UT at front in researching genetics of schizophrenia

By Dr. Neil B. Edwards who is a distinguished professor and former chair of the Department of Psychiatry at the University of Tennessee Health Science Center and a psychiatrist at UT Medical Group, Inc. - June 15, 2004

Schizophrenia is arguably one of the worst diseases that afflict mankind.

About 1 percent of the population suffers from this debilitating disorder, regardless of race, ethnic group or culture. That translates to 10,000 people in a metropolitan area the size of Memphis, nearly 3 million people in the United States, and worldwide a staggering 63.5 million.I have treated many schizophrenics and currently have approximately 25 chronic schizophrenics in my UT Medical Group practice. Most of these patients are stable on medications, without hallucinations and delusions, and - unlike most schizophrenics - many of them work every day. Several are married and have families. One of my patients, when I ask whether he is currently hearing voices, always says with a twinkle in his eye: "Not unless they're sneakin' up on me."

Schizophrenia strikes early, typically in the late teens or early 20s, right about the time a person should become a productive member of society.

Approximately 75 percent of schizophrenics are unable to work. Many are dependent to some degree on relatives, and most do not realize their full potential. About two-thirds - roughly 6,700 in our metropolitan area - are on disability because of their illness.

Depending on which study you read, 5 to 10 percent of schizophrenics commit suicide. They also die earlier of other causes, averaging about 10 years less in a life span than the general population.

To make things worse, treatment for schizophrenia, like that for most mental illnesses, is woefully lacking locally, statewide and nationally.

Insurance restrictions make it more and more difficult to keep patients in the hospital long enough to adequately treat their full range of problems. Once they leave, there aren't enough day hospitals, intensive outpatient programs, halfway houses or other services available to help them stay out of institutions. Many become stuck in a revolving door of hospitalization and release - hardly effective treatment in any sense of the word.

But the future for treating schizophrenics is not all gloomy. Recent research has helped us develop medications that are effective against hallucinations and delusions with fewer side effects than earlier medications.

Many ingenious noninvasive techniques for studying the human brain have been discovered, and more are to come. Neuroscience research promises to help us find new treatments that will head the illness off as it first develops, or possibly even prevent it. The human genome has been characterized and the techniques for uncovering the genetics of this tragic illness are now available.

Future possibilities are exciting.

At the University of Tennessee, we are studying the genetics of schizophrenia in African-American families. We are looking at African-Americans who have received this diagnosis, as well as their family members, to determine what particular genes are important in this tragic illness.

Our collaborative study, which began in August 2002, also involves the University of Alabama at Birmingham, the Morehouse School of Medicine, the Medical University of South Carolina, Duke University, the University of Mississippi, the University of Pittsburgh and the University of Pennsylvania. Over a five-year period, these eight academic research centers will study more than 1,200 African-American families.

We are hopeful that the fruits of this research will help us to understand the causes of this devastating disease and pave the way for new, more effective treatments.

By understanding what the genes are that are important in schizophrenia and how they work, we can develop medications that target the products of these genes, or we can even alter the genes themselves back to normal.

With such powerful means at our disposal, in the future most schizophrenics will be able realize their true potential. Indeed, in many ways we are in the best of times.

This article was originally published in The Commercial Appeal on June 15, 2004.