A catatonic woman awakened after 20 years. Her story may change psychiatry.

[Fla Dem]

Last edited Fri Jun 2, 2023, 12:43 PM - Edit history (1)

New research suggests that a subset of patients with psychiatric conditions such as schizophrenia may actually have autoimmune disease that attacks the brain

By Richard Sima
June 1, 2023 at 6:00 a.m. EDT

The young woman was catatonic, stuck at the nurses’ station — unmoving, unblinking and unknowing of where or who she was.
Her name was April Burrell.
Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia, an often devastating mental illness that affects approximately 1 percent of the global population and can drastically impair how patients behave and perceive reality.

“She was the first person I ever saw as a patient,” said Sander Markx, director of precision psychiatry at Columbia University, who was still a medical student in 2000 when he first encountered April. “She is, to this day, the sickest patient I’ve ever seen.”

It would be nearly two decades before their paths crossed again. But in 2018, another chance encounter led to several medical discoveries reminiscent of a scene from “Awakenings,” the famous book and movie inspired by the awakening of catatonic patients treated by the late neurologist and writer Oliver Sacks.Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments — and more than two decades trapped in her mind — April woke up.

BREAK....................

April, who is turning 50 this year, has lived in a rehabilitation center for the past three years. Her family continues to visit, but she has recently regressed because she was not receiving adequate maintenance care, Markx said. Markx and April’s family remain optimistic that she will improve after resuming treatment. “She would not want society to give up on her or people like her,” Guy Burrell said.

More...................

https://www.washingtonpost.com/wellness/2023/06/01/schizophrenia-autoimmune-lupus-psychiatry/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most&carta-url=https%3A%2F%2Fs2.washingtonpost.com%2Fcar-ln-tr%2F3a2cc41%2F6478c2ae49fef7411d00143d%2F602bea569bbc0f73f6ccfcfc%2F8%2F70%2F6478c2ae49fef7411d00143d

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A wonderful account of the progress being made to identify immunological markers in psychotic patients in order to treat them and reverse the effects of Catatonia.

Not sure whether access is available to full article if you do not have a subscription.

[niyad]

1. So in all those 20 years, nobody ever did a complete diagnostic or physical

on her? She had untreated lupus? Am I reading that correctly?

[Fla Dem]

4. I'm no medical expert, but it would appear they were trying to find the cause of her schizophrenia.

Not necessarily the Lupas.

Markx was stunned to hear that little had changed for the patient he had seen nearly two decades earlier. In the years since they had first met, April had undergone many courses of treatment — antipsychotics, mood stabilizers and electroconvulsive therapy — all to no avail.[div]


Goonch has posted the full article below.

[femmedem]

5. Yes, she had untreated lupus. But the lupus presented no other symptoms.

It doesn't seem to me as if anyone knew lupus could cause this degree of neurological symptoms, or by what mechanism it caused these symptoms--especially since there weren't other indications of lupus.

[onetexan]

26. THIS!!☝️

[Warpy]

19. Immune panels aren't done as a matter of course

because the diseases are rare and the testing expensive. Most autoimmune patients go years or decades before a diagnosis (13 years in my case, I got sick when I was a teenager and my parents were in deep denial and it wasn't until it became life threatening that Mass General decided to do the workup).

I worked in a mental institution in my late teens and I can think of several patients who should have been looked at for autoimmune disease, although testing in the 60s was really primitive and so were the treatments and it probably wouldn't have changed their situations, although their families might have stopped telling them to snap out of it.

Maybe now they'll start looking at things like temperature charts a little more closely, do those immune panels on patients who run low grade fevers every evening.

[Pacifist Patriot]

23. I was lucky. Only 6 years to diagnose mine.

And it was purely by chance when I ran across a news article about a plagiarism case involving a book about the disease. It sounded like me so I asked my doctor about it. She ordered tests and voila! Easy treatment and if I am careful I feel human again.

[Goonch]

2. Full article:

https://web.archive.org/web/20230601122805/https://www.washingtonpost.com/wellness/2023/06/01/schizophrenia-autoimmune-lupus-psychiatry/

[Fla Dem]

7. Thank You!

[barbtries]

3. here's a gift link

https://wapo.st/3MQnS6M


ETA: it would seem automatic that anyone suffering from schizophrenia or other mental issues would be given a thorough physical examination. What a difference a lupus diagnosis may have made for her. jeez

my DIL has had issues for the past year or so that are extreme. I have advocated for a full physical, because I am not convinced that there may not be a medical problem impacting her. One thing is that she had an extreme weight gain in a relatively short span of time.

