The UNC School of Medicine's department of psychiatry has received a five-year $3 million award from the National Institute of Mental Health to promote the early detection and prevention of schizophrenia.

This award comes on the heels of a five-year, $9.3 million grant from the National Institute of Mental Health to form a Silvio O. Conte Center to study the onset of schizophrenia. One component of the center, the Prevention through Risk Identification, Management and Education Clinic, will focus on the comprehensive study of the prodromal phase of schizophrenia.

"These efforts highlight the importance the National Institute of Mental Health has placed on the prevention of mental illness," explains Diana Perkins, MD, associate professor of psychiatry and director of the PRIME Clinic. "This is a progressive area of research for the neuroscience of mental disorders with ambitions not just for more effective treatments but also the possibility of the prevention of schizophrenia altogether."

The symptoms of schizophrenia can occur suddenly but more commonly take months or years to develop. Prior to the onset of schizophrenia, patients and their family members describe subtle changes in feelings, thinking and behaviors that are classified as prodrome or basic symptoms. Prodromal symptoms include unusual thinking, suspiciousness, grandiose ideas, perceptual abnormalities, disorganized thinking and social disinterest.

"These symptoms are often accompanied by a change in behavior, such as decline in functioning at school or work, social withdrawal, impaired hygiene, aggressive behaviors or suicidal ideation," Perkins said.

The research is complicated by the fact that not all people experiencing such symptoms will progress to schizophrenia. Previous research in this area suggests that about 50 percent of people experiencing basic symptoms will progress to psychosis. Sometimes these symptoms may be the early warning signs of another psychiatric disorder such as an anxiety disorder, depression, substance abuse or part of a normal adolescent crisis.

Through this study, specific prodromal symptoms and risk factors will be identified and evaluated to attempt to distinguish what is different about those who progress to psychosis and those who do not. Through examining this distinction researchers aim to increase their ability to define a prodromal state that is highly predictive of a subsequent psychotic illness.

"The better we become at identifying diagnostic and prognostic indicators the better we will be at developing early intervention strategies to delay the onset or quickly treat at the earliest onset of symptoms," said Jeffery Lieberman, MD, principal investigator of the study and director of UNC's Mental Health Clinical Research Center.

For more information, please contact the PRIME clinic at (919) 843-7746 or (877) 774-6319 or visit www.prime.unc.edu.

August Issue of Physicians Practice