Article title: Schizophrenia Research at the NIMH: NIMH
Conditions: Schizophrenia
Source: NIMH
Schizophrenia, the most chronic and disabling of the severe mental disorders, is a major focus of research at the National Institute of Mental Health (NIMH), the world's foremost mental health scientific organization. This Federal agency takes the lead in neuroscientific investigation devoted to understanding the causes, diagnosis, prevention, and treatment of schizophrenia and other mental disorders, which afflict millions of Americans.
Since the Institute's inception 50 years ago, much has been learned about mental disorders and their effects on the brain. Revolutionary scientific advances in neuroscience, molecular biology, genetics, and brain imaging have provided some of the greatest insights into the complex organ that is the seat of thought, memory, and emotion. Thanks to these new tools, the scientific evidence that mental illnesses are brain disorders now exists.
More than 2 million Americans are affected by schizophrenia. The illness, which may impair a person's ability to manage emotions, interact with others, and think clearly, typically develops in the late teens or early twenties. Symptoms include hallucinations, delusions, disordered thinking, and social withdrawal. Most people with schizophrenia continue to suffer chronically or episodically throughout their lives. Even between bouts of active illness, lost opportunities for careers and relationships, stigma, residual symptoms, and medication side effects often plague those with the illness. One of every 10 people with schizophrenia eventually commits suicide.
An NIMH Snapshot
The National Institute of Mental Health (NIMH) is one of 25 components of the National Institutes of Health (NIH), the Government's principal biomedical and behavioral research agency. NIH is part of the U.S. Department of Health and Human Services. The actual total fiscal year 1999 NIMH budget was $859 million.
NIMH Mission
To reduce the burden of mental illness through research on mind, brain, and behavior.
How Does the Institute Carry Out Its Mission?
During the last decade, NIMH research has led to dramatic advances in the treatment of schizophrenia -- primarily in the development of several new medications with fewer side effects. However, some symptoms, such as social withdrawal and loss of motivation, are still insufficiently treated by the new drugs. Studies are continuing to determine how these and other promising medications interact with specific neurotransmitter systems in the brain and to ascertain which drugs work best for which people. In addition, a large-scale community study has shown that less than half of patients with schizophrenia receive appropriate treatment -- medication doses may have been incorrect and there was often inadequate use of psychosocial, vocational, and family therapies.
As the search for better treatments and ways to transfer those treatments to clinical practice continues, NIMH is harnessing the most sophisticated scientific tools available to determine the causes of schizophrenia. This brain disorder, like heart disease or diabetes, is complex and likely results from the interplay of genetic, behavioral, developmental, and other factors. There is an active search on several levels for the specific risk factors that may lead to schizophrenia.
Many years of family studies indicate that a vulnerability to schizophrenia is inherited. Still, scientists do not know how many genes are involved in this complex disorder, how the genetic predisposition is transmitted, or how behaviors or other events may interact with a genetic vulnerability to trigger the disorder. But an arsenal of new molecular tools and modern statistical analyses are allowing researchers to close in on particular genes that might make people more susceptible to schizophrenia by affecting, for example, brain development or neurotransmitter systems governing brain functioning.
On another research front, investigators supported by NIMH are using state-of-the-art imaging techniques to study the living brain. They have recently discovered specific, subtle abnormalities in the structure and function of the brains of patients with schizophrenia that may provide new insights into the origins of the disease. In other imaging studies, scientists have found evidence of early biochemical changes that may precede the onset of disease symptoms, prompting examination of the neural circuits that are most likely to be involved in producing those symptoms.
Research evidence from developmental neurobiologists
suggests that schizophrenia may result when neurons form inappropriate
connections during fetal development.
Schizophrenia Medications
Thanks to NIMH research, a number of new antipsychotic
drugs, "atypical antipsychotics," have been introduced since 1990.
The first, clozapine (Clozaril®), is more effective than older
antipsychotics, although it has possible severe side effects, such
as agranulocytosis-- a loss of white blood cells that fight
infection -- that require patients to be frequently monitored with
blood tests. The newer atypical medications, such as risperidone
(Risperdal®), quetiapine (Seroquel®), and olanzapine (Zyprexa®), are
safer than the older drugs or clozapine and have fewer side effects,
so they may be better tolerated by patients. NIMH is supporting
clinical trials to further understand the role of atypical
antipsychotics in treating
schizophrenia.
