​Part of the issue has been that when we thought of DEVELOPMENTAL DISORDERS we often thought of INTELLECTUAL DISABILITIES.

​Interaction between maternal immune activation and postpartum immune stress in neuropsychiatric phenotypes (2024)

• "Maternal immune activation (MIA) during pregnancy alters the offspring’s immune profile as well as their neurodevelopmental trajectories, thereby increasing the risk of neuropsychiatric disorders, including intellectual disability, autism spectrum disorder (ASD), schizophrenia, and bipolar disorder."

​Neurodevelopmental disorders, immunity, and cancer are connected (2022)

Val's Take:  Denver has made historic progress in providing housing and coordinating with Medicaid case management to substantively address  homelessness in the city.

Credit goes to Mayor Mike Johnston in the first instance --- and then there are all those homeless advocates  and people with lived experience of homelessness.

Other American cities such as Houston and even other countries such as Finland have also made great strides in addressing homelessness and served as models for Denver.

Colorado State Government understands the need to build out a CONTINUUM OF CARE --- they are unsure how they will pay for it.  Better understanding who really needs the HIGHEST LEVELS in the CONTINUUM of CARE could help.

Michael Marshall may not have needed that highest level of care and he might be alive today if he had access to secure housing and adequate case management.

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​MLK Day Marade 2016
Why is Michael Marshall Dead?

​BIOLOGICAL PSYCHIATRY and "LIFESTYLE PSYCHIATRY"

• Theoretically, there is no conflict between Biological Psychiatry and Lifestyle Psychiatry.
• I do think addressing Lifestyle issues can help and even greatly improve Neuro-Developmental & Psychiatric Disorders --- and we should be doing that.
• The concern that I have with "Lifestyle Psychiatry" is it often doesn't seem to appreciate that Neuro-Developmental & Psychiatric Disorders are largely DEVELOPMENTAL and begin IN UTERO.
• Further, I do think there is a need to work one's way back in the CHAIN OF CAUSALITY --- because a lot of these problematic "LIFESTYLE CHOICES" are actually being driven by some problematic biology.

​​Brain cell-type shifts in Alzheimer's disease, autism, and schizophrenia interrogated using methylomics and genetics (2024)

​"We observe and replicate cell-type compositional shifts for

• Alzheimer's disease (endothelial cell loss),

 

• autism (increased microglia), and

 

• schizophrenia (decreased oligodendrocytes), and

find age- and sex-related changes."

Val's Take/Conjecture

• ​In the Middle Ages, they may have thought that someone with a psychiatric disorder was possessed by a demon.
• Further, the person themselves may have thought that

​We haven't thought that for awhile -- but Anti-Social Personality Disorder is a pretty close second.

The science is exploding  and we're not on top of that the way we need to be.
 
​We need to be funding Centers of Excellence in teaching hospitals around the country that can keep up with the science.
​
Further, we need robust Professional and Public Education Campaigns that can address new or modified paradigms.

​It's a Wonderful Life

I think this is a brilliant scene by Frank Capra --- and Capra turns our hero George Bailey into a Bully --- I think that was genius.

We do understand the fear and frustration --- even as "shaking Uncle Billy" isn't going to solve the problem.

Ingmar Bergman 
​The Seventh Seal

The young woman is believed to be in communication with the devil, and she believes that too.

The knight believed it as well, and after a conversation with the young woman doubted any communication with the devil and struggled to address her burning at the stake.

He and his squire determining that the young woman was almost dead anyway.

Additionally, many people in the Criminal Justice System have a "NEURO-DEVELOPMENTAL DISORDER" which is part of the Neuro-Developmental/Psychiatric Continuum.

There is no reason why we can't have HUMANE. THERAPEUTIC, CUSTODIAL CARE if needed.

Further, we're on the verge of biomarkers and treatments involving microglia and other aspects of the IMMUNE SYSTEM --- that were not on the radar screen 20 years ago.

Val's Take/Conjecture

• A little over a decade ago. then National Institute of Mental Health Director Thomas Insel:
  • advised the DSM 5 "lacked validity"
  • mental health professionals often based their treatments more on "religion" than "science"
  • and Insel asked for ATONEMENT. 

Atonement (October 8, 2014): In his blog for Mental Illness Awareness Week, Dr. Insel talks about the complexity of mental disorders and the need for scientists, clinicians, patients, and families to work together in searching for better treatment.
 

• I think for some of us it was clear Mental Health had some real problems.   For me, I saw that in the context of Criminal Justice and Homelessness.

 

• At that time what I understood was on a logical and systemic level --- I would have been hard pressed to flesh out too many specifics.

Now ---- what's going on with Neuro-Developmental & Psychiatric Disorders is much more clear, and there does seem to be a  CONSENSUS in the Research Community even if that is only beginning to get to the professionals on the ground.

​As for a Political Consensus, I think most people are much more concerned with PLACEMENTS, TREATMENTS, and SAFETY.

​Mental Health Professionals who may be on the fringes of Neuro-Diversity themselves ---- can provide the individualized assessment and treatment necessary.

