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Spotting Early Warning Signs of Psychosis

IPR’s Vijay Mittal identifies risk factors for schizophrenia


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Unusual motor behavior and subtle handwriting abnormalities could be early warning signs of schizophrenia.

Schizophrenia, a debilitating disorder characterized by hallucinations, intrusive thoughts, and illogical behaviors, affects about 1 percent of the population. That might sound like a small number, but to psychologist and IPR associate Vijay Mittal, it isn’t small at all—and neither are its consequences. “In a room of 100 people, one is likely to have schizophrenia and several more are related to someone with the disorder,” Mittal pointed out. “We don’t talk about it very often, but it is so detrimental to people’s lives.”

Schizophrenia is complicated to treat and is not typically thought of as preventable. But that’s changing, thanks in part to Mittal, who is an assistant professor at Northwestern and the head of ADAPT, a research clinic that works with teens and young adults at risk for developing a thought disorder. He also recently received an Early Career Impact Award from the Federation of Associations in Behavioral and Brain Sciences.

Mittal and his colleagues have identified early warning signs of schizophrenia that can be spotted in young people before they develop a full-blown psychosis. That kind of early identification opens the door to early treatment, which might one day prove to be effective in mitigating or even preventing future onset of psychotic disorders.

Vijay Mittal
Vijay Mittal

One of the risk factors Mittal has studied is unusual motor behavior—subtle physical patterns such as coordination problems and involuntary jerking movements. His graduate advisor had discovered that some individuals with schizophrenia had shown such movements even as infants and children by using an innovative method of reviewing them in home movies as children.  

Mittal probed the brain science behind the connection to study whether the irregular motor behaviors could differentiate which at-risk adolescents would later develop psychotic disorders. “The same basal ganglia brain circuit that governs motor behaviors is highly implicated in schizophrenia,” he said, explaining that individuals with schizophrenia tend to have irregularities in a neurotransmitter called dopamine in that part of the brain. When he studied at-risk young people, those who exhibited the unusual movements were several times more likely to develop psychotic behavior than those without them.

Applying findings from other fields to psychosis research has become something of a hallmark of Mittal’s career. He teamed up with researchers looking at how handwriting patterns can mark a variety of disorders, showing that subtle handwriting abnormalities could also predict schizophrenia risk. He is now working to assess the potential for tablet-based handwriting assessments for young people at high risk. "The kind of assessment anyone can do,” he said.

He is also testing whether exercise can help prevent schizophrenia in at-risk populations. That work was inspired by studies showing that exercise can reduce memory loss by way of new cell growth in a part of the brain called the hippocampus. Around the time he read those findings, Mittal’s own studies were finding abnormalities in the hippocampus of adolescents at-risk for schizophrenia, so he hypothesized that exercise could help them, too. The preliminary results are promising.  

Mittal hopes that his work will allow for both better early identification of psychosis and treatments for it. He is passionate about translating his research into interventions, and he works with primary-care physicians and schools to help them identify individuals with the highest risk factors. 

Vijay Mittal is assistant professor of psychology and an IPR associate.

This article has been edited from the original by the Federation of Associations in Behavioral & Brain Sciences.