Blog Archives

"Look ON the Bright Side of Life"

6/25/2025

Monty Python
The Holy Grail -- Witch Scene (1975)

Probably one of the things Monty Python did better than anyone else ---

They took an irreverent historical sensibility
And combined it with completely wrong and differing ideas and pitted them against each other -----
- Whose right? Nobody's right.
There is the not so subtle implication that this also rings true in Modern Times.

For me, when I see debates about which flawed, scientifically invalid diagnostic category someone fits into ---

OMG --- how effing stupid are you people --- don't answer I think I know.

On the other hand, someone could say that about me, if they hyper-focused on my flaws.

It doesn't mean those challenges don't exist --- but there are Strengths, too.

RESEARCHERS vs. CLINICIANS

Researchers Around the World understand the URGENCY to get to the underlying biology of psychiatric disorders.
- By and large, Clinicians do not appreciate how shaky current diagnostic foundations actually are.
  - There are exceptions and some Clinicians have spoken out.

On the other hand, Clinicians are playing a major role in trying to hold this society together under often less than ideal circumstances.

Rules of Evidence and the Mess in Mental Health

Analysis of human neuronal cells carrying ASTN2 deletion associated with psychiatric disorders (2024)

*Japanese Researchers

Schizophrenia (SCZ), autism spectrum disorder (ASD), and bipolar disorder (BP) are very common psychiatric disorders, with high lifetime prevalence rates of ~0.5% , 2.5%, and 1%, respectively.

They are characterized by their duration as chronic diseases, from childhood to the time of death. This results in a longer treatment period and extensive social and personal damage.

However, the biological pathogenesis of these psychiatric disorders is not well understood.

Their understanding is urgently needed to develop novel therapies that significantly improve the functional outcomes of patients.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has established the diagnostic criteria for SCZ, ASD, and BP as independent and separate diseases.

In contrast, in clinical settings, the comorbid diagnoses are also allowed, and in some patients, drawing the diagnose line is difficult, suggesting that these psychiatric disorders partially share clinical symptoms and phenotypes.

[Val's Note: The University of Colorado was one of the first to say -- we need the ability to make these diagnoses less by "the book" (meaning the DSM 5).

Further, handing out multiple co-morbid diagnoses is not particularly helpful to the patient --- we need PRECISION MEDICINE that is tailored to the individual and the underlying biology.]

Indeed, studies reported that psychiatric disorders show common alterations, such as dysfunction in the white matter microstructure in the body of the corpus callosum and brain responses in the ventral striatum during reward anticipation.

Additionally, recent genetic studies have uncovered common risk genomic variants in these psychiatric disorders.

These findings imply that there are common underlying mechanisms in these psychiatric disorders, prompting us to examine the molecular and cellular alterations caused by the common risk variants across these psychiatric disorders.

Recently, we identified the variants in ASTN2 as a candidate risk factor for psychiatric disorders by whole-genome copy number variation (CNV) analysis.

Moreover, a study reported that deletions in ASTN2 that would disrupt almost all transcript isoforms . . . are significantly enriched in patients with neurodevelopmental disorders, such as ASD, attention-deficit/hyperactivity disorder, and intellectual disability.

In support of these results, ASTN2 is also listed in multiple databases, such as SFARI (https://gene.sfari.org/) and DBDGD (https://dbd.geisingeradmi.org/), which are centered on genes implicated in these psychiatric disorders.

Juneteenth

6/22/2025

Racism & Mental Health

Chronic Stress, the Immune System & Psychiatric Disorders

The Ethical challenges of: HansEn's disease and Neuro-Developmental & Psychiatric Disorders

6/22/2025

Val's Take/Conjecture

Hansen's Disease is the modern name for "Leprosy."
Leprosy was a disease known from ancient times and it is mentioned in the Bible -- Jesus healing many people with leprosy.
- Faith healers were common in the time of Jesus.
- See Wikipedia: History of Leprosy
- And there have been modern faith healers such as Oral Roberts.

It is at least arguable that the Social Stigma of Leprosy was greater than Mental Illness. Leprosy also was often quite visible and seen as a punishment of the Gods.

Today, leprosy is curable with an MDT -- multi-drug therapy.

There appear to still be issues, but things are a lot better than they were.

Neuro-Developmental & Psychiatric Disorders

Researchers more and more recognize INFLAMMATION as a kind of UNIVERSAL LANGUAGE.

Inflammation–Nature's Way to Efficiently Respond to All Types of Challenges: Implications for Understanding and Managing “the Epidemic” of Chronic Diseases (2018)

Shared Genes & Psychiatric Disorders

Environmental Toxins & Mental Health

There's also Trauma and Intergenerational Trauma that effects us biologically.