Years ago my sister began having issues. She didn't feel well and wasn't acting like herself. She walked into a file cabinet at work. Did she go to the doctor? NO. she joined a gym, quit smoking, quit drinking coffee. Finally one night she laid down on her couch and could not get up. her husband at the time took her pulse it was 34 bpm.

Did he take her to the ER? Call 911? NO. He left her on the couch and come Monday she dragged herself to the doctor, finally. He ended up personally driving her to the hospital and admitting her to the cardiac unit. Long story short it was her thyroid. She could have died.

Her ex told her he was leaving her for her boss while she was still recuperating. he's dead now.

[Fla Dem]

6. Thank You!

[barbtries]

8. you're welcome.

if you go to it please let me know if it doesn't work for any reason.

[Fla Dem]

9. The link workds fine! My God, what an A-hole you sister's former husband was.

Glad she got the care she needed, and hope her health now is in good shape.

If this is the daughter of the sister who had the medical emergency, given her experience, I hope she is strongly advising her daughter to get a medical evaluation.

[barbtries]

16. my DIL is my son's wife,

so no relation to my sister, who has enjoyed many, many years of good health until Alzheimers came along a few years ago. She's still alive and physically healthy, but the decline is heartbreaking.

[Fla Dem]

18. Got it!! Still glad she got the necessary treatment before the situation became critical.

[barbtries]

20. it was critical.

she was hospitalized for 5 days and recovering for 6 weeks or more. a true close call. even though he's dead, i'm still pissed off at her husband. he would have let her die. will never forgive him. My sister and her daughter over lunch and my niece wanted to show me pictures of him (after he died), and I just said Michelle I don't care. the whole time he was schtupping his boss and then he broke up with her while she was still recuperating and it was so bad.

[lucca18]

11. What an in-depth interesting read. Thank You!

[colorado_ufo]

12. Don't fault this lady too much for not going to the doctor!

I had a similar experience with undiagnosed thyroid disease. It greatly affects your brain. When you are "in" the problem, you cannot think straight.

I went to the doc for a checkup because of my fatigue and suggested that maybe it was my thyroid, having just read an article about that. He said, "Looking at your skin and hair, I don't think so, but it's a cheap test so we can just go ahead and order it. We should have the results by next Wednesday." At 11:00 am. the next morning, he personally called me and said, "The lab just called." I do not EVER want to hear that the lab called! He said, "You have no detectable thyroid hormone in your body - they could not even run the tests, and they tried twice. This is a medical emergency. We have to start you off slowly on thyroid replacement so you don't go into cardiac arrest."

It is a cheap test; they should run it on ALL women at least once every two or three years. Looking back, my symptoms came and went for several years before the "crash," especially during pregnancy.

[barbtries]

15. my sister was lucky that she made it to the dr in time.

it was the same story. they ran her thyroid twice because there was none. her heart alarmed her doctor so much he put her into his personal car and drove her to the hospital.

in the context of the OP, I'm just saying that any provider faced with a case like this should make certain there is no underlying disease or condition that could be instrumental.

because of what happened to my sister, I have had my thyroid checked several times over the years, but I asked for it every time.

[colorado_ufo]

24. Good for you - great idea!

[Fla Dem]

17. Wow, what an experience. Thank heaven they jumped on the situation as fast as they did.

[colorado_ufo]

25. Thanks so much - it was a slow recovery.

[Snackshack]

10. wow

What an amazing breakthrough that would be if they could identify genetic markers causing various mental impairments like schizophrenia, dementia to the point that a treatment for something like an autoimmune disease could cure it.

That would be outstanding!

[Bernardo de La Paz]

13. Separately, there is also some evidence Alzheimers may be related to nasal infections

Apparently, cells in the brain defend against infections by entangling them in plaque ala Alzheimers. The nasal passages are very close to the brain and there are some routes for infections to get in.

Perhaps a runny nose helps clear out infectious agents (just my surmise since I have one ).

[JudyM]

21. Whaaa?

Going to have to check that out, fascinating.

[Hekate]

14. What an incredible & highly informative OP and thread. I'm saving this article.

Thank you, Fla Dem and the rest of you.

[progressoid]

22. Where did WaPo get the stat that schizophrenia affects 1 % of the worlds population?

WHO:

Schizophrenia affects approximately 24 million people or 1 in 300 people (0.32%) worldwide. This rate is 1 in 222 people (0.45%) among adults (2). It is not as common as many other mental disorders. Onset is most often during late adolescence and the twenties, and onset tends to happen earlier among men than among women.

[FakeNoose]

27. Dr. Sander Markx at Columbia University is a true, caring hero

His research and discovery (along with Dr. Oliver Sacks) will improve psychiatric medicine for longer than our lifetimes.

Thanks you Dr. Markx!