Thread by @PTenigma

Schizophrenia research pioneer Robin Murray’s Keynote: excess dopamine synthesis in schizophrenia leads to the loss of ability to screen out unimportant stimuli; reading too much significance into unimportant things, “aberrant salience” #ICP2022

Stress or drug abuse also releases more dopamine: dopamine blocker medication can alleviate symptoms; with CBT (cognitive behavioral therapy) this can be successful in first episode psychosis up to 80% of the time #ICP2022

Many schizophrenia patients look back and develop insight but others may never regain insight; patiently talking with our patients is what good psychiatrists do

Glutamate and GABA are involved in controlling dopamine; high doses of antipsychotics can eliminate hallucinations but in the longer team can lead to hypertension, metabolic syndrome

In chromosome 6, the top common schizophrenia risk variant in or near complement C4A gene is involved in stimulating microglia to eliminate pathogens but some think that microglia may devour too many synapses in adolescence #ICP2022

3/4 of the genes now implicated in #schizophrenia are implicated in bipolar disorder and some in major depression but the more schizophrenia-specific ones are involved in brain development; lower IQ is a risk factor for schizophrenia but brilliant people can develop it

Polygenic risk scores for schizophrenia may affect whether bipolar patients develop schizophrenia but a key goal is to understand genetics of medication response

A wonderful thing about this talk is that the speaker asked people to ask questions (including in Turkish, which you can hear here) during the talk; audience member asks if patients can have difficulties w thermoregulation and if deaf or blind people can hallucinate-answer is yes

Neglect, bullying, poor treatment use all worsen a patient’s risk of cognitive decline but schizophrenia need not be progressive

Cities with more cannabis use have more psychosis (lower in Spain and Italy) r=0.8! As much as 30% of psychosis in London is now due to cannabis use (was only 1/3 in 1960!), low in India and Nigeria, high in Trinidad

We need to classify psychosis depending on the cause - can be adversity

Some of us can be briefly psychotic and recover but we may be genetically predisposed to it continuing