be treated."

Before someone develops the psychosis of schizophrenia, there is usually a period when subtle changes in thinking, mood and perception are experienced. Called "prodromal" or "basic" symptoms, these may be confusing and worrisome and sometimes interfere with the person’s ability to study, work, make friends and be with others comfortably.

Examples of basic symptoms of schizophrenia include:

Misperceiving sounds, smells, or things seen. A person may perceive a dog barking or fan humming to be someone speaking, may think they are emitting a foul body odor or see people or objects that aren’t really there.

Noticing frequent, perplexing coincidences. A person may notice things others don’t, begin to make connections between unrelated events, or report clairvoyant or frequent deja vu experiences. For example, a person may find that a particular color or number recurs in otherwise unrelated circumstances and feel it has a special meaning in his or her life.

Thinking others are talking or laughing at you. For example, a person may feel others are taking extra notice of, or making fun of, him or her.

Suspiciousness. A person may suspect that others are conspiring against, harassing, persecuting, cheating or trying to harm him or her in some way. He or she may start to complain that others "have it out" or are "trying to get back" at him or her.

Trouble thinking or concentrating. A person may have difficulty keeping his or her thoughts together and jump from one thought to the next, or experience confused thinking or problems with distraction -- "noticing every little thing," for example.

"Basic symptoms may be due to a number of factors, including a reaction to stress or drugs or part of adolescent turmoil," said Dr. Diana Perkins, associate professor of psychiatry and director of the PRIME Research Clinic.

"Studies indicate that about 40 percent of the time, basic symptoms are the prodromal, early warning signs of schizophrenia or similar psychotic disorders. Our research will investigate factors to determine when basic symptoms indicate the prodromal stage of schizophrenia," she said. "What excites me is that our studies could lead to strategies that could prevent someone from developing schizophrenia and suffering from the frightening and disabling effects of the illness."

Lieberman said that it now takes the average patient with schizophrenia about a year to obtain appropriate treatment.

"This is probably due to ignorance about mental illness and a lack of opportunities for treatment," he said.

Schizophrenia is a degenerative illness. As with other degenerative illnesses such as cancer and heart disease, the longer symptoms are left untreated, the harder it is to treat and the less likely it is that the patient can recover.

"It is important to identify people vulnerable to schizophrenia at the earliest point to best ensure treatment that leads to the fullest recovery possible," Lieberman said.

To learn more about the early warning signs of schizophrenia, call toll-free 1-877-774-6319 or email PRIME@css.unc.edu.

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UNC-CH School of Medicine contact: Lynn Wooten, 919-966-6046