November 28, 2005
examines schizophrenia in pair of studies
By Alicia Sands Lurry
Schizophrenia is a serious mental illness, and research
shows that the longer patients and their families wait to seek treatment
the more debilitating the disease can become. An Emory researcher
at Grady Hospital is involved in two studies trying to identify risk
indicators for schizophrenia, as well as explore why individuals
and families often delay treatment after onset of disease symptoms.
Michael Compton, assistant professor of psychiatry
and behavioral sciences, is leading one project in the Grady Health
study how five traits may be
risk indicators for schizophrenia and examine possible correlations with asymptomatic
The Associations among Risk Indicators in Schizophrenia
(ARIS) Project, funded by a $45,000 grant from the American Psychiatric
for Research and Education,
aims to determine whether risk markers cluster within individuals with schizophrenia,
within first-degree family members, and between patients and their family members.
Compton recently received a $25,000 Emory Medical Care
Foundation grant to extend the project. ARIS-II will add a component
detailed family history and
study “familial loading” (one’s presumed level of genetic tendency
toward developing the illness) in the context of the five risk markers. The researchers
also will add a genetic component by examining a specific gene that is involved
in cognitive functioning.
“We know of about eight to 10 risk markers for schizophrenia,” said
Compton, the study’s principal investigator. “These risk markers
are also present in first-degree family members who don’t have the disease,
and while each marker has been studied individually, they have never really been
studied all together in the same patients and family members.”
The five markers include subtle fingerprint abnormalities,
impairments in smell identification, minor physical anomalies (specific
of the head, face,
hands and feet), neurological “soft signs” (such as mild coordination
problems), and impaired verbal memory.
Schizophrenia affects approximately 1 percent of the
population over the course of a lifetime. It is associated with a
variety of symptoms,
including “positive” ones
such as auditory hallucinations and delusions, “negative” ones such
as social isolation and diminished drive, and subtle cognitive symptoms including
disruptions in attention and memory.
Recently Compton completed data collection for the
first phase of the ARIS project and is now beginning data analysis.
patients, 27 first-degree relatives
and 38 normal comparison controls were enrolled in the project.
“The whole point of this type of research is that maybe someday we can
better understand who is at greatest risk for developing the disease,” Compton
said. “If we know who is at highest risk, then maybe we can do something
down the road to actually prevent, or at least delay, the onset of the disease.”
What happens following onset is the subject of another
Compton study. The ACES project (Atlanta Cohort on the Early course
Schizophrenia) is funded by
a career development grant from the National Institute of Mental Health and
to determine why people wait to get help once the symptoms of schizophrenia
“Research has shown fairly consistently that,
in the case of early schizophrenia, the longer you wait before you
seek treatment, the worse your outcomes are over
the first few years of the illness,” Compton said. “Some patients
may delay treatment for only a couple of weeks; others may delay for several
As part of the project, Compton and other researchers
interview patients between the ages of 18 and 40 who present at Grady
and DeKalb Crisis
Center with a
schizophrenia-related illness. They also assess patients’ family members;
relatives typically bring patients to the hospital rather than the patients
themselves, and the relatives
therefore provide a window into the patients’ early disease course.
Researchers examine family strengths and coping mechanisms;
beliefs about what causes schizophrenia; general level of knowledge
the disease; and health
insurance status to determine if these factors are correlated with how long
patients and their families wait to seek treatment.
So far, 36 patients have been assessed with a first
episode of a schizophrenia-spectrum disorder. Researchers are now
a qualitative component in which they
will interview family members to further study determinants of the duration of
treated psychosis or early treatment delay.
“If treatment delay is related to lack of knowledge about the symptoms
and perceived stigma in the community, for example, then we need to develop public
education campaigns about the early signs of schizophrenia in order to raise
knowledge and decrease stigma,” Compton said. “Someday we might see
a better outcome for the disease because patients are coming into treatment earlier.”