Scientific reports revealed that there were many cases Mental health There are physical barriers, which can lead to conditions such as obsessive-compulsive disorder, tics, anxiety, depression and even psychosis (mental disorder).
The magazine was publishedeconomistA report in which she said that the girl, Jessica Hewitson, was only 12 years old when she began to suffer from involuntary spasms, and over time, her condition worsened until she suffered seizures throughout her entire body and was rushed to hospital, but a local hospital in Durham, England, said she may be suffering from anxiety, a mental health condition, and that she may have ‘ spend a lot of time watching videos on TikTok.
Her mother describes the experience as “underwhelming,” saying, “Actually, Jessica had an autoimmune condition caused by a streptococcal bacterial infection. This condition is known as a pediatric autoimmune disorder. and neuropsychiatric related to pandas. eventually her symptoms began to improve.
Jessica is not the only one suffering from a brain disorder, which is often confused with mental illness Evidence is accumulating that a series of diseases can, in some cases, lead to conditions such as obsessive-compulsive disorder, tics, anxiety, depression, and even psychosis (disorder).
New understanding could make a big difference to the millions of people with undertreated mental health conditions For example, more than 90% of patients with bipolar disorder experience an illness continuous throughout their lives. obsessive-compulsive disorder (OCD), and more than 46% of them do not recover.
For some in the profession, a deeper understanding of the biology of mental health, linked to clear biological signatures of the kind that can come from laboratory tests, would lead to more accurate diagnoses and better targeted treatments.
Historically the field of psychiatry has focused on describing and classifying symptoms, rather than focusing on underlying causes. The Diagnostic and Statistical Manual of Mental Disorders (DSM), sometimes called the psychiatry bible, appeared in 1952 and contains descriptions, symptoms, and diagnostic criteria. On the one hand, he has achieved a useful consistency in judgment. But on the other hand, he grouped patients without considering the underlying mechanisms behind the condition. There is so much overlap between the symptoms of depression and anxiety, for example, that some wonder if they are separate categories of illness.
At the same time, depression and anxiety come in many subtypes – panic disorder with and without agoraphobia, for example, with different diagnoses – and it may not help them distinguish them. This can lead to patient populations in drug trials being so diverse that drugs and treatments fail simply because the group being studied has little in common.
Previous attempts to find causal mechanisms for mental health conditions have been problematic. In 2013, the National Institute of Mental Health, a US government agency, took a big gamble away from research based on symptom-based categories in the Diagnostic and Statistical Manual of Mental Disorders. Funds were diverted to basic research into the pathological processes of the brain, with the hope of directly linking genes to behavior. About $20 billion in new research was funded, but the idea failed miserably, as most of the genes that were discovered had very little effects. Allen Francis, a professor of psychiatry at Duke University, says that “finding biomarkers is an amazing intellectual adventure, but a complete clinical failure.”
Clearly, genes alone are not the solution. Many different conditions such as schizophrenia, attention deficit hyperactivity disorder (ADHD), anxiety and autism can be caused by the same genetic disorder, 22q11.2, caused by the loss of a small piece of chromosome 22.
A key moment came in 2007, when work at the University of Pennsylvania showed that 100 patients with rapidly developing psychiatric symptoms were suffering from an autoimmune disease. Their bodies were creating antibodies against major receptors. in nerve cells called NMDA receptors.
It causes inflammation in the brain and can lead to a range of symptoms including paranoia, hallucinations and aggression The disease is known as “anti-NMDA receptor encephalitis” and, best of all, in many cases can be treated by removing the antibodies. Or use immunotherapy drugs or steroids.
Studies of patients who have the first episode of psychosis have found that between 5% and 10% also have antibodies that attack the brain.
It seems that the immune system can cause it in rare cases as well. This can be seen in the case of childhood pandas, which was confirmed by Ms. Jessica in 2021. But sometimes it is found in adults. A 64-year-old man said he spent an unusual amount of time mowing his lawn, and the next day he felt feelings of regret and guilt. The researchers found that these symptoms were caused by antibodies attacking nerve cells in his brain.
