Monday, December 2, 2013

SSW108: Mental Health - Psychotic Disorders

What is Schizophrenia? (Schizophrenia #1)



ABC 20/20 Schizophrenia




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My Battle with Schizophrenia: "Rats Were Eating My Brain"
Hawkes, E. (2013). My Battle with Schizophrenia: "Rats Were Eating My Brain." Huffington Post Canada.

Over a period of six years (when I was in my early to mid-20s) whenever I was hospitalized for my schizophrenia, restraints and seclusion were used repeatedly, readily, and beyond necessity. Also, I was over-medicated, probably not for my own sake, but to make me a more manageable patient. I was lost in my psychotic world, to the point of bashing my head on the concrete walls on the psych ward. For this, I understand the use of restraints. However, they, along with seclusion, were over-used, to the point of being a punishment rather than for my safety.
By my 12th certification (forced hospitalization) for schizophrenia they would outfit a stretcher with restraints while I was still waiting in Emergency. As soon as I was admitted, they would call a Code White -- aggression -- and within seconds, it seemed, a group of four to five Security officers was there, holding me down as I flailed and kicked and screamed with rage as they restrained me. Wrists, ankles, chest; I couldn't even wipe my falling tears away.
I wept not only because of being tied up; I cried for the high doses of sedatives and anti-psychotics the nurses injected into me, for the strip-search, for the forced changing from street clothes into hospital pajamas in front of all those (mostly male) Security guards.
Then, the stretcher-bound, pajama-clad, medicated me was placed in solitary confinement.
This did not happen just once. Or twice. Try over dozens of incidents. Restraints would last hours, hours, hours; later, when untied, I would be locked in a seclusion cell for as long as a week at a time. Cell, not room: a thin mattress on a concrete "frame," silver toilet in the corner, camera, and a door with no knob on the inside reminds one of a jail cell.
They did all this because I was bashing my forehead bloody on the concrete walls. See, in my schizophrenia, I strongly believed that miniscule rats were eating my brain and, reminiscent of leeching, bleeding them out was most effective.
What else could they do?
Restraint and seclusion: banned?
What would they do with me now?

National study links adolescent marijuana use with higher risk of psychosis

Prest, A. (2013). Winnipeg Free Press. 

"... a four-year national study that revealed that smoking marijuana, particularly heavy use in early adolescence, increases the risk of psychosis by as much as 40 per cent. Psychosis, one of the symptoms of schizophrenia, is often characterized by hallucinations and delusions.
The study, called the Cannabis and Psychosis Awareness Project, showed marijuana use in youth who are prone to psychosis -- mental illness in the family -- makes them four times more likely to develop psychosis."
The study involved 50 young Canadians who then created a video Awareness Strategy for Youth (www.cannabisandpsychosis.ca).
Chris Summerville, executive director of the Manitoba Schizophrenia Society and the CEO of the Schizophrenia Society of Canada, said the youth in the study found the use of cannabis hindered their recoveries and interfered with the effectiveness of medication.
"Here’s the bottom line, from various studies, is that if you have mental illness in your family of origin you are at a greater risk of developing psychosis and schizophrenia being triggered if you use cannabis," Summerville said.
"Kids need to know. Guidance counselors, youth pastors, anyone working with adolescents, they need to give youth this information as part of Health 101, so to speak."
Dramatic growth in anti-psychotic drug use even targets infants, experts say

Kirkey, S. (2013). Dramatic growth in antipsychotic drug use even targets infants, experts say. Postmedia News.

According to Panagiotopoulos, a pediatric endocrinologist at BC Children’s Hospital, so-called “second-generation” antipsychotics, or SGAs, are being prescribed to two- and three-year-olds for aggression. Doctors have become so used to seeing side effects in children on these drugs — including sudden and massive weight gain and diabetes  — that they no longer bother reporting them to Health Canada.

“A lot of parents come to me as a specialist and say, ‘No one ever told me about the side effects, and I didn’t think to ask,’ ” said Panagiotopoulos, an associate professor at the University of British Columbia“They can’t understand why their kid went from drinking water, to seven litres of Coke every week.”

There appears to be no limit to how much we’re willing to allow doctors to medicate our apparent psychological angst. Last year, more than 74 million prescriptions worth $2.6 billion were filled for psychiatric drugs in Canada — more than 203,000 prescriptions a day, and up from 58 million prescriptions in total in 2008, according to data compiled by prescription drug research firm IMS Brogan for Postmedia News.

The growing embrace of medications to treat “broken” minds is a triumph of drug company marketing, experts say, the selling of new diagnoses and overzealous prescribing of pills for conditions for which they have never been approved.

Second-generation antipsychotics are increasingly being prescribed to children for attention deficit/hyperactivity disorder, “conduct” disorders, “frustration intolerance” and even poor sleep. The drugs can cause side effects such as elevated blood fats and abnormal blood sugar levels. As of Dec. 12, 2012, Health Canada had received 17 fatal reports in children related to SGAs, and, despite guidelines to doctors, experts say the risks to children are going largely unmonitored. Only one of the drugs, aripiprazole, or Abilify, has been approved for use in children, and only then for schizophrenia in teens aged 15 to 17.

At UBC, Panagiotopoulos’s research has shown that children exposed to second-generation antipsychotics have three times the risk of developing pre-diabetes or Type 2 diabetes compared to children never treated with the drugs; more than double the risk of becoming overweight or obese; and 30 times the risk of metabolic syndrome — a cluster of health problems that increases the risk of heart attack and stroke later in life.

No one knows what the long-term effects might be on a child’s developing brain. Still, prescriptions for the drugs to children under 14 increased 10-fold in B.C. alone between 1997 and 2007. Across Canada, from 2005 to 2009, antipsychotic drug prescriptions for children and youth increased 114 per cent. Surveys suggest that 12 per cent of all prescriptions are for children aged eight and under.

The drugs — which are being used for symptoms and diagnoses in children that have never been studied — can cause potentially irreversible movement disorders if untreated, such as uncontrollable spasms and tremors, involuntary movements of the jaw and tongue, puckering of the face, and frowning. In older adults, the drugs have been linked with an increased risk of sudden cardiac death. Another rare but life-threatening side effect, neuroleptic malignant syndrome, or NMS, is fatal in about 10 per cent of cases, said David Gardner, a professor of psychiatry and pharmacy at Dalhousie University in Halifax.

Postmedia News. 
Inman, S. (2013). For Psychotic People, Medication Means Survival. Huffington Post Canada.

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What is Delusional Disorder? - Mental Health Guru


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