Exciting advances in brain research are on the verge of transforming the
care for millions of mentally ill patients, but researchers need more funding
from the federal government to support the efforts to bring new discoveries to
the bedside, said psychiatric experts at a congressional briefing organized by
APA.
The briefing, "The Science Behind Mental Health," was held May
13 at the Cannon House Office Building in Washington, D.C. Lead congressional
sponsors were Reps. Grace Napolitano (D-Calif.) and Timothy Murphy (R-Pa.),
co-chairs of the House Mental Health Caucus. The presentations gave
congressional staffers a glimpse of how scientific advances are revealing
important facts about schizophrenia.
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Jeffrey Lieberman, M.D., chair of APA's Council on Research and the
Department of Psychiatry at Columbia University, explained how critical it is
for the National Institute of Mental Health (NIMH) to support the training and
work of brilliant psychiatric researchers in various stages of their careers.
Their scientific endeavors have uncovered many biological mysteries of how
severe mental illnesses originate and develop and how new treatments are being
designed thanks to these understandings. "The best, I'm happy to tell
you, is yet to come," said
Lieberman.
David Lewis, M.D., director of the translational neuroscience program and a
professor of psychiatry and neuroscience at the University of Pittsburgh
Medical Center, described his team's research on the brains of patients with
schizophrenia. Showing imaging photos of brain activities, he pointed to the
areas that light up in schizophrenia patients and healthy volunteers when they
perform cognitive tests and described what goes wrong in the dorsolateral
prefrontal cortex that impairs patients' working memory.
Based on the role of GABA neurons in coordinating neuronal activities in
this brain region and their defects in schizophrenia, Lewis and colleagues are
testing a molecule known as MK-0777 that specifically acts on GABA receptors
to perform the function of the diseased, defective GABA neurons. As an example
of rational drug discovery, they conducted a double-blind, placebo-controlled
study in which schizophrenia patients performed better on cognitive tests when
they were given the active drug than when they took placebo.
"Neuroimaging is still a fairly young field," Laura Rowland,
Ph.D., an assistant professor of psychiatry at the University of Maryland
School of Medicine, explained at the briefing. "Ultimately what we want
to do with this tool is be able to predict who will develop a mental illness,
who will respond to a specific treatment, and the disease's onset and
exacerbation."
This prospect was echoed by Lewis, who noted that the field of psychiatry
is devoting a lot of talent and resources to finding novel approaches to
detect mental illness risks early in life and prevent or limit the development
of psychiatric disorders.
One of the key lessons, these experts noted, is that behavioral symptoms of
mental illness can now be quantified and visualized with brain imaging and
other technologies. "Neuroimaging ... provides a bridge between what we
observe in behavior ... and what's going on in the brain," said Rowland.
These new tools will help physicians better diagnose and treat patients, just
like the tests and tools, such as X-ray imaging and blood tests, used in other
types of diseases do.
Educating lawmakers and the public about the science of mental health can
also help decrease mental illness stigma and misunderstanding. However, the
researchers pointed out that the advances and educational efforts needed to
accomplish this require government support through funding and policies.
Unlike other medical specialties, "there is a lot of opposition to
psychiatry, mental illness, and brain research that has to be overcome,"
said Lieberman. He pointed out that the federal government's funding for NIMH
and psychiatric research and services is proportionally lower than that for
many other types of medical disorders, despite the large public-health burden
of mental illness.
The bipartisan Mental Health Caucus was established in 2003 and has more
than 90 members from the House of Representatives. Attending the briefing were
congressional staff from offices of lawmakers including Rep. Pete Stark
(D-Calif.), chair of the Ways and Means Health Subcommittee; Rep. Edolphus
Towns (D-N.Y.), chair of the Oversight and Government Reform Committee; and
Rep. Nita Lowey (D-N.Y.), a member of the Appropriations Committee. ▪