Recently, Belinda Lennox, head of the department of psychiatry at the University of Oxford, has tested thousands of patients with psychosis. Higher levels of antibodies were found in blood samples of about 6% of patients, mostly targeting NMDA receptors. She says it is not yet known how a single set of antibodies can produce clinical symptoms ranging from seizures to psychosis and encephalitis. It is also not known why these antibodies are made, or whether they can cross the blood-brain barrier, the membrane that controls access to the brain. However, she assumes that they do so, because they connect better with the hippocampus, which explains how they affect memory and lead to delusions and hallucinations.
Dr Lennox says a shift in medical thinking is needed to appreciate the damage the immune system can do to the brain. The “million dollar question” is whether these conditions can be addressed, she says. She is now doing tests to find out more. Work in patients with immune-induced psychosis suggests that a combination of strategies including removing antibodies and taking immunotherapy drugs or steroids can be effective treatments.
Another important finding is that metabolic disorders can also affect mental health. The brain is an energy-starved organ, and metabolic changes related to energy pathways are involved in a number of conditions, including schizophrenia, bipolar disorder, psychosis, eating disorders, and major depressive disorder. Stanford University has a metabolic psychiatry clinic where patients are treated with diet and lifestyle changes, along with medications.
One area of active research in the clinic is the potential benefits of the ketogenic diet, where the use of carbohydrates is limited. This diet forces the body to burn fat for energy, thus creating chemicals called ketones that can be a source of fuel for the brain when glucose is limited.
There are 13 ongoing trials around the world looking at the effects of metabolic therapies on severe mental illness, says Kirk Nylen, head of neurology at the Baszocki Group, a US charity that funds brain research. Preliminary results showed that “a large group of people responded in a very meaningful way as patients who followed a low-carb diet experienced a significant improvement in mood.
It is not only the understanding of the immune system and metabolism that is developing. Large amounts of data are now being analyzed at an unprecedented speed, sometimes with the help of artificial intelligence, to find connections that were previously hidden in plain sight.
This could eventually make biology more central to mental health diagnosis, which could lead to more personalized treatments, as well as better treatments. In early October 2023, Biobank, a biomedical database in the UK, published data showing that people who suffer from depressive episodes have significantly higher levels of inflammatory proteins, such as cytokines, in their blood . A study last year also found that about a quarter of patients with depression had evidence of low-grade inflammation. This may be useful to know because other research shows that patients with inflammation respond poorly to antidepressants.
More innovation is being done. Several researchers are studying different methods to improve the diagnosis of ADHD, for example, classifying patients in several different subgroups, some of which may not have been known before. In three separate announcements in February 2024, different groups announced the discovery of biomarkers that could predict the risk of depression, autism, and psychosis. The search for better search tools is likely to be accelerated through the use of artificial intelligence.
One company, Cognoa, is already using artificial intelligence to diagnose autism in children by analyzing pictures of their behavior, avoiding long waits for doctors to map human interactions. This will greatly aid in further research into diagnostic tools and therapeutics.
Dr. Tebartz van Elst says that this divide between neurology and psychiatry is greater in Anglo-Saxon countries (these include America, Great Britain, Canada, and New Zealand), and in Germany, psychiatry and neurology are more integrated, as neurologists train in psychiatry. , Psychiatrists study neurology for a year as part of their training.
This makes it easier to diagnose cases, and he says he offers most patients with first-time psychosis or severe psychotic syndromes brain MRIs, EEGs, lab tests for inflammation, and lumbar punctures to find evidence to support different treatments in some patients. The cost, around 1,000 euros ($1,070), is no more than the cost of admitting a patient to hospital for three or four days, so it could be good value for money. ‘ there, says Dr Tebartz van Elst.
2024-04-26 14:16:00
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