Sunday, November 26, 2023

Schizophrenia: treatment and recovery, research papers

Antipsychotic drugs versus cognitive behavioural therapy versus a combination of both
MAY 01, 2018
CBT as effective as meds
Our single-blind, randomised, controlled pragmatic pilot and feasibility trial showed that a study comparing antipsychotics, CBT, and antipsychotics plus CBT is possible in people with psychosis. Our trial had low attrition (<20% at each timepoint) that was balanced across interventions, and only a small proportion of participants received an intervention to which they were not allocated. All three interventions were broadly safe and acceptable.
Emerging Behavioral and Psychotherapeutic Interventions for Schizophrenia
May 2016
 There is rigorous empirical support for the efficacy of short term CBTp, and psychosocial interventions, such as supported employment and family interventions. Both effect sizes and other outcome measures indicate that these interventions have the potential to make a major difference in the lives of patients and caregivers, and to reduce economic burden of psychiatric disability. While cognitive remediation has been supported by several meta-analytic reviews, larger scale studies with systematic assessment of dose, task generalization, changes in everyday behavior, and individual differences in response are needed to establish standard implementations for dissemination. The striking procognitive and neurotrophic effects of physical activity in animal models has motivated preliminary studies of exercise based intervention for cognitive improvement in schizophrenia. Additionally, increased physical activity would likely improve health outcomes for patients with psychotic disorders. While clinical studies of exercise and activity interventions are very premature now, this approach is extremely promising. 

Problems with meds

Mental health professionals’ views and experiences of antipsychotic reduction and discontinuation

Exercise Therapy for Schizophrenia
Three randomized controlled trials met the inclusion criteria. Trials assessed the effects of exercise on physical and mental health. Overall numbers leaving the trials were similar. Two trials compared exercise with standard care and both found exercise to significantly improve negative symptoms of mental state (Mental Health Inventory Depression: 1 RCT, n = 10, Mean Difference [MD] 17.50 CI 6.70–28.30, Positive and Negative Syndrome Scale [PANSS] negative: 1 RCT, n = 10, MD 8.50 CI 11.11 to 5.89; figure 1). No absolute effects were found for positive symptoms of mental state. Physical health improved significantly in the exercise group compared with those in standard care (1 RCT, n = 13, MD 79.50 CI 33.82–125.18; figure 2), but no effect on peoples’ weight/BMI was apparent. One study compared exercise with yoga and found that yoga had a better outcome for mental state (PANSS total: 1 RCT, n = 41, MD 14.95 CI 2.60–27.30). The same trial also found that those in the yoga group had significantly better quality of life scores

Wednesday, January 15, 2020

Mental health: Videos I recommend

What I watch.

GREAT resource:

Excellent - the genetics of persons vulnerable to cannabis.

Cannabis and Schizophrenia: A causal (not coincidental) association

The evidence linking cannabis use to schizophrenia is compelling. No one who is truly open-minded and rational can dismiss the possibility that cannabis exposure causes schizophrenia (or a schizophrenia-identical persisting psychotic disorder).

Cannabis use affects brain maturation and affects the signaling of both dopamine and glutamate – two neurotransmitters with known relevance to schizophrenia. There is clear evidence of a dose-response relationship. Higher cumulative exposure to cannabis in early life translates into higher risk of schizophrenia in later life. Mendelian randomization, a genetic analysis strategy that eliminates the influence of confounding variables, suggests that the relationship between cannabis use and schizophrenia is causative – not coincidental.

This lecture is part of Northeast Ohio University's education(+)consultation service, SZconsult. A powerpoint file for this lecture is available at

The fabulous Robert Sapolsky, Stanford Lectures -watch them all! but here are two specifically relating to mental illness:

The cause of psychosis with Dr. Kwame McKenzie


Early Intervention in Psychosis - Dr. Paddy Power


First Psychotic Episode by Dr. Alex Kopelowicz

Monday, November 4, 2019

Have you wondered why, for example, after years of yoga, you cannot sit in a perfect lotus, while others manage it effortlessly?
The answer may lie in the structure of your hips.

Stuart Mcgill, back and Yoga

Structure - we are all built differently!

Have you wondered why, for example, after years of yoga, you cannot sit in a perfect lotus, while others manage it effortlessly?
The answer may lie in the structure of your hips.

