Silk Road forums

Robert B. Zipursky, M.D.
Professor and Chair
Department of Psychiatry and Behavioural Neurosciences
McMaster University

Clinicians generally think of Schizophrenia as a progressive illness, beginning early in life with psychotic episodes in adolescence and the early twenties, and resulting in a state of disability. Yet these assumptions may be incorrect. Reasons for the assumption that Schizophrenia is a progressive disease may include the ‘clinician’s illusion’, which is the attribution of the characteristic and course of those patients who are currently ill to the entire population contracting the illness. Another component that may contribute to the assumption of progression is Berkson’s fallacy, the idea that those who have other disabilities that are not causally connected to the condition being investigated are more likely to enter the formal treatment system, and that these etiologically unrelated conditions may have a negative influence on the course of the illness. A longitudinal study found that the best predictor for a long-term successful outcome is the patient’s treatment success in the first two years of the illness. Thus, there is no reason to believe that the percentage of those doing poorly increases over time. Conclusions emphasized the following: there is little evidence that there is substantial progression of the disease, most remitted patients remain well with going treatment, short-term course predicts long-term outcome, the percentage of patients with a poor outcome remains stable over time, and many patients can be symptom free and obtain employment. The reasons why patients do poorly can be due to premorbid deficits, concurrent disorders, extended period of the disability before treatment, limited access to necessary interventions, non-adherence with resulting relapses, and a downhill spiral due to stigma, poverty, homelessness, and unemployment. Clinicians must work hard to intervene in ways that are known to be effective.

Progressive: Increasing in scope or severity, advancing, or going forward. For example, a disease that is progressive is worsening.

   I agree it is undecided. The article I cited includes a meta analysis of first episode schizophrenics with statistically significant neurodegeneration. Anti-psychs would be an unlikely culprit in these patients I believe.

I think a LSD trip or more a comedown is the closest you can get to experience the effects of schizophrenia. I've read in the early days it was consumed by psychologists to have an insight in schizophrenia patients.
Interesting topic.

Schizophrenia definitely qualifies as a progressive, neurodegenerative disease. Over the past couple of decades that qualification has been challenged by psychiatrists who believe it is linked to developmental processes and remains latent until onset, but their theories remain without solid evidence.
   Modern imaging techniques have demonstrated statistically significant loss of brain tissue in schizophrenics that could only have occurred after the cranium had finished growing.

Young people who experience a first episode of psychosis often receive a diagnosis of schizophrenia.

Historically there has been the view that schizophrenia is a progressive, deteriorating condition and many clinicians were taught that point of view in their training.

When the field of Early Psychosis began to develop in the 1990s, a major theme was to discard the pessimistic attitude that clinicians held toward the possibility of significant recovery in psychotic disorders and replace it with a more balanced positive approach. The specialized Early Psychosis services that are now widely available are based on this attitude of realistic optimism.

As well, people with lived experience of psychosis, and their families, have increasingly insisted and demonstrated that recovery in schizophrenia is a realistic and attainable goal.

Yet studies of brain structure and function continue to produce data suggesting that there may be progressive changes associated with a diagnosis of schizophrenia.

In an article published in the Schizophrenia Bulletin journal in November 2012, Dr. Robert Zipursky, a leader in psychosis reseach in Canada, along with eminent colleagues in the UK, reviews the current evidence related to the question of whether or not a diagnosis of Schizophrenia indicates the person has a progress brain disease.

The article reviews all the recent evidence from brain scans, as well as other sources of data, and concludes that “schizophrenia is not a malignant disease that inevitably deteriorates over time, but one from which most people can achieve a significant degree of recovery”.

The authors strongly urge clinicians to provide young people and their families with this up-to-date information so that the old myths regarding negative outcomes for people receiving a diagnosis of schizophrenia can be laid to rest.

Researchers from Canada and the U.K. review, in Schizophrenia Bulletin, the evidence of clinical outcomes, brain volume, and cognitive functioning from longitudinal studies and find that although 25% of people with schizophrenia diagnoses have poor long-term outcome, few show the characteristics of neurodegenerative illness. Rather, decreases in brain tissue volumes are attributable to antipsychotic medication, substance abuse, and other secondary factors. The authors conclude that the majority of people with schizophrenia diagnoses have the potential to achieve long-term recovery.

Quote from: Rocknessie on July 19, 2013, 01:51 am

A fat paranoid heavily armed obese Mexican murdered a black child on the grounds he was eating sweeties.

A jury of white witches pulled pillow-cases on their heads, cackled, and rode broomsticks.

Lots of right-wing people moaned if you're not allowed to hunt down and murder innocent black children then it's just not the kind of America they want to live in.

Europeans looked at each other and realised no matter how bad things get in the Old Lands it'll never be the USA.

The only happy people from this entire sorry saga are MARS, INC for their free national adverts.

He was not heavily armed he was using 9mm which he shot once well he was between 1 and 18 inches from Trayvon. Witnesses said they believed Trayvon was the aggressor and that Martin was on top of zimmerman their is also no video theirs not enough evidence to prove second degree and the prosecutions sole focus was this charge, so even if he could of been charged with manslaughter proper evidence was not shown to the jury. The case is not about staying in your car, its about how and why Trayvon was killed. Also this has little to do with with EU vs American murder stats as a whole you literally half to ignore all homicide statistics to come to that conclusion from this one case. Remember 94% of black people are murdered by other black people which leaves little room for racist whites.