My Mom has been schizophrenic since 1982.
1982-2021: no suicide attempts
2021-23: 4 suicide attempts.
Something has changed… Since some years she has a recurring eye problem: keratitis (inflammation of the cornea). It happens every 3-4 months, the doctors find no cause and we noticed that it correlates with the psychotic episodes. I am wondering can it be that there is inflammation also in the brain which triggers the psychotic symptoms?
Actually I myself also have an eye problem, I have a scar on my retina discovered in early childhood. Doctors always tell me that most probably this is from an intrauterine toxoplasmosis infection from my mother. This is very interesting as toxoplasmosis is widely researched as a possible cause of schizophrenia, although with mixed results as I understand… and - of course according to mr google - it does harm the retina but not the cornea. But, this is what I have recently found: there is something else which my mom definitely has, and can potentially cause inflammation in both the brain and the cornea and that is the herpes virus… Does anybody has any experience with this is in case of a loved one?
After the first suicide attempt my mom’s CRP (leading inflammation marker) was 200 mg/l which is superhigh. Ok, it was an overdose, but Olanzapine overdoses are actually very well documented on the internet and compared to those this is still a too high CRP.
I am not a doctor and I am doing this mini-investigation only because I am very desperate… since 2021 no med works for my mom on the long term… she was put on clozapine as a “last resort” last September and it lasted until now… she had to get into hospital today again. And as she is 71 the approach of the doctors is just “she is old, she needs to be put into a care-home”. Awful.
My Mom has been schizophrenic since 1982.
Welcome to the forum, glad you found us.
I don’t have anything on your eye questions, I do have a thought on your suicide attempt question.
After searching the forum for a long term study that was posted some years ago, that might pertain to your mom. I finally found it, here it is … These people were all released at the same time due to politics.
The numbers from the Vermont mental hospital 10 and 30 year follow ups were:
10% are dead, mostly suicide
25% much improved with extensive supports
25% much improved
25% fully recovered
Same group at 30 years
15% dead, mostly suicide
10% hospitalized unimproved
15% improved but require extensive support network
35% much improved relatively independent
25% completely recovered
The number that I thought might apply to your mother was the uptick in suicides that occurs in the later years.
The uptick in suicides has been attributed to the “lightening of the symptoms” that has been reported by some of the sufferers later in life. I don’t know if there are any hard numbers on it, some sources say that the new awareness of what has been happening most of their lives, can cause depression and lead to suicide.
It might also be (to play Devil’s advocate for your mother’s doctors) that they are trying to get her more constant access to care.
As to the specifics of toxoplasmosis exposure and some of the other diseases like herpes virus, I don’t know. When it comes to exposures like that over the course of a lifetime, correlation does not equal causation until you can suss out whether or not exposure alone is the cause of illness development. Because it seems Schizophrenia is so diverse both in appearances but in underlying patient pathology and personal health, I don’t think that alone is the key contributing factor if it is one at all.
The flips side of the argument, is that just because your mother has SZ on top of toxoplasmosis, is that she is getting picked in the sample group as the psychosis presents itself and is being put directly in front of an eye doctor. Many others either have any plasmosis exposure going completely undiagnosed, OR it’s likely that it may have absolutely no impact on their psychosis. The other reason your mother could notice or complain about the symptoms of her inflammation is because of the perceptual changes that occur for patients experiencing psychosis. Again, this does not indicate plasmosis and the inflammation is a cause, but merely a noted symptom of her underlying condition, like hypersensitivity and irritation with her other physical ailments. Her mind attributes it to one cause, because SZ interferes with electrical signaling of the brain and thus more acutely interprets her signs of keratitis and the irritation to you.
This is a summary article with a small sample group of 228 people (the gold standard is 1000). The key finding was that “There was no difference in the symptoms or course of psychosis between the patients with the NMDAR antibodies and those without.” in 7 of the total psychosis patients who had blood draws, while none of the NMDAR antibodies were present in the healthy controls. Set for limitations in the statistical modeling and measures for significance (the full study is behind a paywall so I can’t parse those results), it’s highly unlikely that these findings of the NMDAR antibodies as contributing factors to psychotic episodes is significant. Likely, another study attempting to measure the found number of antibodies simply indicates that they tested for those antibodies, and found them present at the time of their psychiatric diagnosis. Much like if someone was found to have MERSA on top of having the pneumonia or flu during check-ins on the lab values. Having a concurrent condition does not equate that the flu was the cause of the Mersa, simply that a bad case of the flu probably landed the person in a setting where they could contract the disease.
