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Neuroprogression: What it is and why you should know about i…

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by Shivani Kapadia, PharmD, Medical Director of Global Medical Affairs, Neuropsychiatry, Otsuka Pharmaceutical Development & Commercialization, Inc (OPDC); and Sara Asif Spencer, PharmD, MS, BCGP, Medical Science Liaison, Neuropsychiatry, OPDC

This post was sponsored and developed by Otsuka Pharmaceutical Development & Commercialization, Inc.

1 Mental health conditions may start with mild symptoms initially but can have a progressive nature.

Physical, behavioral, and emotional changes may signal an underlying mental health condition.4 Examples of signs and symptoms that may indicate a mental health condition include changes in eating and sleep habits, irritability, and physical ailments without cause.4 Just as with a physical health condition, a mental health condition can start off as mild and worsen over time; therefore, it is very important not to ignore these signs and symptoms.4,5

2 Delays in addressing symptoms of a mental health condition may lead to neuroprogression.

Neuroprogression relates to a series of biological processes that contribute to gradual worsening, relapse, and recurrence of mental health conditions.6 Neuroprogression has interconnected mechanisms, with physiological, neurochemical, immunological, and genetic factors playing a role.6 The result is structural and functional changes in multiple systems, specifically in the nervous, immune, and metabolic systems.6 

3 Stress and inflammation play a role in neuroprogression.

Stress is associated with worse health outcomes for both physical and mental health and can exacerbate underlying or existing conditions.12 Mental health conditions are correlated with both physical and psychological stress, which leads to systemic inflammation, including neuroinflammation.6,13 Prolonged inflammation can lead to structural and chemical changes in the brain associated with neuroprogression. These changes could be irreversible if left untreated and can lead to worse clinical outcomes.6 

4 Early detection and timely intervention may limit or halt neuroprogression.

Longer and increased episodes of mental health conditions may accelerate neuroprogression and lead to further cognitive and physical decline.1,2,7,14,15 The sooner an individual recognizes symptoms of a possible mental health condition and seeks help, the sooner they could slow neuroprogression.16 For many mental health conditions, early intervention can lead to a greater likelihood of better outcomes.17 Timely intervention can help reduce disease burden and health care costs and improve quality of life both for those with the mental health condition and for their loved ones.17 

5 Screening is key to early detection and early intervention

Screening is a quick way to check for the symptoms of mental health conditions.18,19 Mental health screening is recommended for everyone starting at age 8 years and can lead to early intervention.20-23 Primary care physicians and mental health professionals can provide screenings.18 There are also online, free, confidential, and scientifically validated mental health screening tools that can help you determine whether you are experiencing symptoms of a mental health condition.19 

6 One size does not fit all: Every mental health journey is unique!

 Even with similar symptoms and the same diagnosis, each individual has a different mental health journey.24 Finding the right therapy might take time; the earlier a patient seeks therapy, the sooner they can potentially benefit from treatment.7,25 Remember that in many cases without proper treatment, neuroprogression may go unchecked, can worsen symptoms, and may make recovery more difficult.6

Learn more | Now that you know about neuroprogression and its impact on mental health conditions, here are some resources and options for you to learn more

Don't ignore what your body's telling you. Learn more about warning signs and early symptoms of mental health conditions...| Click here to view video

Hear from a real patient about their mental health journey | Click here to view the interview on PsychU

Finding the right support may help you manage the stress in your life | Click here to find support groups in your area

Learn more about the importance of early intervention | Click here to read the article

Take a weight off your mind: get screened | Click here to access MHA's screening tools

Learn more about the journey of recovery | Click here to read more about recovery

Shivani Kapadia, PharmD, is the medical director of global medical affairs, neuropsychiatry, at Otsuka Pharmaceutical Development & Commercialization, Inc (OPDC). She received her doctor of pharmacy degree from St. John’s University in Queens, New York.

Sara Asif Spencer, PharmD, MS, BCGP, is a medical science liaison, neuropsychiatry, at OPDC. She received her doctor of pharmacy degree from Albany College of Pharmacy in Albany, New York.

The views and opinions expressed in this blog solely belong to the author, and external content does not necessarily reflect the views of Mental Health America. 

