Episode 008: Schizophrenia with Dr. Cummings: Controversies, Brain Science, Crime, History, Exercise, Successful Treatment

In this episode, Dr. Puder addresses the fascinating realm of schizophrenia with Dr. Cummings, a previous guest in the show. Dr. Cummings is a psychiatrist with a wealth of experience from working at Patton State Hospital in California, one of the biggest forensic hospitals in the world.

By listening to this episode, you can earn 1 Psychiatry CME Credits.

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Article Authors: David Puder, MD

There are no conflicts of interest for this episode.

• Defining Schizophrenia

  • Swedish survey about misperceptions of the environment found that roughly 50% of the population have had misperceptions that could be considered psychotic in nature.

• The Loss of Brain in Schizophrenia

  • Schizophrenic patients lose 2% of brain mass per year for the first 5 years in the course of illness.

• Living with Schizophrenia and Perception of Reality

• Are Negative Symptoms in Schizophrenia Precipitated by Medications?

• The Pathology, Biology, and Genetics of Schizophrenia

• Cannabis Use and Risk For Schizophrenia

• Counter-arguments Against Robert Whitaker’s “Anatomy of an Epidemic”

  • Emil Kraepelin, and the Early Studies on Schizophrenia

    • The majority of schizophrenic patients during Kraepelin’s observation became vegetative in their 40s.

    • After the advent of antipsychotic medications, schizophrenic patients are able to function until their 70s-80s

  • Gitlin 2001 Neuroleptic Discontinuation Study

    • Exacerbation or relapse was almost universal within 2 years in those who discontinued antipsychotics

• Schizophrenia Prevention in High Risk Population

  • Australian study on children of schizophrenic parents (Yung, 2011)

• Australian Study on Children of Schizophrenic Parents

• Crime, Violence, Mass Shootings and Schizophrenia

• Medical Management of Schizophrenia

• 1st Break Psychosis

• Long-acting Injectable Antipsychotics in Early Illness

• Medication Adherence

• Exercise

  • Exercise for schizophrenia increased hippocampal size by 12% vs. -1% for non-exercising groups of patients (Pajonk, 2010)

• Lifestyle, Diet Optimization 

References

Gitlin, M., Nuechterlein, K., Subotnik, K. L., Ventura, J., Mintz, J., Fogelson, D. L., ... & Aravagiri, M. (2001). Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia. American Journal of Psychiatry, 158(11), 1835-1842.

Pajonk, F. G., Wobrock, T., Gruber, O., Scherk, H., Berner, D., Kaizl, I., ... & Backens, M. (2010). Hippocampal plasticity in response to exercise in schizophrenia. Archives of general psychiatry, 67(2), 133-143.

Yung, A. R., & Nelson, B. (2011). Young people at ultra high risk for psychosis: research from the PACE clinic. Revista Brasileira de Psiquiatria, 33, s143-s160.