The percentage total and comparison groups to rule out things like placebo effect on the immune therapy proposed are too small and limited to make any sweeping generalizations as the study already noted above that the presence of the NMDAR had no impact on the length or severity of their psychosis compared to the patients who had none present (and yet still experienced psychosis).
I don’t think there’s an uptick in suicides in later years. It looks like 10% commit suicide in the first 10 years and then an additional 5% kill themselves in the next 20 years.
This is both really scary and somewhat encouraging! 60% either eventually recover or are much improved, but 40% never get there.
Yes, I see your point, it doesn’t mean they complete suicide 20 years later, it was over the 20 year span.
If you do an internet search you can find more details about the Vermont study.
I agree, it’s encouraging and scary. I guess it’s important for people to know they aren’t alone when their family members don’t show some recovery over time.
I understand your distress and I pray for you
Actually she did not experience lightening of the symptoms. On the contrary: after a stable period of 20 without any positive symptom (!) in 2021 suddenly the meds which worked for long years stopped working… The voices are so aggressive now that she just cannot live with them.
Ok I agree that maybe age is a factor in a way that people look back at their lives and realize that they do not like what they see…
I agree that correlation does not equal causation, but… after much hardship in the 1980-90s (my childhood) my mom had a very stable period in 2000-2021. She took her meds, she did not need any hospitalization, she had the negative symptoms but did not have any positive symptom (!). I think this is extraordinary… last year when she was in the hospital the doctor asked her if he can present her as a case study to students…
So what happened in 2021? She got a covid vaccine, 2 days after the voices came back, 1 week after she took a box of olanzapine… shall I say that is was because of the vaccine? I don’t think there is anything wrong in the vaccine itself just maybe when the body was too busy creating covid antibodies some old virus infections could get more space… or the vaccine triggered some autoimmunity, as I heard this happened also in other cases. By the way due to the eye problems my mom was sent to do an immune lab and the “double stranded DNA antibodies” came out very high (which could cause lupus for instance). Now that I googled these antibodies… (see : Double Stranded DNA Antibody - an overview | ScienceDirect Topics) the article mentions also these NMDAR antibodies… but this article is really too medical for me… are these the same antibodies? or similar?
And about the article you sent: you highlight that “There was no difference in the symptoms or course of psychosis between the patients with the NMDAR antibodies and those without”. BUT I would highlight that “Prof. Lennox and her team have successfully treated a number of patients with psychosis who test positive for these antibodies.”. So… if my mom could be treated with immunotherapy I would be happy even if not 100% of the other patients can be…
And by the way my mom does not think at all that her psychoses is related to the vaccine or the eye problems… these are MY guesses. I myself also suffer from an illness which science cannot explain (endometriosis). This is so infuriating, 2 such illnesses in one family and the medical world is just guessing… so I am guessing too…
There isn’t any factual evidence to indicate a lessening of symptoms had to do with the suicides in later life, most likely that line of thought is conjecture.
Is she a contact lens wearer? I had keratitis in high school wearing contact lenses too long while pulling all-nighters for a paper that was due. It’s common during psychotic episodes to get little to no sleep for hours and days. Injuries and infection are the most common causes and neglect of hygiene and self-care are common in the run-up to psychotic episodes.
While there are many reported visual perception issues associated with SZ, the main directly observable eye issue I’m aware of is oculomotor dysfunction. It’s a version of nystagmus where eyes can move involuntarily or fail to track objects normally. It’s thought to be related to dopamine levels, although it’s unclear if it’s caused by medications or inherent to the disease. It’s useful for diagnosed people who drive to be aware of the issue, because eye tracking is sometimes used in field sobriety tests. I failed such a test, and without getting specific mentioned I took medication for a condition which affects eye tracking. Some caregivers also report enlarged pupils or widened “sanpaku” eyes in diagnosed people with active psychosis.