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Psychological and Biological Characteristics of Obsessive Compulsive Symptoms in Schizophrenia

This week’s blog post is from Marjan Biria who is nearing the end of her PhD. Marjan is studying at Cambridge University and her PhD is: Understanding the Psychological and Biological Characteristics of Obsessive Compulsive Symptoms in Schizophrenia caused by Clozapine Treatment. She describes how her interest in mental illness began.

As a child I was always curious about other people's behaviour and emotions, and why some people were happier than others. Having had close relatives with mental health disorders such as schizophrenia and depression, my family used to put a lot of emphasis on the importance of mental health.

As an adult, I decided to study psychology to be able to help people experiencing mental health difficulties. At the end of my bachelors, I knew I wanted to know more about the brain. I wanted to know how these bad outcomes took place in our brain and why some people were more predisposed to develop depression or schizophrenia for example. I decided to study a masters in neuroscience to understand behaviour and feelings at a neurobiological level. As I had a personal interest in studying schizophrenia, I became involved in a project trying to understand the visual impairments in a population with a high genetic risk for schizophrenia development. The result of this study is published here.

After finishing my masters in neuroscience, I had become very much interested in ways we could improve our mental health, one of which was meditation. I used to meditate regularly myself and started writing blog posts about meditation and healthy lifestyle articles with two other colleagues.

My interest in depression led me to become curious about the function of our frontal lobes, areas important for decision making, self management and executive functioning. These regions tend to have a reduced size in depression, and increase in size after regular and long term meditation practice. Since abnormal functioning of frontal lobes plays a crucial role in obsessive compulsive disorder (OCD) symptomatology, I became interested in studying OCD as a way of understanding more about these brain regions. In parallel, I decided to work on a project trying to understand how an antipsychotic medication called clozapine produced OCD symptoms in treatment resistant patients with schizophrenia. While our projects are still ongoing, in a previous analysis, we found that patients with schizophrenia who experience higher positive and depressive symptoms had a higher risk of experiencing OCD symptoms while on clozapine. Additionally, we found that they had a much lower well being compared to people who were on clozapine but did not experience OCD as a side effect. Another important factor was that OCD symptoms could be covered by their positive symptoms and it was much harder to diagnose them. It makes many people on clozapine suffer silently without getting any help for their OCD symptoms. Two of our studies so far can be found here and here.

I am now towards the end of my PhD which was delayed for about a year by the pandemic. We are finalising another project in which we are trying to measure neurochemical ratios important for OCD symptoms. We use a technique called Magnetic Resonance Spectroscopy (MRS) at 7 Tesla (the number shows the strength of the scanner, to give you a reference, the MRI scanners in hospitals have a strength of 1.5 or 3 Tesla). Our stronger scanner enables us to measure Glutamate and GABA, two main excitatory and inhibitory neurotransmitters in the brain, with a much higher precision. Both of these neurochemicals are important for OCD and schizophrenia symptoms. I have published a book chapter about this technique, which can be found here.

Although at the moment of writing this post It is not decided yet what I will do exactly after my PhD, I know my long term goal is to find new and better ways to measure mental health symptoms more accurately but also create effective solutions for their improvement.

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