Great analysis. I think a missing aspect of these facts so far - and I realize you never said this was comprehensive - is the confusing relationship between psychosis and schizophrenia. Obviously, psychosis is just one part of schizophrenia, and not all (or maybe even most!) psychosis is schizophrenia. So it seems like we will also need to better understand both psychosis on its own (eg drug induced psychosis) as well as its relationship with schizophrenia.
I believe left handed people tend to have a reverse effect on medication. For example b12 sould give you energy but a left handed person will not feel anything or feel sleepy. Another example is melatonin it will put most to sleep but energize a left handed person. This also effects how mental illness are treated. It's a right handed world and the MAOI work in a right handed person's brain. Left handed people are more prone to mental illness with no treatment because it is a right handed medication for a left handed illness.
One of my closest friends is schizophrenic and I feel like his psychosis has been consistently worse since he did methamphetamine. He believes that the person he hears as a voice who he believes persecutes him used this as a convenience smokescreen to radically doubledown on the persecution and monitoring because friends and family would thus believe it to be meth-induced psychosis. He has also insisted that the psychosis induced by meth is only ever short-term and thus it cannot be related. While I am not so foolish or stubborn to try to convince him that a relationship exists, is he simply correct in saying that meth has no relation to long-term psychosis to your knowledge?
One thing I really feel for him about is that both his parents lecture him about how he caused his own schizophrenic through his drug use (lecturing which hardly makes his condition better, which is why I am very much not inclined to do it myself!) but having known him very well since childhood I know that he's hardly every smoked cannabis in particular.
That's fair enough - thanks. His anti-psychotics definitely help, but I also understand why he sometimes hates taking them. He has put on a lot of weight over the last few years and again his parents just blame it on diet and lifestyle, but he has a friend on the same meds who goes on ten mile wals and largely just eats vegetables who is much the same. His mother does a lot for him, but I think both his parents have been so judgemental about his addiction issues and the hurt it's caused them that they don't always appreciate the amount of genetic and biological factors, as well as all the symptoms (like the weight gain) his meds cause him.
He's a sweetheart and Freddie's posts on the memeification/ gentrification of mental health really hit home to me because I wouldn't wish what he struggles with on my worst enemy.
Adverse childhood experiences. Child abuse, sexual abuse, urbanisation, migration.. Evidence shows the risk of mental health problems is increased for such populations by many magnitudes.
Good point. I think this would warrant a post in itself! Obviously wouldn’t be on the same causal pathway as handedness but exposure to such risk factors might explain why some people with neurodevelopment insults go on to develop schizophrenia and others do not
What’s your take on whether in addition to being neurodevelopemental SCZ is also degenerative. One implication being that AP treatment may be disease modifying. DUP literature always unimpressive to me due to confounding but open to it.
I am not convinced that AP is disease modifying (other than preventing relapses and thus allowing a person to maintain occupation + social roles). My sense is that reducing the duration of untreated psychosis was oversold but I’d like to look at it in more detail!
Great analysis. I think a missing aspect of these facts so far - and I realize you never said this was comprehensive - is the confusing relationship between psychosis and schizophrenia. Obviously, psychosis is just one part of schizophrenia, and not all (or maybe even most!) psychosis is schizophrenia. So it seems like we will also need to better understand both psychosis on its own (eg drug induced psychosis) as well as its relationship with schizophrenia.
I think there’s an argument to be made that negative symptoms and thought/behavior disorganization are the real Category A symptoms.
Agreed!
Fascinating, with complex issues and research communicated magnificently. Thank you
I believe left handed people tend to have a reverse effect on medication. For example b12 sould give you energy but a left handed person will not feel anything or feel sleepy. Another example is melatonin it will put most to sleep but energize a left handed person. This also effects how mental illness are treated. It's a right handed world and the MAOI work in a right handed person's brain. Left handed people are more prone to mental illness with no treatment because it is a right handed medication for a left handed illness.
One of my closest friends is schizophrenic and I feel like his psychosis has been consistently worse since he did methamphetamine. He believes that the person he hears as a voice who he believes persecutes him used this as a convenience smokescreen to radically doubledown on the persecution and monitoring because friends and family would thus believe it to be meth-induced psychosis. He has also insisted that the psychosis induced by meth is only ever short-term and thus it cannot be related. While I am not so foolish or stubborn to try to convince him that a relationship exists, is he simply correct in saying that meth has no relation to long-term psychosis to your knowledge?
One thing I really feel for him about is that both his parents lecture him about how he caused his own schizophrenic through his drug use (lecturing which hardly makes his condition better, which is why I am very much not inclined to do it myself!) but having known him very well since childhood I know that he's hardly every smoked cannabis in particular.
Sorry I can't comment on individuals but I do hope things get better for your friend.
That's fair enough - thanks. His anti-psychotics definitely help, but I also understand why he sometimes hates taking them. He has put on a lot of weight over the last few years and again his parents just blame it on diet and lifestyle, but he has a friend on the same meds who goes on ten mile wals and largely just eats vegetables who is much the same. His mother does a lot for him, but I think both his parents have been so judgemental about his addiction issues and the hurt it's caused them that they don't always appreciate the amount of genetic and biological factors, as well as all the symptoms (like the weight gain) his meds cause him.
He's a sweetheart and Freddie's posts on the memeification/ gentrification of mental health really hit home to me because I wouldn't wish what he struggles with on my worst enemy.
Interesting. But why is there such a lack of focus on environmental factors here?
I would class perinatal complications, Winter birth, and cannabis use as environmental factors - were there others you had in mind?
Adverse childhood experiences. Child abuse, sexual abuse, urbanisation, migration.. Evidence shows the risk of mental health problems is increased for such populations by many magnitudes.
Good point. I think this would warrant a post in itself! Obviously wouldn’t be on the same causal pathway as handedness but exposure to such risk factors might explain why some people with neurodevelopment insults go on to develop schizophrenia and others do not
What’s your take on whether in addition to being neurodevelopemental SCZ is also degenerative. One implication being that AP treatment may be disease modifying. DUP literature always unimpressive to me due to confounding but open to it.
I think there are some ways it fits with neurodegenerative, but again with some unanswered questions - https://rationalpsychiatry.substack.com/p/cognitive-trajectories-in-schizophrenia
I am not convinced that AP is disease modifying (other than preventing relapses and thus allowing a person to maintain occupation + social roles). My sense is that reducing the duration of untreated psychosis was oversold but I’d like to look at it in more detail!
Great linked post. Agree that the two hypotheses need not be mutually exclusive.