Posts Tagged ‘paranoia’

An automated speech analysis program correctly differentiated between at-risk young people who developed psychosis over a two-and-a-half year period and those who did not. In a proof-of-principle study, researchers at Columbia University Medical Center, New York State Psychiatric Institute, and the IBM T. J. Watson Research Center found that the computerized analysis provided a more accurate classification than clinical ratings. The study, “Automated Analysis of Free Speech Predicts Psychosis Onset in High-Risk Youths,” was recently published in NPJ-Schizophrenia.

About one percent of the population between the age of 14 and 27 is considered to be at clinical high risk (CHR) for psychosis. CHR individuals have symptoms such as unusual or tangential thinking, perceptual changes, and suspiciousness. About 20% will go on to experience a full-blown psychotic episode. Identifying who falls in that 20% category before psychosis occurs has been an elusive goal. Early identification could lead to intervention and support that could delay, mitigate or even prevent the onset of serious mental illness.
Speech provides a unique window into the mind, giving important clues about what people are thinking and feeling. Participants in the study took part in an open-ended, narrative interview in which they described their subjective experiences. These interviews were transcribed and then analyzed by computer for patterns of speech, including semantics (meaning) and syntax (structure).

The analysis established each patient’s semantic coherence (how well he or she stayed on topic), and syntactic structure, such as phrase length and use of determiner words that link the phrases. A clinical psychiatrist may intuitively recognize these signs of disorganized thoughts in a traditional interview, but a machine can augment what is heard by precisely measuring the variables. The participants were then followed for two and a half years.
The speech features that predicted psychosis onset included breaks in the flow of meaning from one sentence to the next, and speech that was characterized by shorter phrases with less elaboration. The speech classifier tool developed in this study to mechanically sort these specific, symptom-related features is striking for achieving 100% accuracy. The computer analysis correctly differentiated between the five individuals who later experienced a psychotic episode and the 29 who did not. These results suggest that this method may be able to identify thought disorder in its earliest, most subtle form, years before the onset of psychosis. Thought disorder is a key component of schizophrenia, but quantifying it has proved difficult.

For the field of schizophrenia research, and for psychiatry more broadly, this opens the possibility that new technology can aid in prognosis and diagnosis of severe mental disorders, and track treatment response. Automated speech analysis is inexpensive, portable, fast, and non-invasive. It has the potential to be a powerful tool that can complement clinical interviews and ratings.

Further research with a second, larger group of at-risk individuals is needed to see if this automated capacity to predict psychosis onset is both robust and reliable. Automated speech analysis used in conjunction with neuroimaging may also be useful in reaching a better understanding of early thought disorder, and the paths to develop treatments for it.

http://medicalxpress.com/news/2015-08-psychosis-automated-speech-analysis.html

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The Princeton mathematician, who along with his wife died in a car crash last month, claimed that aging as opposed to medicine helped improve his condition

Mathematician John Nash, who died May 23 in a car accident, was known for his decades-long battle with schizophrenia—a struggle famously depicted in the 2001 Oscar-winning film “A Beautiful Mind.” Nash had apparently recovered from the disease later in life, which he said was done without medication.

But how often do people recover from schizophrenia, and how does such a destructive disease disappear?

Nash developed symptoms of schizophrenia in the late 1950s, when he was around age 30, after he made groundbreaking contributions to the field of mathematics, including the extension of game theory, or the math of decision making. He began to exhibit bizarre behavior and experience paranoia and delusions. Over the next several decades, he was hospitalized several times, and was on and off anti-psychotic medications.

But in the 1980s, when Nash was in his 50s, his condition began to improve. In an email to a colleague in the mid-1990s, Nash said, “I emerged from irrational thinking, ultimately, without medicine other than the natural hormonal changes of aging,” according to The New York Times. Nash and his wife Alicia died, at ages 86 and 82, respectively, in a crash on the New Jersey Turnpike while en route home from a trip on which Nash had received a prestigious award for his work.

Studies done in the 1930s, before medications for schizophrenia were available, found that about 20 percent of patients recovered on their own, while 80 percent did not, said Dr. Gilda Moreno, a clinical psychologist at Nicklaus Children’s Hospital in Miami. More recent studies have found that, with treatment, up to 60 percent of schizophrenia patients can achieve remission, which researchers define as having minimal symptoms for at least six months, according to a 2010 review study in the journal Advances in Psychiatric Treatment.

It’s not clear why only some schizophrenia patients get better, but researchers do know that a number of factors are linked with better outcomes. Nash appeared to have had many of these factors in his favor, Moreno said.

People who have a later onset of the disease tend to do better than those who experience their first episode of psychosis in their teens, Moreno said. (“Psychosis” refers to losing touch with reality, exhibited by symptoms like delusions.) Nash was 30 years old when he started to experience symptoms of schizophrenia, which include hallucinations and delusions.

In addition, social factors—such as having a job, a supportive community and a family that is able to help with everyday tasks—are also linked with better outcomes for schizophrenia patients, Moreno said.

Nash had supportive colleagues who helped him find jobs where people were protective of him, and a wife who cared for him and took him into her house even after the couple divorced, which may have prevented him from becoming homeless, according to an episode of the PBS show “American Experience” that focused on Nash. “He had all those protective factors,” Moreno said.

Some researchers have noted that patients with schizophrenia tend to get better as they age.

“We know, as a general rule, with exceptions, that as people with schizophrenia age, they have fewer symptoms, such as delusions and hallucinations,” Dr. E. Fuller Torrey, a psychiatrist who specializes in schizophrenia, said in an interview with “American Experience.”

However, Moreno said that many patients will get worse over time if they don’t have access to proper medical care and are not in a supportive environment.

“When you have a schizophrenic who has had the multiple psychotic breaks, there is a downward path,” Moreno said. Patients suffer financially because they can’t work, physically because they can’t take care of themselves, and socially because their bizarre behaviors distance them from others, Moreno said.

It may be that the people who have supportive environments are the ones who are able to live to an older age, and have a better outcome, Moreno said.

Still, there is no guarantee that someone will recover from schizophrenia—a patient may have all the protective factors but not recover, Moreno said. Most patients cope with their symptoms for their entire lives, but many are also able to live rewarding lives, according to the National Institute of Mental Health.

http://www.scientificamerican.com/article/beautiful-mind-john-nash-s-schizophrenia-disappeared-as-he-aged/