Schizophrenia is a mental illness which affects one percent of the population worldwide, and the lasting economic and mental impact on personal lives is staggering. The symptoms are numerous: hallucinations, delusions, disordered thinking/movement, and problems with comprehension. Individuals have often struggled with school, lost jobs or relationships, and needed hospitalization.

Over time, a schizophrenic can lose up to 25 percent of frontal and temporal lobe brain matter.

A Smoking Cessation Study has had considerable success with a nearly 50 percent quit rate for patients with schizophrenia who follow the complete program. It combines medication management with group therapy and is now also being tested for patients with bipolar disorder.

However, the largest study in scope - 35 sites in 21 states - is the National Institute of Mental Health study for treating an initial episode schizophrenia, called RAISE – Recovery After an Initial Schizophrenia Episode. Michigan sites for this $40 million study are in Ann Arbor, Lansing and Touchstone Innovare in Grand Rapids, the latter under the direction of Dr. Achtyes.

Dr. Achtyes points out the emphasis on this federally-funded study is to head off, as much as possible, those negative life impacts by identifying the problem as early as possible. “With intensive treatment right away, in the teens and early 20s, the goal is to prevent escalation and the development of long-term symptoms.”

This study utilizes a set of proven treatments, including: computer-assisted drug prescribing, family education, individual counseling with supported education and employment specialists.

These treatments are compared to standard care within the community, and subjects are followed for two to three years.

The symptoms of schizophrenia and therefore the treatments are thought to be based on the nervous system’s balance of neurotransmitters in the brain. Nerve cells or neurons produce these chemical molecules to communicate with each other via electrical impulses that pass from one neuron to the next in our brain. If the chemicals are unbalanced, symptoms of mental illness will emerge. This is where medications can be so crucial in treatment to correct the imbalance and restore normal functioning.

Dr. Achtyes stresses “that for patients with schizophrenia, staying on their medication is the key to keeping illness in remission.”

He points out that genetic and environmental factors are equally important in the development of schizophrenia. For example, if a parent or sibling has it, there is a 10 per cent chance that person will develop the illness. But if a person has an identical twin, their risk rises to 40 to 70 percent.

While genes are important, they do not tell the whole story. Environmental factors also play a key role. Stressful life situations such as going off to college, joining the military, relationship struggles, getting married, having a baby, changing jobs, can provide the trigger that signals the beginning of the illness in someone who is at risk genetically.

As studies on mental illness continue and awareness increases, Dr. Achtyes joins other researchers to help find answers. For instance, given the importance of each person’s genetic profile on response to medications, he is engaged in a pilot study at Pine Rest that attempts to select the right medicine for individuals the first time based on their unique genetic profile. “It is called personalized medicine. We want to be able to prescribe anti-depressants based on each patient’s unique genetic make-up. This will, we hope, reduce the time it takes to find the right medicine for patients.”

Counseling, Dr. Achtyes adds, “can also affect neuro-transmitters. While medicine works from the bottom up, counseling, works from the top down from the brain’s cortex, to create some of the same changes seen with medication.”

Counseling is most effective for the treatment of depression, anxiety disorders, obsessive/compulsive disorder, and addictive disorders such as alcoholism, smoking or drug use.

Due to the nature of the studies, proximity to Grand Rapids is a consideration. For full information on Pine Rest Christian Mental Health Services’ Clinical Services, call 1-800-678-5500, or on the web at www.pinerest.org

Dr. Achtyes is the staff psychiatrist at Pine Rest Christian Mental Health Services in Grand Rapids, as well as the director of the Division of Psychiatry and Behavioral Medicine at the Michigan State University College of Human Medicine.

Dr. Achtyes joins his patient practice with a deep interest in academic scholarship and research. He is participating in several federally funded studies.

This professional division is ideal for Dr. Achtyes. Four mornings a week, as staff psychiatrist at the Touchstone Innovare Community Mental Health Center, he treats patients with severe and persistent mental illnesses such as bipolar disorder, schizophrenia, depression and substance use disorders.

Dr. Achtyes For more information about these studies, contact Dr. Achtyes’ research coordinator, Heather Willett, at: 616-459-0255.