News archive 2009

Dopamine presence linked to early psychosis

07 Jan 2009, PR 02/09

A new study involving research from the Institute of Psychiatry shows, for the first time, that people who may be at risk of schizophrenia show increased levels of the brain chemical messenger dopamine. The paper is published online in the Archives of General Psychiatry.

Dr Oliver Howes at the Institute of Psychiatry, King’s College London, and colleagues at the Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, used a brain scanning technique to measure levels of dopamine in people attending the OASIS clinic. This specialist clinic, headed up by Professor Philip McGuire also of the Institute of Psychiatry, is for people who show possible early signs of schizophrenia.

The researchers compared the brain dopamine levels in those patients attending the OASIS clinic to levels in people already diagnosed with schizophrenia, and volunteers free of such problems. Dopamine levels were elevated in the people who may be at risk of schizophrenia, to a degree approaching that seen in the patients with schizophrenia. The researchers also found that higher levels of dopamine were linked to more severe symptoms, and to worse performance on thinking tests.

Dr Howes, Senior Clinical Lecturer at the MRC-Clinical Sciences Centre and Institute of Psychiatry, King’s says: ‘Schizophrenia is one of the top ten health problems in young adults worldwide. Current treatments are helpful but we desperately need better ones.

‘The holy grail of research is to find a way of preventing this devastating illness before it starts. Our finding that dopamine levels are high in people showing very early signs of developing schizophrenia gives an important clue as to what is causing schizophrenia and other psychotic illnesses.

‘If the results are confirmed, future treatments could target this part of the brain’s dopamine system to prevent the full development of the illness. As roughly one in ten people with schizophrenia die from suicide, predominantly in the first few years after the illness starts, a treatment that prevents the full illness could save many lives as well as alleviating suffering. The scans, in conjunction with previous work by us and others, also indicated that the problem is specific to a particular part of the dopamine system. This suggests that all current drugs are acting in the wrong place to address the primary problem - designing drugs to reverse the primary problem could offer the hope of better treatments for schizophrenia.’

What is schizophrenia?

Schizophrenia is the most common of the severe mental illnesses, and interferes with the sufferers’ thoughts, feelings, and ability to plan and carry out actions. It can diminish motivation, initiative, mood and emotional expression. This may lead sufferers to become slower to talk and act, and increasingly indifferent to social contact and emotional interaction. Over time patients may lose contact with their friends and family, be unable to continue working, and become withdrawn and isolated. 

Just fewer than one in a hundred people will suffer from schizophrenia at some point in their life. It is more common in those living in urban than rural areas, and in some migrant groups, such as African-Caribbean people living in the UK. It is an illness that affects adults, being rare in children and gradually more common during adolescence.

Schizophrenia is a complex and variable condition, and treatment often requires sustained input from a multi-disciplinary care team involving psychiatrists, nurses, social workers, occupational therapists and psychologists. Although there is no ‘cure’ for schizophrenia, the rapidly increasing understanding of the psychological and neurobiological aspects of the illness is now feeding through into better treatments and an improved outlook.

[Image: Scan showing the availability of dopamine in the brain of people at risk of schizophrenia (Howes et al 2009). Red and yellow colours indicate areas of high dopamine availability.]



Notes to editors

The paper's authors are: Oliver D Howes, MRCPsych, DM; Andrew J Montgomery, MRCPsych, PhD; Marie-Claude Asselin, PhD; Robin M Murray, FRCPsych, DSc; Isabel Valli, MBBS; Paul Tabraham, PhD; Elvira Bramon-Bosch, MRCPsych, PhD; Lucia Valmaggia, PhD; Louise Johns, PhD; Matthew Broome, MRCPsych; Philip K McGuire, FRCPsych, PhD,  Paul M. Grasby, MRCPsych, MD.

For a copy of the full paper Elevated Striatal Dopamine Function Linked to Prodromal Signs of Schizophrenia please go to the following link: http://archpsyc.ama-assn.org/cgi/content/short/66/1/13 or refer directly to the journal The Archives of General Psychiatry, 2009;66(1):13-20. 

King’s College London
King’s College London is one of the top 25 universities in the world (Times Higher Higher 2008) and the fourth oldest in England. A research-led university based in the heart of London, King’s has 19,700 students from more than 150 countries, and 5,400 employees. King’s has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 60 per cent of research activity at King’s was deemed world-leading or internationally excellent. The College is in the top group of UK universities for research earnings and has an overall annual income of approximately £450 million. An investment of £500 million has been made in the redevelopment of its estate.

King’s has a particularly distinguished reputation in the humanities, law, social sciences, the health sciences, natural sciences and engineering, and has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA. It is the largest centre for the education of healthcare professionals in Europe and is home to more Medical Research Council Centres than any other university.

King’s College London and Guy’s and St Thomas, King's College Hospital and South London and Maudsley NHS Foundation Trusts are working together to create a world-leading Academic Health Sciences Centre (AHSC). Our AHSC brings together an unrivalled range and depth of clinical and research expertise, spanning both physical and mental health. Our combined strengths will drive improvements in care for patients, allowing them to benefit from breakthroughs in medical science and receive leading edge treatment at the earliest possible opportunity. For more information, visit www.londonsahsc.org

MRC Clinical Sciences Centre
The Medical Research Council’s Clinical Sciences Centre (CSC) is a world-class Research Institute within the Faculty of Medicine of Imperial College London, at its Hammersmith Hospital Campus. The Hammersmith Hospital campus has the largest concentration of PET facilities and PET imaging knowledge in the UK and many of the world’s leading experts in medical imaging.

Further information
Camilla Palmer, Public Relations Manager,
Institute of Psychiatry, King's College London,
Telephone:  020 7848 0483; email:  camilla.palmer@iop.kcl.ac.uk

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