<![CDATA[Orchid Advocacy - ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY]]>Sat, 12 Jul 2025 23:44:34 -0700Weebly<![CDATA[Researchers call for ---Policymakers, payors, Patients and academia to advance Immuno- and Precision Psychiatry]]>Fri, 11 Jul 2025 03:26:47 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/researchers-call-for-policymakers-payors-patients-and-academia-to-advance-immuno-and-precision-psychiatry
Val's Take/Conjecture
  • ​One  of the things that was interesting is that the Department of Symptom Research at The University of Texas MD Anderson Cancer Center is included in the affiliations for this paper.
  • When we talk about STAKEHOLDERS for IMMUNO- and PRECISION PSYCHIATRY, that STAKEHOLDER POOL is larger and broader than we might think.
  • Further, we not only appreciate the flaws in the current DSM Categorical System, there is a practical, research-based ALTERNATIVE to shoot for in IMMUNO- and PRECISION PSYCHIATRY.
  • The people involved in CRIMINAL JUSTICE and HOMELESSNESS often have idiosyncratic medical histories, including:
    • ​Neuro-Developmental Disorders
    • Psychiatric Disorders
    • Brain Injuries, and
    • Substance Issues
  • MOST PEOPLE DO WANT TO WORK
    • ​But if we are MISINTERPRETING complex Neuro-Immune Disorders affecting multiple systems of the body --
      • ​We're probably not going to get the results we want and we may be setting some people up for failure.
Advancing precision psychiatry and targeted treatments: Insights from immunopsychiatry  (2025)

*Researchers from the US, Australia, France, Belgium and the UK
Abstract

​Despite tremendous advancements in neuroscience, there has been limited impact on patient care.

Current psychiatric treatments are largely non-specific, and drug development is hindered by outdated, overinclusive diagnostic categories and a "one-size-fits-all" approach.

Additionally, mechanisms underlying psychiatric illnesses and their treatments with conventional medications remain poorly understood.

Precision psychiatry is a strategy that holds great promise for novel therapies targeting specific pathophysiologic mechanisms in selected patients, ultimately contributing to more effective, personalized treatments.

Immunopsychiatry, which focuses on the immune system's role in psychiatric disorders, exemplifies the challenges and potential solutions for precision psychiatry.

Despite understanding how inflammation contributes to psychiatric illness, results of clinical trials with anti-inflammatory drugs have been inconsistent and underwhelming.

Shortcomings of these trials include a lack of focus on subgroups of patients with increased inflammation, the use of non-specific outcome variables (e.g., not specific to inflammation's impact on the brain and behavior), and failure to establish target engagement of the inflammatory response.

To advance anti-inflammatory treatments, clinical trials should:
1) enrich for patients using predictive biomarkers;
2) use clinical outcome assessments that align with inflammation's effects on the brain;
3) consider novel diagnostic constructs linked to inflammation; and
4) verify target engagement.

Moreover, greater attention should be paid to efforts to repurpose available anti-inflammatory drugs while awaiting development of novel treatments targeting more specific immune pathways.

Taken together, a collaborative approach involving academia, industry, funding agencies, patients, payors, and policymakers is required to advance Immunopsychiatry and ultimately provide a roadmap for successful implementation of precision psychiatry.
]]>
<![CDATA[In the back of my head --- Mr. Universe]]>Mon, 07 Jul 2025 15:27:46 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/in-the-back-of-my-head-mr-universe
Val's Take:  "I know what I know.  I say what I said.  We come, and we go.  That's the thing I keep in the back of my head.  It's in the back of my head."

Paul Simon pairs a jaded view with a recognition of mortality.
There are a lot of ways you could go with this  --- For me (among many, many other things) --- Mr. Universe is in a Colorado Prison --- That's the thing I keep in the back of my head.   It's in the back of my head.  In the back of my head.
We're well aware that we need to build out a Continuum of Care --- but some people get defined out of that, especially if they get that "ANTI-SOCIAL PERSONALITY DISORDER" diagnosis.
Paul Simon & Ladysmith Black Mambazo

I Know What I Know
There is RACIAL BIAS in Psychiatry and Criminal Justice. 

Generally, our response to this is to try to treat everyone HORRIBLY --- that's fair, isn't it?


One of the things that needs to be done is to apply IMMUNO- and PRECISION PSYCHIATRY to Anti-Social Personality Disorder.
Picture
Dr. Ruth S. Shim, M.D., M.P.H.
]]>
<![CDATA[What are the RAMIFICATIONS of the Developmental Origins of Health & Disease for:  The American Psychiatric Association andThe Criminal Justice System]]>Sat, 05 Jul 2025 00:39:24 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/what-are-the-ramifications-of-the-developmental-origins-of-health-disease-for-the-american-psychiatric-association-andthe-criminal-justice-system
Val's Take/Conjecture
  • Researchers are already working on means to re-regulate the immune system after Maternal Immune Activation either in utero or after birth.
  • That certainly sounds like:
    • Obstetrics,
    • Pediatrics
    • Immunology and 
    • Neuro-Immunology.
"Stimulation of offspring Tregs with interleukin-2 reversed brain inflammation and cured established ASD-like behaviors."

