We have chosen "Concordance" as our title because of our desire for agreement. While almost everyone is in agreement about our need to know more about the causes of serious psychotic illnesses, there has been less agreement about what is established fact. We hope through our research to help establish consensus in this field. In order to do so, we rely on the kind help of several groups to increase participation in our studies - family support groups, clinicians, and most important, individuals with illnesses. We could not achieve what we have without the aid of these wonderful people. Our hope is that our discoveries will eventually lead to better treatments and possibly prevention of schizophrenia.
What is known about the causes of schizophrenia?
The widespread disagreement about causes has been alluded to above, but almost all concerned people agree that illnesses like schizophrenia can cluster in some families. This may be due to shared inherited factors and / or shared environments. It is our belief that the clustering in families, and indeed the causation of these illnesses in general, are due to interactions between inherited and non-inherited (environmental) factors. In support, it is widely accepted that among pairs of identical twins with one ill twin, the second of the pair is not invariably doomed to be ill. Thus, even among individuals who share virtually all their genetic material (and a good deal of their environment), the chances of falling ill are not identical. The difference in risk of illness among the well and ill identical twins is likely to be due to differences in interactions between their inherited factors and their respective environment.
Another neglected area of research is the likelihood of protective inherited and non-inherited factors. Indeed, the differences in risk of illness among identical twins could equally be explained due to such factors. We are keen to pursue these possibilities.
How do we find the causes?
Since the number of possible causative environmental factors is enormous, we have chosen to work first with inherited factors. We realize that such factors may not by themselves fully explain causation. Rather, they may be predisposing risk factors, in the same way that smoking predisposes to lung cancer. Once we have identified inherited predisposing factors, we hope to understand how they interact with non-inherited factors. Our initial study of inherited factors is comprised of two parts, one that compares well family members with those affected with schizophrenia, and one that compares pairs of ill siblings with each other. In view of the enormous number of possibilities (the number of genes in any human being are estimated at 1,00,000), it is necessary to survey a large number of participants.
To achieve our goal of concordance about causes, we wish to conduct our studies among a variety of ethnic groups. Hence, the study is being conducted in the United States, India and Canada. We are also collaborating with scientists in Singapore and Sweden. Our goal is to recruit 600 families in the USA alone over the next five years- a large task, but one we are confident of achieving with your help.
How can you help us learn more?
We are currently looking for families to help us learn more about the causes of schizophrenia. Individuals anywhere in the US are welcome to participate. The study requires help from the person with schizophrenia, schizoaffective disorder or bipolar disorder. In addition, the participation of one or both parents, or an ill sibling is required. All participants need to give a small sample of their blood, and provide some information. This can be done wherever is most convenient for you. All information is strictly confidential.
Progress to date
We have already enlisted the co-operation of over 60 families for our research. Most of these families live in Western Pennsylvania, West Virginia and Ohio. Approximately the same number of families have offered to participate, and we are in the process of interviewing them. We have received help from over 30 families in India. While these numbers are encouraging, we need to continue our survey apace. To this end, we are in the process of hiring more research associates in these regions. Many of our staff members belong to family support groups organized by the National Alliance for the Mentally Ill (NAMI). We hope thus to share our expertise and information with the communities we receive help from.
We have also begun laboratory analysis of blood samples. We have identified two inherited factors which may be involved in the causation of schizophrenia: the dopamine D3 receptor gene and the HLA DQB1 gene. We are pursuing these clues carefully.
Our research is funded by the Federal Government, through the National Institute of Health. We have also received support for our work in Canada from the Stanley Foundation.
Send information/ideas to Dr. Vishwajit Nimgaonkar at nimga+@pitt.edu. We look forward to hearing what you have to say!