The Similarities Between Schizophrenia and Dementia 

“Is there a link between schizophrenia and dementia?” asked Marc Lener, MD, in an article for Medical News Today in December.

A number of studies have suggested that there is a relationship between schizophrenia and dementia. People with a late onset of schizophrenia appear to be more likely to develop dementia. “Researchers do not know whether schizophrenia is a risk factor for dementia, a cause of dementia, or whether one may help to predict the other. In fact, schizophrenia was once called ‘dementia praecox,’ which means premature dementia,” wrote Dr. Lener

Now, researchers have, for the first time, compared schizophrenia and frontotemporal dementia—disorders that are both located in the frontal and temporal lobe regions of the brain. “With the help of imaging and machine learning, scientists have found the first valid indications of neuroanatomical patterns in the brain that resemble the signature of patients with frontotemporal dementia,” reported Neuroscience News in August. 

Frontotemporal dementia (FTD), especially the behavioral variant (bvFTD), is difficult to recognize in its early stages because it is often confused with schizophrenia. Thus, the similarities are obvious: in sufferers of both groups, personality, as well as behavioral changes, occur. Since both schizophrenia and FTD are located in the frontal, temporal and insular regions of the brain, it was obvious to compare them directly as well.

Nikolaos Koutsouleris and Matthias Schroeter, who are both physicians and researchers at the Max Planck Institute in Germany revisited seemingly obsolete “dementia praecox” findings that are more than 120 years old. The term was coined by psychiatry pioneer Emil Kraepelin, the founder of the Max Planck Institute for Psychiatry. 

Kraepelin assumed that the reason for the sometimes-debilitating course of the patients is located in the frontal and temporal lobe areas of the brain. That’s where personality, social behavior, and empathy are controlled.

“But this idea was lost as no pathological evidence for neurodegenerative processes seen in Alzheimer’s Disease was found in the brains of these patients,” Koutsouleris told Neuroscience News. But schizophrenia and FTD seem to be on a similar symptom spectrum, “so we wanted to look for common signatures or patterns in the brain,” Koutsouleris said.

With an international team, Koutsouleris and his colleague Matthias Schroeter used artificial intelligence to train neuroanatomical classifiers of both disorders, which they applied to brain data from different cohorts.

The result, published in the journal JAMA Psychiatry, was that 41 percent of schizophrenia patients met the classifier’s criteria for bvFTD. “When we saw this in schizophrenic patients as well, it rang a bell—indicating a similarity between the two disorders,” Koutsouleris and Schroeter recall. Hopefully, their research will contribute to improving treatment options for both disorders.

“Schizophrenia is a psychosis—a severe mental disorder in which the person’s emotions, thinking, judgment, and grasp of reality are so disturbed that his or her functioning is seriously impaired,” explained the late Colorado Recovery founder Richard Warner in his book The Environment of Schizophrenia. It is a disorder still not well understood and as a result, there are many misconceptions regarding the treatment of schizophrenia in our society. 

Dr. Warner used empirical evidence to challenge the previously prevailing view of schizophrenia, which suggested that psychosis was strongly characterized by poor clinical and social outcomes. Warner distinguished between “complete recovery” and “social recovery”. He defined the former as loss of psychiatric symptoms and return to a pre-illness level of functioning, whereas he described social recovery in functional terms; economic and residential independence with low social disruption, an important component of which is employment.

Colorado Recovery provides services for adults with serious mental illnesses that will stabilize their illness, minimize symptoms, improve functioning and enhance each person’s social inclusion, quality of life, and sense of meaning in life. We provide residential and outpatient treatment options for schizophrenia, bipolar, schizoaffective disorder, and other mental health conditions. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.