"Thus, MIA-induced ASD is a neuroimmune disorder that can be reversed by immunomodulation."
]]>
<![CDATA["Look ON the Bright Side of Life"]]>Wed, 25 Jun 2025 14:11:42 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/look-on-the-bright-side-of-life
Monty Python
The Holy Grail -- Witch Scene (1975)
Probably one of the things Monty Python did better than anyone else ---
  • They took an irreverent historical sensibility
  • And combined it with completely wrong and differing ideas and pitted them against each other -----
    • ​Whose right?  Nobody's right.
  • There is the not so subtle implication that this also rings true in Modern Times.
For me, when I see debates about which flawed, scientifically invalid diagnostic category someone fits into ---
  • ​OMG --- how effing stupid are you people --- don't answer I think I know.
On the other hand, someone could say that about me, if they hyper-focused on my flaws.

It doesn't mean those challenges don't exist --- but there are Strengths, too.
RESEARCHERS vs. CLINICIANS
  • Researchers Around the World understand the URGENCY to get to the underlying biology of psychiatric disorders.
    • By and large, Clinicians do not appreciate how shaky current diagnostic foundations actually are.
      • ​​There are exceptions and some Clinicians have spoken out.​​​​​
  • On the other hand, Clinicians are playing a major role in trying to hold this society together under often less than ideal circumstances.
Picture
Schizophrenia (SCZ), autism spectrum disorder (ASD), and bipolar disorder (BP) are very common psychiatric disorders, with high lifetime prevalence rates of ~0.5% , 2.5%, and 1%, respectively.

They are characterized by their duration as chronic diseases, from childhood to the time of death. This results in a longer treatment period and extensive social and personal damage.
However, the biological pathogenesis of these psychiatric disorders is not well understood.

Their understanding is urgently needed to develop novel therapies that significantly improve the functional outcomes of patients.


The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has established the diagnostic criteria for SCZ, ASD, and BP as independent and separate diseases.
In contrast, in clinical settings, the comorbid diagnoses are also allowed, and in some patients, drawing the diagnose line is difficult, suggesting that these psychiatric disorders partially share clinical symptoms and phenotypes.
[Val's Note:   The University of Colorado was one of the first to say -- we need the ability to make these diagnoses less by "the book" (meaning the DSM 5).

Further, handing out multiple co-morbid diagnoses is not particularly helpful to the patient --- we need PRECISION MEDICINE that is tailored to the individual and the underlying biology.]
Indeed, studies reported that psychiatric disorders show common alterations, such as dysfunction in the white matter microstructure in the body of the corpus callosum and brain responses in the ventral striatum during reward anticipation.

Additionally, recent genetic studies have uncovered common risk genomic variants in these psychiatric disorders.
These findings imply that there are common underlying mechanisms in these psychiatric disorders, prompting us to examine the molecular and cellular alterations caused by the common risk variants across these psychiatric disorders.

Recently, we identified the variants in ASTN2 as a candidate risk factor for psychiatric disorders by whole-genome copy number variation (CNV) analysis.
Moreover, a study reported that deletions in ASTN2 that would disrupt almost all transcript isoforms . . . are significantly enriched in patients with neurodevelopmental disorders, such as ASD, attention-deficit/hyperactivity disorder, and intellectual disability.

In support of these results, ASTN2 is also listed in multiple databases, such as SFARI (https://gene.sfari.org/) and DBDGD (https://dbd.geisingeradmi.org/), which are centered on genes implicated in these psychiatric disorders.
]]>
<![CDATA[Juneteenth]]>Mon, 23 Jun 2025 01:19:33 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/juneteenth]]><![CDATA[The Ethical challenges of:  HansEn's disease and Neuro-Developmental & Psychiatric Disorders]]>Sun, 22 Jun 2025 23:18:26 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/the-ethical-challenges-of-hansens-disease-and-neuro-developmental-psychiatric-disorders
Val's Take/Conjecture
  • Hansen's Disease is the modern name for "Leprosy."
  • Leprosy was a disease known from ancient times and it is mentioned in the Bible -- Jesus healing many people with leprosy.
    • ​Faith healers were common in the time of Jesus.
    • See Wikipedia:  History of Leprosy
    • And there have been modern faith healers such as Oral Roberts.
It is at least arguable that the Social Stigma of Leprosy was greater than Mental Illness.  Leprosy also was often quite visible and seen as a punishment of the Gods.

Today, leprosy is curable with an MDT -- multi-drug therapy.  

There appear to still be issues, but things are a lot better than they were.

Neuro-Developmental & Psychiatric Disorders​
  • Researchers more and more recognize INFLAMMATION as a kind of UNIVERSAL LANGUAGE.
There's also Trauma and Intergenerational Trauma that effects us biologically.

