The Mental Health Minute

Articles and news about mental health issues

Childhood disorder prompts study of infection link to mental illness

Here’s yet another article from the Los Angeles Times about mental health.  Is California just more aware of the problem we have in society with mental disorders, or do they have a higher number of mentally ill people?  Just a question.

I thought this article was interesting and felt it needed to be posted here for your perusal.  Won’t you read this article and then let me know what you think?  Is there a connection between infection and mental illness?

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By Shari Roan, Los Angeles TimesDecember 5, 2011

Brody Kennedy was a typical sixth-grader who loved to hang out with friends in Castaic and play video games. A strep-throat infection in October caused him to miss a couple of days of school, but he was eager to rejoin his classmates, recalls his mother, Tracy.

Then, a week after Brody became ill, he awoke one morning to find his world was no longer safe. Paranoid about germs and obsessed with cleanliness, he refused to touch things and showered several times a day. His fear prevented him from attending school, and he insisted on wearing nothing but a sheet or demanding that his mother microwave his clothes or heat them in the dryer before dressing.

So began a horrific battle with a sudden-onset mental illness that was diagnosed as pediatric autoimmune neuropsychiatric disorder associated with streptococcus, or PANDAS. The puzzling name describes children who have obsessive-compulsive disorder that occurs suddenly — and often dramatically — within days or weeks of a simple infection, such as strep throat.

“He washed his hands over and over and was using hand-sanitizer nonstop,” said Tracy Kennedy, who has home-schooled her 11-year-old son since early November. “He had never been like this before. Ever. He just woke up with it.”

The bizarre illness, first recognized in the mid-1990s, has been cloaked in controversy. Now, however, studies are reinforcing the belief that some psychiatric illnesses can be triggered by ordinary infections and the body’s immune response. While the theory remains unproved, the research raises the possibility that some cases of mental illness might be cured by treating the immune system dysfunction.

“Some people get sick with whatever infection, and they recover and they’re fine,” says M. Karen Newell Rogers, an immunologist at Texas A&M Health Science Center College of Medicine in Temple, Texas, who studies such illnesses. “Other people get sick and recover, but they are not the same.”

PANDAS is thought to be caused by antibodies generated as a result of an infection, usually strep. Normally, an infection causes the body to generate antibodies that fight the infection and promote healing. But in PANDAS, the antibody response is thought to go awry, attacking brain cells and resulting in OCD symptoms.

A greater understanding of the link between strep and OCD has opened the door to the study of other psychiatric or neurological illnesses that may be linked to improper immune response, including cases of autism, schizophrenia and anorexia.

“The whole area of mental illness caused by infections is being looked at more closely because of PANDAS,” says Dr. Michael A. Jenike, a professor of psychiatry at Harvard Medical School and chairman of the International OCD Foundation’s scientific advisory board. “If you can prevent lifelong suffering by using antibiotics or some acute intervention, that would be huge.”

Little understood disorder

PANDAS is generally poorly understood in the medical field, said Dr. Margo Thienemann, a Palo Alto child psychiatrist who has treated several cases. There is no test to help doctors diagnose it, although the National Institute of Mental Health says that PANDAS can be identified after two or three episodes of OCD or tics that occur in conjunction with strep infection — a vague guideline that results in much confusion.

Thienemann says patients tend to fall between the cracks of psychiatry and immunology. But early diagnosis is important.

“In psychiatry, we generally spend our time treating diseases without knowing the reason they happen,” she says. “With PANDAS we are able to see the cause of a problem rather than the downstream effects. This is the exciting part.”

OCD affects about 1% of people and can feature a fear of contamination by germs or other substances, hoarding, intense anxiety over one’s moral behavior, tics, compulsive skin-picking or body dysmorphic disorder (obsession with some perceived bodily imperfection). The disorder tends to run in families and usually appears around the ages of 10 to 12, with a later spike in rates from age 18 to 22.

No one knows what portion of obsessive-compulsive disorder cases may be tied to PANDAS — or even how prevalent the condition may be, Jenike says.

“I used to think it was exceedingly rare,” he says. “Now I think it’s exceedingly common.”

Recent research has strengthened support for PANDAS. For instance, one study demonstrated that in mice prone to autoimmune disorders (in which the immune system attacks healthy cells), exposure to strep led to OCD-like behavior. The study was published in 2009 in the journal Molecular Psychiatry.

A 2010 Yale study found that tic symptoms worsened somewhat in children with OCD following a strep infection. That study, published in Biological Psychiatry, suggests some children are vulnerable to flare-ups of OCD symptoms when stressed by infections.

Another paper, published online in August in the Journal of Pediatrics, found that, compared with children with typical OCD, children diagnosed with PANDAS were more likely to have biological evidence of a recent strep infection, a sudden onset of psychiatric symptoms and an easing of those symptoms while taking antibiotics…[read more]

 

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December 10, 2011 Posted by | Mental Health | , , , , | Leave a comment

Recovery emphasis of Long Beach homeless program

Cover of "The Soloist"
Cover of The Soloist

This article below is enlightening and uplifting.  Here is an organization that actually understands the plight of our homeless mentally ill and tries to do something about it.  I hope you read this and feel positive about the possibility of correcting the stigma of mental illness in our society and feel that there is a way to give hope to the hopeless.

I am touched by the work of Dr. Ragins.  Please read this article and let me know what you think.