On top of this, Neuro-Developmental and Psychiatric Disorders are now conceptualized as Multi-System, Neuro-Immune Disorders.

Further, most chronic diseases do have psychiatric symptoms.

Genetic correlation and causal associations between psychiatric disorders and lung cancer risk (2024)
- "These causal associations are unlikely to be mediated solely via smoking."
Relation Between Diabetes and Psychiatric Disorders (2022)
Psychiatric symptoms in multiple sclerosis: a biological perspective on synaptic and network dysfunction (2023)
Psychiatric hospitalizations in a cohort of Danish polio patients (2007)
Chronic pain and comorbid posttraumatic stress disorder: Potential mechanisms, conceptualizations, and interventions (2025)
Patterns and prevalence of psychiatric morbidity among individuals with rheumatoid arthritis (2024)
- "Psychiatric morbidity is associated with RA [Rheumatoid Arthritis] and there is a need for psychiatric services to be made available to these patients."
The impact of autoimmune thyroid disease on cognitive and psychiatric disorders: focus on clinical, pre-clinical and molecular studies (2025)
Psychiatric and cognitive symptoms of Parkinson's disease: A life's tale (2025)
Demyelination in psychiatric and neurological disorders: Mechanisms, clinical impact, and novel therapeutic strategies (2025)

Underwood & Underwood Publishers
"Unclean! Unclean! Wretched Lepers Outside of Jerusalem" (1891)

also written in French, German, Spanish, Swedish and Russian

I've viewed this picture along with others of Jerusalem many, many times through a Stereoscope that gave a 3-D effect.

It was originally my paternal great, grandfather's who I never knew.

He was a linguist and also likely had "bipolar disorder."

He gave up his academic post to become one with the land--a farmer --- of which he knew nothing about.

My great grandmother gave music lessons to keep the family from starving -- she died of cancer and was treated at the Mayo Clinic before her death.

Auto-Immune Disease, Polio and Parkinson's

Further, I don't just have a family history of mental illness and cancer, but also auto-immune disease, polio and neuro-degenerative disease.

Transgenerational consequences of maternal immune activation (2020)

Val's Take/Conjecture

Psychiatric Disorders are not uncommon in a wide-range of health issues and across the lifespan.

The Biopsychosocial Model of the 1970s advocated for a more HOLISTIC view.

Ironically, the BIOLOGY was actually given short shrift because they didn't have access to it -- or they thought what they had access to was more than it was.

We are undergoing a BIOLOGICAL RESEARCH REVOLUTION that is INTEGRATING Developmental, Physical & Mental Health.

Reasoning to reform without perfect information

6/22/2025

Val's Take

Those of us living now will not see the full benefit of research on Neuro-Developmental and Psychiatric Disorders that is such a long- term, multi-generational effort.

In 2025, most people can live in the Community with current treatment but some can't.

It's time to get rid of Medicaid's Exclusion of Payment for Institutes of Mental Disease (IMD) Rule while also:
- Bringing Intensive Community Supports to Scale.

I posted the study to the right because it represents a different take on the research.

The point is not so much the Conclusion --- as that the researchers are still working on this and it is not done.

On the other hand, we have plenty of people with Schizophrenia and other Neuro-Developmental and Psychiatric Disorders incarcerated.

We have substantial reason to believe we are punishing people for a not sympathetic underlying biology.

It's not like we're not doing anything, but we're not doing enough.

Genetic contribution to microglial activation in schizophrenia (2024)

"We conclude that microglia of the patients with SCZ (Schizophrenia) have gene expression aberrations related to inflammation response and extracellular matrix without contributing to increased microglial activation."

Do we have the right professional? From PSYCHOLOGY to integrative immuno-biology

6/21/2025

Val's Take/Conjecture

When all the research gets sorted out ---- Societal Responses won't be the Ethical & Moral Nightmare they are today.
BUT right now the research continues to corroborate Developmental multi-system Neuro-Immune Disorders.
Further, that is a refinement from a decade ago.

What has not been corroborated by the research is the DSM categorical system.

Perfectionism, and the failure to adequately address an out-of-date DSM --- we need interim procedures

Science Up

NAMI Montana
It's Time to Improve the Mental Illness Diagnostic Process
(2013)

TRANSLATIONAL JusTICE as "A THING"

6/21/2025

Val's Take/Conjecture

The article to the right addresses Translational Justice in Healthcare.
When I'm referring to "TRANSLATIONAL JUSTICE" --- I'm generally referring to the need to appreciate the ramifications of Medical Research through a Criminal Justice Lens.
- Might also be Translational Justice in Criminology or Translational Criminology.