On top of this, Neuro-Developmental and Psychiatric Disorders are now conceptualized as Multi-System, Neuro-Immune Disorders.
Underwood & Underwood Publishers
"Unclean! Unclean!  Wretched Lepers Outside of Jerusalem"  (1891)


also written in French, German, Spanish, Swedish and Russian
I've viewed this picture along with others of Jerusalem many, many times through a Stereoscope that gave a 3-D effect.

It was originally my paternal great, grandfather's who I never knew.

He was a linguist and also likely had "bipolar disorder."
He gave up his academic post to become one with the land--a farmer --- of which he knew nothing about.

My great grandmother gave music lessons to keep the family from starving -- she died of cancer and was treated at the Mayo Clinic before her death.​
Auto-Immune Disease, Polio and Parkinson's
  • Further, I don't just have a family history of mental illness  and cancer, but also auto-immune disease, polio and neuro-degenerative disease.
Val's Take/Conjecture

Psychiatric Disorders are not uncommon in a wide-range of health issues and across the lifespan.

The Biopsychosocial Model of the 1970s advocated for a more HOLISTIC view.
Ironically, the BIOLOGY was actually given short shrift because they didn't have access to it -- or they thought what they had access to was more than it was.

We are undergoing a BIOLOGICAL RESEARCH REVOLUTION that is INTEGRATING Developmental, Physical & Mental Health.
]]>
<![CDATA[Reasoning to reform without perfect information]]>Sun, 22 Jun 2025 22:13:34 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/reasoning-to-reform-without-perfect-information
Val's Take
  • Those of us living now will not see the full benefit of research on Neuro-Developmental and Psychiatric Disorders that is such a long- term, multi-generational effort.

  • In 2025, most people can live in the Community with current treatment but some can't.

  • It's time to get rid of Medicaid's Exclusion of Payment for Institutes of Mental Disease (IMD) Rule while also:
    • Bringing Intensive Community Supports to Scale.
I posted the study to the right because it represents a different take on the research.

The point is not so much the Conclusion --- as that the researchers are still working on this and it is not done.

On the other hand, we have plenty of people with Schizophrenia and other Neuro-Developmental and Psychiatric Disorders incarcerated.

We have substantial reason to believe we are punishing people for a not sympathetic underlying biology.

It's not like we're not doing anything, but we're not doing enough.
"We conclude that microglia of the patients with SCZ (Schizophrenia) have gene expression aberrations related to inflammation response and extracellular matrix without contributing to increased microglial activation."
]]>
<![CDATA[Do we have the right professional?  From PSYCHOLOGY to integrative immuno-biology]]>Sun, 22 Jun 2025 02:24:18 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/do-we-have-the-right-professional-from-psychology-to-integrative-immuno-biology
Val's Take/Conjecture
  • When all the research gets sorted out ---- Societal Responses won't be the Ethical & Moral Nightmare they are today.
  • BUT right now the research continues to corroborate Developmental  multi-system Neuro-Immune Disorders.
  • ​Further, that is a refinement from a decade ago.
What has not been corroborated by the research is the DSM categorical system.
Picture
NAMI Montana
It's Time to Improve the Mental Illness Diagnostic Process
(2013)
]]>
<![CDATA[TRANSLATIONAL JusTICE as "A THING"]]>Sat, 21 Jun 2025 12:21:14 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/translational-justice-as-a-thing
Val's Take/Conjecture
  • ​The article to the right addresses Translational Justice in Healthcare.
  • When I'm referring to "TRANSLATIONAL JUSTICE" --- I'm generally referring to the need to appreciate the ramifications of Medical Research through a Criminal Justice Lens.
    • ​Might also be Translational Justice in Criminology or Translational Criminology.
Affiliations
1Mayo Clinic.
2University of Toronto.
3University of Miami.
4Case Western Reserve University.
5University of Pennsylvania.
6ETH Zurich.
7Stanford University.
]]>
<![CDATA["Micro-Credentialling" in Behavioral Health & the crying need for more advanced care in immuno-psychiatry]]>Fri, 20 Jun 2025 11:25:17 GMThttps://orchidadvocacy.org/8203translational-8203transitional-justice-monday/micro-credentialling-in-behavioral-health-the-crying-need-for-more-advanced-care-in-immuno-psychiatry
Val's Take/Conjecture
  • The Colorado Community College System is promoting "micro-credentialing" in Behavioral Health.
  • There have been work force problems in mental health for a long time --- and there are immediate, practical issues and needs.
  • Providing a more thorough understanding of Neuro-Developmental and Psychiatric Disorders with New and Modified Paradigms is also critical to addressing "work force" issues.
​​
  • Neuro-Developmental and Psychiatric Disorders are more and more seen through a lens of "Neuro-Immunology" and "Brain, Behavior & Immunity."
Jonathan Kipnis
Pioneer in Neuro-Immunology
This isn't to say that everyone should be a world-renowned researcher --- but if you want to--- go for it.

Kipnis talks about how ideas can become entrenched and self-perpetuating even if they are wrong --- and that is a problem in Mental Health.

Further, out-dated paradigms are not irrelevant to the mental health profession's work force problems.
]]>