Drs. Ariel Graff
and Phil Gerretsen want to know why some people don’t recognize their own mental health conditions. They specialize in illness unawareness in people living with schizophrenia.Not being aware of illness
— also known as anosognosia
— is a major issue for many patients, especially those coping with
dementia, various types of strokes and schizophrenia.
“If someone doesn’t feel that they are sick, they can hide from treatment,” explained Dr. Graff, a clinician-scientist with CAMH's Campbell Family Mental Health Research Institute. “This is a huge concern because people who don’t manage their schizophrenia may suffer from delusions, hallucinations and become socially withdrawn.”
In other cases, patients who are successfully managing their illness — but are still unaware that they are sick — might stop taking their medication, resulting in a relapse.
Using brain imaging techniques, Dr. Graff’s team hopes to identify exactly which parts of the brain are triggered when people recognize that they have a disorder. This information could be valuable for designing therapies that make patients fully aware of their conditions so they continue to receive help.
In Dr. Graff’s new study, participants with schizophrenia will have their brains scanned with functional magnetic resonance imaging (fMRI) while watching a presentation. The study group — consisting of both individuals who do not acknowledge their disorder and those who do — will see a mix of generic information and statements that refer to schizophrenia. By seeing which parts of the brain are triggered when people recall that they have a disorder, the scientists hope to shed light on which parts of the brain are involved in illness awareness.
“By knowing this information, we have a target,” said Dr. Graff. He explained that non-invasive and safe techniques such as transcranial magnetic stimulation might potentially be used to stimulate these key brain regions. This way, patients can regain recognition of their illness and need for treatment.
The team is currently recruiting participants and hopes to finish the study, which is funded by the Ontario Mental Health Foundation, this year.