Burden of Proof

Nothing About Us Without Us: Criminal Justice Edition

Inclusion: Nothing About Us Without Us

Building Better Medicine: Translational Justice and the Quest for Equity in US Healthcare (2025)

Affiliations
1Mayo Clinic.
2University of Toronto.
3University of Miami.
4Case Western Reserve University.
5University of Pennsylvania.
6ETH Zurich.
7Stanford University.

"Micro-Credentialling" in Behavioral Health & the crying need for more advanced care in immuno-psychiatry

6/20/2025

Val's Take/Conjecture

The Colorado Community College System is promoting "micro-credentialing" in Behavioral Health.
There have been work force problems in mental health for a long time --- and there are immediate, practical issues and needs.

Providing a more thorough understanding of Neuro-Developmental and Psychiatric Disorders with New and Modified Paradigms is also critical to addressing "work force" issues.

Neuro-Developmental and Psychiatric Disorders are more and more seen through a lens of "Neuro-Immunology" and "Brain, Behavior & Immunity."

Jonathan Kipnis
Pioneer in Neuro-Immunology

This isn't to say that everyone should be a world-renowned researcher --- but if you want to--- go for it.

Kipnis talks about how ideas can become entrenched and self-perpetuating even if they are wrong --- and that is a problem in Mental Health.

Further, out-dated paradigms are not irrelevant to the mental health profession's work force problems.

It's not just access To care ---It's access to Up-to-Date Translational medicine

6/19/2025

RE-allocating resources Responsibly

Val's Take/Conjecture

There are news reports of 500 mental health professionals in Colorado being laid off and 3 mental hospitals being closed.

Mental Health does need SIGNIFICANT TRANSFORMATION and INTEGRATION with the rest of Health Care.
- Better Systems and Support to Keep Up with the Research.

For me this is akin to the "Defund the Police" or "Cost Shift to the Police" debates and realities --- BUT re-purposing law enforcement to gain even more safety and humane treatment --- yes, that is worthy of doing.

And perhaps providing law enforcement an expanded career ladder into Public Health and Medicine.

Decision Lab --- Status Quo Bias

I am not for FUNDING THE STATUS QUO in mental health.

On the other hand, I'm not for people summarily losing their jobs either.

That's a lot of chaotic, unpredictable stress that is not going to be good for patients, clinicians or the community.

Scapegoating not necessarily the innocent, but the closest link in the chain of causality

The evil society games

When the wrong antidote is like a bone in the throat

One Thing Leads to Another

Why is MIchael Marshall Dead?

Neuro-Developmental Disorders, Criminal Justice & An Emerging Global Consensus

6/16/2025

Val's Take/Conjecture

The Connection between ADHD and greater risk of Criminal Justice involvement has been around at least since the 1990s.
Sweden led this at one point.
There has been more and more work on this in the UK and with this latest 2025 article in the International Journal of Law & Psychiatry --- Italy.

It does seem that European academic articles and government reports are asking more interesting questions:

What should the law be?
What should the range of services be?

American Academic articles can get bogged down in the finer points of Not Guilty by Reason of Insanity and Competency ---

We can' ignore current law.
But we need to be thinking about what "ought to be" not just what "is."

On the other hand, the American Legal System by and large would be happy to hand over the oversight of Defendants with various aspects of "ADHD" and "Co-Morbidities" to the Public Health System ----

Not only are the RESOURCES not there to handle that in PUBLIC HEALTH;
The UNDERSTANDINGS are getting a lot better but they're not perfect and it's not clear that you can get out of some kind of "CUSTODIAL CARE" in every case.
It's exceedingly inconvenient to know that there are actual biological mechanisms.
Further, these "Social Concerns" affect people's biology, too and are often diverse forms of "Chronic Stress."

ADHD in adults and criminal behavior: The role of psychiatric comorbidities and clinical and sociodemographic factors in a clinical sample (2025)

[Italian Researchers]

Conclusions: Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior.

The findings highlight the need for personalized and multimodal interventions to mitigate these risks.

Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.

Offending and clinical characteristics of adults with autism spectrum disorder: Experience at forensic psychiatry center in Türkiye between 2012 and 2022 (2025)

[Turkish Researchers]

Transitional/ Translational Justice Monday

"Look ON the Bright Side of Life"

Juneteenth

The Ethical challenges of: HansEn's disease and Neuro-Developmental & Psychiatric Disorders

Reasoning to reform without perfect information

Do we have the right professional? From PSYCHOLOGY to integrative immuno-biology

TRANSLATIONAL JusTICE as "A THING"

"Micro-Credentialling" in Behavioral Health & the crying need for more advanced care in immuno-psychiatry

It's not just access To care ---It's access to Up-to-Date Translational medicine

RE-allocating resources Responsibly

Neuro-Developmental Disorders, Criminal Justice & An Emerging Global Consensus

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