References

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  2. Lieberman JA, Perkins D, Belger A, et al. The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches [published correction appears in Biol Psychiatry. 2002;51(4):346]. Biol Psychiatry. 2001;50(11):884-897. doi:10.1016/s0006-3223(01)01303-8
  3. Kanter JW, Busch AM, Weeks CE, Landes SJ. The nature of clinical depression: symptoms, syndromes, and behavior analysis. Behav Anal. 2008;31(1):1-21. doi:10.1007/BF03392158
  4. American Psychiatric Association. Warning signs of mental illness. Accessed July 15, 2024. https://www.psychiatry.org/patients-families/warning-signs-of-mental-illness 
  5. Mental Health America. Is mental illness physical or mental? Accessed July 19, 2024. https://screening.mhanational.org/content/mental-illness-physical-or-mental/ 
  6. Halaris A, Leonard BE. Unraveling the complex interplay of immunometabolic systems that contribute to the neuroprogression of psychiatric disorders. Neurol Psychiatry Brain Res. 2019;32:111-121. doi:10.1016/j.npbr.2019.05.005
  7. Post RM, Fleming J, Kapczinski F. Neurobiological correlates of illness progression in the recurrent affective disorders. J Psychiatr Res. 2012;46(5):561-573. doi:10.1016/j.jpsychires.2012.02.004
  8. Fond G, Lançon C, Korchia T, Auquier P, Boyer L. The role of inflammation in the treatment of schizophrenia. Front Psychiatry. 2020;11:160. doi:10.3389/fpsyt.2020.00160
  9. Lee DH, Lee JY, Hong DY, et al. Neuroinflammation in post-traumatic stress disorder. Biomedicines. 2022;10(5):953. doi:10.3390/biomedicines10050953
  10. Hassamal S. Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories. Front Psychiatry. 2023;14:1130989. doi:10.3389/fpsyt.2023.1130989
  11. Calcia MA, Bonsall DR, Bloomfield PS, Selvaraj S, Barichello T, Howes OD. Stress and neuroinflammation: a systematic review of the effects of stress on microglia and the implications for mental illness. Psychopharmacology (Berl). 2016;233(9)1637-1650. doi:/10.1007/s00213-016-4218-9
  12. Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005;1:607-628. doi:10.1146/annurev.clinpsy.1.102803.144141
  13. Davis MT, Holmes SE, Pietrzak RH, Esterlis I. Neurobiology of chronic stress-related psychiatric disorders: evidence from molecular imaging studies. Chronic Stress (Thousand Oaks). 2017;1:2470547017710916. doi:10.1177/2470547017710916
  14. Wertz J, Caspi A, Ambler A, et al. Association of history of psychopathology with accelerated aging at midlife [published correction appears in JAMA Psychiatry. 2021;78(5):569. doi:10.1001/jamapsychiatry.2021.0268]. JAMA Psychiatry. 2021;78(5):530-539. doi:10.1001/jamapsychiatry.2020.4626
  15. Ruiz NAL, Del Ángel DS, Olguín HJ, Silva ML. Neuroprogression: the hidden mechanism of depression. Neuropsychiatr Dis Treat. 2018;14:2837-2845. doi:10.2147/NDT.S177973
  16. Correll CU, Galling B, Pawar A, et al. Comparison of early intervention services vs treatment as usual for early-phase psychosis: a systematic review, meta-analysis, and meta-regression. JAMA Psychiatry. 2018;75(6):555-565. doi:10.1001/jamapsychiatry.2018.0623
  17. Singh V, Kumar A, Gupta S. Mental health prevention and promotion—a narrative review. Front Psychiatry. 2022;13:898009. doi:10.3389/fpsyt.2022.898009
  18. American Academy of Family Physicians. Mental and behavioral health care services by family physicians (position paper). Accessed July 17, 2024. https://www.aafp.org/about/policies/all/mental-health-services.html 
  19. Mental Health America. About MHA Screening. Accessed July 17, 2024. https://mhanational.org/cri/screening 
  20. US Preventive Services Task Force. Screening for anxiety in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2022;328(14):1438-1444. doi:10.1001/jama.2022.16936
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  24. Mental Health America. Mental health treatments. Accessed July 17, 2024. https://mhanational.org/mental-health-treatments 
  25. Mental Health America. Finding the right clinical mental health care for you. Accessed July 17, 2024.



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