Birnbaum et al (2004), “Protein kinase C overactivity impairs prefrontal cortical regulation of working memory” ( Science 29 October 2004 Vol 306),demonstrated the influence of protein kinase C (PKC) intracellular signaling on prefrontal cortical cognitive function. These investigators showed that high levels of PKC activity in prefrontal cortex, as seen for example during stress exposure, markedly impaired behavioral and electrophysiological measures of working memory. The data suggested that excessive PKC activation, as mobilized during psychogenic stress, can disrupt prefrontal cortical regulation of behavior and thought, possibly contributing to signs of prefrontal cortical dysfunction such as distractibility, impaired judgment, impulsivity and thought disorder. This has significant implications for a view of both the schizophrenias and bipolar disorders (lately researchers have been focusing on PKC in the latter) as being highly stress-driven disorders. The mounting evidence is, from my perspective, overwhelming in its validation of anxiety/stress/fear as being central to both schizophrenia and bipolar disorder. My book-in-progress documents this evidence from many different perspectives, including, but not limited to: molecular neurobiology, epigenetics, epidemiology, developmental psychobiology, behavioral perinatology, neuroplasticity and neurogenesis, neuroimaging, sociocultural research, phenomenology, as well as extensive psychotherapeutic experience.

The research below recently published in the journal Psychological Medicine points to the integral role of stress/anxiety/fear in the core symptoms of the psychoses. This research along with the continuously emerging data demonstrating that the neuroscience of the schizophrenias is largely the neuroscience of profound stress points to the importance of meaningfulness in psychotic symptomatology as well as the vital role of psychosocial interventions, including psychotherapy.

Brian Koehler PhD
New York University

Psychological Medicine (2006), 36: 221-230 Cambridge University Press
Copyright © 2005 Cambridge University Press

Original Article
Event attributes and the content of psychotic experiences in first-episode psychosis, DAVID RAUNE , PAUL BEBBINGTON, GRAHAM DUNN and ELIZABETH KUIPERS, Department of Adult Clinical Psychology, Acute Directorate, Ealing

Locality, John Conelly Wing, West London Mental Health Trust, London, UK

Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences ( Bloomsbury Campus), Wolfson Building, London, UK

Division of Epidemiology and Health Sciences, University of Manchester , Stopford Building, Manchester, UK

Department of Psychology, Institute of Psychiatry, King's College London , De Crespigny Park, London, UK

Abstract

Background.
Previous psychosocial stress research, contemporary cognitive models, and new cognitive behavioural treatments for psychosis converge in suggesting that stressful events influence the content of psychotic experiences. In this paper we test whether the attributes of stressful events preceding the initial onset of psychosis are associated with core themes of the illness.

Method.
Forty-one people who had experienced a first episode of psychosis were assessed on the attributes of stressful events occurring in the year before onset, the themes (persecutory, depressive, and grandiose) associated with their delusions and the content of their auditory hallucinations.

Results
Principal component analysis yielded four components accounting for 72% of the variance. As hypothesized, intrusive events were associated with the development of delusions with persecutory themes. Grandiose delusions were negatively associated with loss events. Depressive delusions appear to be associated with danger events rather than loss events.

Conclusion.
There are links between stressful event attributes and core psychotic themes at first-episode psychosis. This has implications for theoretical models of, and early psychological intervention for, psychosis.

Correspondence:

Royal Free & University College London Medical School, UCL – Department of Mental Health Sciences ( Bloomsbury Campus), Wolfson Building, 48 Riding House Street, London W1W 7EY, UK. (Email: p.bebbington@ucl.ac.uk)

The following research gives support to the viewpoint that 'normality' and psychosis are continuous with each other. This is a viewpoint addressed by Oxford University psychologist Gordon Claridge in a series of books (perhaps the most interesting would be "Sounds from the Bell Jar" written with Ruth Pryor & Gwen Watkins and published in 1998 by Malor Books).

Brian Koehler
New York University

Psychological Medicine (2006), 36: 231-238 Cambridge University Press
Copyright © 2005 Cambridge University Press
Original Article

Psychotic-like experiences in the general community: the correlates of CIDI psychosis screen items in an Australian sample

JAMES SCOTT, DAVID CHANT, GAVIN ANDREWS and JOHN McGRATH, Mater Child & Youth Mental Health Service, Mater Children's Hospital, South Brisbane , Queensland, Australia

Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia

Department of Psychiatry, University of Queensland, St Lucia, Queensland, Australia

Clinical Research Unit for Anxiety and Depression (CRUfAD), School of Psychiatry, University of New South Wales, Darlinghurst, New South Wales, Australia

Background. Apart from individuals with clinical psychosis, community surveys have shown that many otherwise well individuals endorse items designed to identify psychosis. The aim of this study was to characterize the demographic correlates of individuals who endorse psychosis screening items in a large general community sample.

Method. The National Survey of Mental Health and Wellbeing interviewed 10641 individuals living in private dwellings in Australia. As part of a diagnostic interview (the CIDI), respondents were asked between three and six items originally designed to screen for potential psychosis. We examined the impact of selected demographic variables on endorsement of these items including sex, age, marital status, migrant status, urban/rural status, employment, education, and socio-economic status.

Results. An estimated 11·7% of the Australian population endorsed at least one psychosis-screening item. Significantly higher endorsement was associated with younger age, migrants from non-English-speaking backgrounds, those who had never married or who were divorced/separated or unemployed, those living in urban regions and those from the lowest socio-economic levels.

Conclusions.
Many of the correlates of endorsement of psychosis-screen items are also associated with psychosis. Unravelling the factors that contribute to this broader non-clinical phenotype will aid our understanding of psychosis.

Correspondence:

Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia.

Email: john_mcgrath@qcsr.uq.edu.au)