The Patient as Meeting Participant

As has been the case for the last 27 years, patients and their family members were full participants at the annual one-day Pittsburgh Schizophrenia Conference. With fees waived, they accounted for at least a quarter of the audience. Artwork by patients was for sale on tables at the back of the meeting room. Patient artwork and poetry were also featured in the meeting program as punctuation between session handouts.

Artwork by patients with schizophrenia / Photo by Miriam E. Tucker

And yet, the meeting content was not simplified for laypersons. For example, University of Pittsburgh psychiatry department chair David A. Lewis, M.D., outlined his research into the connections between cannabis, cognition, and schizophrenia. In a nutshell: The effects of cannabis on the brain are mediated by the cannabinoid-1 receptor (CB1). Evidence suggests that lower CB1 receptor levels found in the prefrontal cortex of people with schizophrenia might reflect a normalizing response to deficient glutamic acid decarboxylase-mediated synthesis of gamma-aminobutyric acid (GABA), partially compensating for that deficit by reducing cannabinoid suppression of GABA release. Use of marijuana would prevent this compensation, thereby increasing the risk for schizophrenia or exacerbating symptoms among those who already have it.

Other talks on impairments of auditory cortex circuits in schizophrenia, potential prevention of schizophrenia, and pharmacological treatment of cognitive impairments in schizophrenia were equally scientific. Yet patients and family members asked at least half of the questions, most often related to treatments and potential research avenues.

For the last presentation of the day, a panel of three laypeople described how schizophrenia affected their lives. One man shared his struggles with imprisonment and alcoholism, in addition to the psychiatric diagnosis. A woman described how her diabetes and issues with food often affected her day-to-day life at least as much as her schizophrenia. A young man who has several family members with schizophrenia relayed how the family’s Christian faith helps them cope.

Conference chair K. N. Roy Chengappa, M.D., told me that the Pittsburgh Schizophrenia Conference—co-sponsored by the University of Pittsburgh and Western Psychiatric Institute and Clinic—has welcomed patients from the beginning, under the leadership of its original chair, Rohan Ganguli, M.D. “He always felt his constituency wasn’t just the doctors coming to learn about new medicines. He felt that people who administer healthcare, people who pay for it, people who consume it, and people who have made their careers out of it are all stakeholders,” Dr. Chengappa said.

He noted that there is an increasing trend in medical meeting participation by educated patients, particularly in psychiatry. “You see it in bipolar conferences. It’s slowly spreading in some areas of medicine, but not all…For us, it’s just normal.”

-Miriam E. Tucker (on Twitter @MiriamETucker)

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Filed under Alternative and Complementary Medicine, Family Medicine, IMNG, Internal Medicine, Neurology and Neurological Surgery, Primary care, Psychiatry, Uncategorized

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