Research into autoimmune disease and its effect on patients with psychiatric conditions is bringing hope to many. Reports suggest that patients with illnesses like schizophrenia may have immune system responses damaging the brain, leading to the development of psychosis and other cognitive disorders. While it was previously thought that such patients were unaffected by inflammation or autoimmune responses, new findings indicate that such responses may be behind many cases of psychiatric illness and could be treated by targeting the underlying autoimmune condition. Research carried out in New York State identified around 200 patients with autoimmune diseases such as lupus and rheumatoid arthritis who may benefit from this approach, however, scientists around the world are also studying the effects of underlying autoimmune and inflammatory processes on a much wider range of psychiatric syndromes.
One success of this new approach to mental health treatment is the story of April Burrell. Burrell was an undergraduate accounting major at the University of Maryland Eastern Shore where she was an outgoing, straight-A student. However, after a traumatic event when she was 21, Burrell began to experience symptoms of psychosis. She was diagnosed with schizophrenia, an often devastating illness that affects approximately 1 percent of the global population and can drastically impair how patients behave and perceive reality. Burrell’s condition continued for more than 20 years, leaving her trapped in her own mind, until researchers discovered that an underlying and treatable autoimmune condition, lupus, was also attacking her brain. After months of targeted treatments, Burrell eventually woke up. Researchers and psychiatrists are calling success stories like Burrell’s a “game changer” because they show how understanding underlying autoimmune diseases may offer a path to long-term recovery for some of psychiatry’s sickest patients.
The idea that mental health conditions could be caused by underlying biology has been around since the early 1900s but was largely ignored in favor of psychological explanations. However, it is clear that a new era of research has begun in which scientists and psychiatrists are taking a closer look at biology to understand the root causes of mental health conditions. Research is increasingly showing a strong link between autoimmune and inflammatory responses and serious mental health disorders. This research marks a shift in thinking on the causes of psychiatric illness, much of which was previously thought to be rooted in genetics, environment, lifestyle or traumatic events.
One of the pioneers in this field is Dr. Sander Markx, director of precision psychiatry at Columbia University, who first encountered April Burrell when she was a patient and a medical student at Pilgrim Psychiatric Center in 2000. Markx’s chance encounter with Burrell twenty years later led to the discovery that autoimmune diseases could be at the heart of her long-standing psychiatric illness. The case led Markx to study how other psychiatric patients may be suffering from the same immune response as Burrell. Markx and his team of 70 experts used advanced medical technologies such as brain scans and blood tests to identify the antibodies produced by Burrell’s immune cells. The process also took into account Burrell’s mental health history along with family medical histories to piece together a complete clinical picture of her condition.
Markers of autoimmune responses and inflammation are linked to a range of mental health disorders, many of which could be treated by drugs designed to target the immune system response and prevent damage to the brain. The research in this area is still in its infancy, but if successful, it could lead to the development of new treatments for patients with schizophrenia, depression, anxiety and other mental health conditions. Markx and his team hope that by focusing on underlying autoimmune conditions, they can transform the way psychiatry diagnoses and treats mental health disorders, unlocking new possibilities for patients who are suffering from serious psychiatric illnesses or are institutionalized.
The research holds great promise for the future of psychiatric healthcare. However, it’s clear we still have a long way to go before autoimmune treatments become a standard in mental health care. Research into autoimmune diseases and their relationship to mental health is still very much in its early stages and much work is needed to understand the biology behind this link. However, Markx and his team’s work is offering hope that the future will be brighter for those who suffer from mental illness.
