In the vicious circle that can be schizophrenia, the resulting paranoia and hallucinations, as well as apathy and blunted emotions that are often part of the disorder, can cause patients to withdraw socially, an action that just might shorten their lives.
A new $3.5-million, five-year grant from the National Institute of Mental Health (NIMH) will enable Godfrey Pearlson, MD, director of research at the Olin Neuropsychiatric Research Center at the Institute of Living, part of Hartford HealthCare’s Behavioral Health Network, to launch a research study into the effect of long-term social isolation on older people with schizophrenia and, hopefully, determine ways to combat it.
Olin is the only American study site, with others in Spain, the Netherlands and England.
“This is incredibly important. If someone is diagnosed with schizophrenia in their late teens or early 20s, as is typical, they will die 15 years earlier on average than someone without schizophrenia,” Dr. Pearlson noted of the disease that affects about 1% of the population and is one of the top 15 leading causes of disability worldwide.
> Learn more about the work being done at the Olin Neuropsychiatric Research Center
Shortened lifespan
The reasons for earlier death for people with schizophrenia, he explained, stem from the disease itself, which, in addition to hallucinations and delusions, is characterized by disorganized thinking, speech and cognition.
The disease, side effects of medications used to treat it and the resulting lifestyle, Dr. Pearlson noted, are also associated with:
- Personal and health neglect
- Increased tobacco smoking
- Unhealthy eating
- Lack of exercise
- High blood pressure and cholesterol
- Being overweight
In addition, 10% of people with schizophrenia die by suicide.
“We know these things, but even when they are taken into account, they don’t fully explain why people with schizophrenia die earlier,” he said. “We do, however, know that social isolation is worse for one’s health than smoking 30 cigarettes a day, so we want to determine the mechanism of social isolation, how it increases mortality in this disorder, and how we can help.”
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Researching a cause
The absence of social contact is known to pose enormous challenges for physical health in any older person, which caused Dr. Pearlson and his collaborators to wonder whether isolating behavior in patients with schizophrenia may contribute significantly to their premature death.
The first step in recruiting the 150 participants Olin is slated to study, Dr. Pearlson said, is going through IOL files to see patients who were treated about 30 years ago for schizophrenia and track where they are now.
The team can also test whether introducing social interactions can help improve the health and eventual life expectancy, of people with schizophrenia, he said.
The research, he added, represents the second NIMH grant in two months in the same area, and dovetails nicely with other work already underway at Olin. Projects include:
- A clozapine randomized trial investigating whether psychosis patients with particular biomarkers respond best to specific medications.
- The ProNET longitudinal study with Jimmy Choi, a senior scientist at Olin, and Dr. Pearlson, that tries to identify among young individuals at risk for psychosis who will stay well and who will develop a psychotic illness.
- The BICEPS study which determines whether biological markers measured at the onset of a psychotic illness can help predict clinical outcomes into the future.
“Together, these four awards provide useful information about psychosis across the lifespan – individuals at risk, those who just developed the illness, people with ongoing disease, and, finally, those who have had the disorder for many years,” Dr. Pearlson said.
For more information on this project, email Angelo.Richardson@hhchealth.org.