Although a defect may be present at birth, it may lie dormant until puberty, a time when significant nerve cell reorganization occurs in the brain. This research has spurred efforts to identify prenatal factors, including infections in utero, that may affect development.
The Broad NIMH Research Program
In addition to schizophrenia, NIMH supports and conducts a broad based, multidisciplinary program of scientific inquiry aimed at improving the diagnosis, prevention, and treatment of other mental disorders. These illnesses include manic-depressive illness, clinical depression, panic disorder, and obsessive-compulsive disorder.
Increasingly, the public as well as health care professionals are recognizing these disorders as real and treatable medical illnesses of the brain. Still, there is a need for more research that examines in greater depth the relationships among genetic, behavioral, developmental, social, and other factors to find the causes of these illnesses. NIMH is meeting this need through a series of research initiatives.
More Than 2,000 Grants and Contracts
In total, NIMH supports more than 2,000 research grants and
contracts at universities and other institutions across the nation and
overseas. It also conducts basic research and clinical studies involving
9,000 patient visits per year at its own facilities on the National
Institutes of Health campus in Bethesda, MD, and elsewhere. NIMH research
projects focus on:
NIMH Research Divisions
NIMH Intramural Research Program
The NIMH Division of Intramural Research Program (DIRP)
encompasses a broad array of research activities that range from
clinical investigation into the diagnosis, treatment, and prevention
of mental illness to basic neuroscience studies conducted at the
behavioral, systems, cellular, and molecular levels. DIRP is
composed of more than 500 scientists working in 22 clinical branches
and basic research laboratories, as well as four free-standing
specialized research groups. Intramural research is conducted under
the leadership of the Office of the Scientific
Director.
At the beginning of the 21st century, NIMH stands poised to surmount the burden, loss, and tragedy of mental illnesses that afflict millions of Americans.
For More Information About NIMH
The Office of Communications and Public Liaison carries out educational activities and publishes and distributes research reports, press releases, fact sheets, and publications intended for researchers, health care providers, and the general public. A publications list may be obtained on the web at http://www.nimh.nih.gov/publist/puborder.cfm or by contacting:
Office of Communications and Public Liaison, NIMH
Information
Resources and Inquiries Branch
6001 Executive Blvd.,
Room 8184, MSC
9663
Bethesda, MD 20892-9663
Phone: 301-443-4513
FAX:
301-443-4279
Mental Health FAX4U:
301-443-5158
E-mail: nimhinfo@nih.gov
NIMH home page address:
www.nimh.nih.gov
Anxiety Disorders Information:
1-88-88-ANXIETY
Depression Information: 1-800-421-4211
Information about research opportunities at the NIMH Intramural Research Program may be obtained from:
Office of the Scientific Director, NIMH
9000 Rockville
Pike
Building 10, Room 4N224, MSC 1381
Bethesda, MD
20892-1831
Phone: 301-496-3501
FAX: 301-480-8348
Information for scientists on NIMH grants and contracts programs, including grant application and review, Requests for Applications, Requests for Proposals, program announcements, research training and career development, small business programs, program analyses of NIMH extramural research grants and applications, access to NIH Grants policy, and other material may be obtained from the NIMH home page: www.nimh.nih.gov.
Schizophrenia Bulletin
NIMH publishes a quarterly scientific journal, the Schizophrenia Bulletin, which covers all aspects of schizophrenia research and treatment. In a recent poll, the Bulletin was ranked 3rd out of 68 psychiatric journals in scientific impact by the Social Science Citations Index a particularly remarkable feat given the small number of annual issues and the focus on a single illness. To subscribe, contact:
Superintendent of Documents
PO Box 371954
Pittsburgh, PA
15250-7954
Phone: 202-512-1800
FAX:
202-512-2250
Prepared by:
National Institute of Mental Health
Office of
Communications and Public Liaison
6001 Executive Boulevard, Rm. 8184,
MSC 9663
Bethesda, MD 20892-9663
NIH Publication No. 99-4500
Printed 1999
Updated: August 24, 2000
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