SchizophreniaWatch :- November 17th 2015...under reconstruction.:
A UK website, principally for carers about and carers for schizophrenia; family, community, and professional service caring, who should - must ! - give voice for the best interests of those cared for they can't, they won't, theydon't, voice for themselves.
The site is edited by a retired psychiatrist who has looked after someone with the schizophrenia condition, at home, affected by the negative form of schizophrenia, for the last twenty years. [The blue highlit links take you to another page.. ] You return via the back arrow at the top of your screen or from a link at the bottom of a page
what carers should know about the structure and functioning of the clinical services in their area. [ under construction ]
The early illness. What to be aware of ,what to do, what when it goes wrong.
What carers should know about the understanding of illness schizophrenia and its difficulties.
Carers and those who live day to day with the illness have no doubts that it is an illness.
There is a break change in observed behaviour from before, sometime placing the person in alien behaviour, to their disadvantage, which they are unable to reverse themselves to regain the previous state.
The illness continues on it's 'course' to be continuing schizophrenia with the same pattern of behaviour and misbelief, as an autonomous system, isolating the person from others, who cannot identify with the changed behaviour by using their own experience to understand it. After the illness arrives, they do not move on in their lives.There is some difficulty in sustaining memory, for recent happenings and decisions ; especially accounting for abnormal behaviour and beliefs. The memory for before illness remains.
Q. What has happened? A. The crucial failure
The disabling brain change is a failure to sustain continual new cell formation [ neurogenesis ] in the hippocampus area of the brain.
Intact new cell proliferation in the hippocampus is necessary for building on incoming experience and managing it in an accessible memory frm an available store.
People with schizophrenia don't update their store and are stuck with what they have got at the age the illness arrives schizophrenia.
They cannot move on with their lives..
What carers should know about the understanding of illness schizophrenia and its difficulties
[ In 2006 a study, found in continuing schizophrenia reduced new cell activity in the hippocampus
This is the original finding - ignored !! for 9 years. The change in the brain that lead into continuing schizophrenia Reif et al 2006 - Reif et al 2006
the most important finding
NOW Replicated and Confirmed !!! - by Allen et al Here, replicated and confirmed in a different group of people with continuing schizophrenia.Now it must be accepted
having to wait !!!! NINE YEARS.
... [ Allen et al :- - if linking is difficult go to this Quote
We find a decrease in cell proliferation in the anterior hippocampus of people with schizophrenia, confirming the results of previous studies that have suggested a deficit in hippocampal cell proliferation and of neurogenesis in schizophrenia [ Reif et al ] in an independent cohort. Our results are consistent with those of Reif; however, we found a slightly larger decrease in Ki67 expression, [ Ki67 numbers indicate new cell formation ] 60% in the current study vs. 50% in Reif et al. ]
Normally the hippocampus new cells function to take from incoming environment observation, only what is a useful addition to stored away skill and experience. They hold on to it temporarily.
What is taken in goes in with the useful context and the associated relationships, not just the single items.
Once consolidated in the brain long term memory the temporary new information fades away leaving succeeding new cells to continue the updating.
Once the information is updated, the hippocampus will later take part in retrieving from store whatever information is to be carried 'in mind' so as to deal with what ever crops up in daily living , putting together in sequence the relevant contexts.
Sufferers from schizophrenia have to try to manage daily life problems and coping decisions with half the new hippocampal cells that those without the illness NEED to have to be able deal and move on progressing in their lives.
Schizophrenia continues with cognitive and maturing difficulty because of this working memory failure.
People suffering to any extent from continuing schizophrenia are producing only half the proliferating new hippocampal cells. They often experience incoming stimulus information overload in their environment.[.Foerde et al
memory overload: what happens 'normally' ]ccc
As a consequence of that they do not sort out the useful from the chaff. Information gets into the wrong memory stream, and is less flexibly available. Calling up from memory store what is required to be able to react to things that need doing can provide limited, sometims wrong, context to the intention that is to be executed.
They do not move on in their lives stuck at the level of ability and useful experience that they have at the age the illness arrived. Information that passes the hippocampal new cell sorting, will be consolidated in the other memory stream through a different route [ the striatal ] which deals with automated network storage , into an autonomous delusional explanation.,that gets consolidated into a different 'parallel' network.
People with continuing schizophrenia suffer from incoming information overload with limited background context
That is why carers should try , providing a fixed routine, reducing the incoming information load in a daily life, providing a fixed routine, in a reduced setting like a day centre helps ,where regularity and repetition with plenty of uninterrupted time and less going on, is a relieving care situation. Anchoring the life like this is security, Once established more 'newness' can be venrured
The hippocampal gate-keeping function - keeping out irrelevant information whilst allowing in useful experience - can't cope with only half the usual hippocampal new cell provision - i letting some incoming stimuli witha worrying context to go directly, 'uncensored ' ,
to the striatal memory net work - normally used for procedural learning - habits - grammar bicycle riding: relative to the hippocampal stream where stored material can be consciouly sought, the striatal route is less flexible, less conscious, less accessible, uses a different net work to consolidate what it has taken in, and where dopamine imprints value on what is passing through.
Stand out material that gets into storage this way is abnormal, carries anxiety with it, yet has to be dealt with , given an account in some way - so becomes consolidated as an explanatory delusional system, normally segregated , but returned to when stress/anxiety returns .
Less intact 'working memory' means at the age the illness arrives they do not , cannot, move on in their lives.
The earlier the illness arrives the less accumulated store of experienced information is there to cope with what crops up during the day .
An active working memory is what keeps you up to date: keeps you going. Without new cell proliferation in the hippocampus workimg memory is not sustained.
So, when and how does the brain change happen.
Maybe ? foetal inflammation promotes interleukin-17
interleukin ablates adult NG
a good ' insider' carer website, with a forum :- pamshouse: a guide for carers