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Schizophrenia test moves closer

Wednesday, 1 November, 2000, 01:16 GMT - Scientists believe they could soon
develop a screening test for schizophrenia after discovering changes in the
brain that occur at the earliest stages of the illness.

A team from the Institute of Psychiatry in London has used a brain imaging
technique to pinpoint substantial changes to brain structure which appear
to take place before the onset of psychotic symptoms.

The discovery could mean brain imaging is one day used to search for
tell-tale signs of schizophrenia.

It also raises the possibility that new treatments could be developed to
stall progression of the illness.

The study, led by Dr Tonmoy Sharma, involved 68 participants, including 37
people experiencing their first episode of psychosis and a group of healthy
volunteers.

Magnetic resonance imaging (MRI) scans identified differences in the
structure of key regions, such as the temporal lobe, between the healthy
volunteers and those experiencing psychosis.

Previous research had established differences in the brain structure of
schizophrenics - but only those with more advanced symptoms.

Because of this, it was difficult to identify whether brain changes are due
to the ageing process, a result of their illness or the side effects of
their medication.

In this study, all the participants had experienced psychosis for only
three months or less, and some had never taken antipsychotic drugs before.

Still, the MRI scans showed quite distinct brain changes in key regions,
suggesting that by the time someone starts to showed signs of psychotic
behaviour, their brains were already structurally different.

Early intervention

It is now recognised that people with schizophrenia have a better chance of
recovery if their psychosis is treated at the earliest possible stage.

The government recognised this by prioritising early treatment for
psychosis in its NHS plan published in July.

Until now it has been very difficult to distinguish the early stages of
schizophrenia from the beginnings of other psychiatric illnesses, or even
just normal adolescence.

Dr Sharma said: "In schizophrenia, we have had a romantic notion of
intervening before the condition has developed but so far, our instruments
for diagnosis have not been good enough to allow us to do so."

"From this study, we can see that characteristic brain differences are
present at a very early stage.

"Brain imaging may become a powerful predictor of future illness.

"In cancer, we've seen that screening people at risk can have a great
effect on treatment success.

"With a suitable schizophrenia screening method, for the first time,
preventive psychiatry becomes a realistic possibility."

Cliff Prior, chief executive of the National Schizophrenia Fellowship,
said: "We already know that outcomes are vastly improved when the illness
is spotted earlier and quality care and treatment packages offered.

"This new research underlines the urgent need to act on the government's
NHS Plan which prioritised early intervention in the treatment of
schizophrenia."

Schizophrenia is the most common form of severe mental illness.

It affects about one person in a hundred. The illness usually begins in the
late teens and early 20s and is characterised by hallucinations, delusions,
hearing voices and changes in behaviour.

In a minority of cases sufferers can become violent towards parents and
carers or even complete strangers.

Men and women are equally affected but the age of onset is usually younger
in men.

The research is published in the American Journal of Psychiatry.


Related to this story:
Warning over schizophrenics (18 Oct 00 | Health)
Schizophrenia: The facts (13 Oct 99 | Medical notes)
Doctors 'ration best mental health drugs' (08 Oct 00 | Health)
UK life blamed for ethnic schizophrenia (14 Jul 00 | Health)
Breath test 'can diagnose schizophrenia' (04 Jul 00 | Health)
Test 'to transform schizophrenia treatment' (14 Jun 00 | Health)
Brain discovery may help schizophrenics (19 Jan 00 | Health)

Internet links:
American Journal of Psychiatry
Institute of Psychiatry
National Schizophrenia Fellowship

BBC News Online: Health
http://news.bbc.co.uk/low/english/health/newsid_999000/999816.stm

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