Schizophrenia with a Technology Twist
On August 22nd, the Food and Drug Administration approved the use of Risperdal to treat children with schizophrenia and bipolar disorder.
The drug is not new; it has been used to treat adults with the same diseases since 1993, and in general, psychiatrists have been prescribing the drug in lower doses to children in need of the drug as well, a practice called off-label prescribing. However, because the side effects of this and other relatively newer antipsychotic drugs can be harsh and sometimes fatal, the FDA requested that Janssen, the pharmaceutical company that manufactures the drug, perform clinical studies specifically directed at children to determine its efficacy and risks.
An article in the Boston Globe on August 23rd (click here for the article) provides more detail on this approval and the proponents and opponents to the drug’s use. The drug, according to some, is too dangerous and overprescribed, and the same effect on patients can be achieved with existing, first generation drugs that have none of the same side effects. The FDA has done little to allay doubts, as it approved the use without first airing scientific evidence through the use of an advisory committee. Whether this turn of events will have a positive or negative impact on the drug’s prescription rate remains to be seen.
Schizophrenia is a debilitating disease in which the reality perceived by the patient is laden with hallucinations and disembodied voices commanding them to perform acts that could lead to harm. It is often confused with multiple personality disorder, but they are distinctly different diseases. I didn’t understand the concept too much myself, even though I’ve met a couple of people afflicted with the disease.
Recently, I discovered that I could get a better understanding of the disease thanks to the efforts of Dr. Peter Yellowlees, a professor of psychiatry at the University of California, Davis. Yellowlees took advantage the online digital world of Second Life to build a virtual hallucinations lab, in which residents can come in and tour a building set up to provide imagery and sounds associated with someone who might be suffering from schizophrenia. Users are given a badge at the start of their tour which allows them to hear the disembodied voices of a schizophrenic sufferer and what they might say. As they walk through a virtual hospital ward, the floor may drop away, revealing the sky below. A gun may come into focus on a table with a voice that whispers, “kill yourself”. Innocuous posters on the wall may suddenly become profane.
While I can’t say I was frightened by any of the images I saw, it did give me significant insight into the disease and what effects it may have on those who suffer from it. According to data collected from a survey that’s taken at the end of the experience, over 70% of Second Life residents agree with me. I also wondered how this type of technology might be able to give perspective on other diseases in which patients suffer from some sort of altered perception of reality. To read more about Peter Yellowlees’ efforts and other practical applications of Second Life’s online metaverse, see this article from the Economist.
Yellowlees wasn’t the only one to take advantage of virtual reality to peer into the mind of a schizophrenic. Janssen, perhaps in an effort to promote the treatment of schizophrenia through the drug Risperdal, created the 6-minute virtual reality hallucination called “MINDSTORM” a 3D theater experience to give people a first person point-of-view of the sights, sounds and smells of schizophrenia. Like Yellowlees, the developers of this 3D world took cues from actual schizophrenic patients and incorporated their insights into MINDSTORM’s virtual reality. According to Janssen’s MINDSTORM site:
A Virtual Hallucination: MINDSTORM invaluable teaching aid for medical students, physicians, the healthcare community, and law enforcement personnel. The simulation has the potential to create empathy for a frightening condition that most people can barely imagine.
Clearly, technology continues to play a growing role in both perception and understanding of mental diseases afflicting patients around the world. Pioneering efforts in understanding and treating schizophrenia using pharmaceutical and virtual reality technological tools could encourage similar approaches in treating other debilitating mental disorders, such as multiple personality disorder, bipolar disorder, autism or depression. If you have information on links between virtual reality and medicine, or know someone who has been treated using both, I’d like to hear about it. I look forward to your comments.
