Hopkins to probe virus-schizophrenia link

May 25, 1994|By Jonathan Bor | Jonathan Bor,Sun Staff Writer

Jumping into one of the liveliest debates in psychiatry, researchers at the Johns Hopkins Medical Institutions will investigate an unconventional theory that viruses or other infectious agents trigger schizophrenia.

The project, made possible by a $7 million grant from the private Theodore and Vada Stanley Foundation of Arlington, Va., is a large effort considering its speculative focus. It will involve nine faculty members and nine research "fellows" to be recruited over three years.

Most schizophrenia studies have been dominated by research psychiatrists and geneticists, but this one will be centered in the department of pediatric infectious diseases.

"I wouldn't say that's unusual -- I'd say it's unheard of," said Dr. E.Fuller Torrey, a clinical and research psychiatrist in Washington, D.C., who runs the Stanley Foundation's Research Program on Serious Mental Illnesses.

"This is not traditional mainstream psychiatric research," said Dr. Torrey, adding that the theory was more popular 60 years ago than it is today.

The study is based on the theory that exposure to an infectious agentin the womb or in early childhood produces the brain abnormalities responsible for schizophrenia later in life. One possibility is that an infection interacts with heredity to cause the disease.

Schizophrenia, the most common psychotic illness, with 1.5 million sufferers in the United States alone, usually doesn't manifest itself until the teens or early twenties.

It often causes people to hear strange voices, to withdraw socially and to sink into disturbed thinking and disjointed, jumbled speech. Medications can reduce symptoms, but victims frequently have trouble holding jobs, maintaining friendships and functioning independently.

Dr. Torrey, speaking at a news briefing yesterday, said the idea that infections lie at the root of schizophrenia emerged early in the century when many people who caught influenza in the great flu epidemic of 1918 developed symptoms similar to those of schizophrenia and mania, another mental disorder.

The notion fell out of favor as psychiatry became dominated by the idea that mental illnesses are caused by poor parenting or other troubling experiences in life.

In recent years, however, the field has come full circle -- dominated now by evidence that severe mental disorders are diseases of the brain.

The Hopkins study will be the largest into a viral cause, Dr. Torrey said.

In recent years, many researchers have focused on the role played by genetics. The disease often runs in families, and in some cases afflicts a startling number of family members within the span of a few generations.

But the thesis that schizophrenia is inherited is far from settled. While a third of schizophrenics have one or more close relatives with the disease, the rest have no such family history.

If the disease were purely genetic, it would never afflict one identical twin and not the other since the siblings have virtually the same genetic makeup. But studies of identical twins have shown that the disease is shared only 30 percent to 50 percent of the time.

Evidence linking viruses or other infectious agents to schizophrenia is purely circumstantial, Dr. Torrey said. Some studies, for instance, have found high levels of antibodies to certain viruses in the spinal fluid of schizophrenic patients.

Also, numerous studies have shown that people born in the late winter and early spring -- when common viral illnesses are at their peak -- have a greater chance of developing the disease than those born at other times of year. This has fueled speculation that the disease can be traced to a viral illness in infancy or during a prenatal stage.

It is possible that some people carry genes that made them vulnerableto an infection or its complications, said Dr. Robert H. Yolken, chief of pediatric infectious diseases and the study's director.

"Infections and genetics are not mutually exclusive," he said.

The project will cross several disciplines, involving faculty in neurology, psychiatry, neuroscience, genetics and immunology as well as infectious disease.

It will be a collection of independent projects, each to be determined by a research fellow. But Dr. Yolken said he expects the research overall to focus on identical twins who do not share the disease.

"We want to see what happened to the ill twin during his lifetime or in the womb that may have caused the illness," he said. Scientists will be able to examine blood and tissue samples already collected by Dr. Fuller during his own research on identical twins.

"I think this really puts to rest" the idea that child rearing is responsible for schizophrenia, said Laurie M. Flynn, executive director of the National Alliance for the Mentally Ill.

The study is sure to encounter skepticism.

Dr. Daniel Weinberger, a leading schizophrenia researcher at the National Institute of Mental Health, said the viral theory is based on "interesting" strands of evidence that "are not conclusive by any stretch of the imagination."

A believer in a nongenetic cause, he said the viral theory is worth studying but may well turn out to be wrong.

"The virus story -- it's a little like the way viruses are implicated in many medical illnesses when we really have no idea what the illness is," he said.

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