Stuart Mcgill, back and Yoga

Sunday, June 30, 2019

Do you have pain, discomfort, or an uncomfortable feeling of tightness between your shoulder blades?
Here are a few stretches that I myself use - especially when I have been on the computer for a long stretch of time.
In the stretch shown in the next image, the trick is to keep one arm bent as shown below, and use the opposite arm as a lever to pull it towards your body. Vary the angles to stretch different areas. 

The next stretch is a bit hard to understand from the picture.
-Sit down, bend over a bit, and cross your arms, placing your hands on the outer sides of your knees.
-Push your knees outward--you should feel a lovely stretch across your shoulders.
-Vary the angles; you can stretch different areas by bending over less, or more.

I love this neck stretch!

That's it for now-hope these help!

Thursday, August 9, 2018

Heel Pain-Plantar Fasciitis and Neurodynamics

This is a fascinating read on a subject near and dear to me.
It was pain diagnosed as Plantar Fasciitis that sent me on a path that eventually led me to study massage, and my fascination with painscience and neuroscience
In my case, I may have had inflamed plantar fascia--but I definitely had a neurodynamic disorder/nerve entrapment, which was relieved by a medical massage therapist (my hero!) and self-massage and mobilization.

Some key points from this article:

>However in relation to the more physical and benign causes, there are some key facts about neurodynamic problems at the ankle that are important when considering foot pain:

  • clearly not all foot/heel pain comes from nerves, but some does.
  • nerve abnormality is an underestimated cause of foot pain. Research shows that patients with foot pain can show reduced nerve conduction in various nerves in the ankle/foot region (Schon et al 1993)).
  • nerve problems can masquerade as plantar fasciitis and other local causes of heel pain.
  • there should be a distinction between 'nerve entrapment' and 'neurodynamic disorders' around the ankle and foot. Nerve entrapment is frank trapping of the nerve which is mostly likely a compressive lesion (eg. tarsal tunnel syndrome). But, whilst the term 'neurodynamic disorders' includes 'nerve entrapment', the term should be used to denote other types of mechanical and physiological problems in nerve function at this location, eg. nerve irritation and inflammation due to excessive use of the ankle combined with excessive pronation. This may produce a neurodynamic disorder (probably neuritis) caused by mechanical irritation.
  • tissue changes in the foot/heel eg. swelling and tenderness DO NOT EXCLUDE a neurodynamic cause. This is because the nerves can produce inflammatory changes in the tissues they innervate by a mechanism called 'neurogenic inflammation'.<

>Nerves that are exposed to excessive or repeated mechanical force may become hypersensitive and produce impulses in both afferent and efferent directions. Afferent impulses may cause pain and efferent ones may cause inflammation in the tissues innervated by the sensitised nerve (neurogenic inflammation).<

Thursday, August 2, 2018

Antidepressants Work for Major Depression! Not so Fast...

A recent article in Medscape states:
>The latest attempt to trick ourselves into believing that the past few decades of prescribing antidepressants has been an effective strategy comes from one of the most prestigious medical journals, The Lancet. The published meta-analysis' basic finding—since repeated all over the press—is that antidepressants work because they are all better than placebo. What they don't tell you is that they are hardly any better than placebo, and that the only drugs with clinically meaningful benefits are the ones that are used rarely today, the older tricyclic agents.<
The effect sizes seen are about a 2-point improvement versus placebo on the Hamilton Depression Rating Scale, which is lower than the minimum threshold of a 3-point improvement for clinically meaningful benefit set by an earlier 2004 guidance by the UK's then-named National Institute for Health and Clinical Excellence.[3]
They have found, repeatedly, that antidepressants either are not more effective than placebo, or they are slightly more effective.>Because of this, their results are not limited to or mostly influenced by the published literature, which is known to be markedly biased in favor of antidepressant drug efficacy. (This is because pharmaceutical companies usually have not published negative studies of antidepressants.)<


Read it all:
Antidepressants Work for Major Depression! Not so Fast

About the older tricyclics:
from Mayo Clinic: Tricyclic antidepressants and tetracyclic antidepressants

Schizophrenia: treatment and recovery, research papers

Lancet: Antipsychotic drugs versus cognitive behavioural therapy versus a combination of both MAY 01, 2018 CBT as effective as meds htt...