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L.B. homeless expert played key role in ‘The Soloist’s’ creation

By Greg Mellen Staff Writer

Posted: 02/27/2010 08:27:24 PM PST

Updated: 02/27/2010 08:48:22 PM PST

Mental Health America of Los Angeles member Karen Chandler,left, talks with Mark Ragins, right, the founding psychiatrist and medical director of the MHA Village in Long Beach. He advised Steve Lopez during the writing of The Soloist, which is the selection this year of Long Beach Reads One Book. (Stephen Carr / Press-Telegram)

Mental Health America of Los Angeles member Louie Shirpser holds one of several homemade wooden ship medels he made and that are on display at the MHA Village in Long Beach. The MHA Village provides a kind of humanistic approach to mental illness and seeks to help patients, or members as they re called at the Village, not only experience remission of their disease, but get better and reclaim their lives. (Stephen Carr / Press-Telegram)
  • LONG BEACH — Ralph Scialdone walks by with the neck of a guitar in his hand.”A bass,” he corrects, adding that its name is Ralphy Jr.When asked what the guitar, er, bass neck represents, Scialdone says, “It’s half a dream. The Village is going to make the other half come true.”Then he is off with a caseworker on a quest to find a new apartment.In the cafeteria, Dr. Mark Ragins, the medical director and founding psychiatrist of the Mental Health America Village in downtown Long Beach, makes the mistake of calling Karen Chandler, a client.”I am not a client,” Chandler says loudly. “I am a black woman member.”

    At the Village, it’s an important distinction that defines the organization’s whole approach. Namely, that those who use the services are part of a team, not divided into patients or clients and staff, but members of the collaborative whole.

    The extent to which Chandler, who has been a member since the Village’s inception, gets all that isn’t entirely clear. What is clear is that she likes to correct Ragins whenever the opportunity arises.

    The doctor is contrite as he’s scolded.

    In the course of a day, Ragins has numerous comical interactions, but it only underscores the serious business he’s in.

    For the past 20 years, Ragins has played a lead role in turning the Village from a fledgling recovery-focused mental health and homeless treatment and services center that operated on the fringes of accepted medical practice — into a model program.”I’ve known about them for 20 years,” said the Rev. Kit Wilke, a homeless advocate, of Woodruff Church. “They’ve consistently been one of the best things going and working with one of the most difficult populations.”

    A writer’s mentor

    Ragins was an integral figure in helping author Steve Lopez in his understanding of homelessness and mental illness. He also helped Lopez figure out how best help Nathaniel Ayers, the homeless mentally ill cellist the Los Angeles Times columnist befriended and profiled.

    Ragins also became what Lopez called his “on-call adviser” for Lopez’s book, “The Soloist,” which is this year’s choice by the Long Beach Library Foundation for the annual Long Beach Reads One Book series of events.

    Ragins has been at the forefront of so-called “recovery movement” in psychiatry and psychology. Once a kind of radical approach, it is now widely accepted, if not well-practiced.

    For years, the goal of psychiatrists treating the mentally ill was to achieve remission, meaning the patient ceased to display abnormal behaviors.

    In recovery psychology, the goal is to treat the person as one who can recover, and then find ways to help the person create a life of his or her choosing.

    In a sense, the goal is to treat the person rather than the illness.

    Martha Long, the director emeritus of the Village, sums up the facility’s goal as helping members “get a life.” That may sound flip, but it gets to the heart of what the Village is about.

    Ragins is an author himself, and his book, “A Road to Recovery,” lays out in straight-forward and spare prose his model for treatment.

    The recovery process, in his view, rests on four pillars: hope, empowerment, self- responsibility and finding meaningful roles in life.

    Sessions at the Village often begin with a question along the lines of “What do you WANT?”

    Then begins the process, no matter how slow, halting and protracted it may seem, to attaining that goal and, in the process, living a desired life.

    The road is never linear and rarely easy.

    Richard, who didn’t give his last name, suffered from 25years of addiction and 2years of homelessness before coming to the Village, and now he works there.

    “I was sleeping under a bridge,” he says. “But if you put in some work and effort and have faith, you can turn your life around.”

    Feeling of safety is key

    To illustrate the patience required, Richard mentions the case of a man who comes to the Village daily. Richard says intake information has been slowly collected on the man for a year now. There’s no real timetable for when the man will feel comfortable enough to become a member, but for the time being he feels safe coming in, and that’s something.

    It sounds simplistic, maybe even naive, but the results can be profound.

    The Village offers three-day immersion classes to health professionals to teach them its methods.

    Executive Director Paul Barry says he remembers one student who seemed unimpressed afterward and said “What you teach is just common sense.”

    Barry said that was a student who got exactly what the Village is trying to preach.

    Although that’s the simple answer, Ragins says it doesn’t “deprofessionalize” what is done. Members are medicated and receive psychological and social help.

    However, Ragins says, “The same way you can help a friend who is suffering is the way you can treat a client.”

    Ragins, the bearded leader of the Village, wants nothing less than to revolutionize mental health care and perceptions.

    “This is a revolution not just for how (professionals) act or how (mentally ill) view themselves, but how the community views the mentally ill.”

    Ragins wants to see a day when the community doesn’t seek to merely put the homeless and mentally ill away and isolate and separate them, but find ways to include them.

    Ragins recalls when Lopez called. “He said, `can you give me ideas on how I can help (Ayers),”‘ Ragins said. “That was a revolutionary different call than you get from the rest of the community.”

    As Ragins was an integral part of Lopez’s book, he also will be integral in the week’s activities.

    Ragins will take part in a $100 admission panel discussion fundraiser with Lopez and others Wednesday at the Village. On Thursday, Ragins will speak at a free event at the Barnes and Noble book store, 6326 Pacific Coast Highway.

    The Village also will be involved in an event called Sending a Book on a Journey. New and used copies of “The Soloist” and other books may be dropped off Wednesday through March 13 at Long Beach Reads events and city libraries for distribution to Village members to encourage them to read the books and pass them along to others.

    greg.mellen@presstelegram.com, 562-499-1291

    Here’s the link to the original article

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    March 22, 2010 Posted by | Mental Health | , , , , , , | 1 Comment