One of the big psychological challenges in Modern Times is Illness that is not completely understood now, and yet the expectation is that treatments or cures will be available in the future.

​For People with Neuro-Developmental / Psychiatric Disorders and an IQ over 70 --- outdated conceptualizations put many at risk of homelessness and/or incarceration.​

Further, the needs and types of support needed are often different than what is being provided.

Updated paradigms have the real possibility of directly addressing underlying Developmental processes and subsequent inflammatory exposures that may be magnified by dysregulated microglia, etc.

Val's Take/Conjecture

• One of the big discoveries of the 21st Century is that NEURO-DEVELOPMENTAL & PSYCHIATRIC DISORDERS involve MULTIPLE SYSTEMS OF THE BODY.
• That does include the Brain and the Central Nervous System (CNS).
• It also includes the Immune System, the Microbiome and the Endocrine System.

​Role of the immune-kynurenine pathway in treatment-resistant schizophrenia.  (2024)

​Is depression the missing link between inflammatory mediators and cancer?  (2022)

Three major routes to depression in cancer in which proinflammatory mediators are implicated, seem likely.

Activation of the kynurenine pathway involving cytokines, increases tryptophan catabolism, resulting in diminished levels of serotonin which is widely acknowle …

​

• Transgenerational Epigenetic Inheritance was discovered by Alexander Brink in 1956 as it relates to maize.
• Since then Epigenetics has been identified as a Key Component of our most difficult chronic diseases, including:
  • Autoimmune Diseases
  • Cancer
  • Type 2 Diabetes
  • Neuro-Developmental Disorders, and
  • Psychiatric Disorders

Val's Take/Conjecture

• One of the big discoveries of the 21st Century is that NEURO-DEVELOPMENTAL & PSYCHIATRIC DISORDERS involve MULTIPLE SYSTEMS OF THE BODY.
• That does include the Brain and the Central Nervous System (CNS).
• It also includes the Immune System, the Microbiome and the Endocrine System.

​Maternal immune activation and role of placenta in the prenatal programming of neurodevelopmental disorders (2023)

​How Inflammation Affects the Brain in Depression (2021)

While it is unclear how the inflammatory response affects brain networks involved in the psychopathology of depression, it has been suggested that proinflammatory cytokines and several metabolites from inflammatory processes in the central nervous system (CNS) exert direct neurotoxic effects on the brain. 

These effects may lead to dysfunction of the neural circuits involved in emotion regulation and reward or cognitive processing, which is associated with overwhelming low mood, failure of...

​
​Society of Biological Psychiatry

Dysfunction of Kynurenic Acid in Major Psychiatric Diseases

​This will focus largely on the contexts of:

• Maternal Immune Activation
• and Exposure to Endocrine-Disrupting Chemicals

2nd Draft:  More References with regard to Endocrine Disruptors and Neuro-Developmental & Psychiatric Disorders.

As we're slowly moving from the SYMPTOM-CLUSTERS of the DSM to BIOMARKERS we're finding a COMPLEX ENVIRONMENT in which multiple systems of the body appear impacted in highly idiosyncratic ways by Maternal Immune Activation IN UTERO.

Tuning neural circuits and behaviors by microglia in the adult brain. (2024)

Microglia are the primary immune cells of the CNS, contributing to both inflammatory damage and tissue repair in neurological disorder. ...We discuss current studies utilizing microglial optogenetic and chemogenetic approaches to modulate adult neural circuits. Thes …

Maternal immune activation and neuroinflammation in human neurodevelopmental disorders  (2021)

Evidence from human and animal studies indicates that maternal immune activation programmes the fetal brain and immune system through inflammatory and epigenetic mechanisms during key periods of CNS, microglial and immune system development, and colonization of gut.

Conclusion

• Researchers are providing a much more comprehensive narrative and understanding of Neuro-Developmental and Psychiatric Disorders.
• These new understandings are also relevant for:
  • Autoimmune Disorders
  • Cancer
  • Dementia, and
  • Neuro-Degenerative Disorders
• With respect to Neuro-Developmental/Psychiatric Continuum:
  • A focus on improving Microglial health as well as
  • Re-colonization of the gut could go a long way to addressing the effects of Maternal Immune Activation.
    

Ultimately, what everyone wants is PREVENTION.

Val's Take:   We're slowly moving away from the Adversary System to a more Collaborative Approach --- a more Problem-Solving Approach.

Given modern science on AGGRESSION --- one of the problems with the Adversary System --- it tends to make everyone  in it --- MORE AGGRESSIVE in relative terms.  

The Legal System was really designed in the beginning to be an ALTERNATIVE to the BLOOD FEUD.   And from that vantage point, the Adversary Legal System was a big step up.

Historically, there actually have been numerous reform efforts over hundreds of years.   It seems like we're getting  the medical  understanding  of  the  biological basis  of behavior.  It's more complicated than we thought and not always what we thought historically, most notably the immune system and the immune system in the brain seem very important.

The more we can de-personalize illness or dysregulation ---- the more we can get on the same page.  In many cases, people themselves will be advocating for the healthcare they need.

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