05NAMIconv M10542

What is Mental Illness?The Relationship between Religion and Psychiatry: 

What is Mental Illness? The Relationship between Religion and Psychiatry Shari Y. Thompson thompsons@mail.nih.gov June 20, 2005

Overview: 

Overview Historical Review of the Relationship with 5 Major Religions Impact of Religion on 20th Century Psychiatric Practices Acquiring Scientific Knowledge

Hinduism: 

Hinduism 1500 B.C.- One supreme deity but recognizes other gods as facets of the supreme deity All illnesses are caused by animistic beliefs, demons and evil spirits and certain human excesses 100-200 A.D. recorded the first description of insanity with no mention of provisions for caring for the sufferer Segregation of people with mental illness first occurred in the 19th century In 1922, the “lunatic asylums” were called mental hospitals

Buddhism: 

Buddhism 563 B.C.- 2 forms Mahayana (Buddha is the Savior) and Theravada (individual responsibility) Goal of enlightenment is wisdom and the monastic order is the heart of the spiritual quest A vast spiritual world influences diseases and illnesses Individuals are not responsible for their mental illnesses so they are not persecuted Formal Buddhist writings contain very few comments about psychosis

Judaism: 

Judaism 2000 B.C.- Belief that God is good and righteous, and His creations, the world and its people are good Emphasis on social services and humanitarian activities Late 12th Century Maimonides described the anatomy of the brain and psychiatric disorders Early 13th Century Maimonides first wrote, “Mental health is as important as physical health.” Stresses prevention not treatment – “The ill cannot serve the Lord properly.”

Islam: 

Islam 570 A.D.- Mohammed taught respect for the world order allowing Muslims to approach science sooner than Christians Absence of demonic theory of disease advanced medical knowledge 872 A.D. Cairo - First hospital for those suffering mental illness was fashioned after Christian hospitals 12th Century -Sufism ideology of health and illness depended on God alone causing tension with the medical profession during the Middle Ages 13th Century record listed 1400 drugs produced by Arab scientists

Christianity: 

Christianity 4 B.C.- Christian church came from a faith in Jesus’ resurrection and that he continues to live Gospel writers recorded that healing and exorcism played a role in Jesus’ ministry 4th Century healing through the laying of hands, prayer, fasting, invocation of Christ’s name, sign of the cross, and exorcism Care of those suffering was led by the church leading to extended, organized community care 14th Century pre-scientific demonology gave rise to the Inquisition

Middle Ages (14th – 17th Century): 

Middle Ages (14th – 17th Century) 2000 BC 1000 BC 563 BC 4 BC 570 AD 1300 AD 1600 AD 2000 AD Judaism Hinduism Buddhism Christianity Islam MIDDLE AGES

Scripture: 

Scripture MATTHEW 4:24 Tormented with illness and pain “And his fame went throughout all Syria: and they brought unto him all sick people that were taken with diverse diseases and torments, and those which were possessed with devils, and those which were lunatick, and those that had the palsy; and he healed them. ” MARK 9:17 Possessed by devils “And one of the multitude answered and said, Master, I have brought unto thee my son, which hath a dumb spirit; ” LUKE 9:39 Epileptics “And, lo, a spirit taketh him, and he suddenly crieth out; and it teareth him that he foameth again, and bruising him hardly departeth from him”

The Impact of Religion on 20th Century Psychiatric Practices: 

The Impact of Religion on 20th Century Psychiatric Practices Hinduism – yoga and relaxation techniques based on psychophysiological methods that were used to achieve control Buddhism – Direct meditation may enhance psychotherapy and Zen-derived Morita suggested as a form of treatment for social phobias and specific obsessions Judaism – 52% of psychotherapists in American cities are Jewish-Sigmund Freud and his followers made a profound impact on psychiatry from the perspective of clinicians, researchers, and patients

Impact of Religion on 20th Century Practices Contin’d: 

Impact of Religion on 20th Century Practices Contin’d Islam – employ elements of Islamic worship in group psychotherapy success in relieving psychiatric symptoms and re-grounding spiritual faith Christianity – reform mental hospitals to improve conditions of care and mainstreamed the language for psychoanalysis

Is there a Role for Clergy in Mental Health Care?: 

Is there a Role for Clergy in Mental Health Care? Points to consider: Religious life of Americans Religious practices, beliefs, and values may help prevent illness Religious commitment may influence decisions about mental health care ***Clergy may support and complement traditional medical care***

Summary: 

Summary The study and treatment of mental illnesses have been influenced by societies’ views of the spiritual world Belief in an evil or supernatural causation is not problematic per se, the issue is how that view influences the care of individuals with mental illnesses Are we a society that persecutes suffering individuals or do we provide the best care and treatment that technology will allow

Summary Contin’d: 

Summary Contin’d Medical practices are guided by the true inspiration of religions - compassion, fairness, sense of justice, and love The continuing challenge is to be truly worthy of our moral responsibilities and intellectual inheritance.

2ND BIGGEST BREAKTHROUGH IN 2003 : 

2ND BIGGEST BREAKTHROUGH IN 2003 Decoding Mental Illness www.sciencemag.org/cgi/content/full/302/5653/2039

What is Risk?: 

What is Risk? Genetics – the genes you inherit from your parents Environment – stress, smoking, drugs…

Slide18: 

The Human Genome Sequence is Done (ca.2003) Genes: 25,000 Proteins: 600,000 SNPs: 6 million Nucleotides: 3 billion

What is Risk?: 

What is Risk? Genetics – the genes you inherit from your parents Environment – stress, smoking, drugs…

Genetic Loci Linked to Schizophrenia: 

Genetic Loci Linked to Schizophrenia 1 2 3 4 5 12 11 10 9 8 7 6 13 14 15 16 17 18 19 20 21 22 X Y = genome-wide significance DISC1 DTNBP1 GRM3 NRG1 G72 COMT GAD1 MRDS1

Slide21: 

Genes: multiple susceptibility alleles each of small effect Cells: subtle molecular abnormalities Systems: abnormal information processing schizophrenia Behavior: complex functional interactions and emergent phenomena The path from here to there… temperament cognition

Slide22: 

Functional genomics in human brain gene and protein expression neuroimaging cognition Risk allele/haplotype how does it do it?

Slide23: 

The “N-back” working memory task

Slide24: 

GOAL To use postmortem human brains to discover the cellular and molecular mechanisms that lead to schizophrenia Neuropathology

Neuropathology Brain Collection: 

Neuropathology Brain Collection Total number of brains = 861. Number collected since last year = 359. Clinical history ( phone screening, medical records, interviews with next of kin), neuropathology and toxicology screening yields: normal controls = 100; schizophrenics = 55. Molecular biology screening (pH, in situ histochemistry hybridization, 28s/18s ratios and capillary electrophoretic analysis (Agilent) yields: normal controls = 86; schizophrenics = 39.

Slide26: 

What causes schizophrenia??

Slide28: 

Acknowledgements Special Thanks: Dr. Daniel Weinberger Dr. Joel Kleinman Dr. Karen Berman All the Principle Investigators and Support Staff at the National Institute of Mental Health/NIH Genes, Cognition, and Psychosis Program (GCAP) Clinical Brain Disorders Branch (CBDB) CONSUMERS, FAMILIES, AND SUPPORTERS