Roughly one third of people with schizophrenia will not respond to treatment or be resistant to treatment, with no known reason as to why.
That’s a problem Western Sydney Local Health District psychiatrist Anoop Sankaranarayanan wanted to solve, so he started by looking in an unusual place.
Anoop and researchers began to question whether they could find something, a measurable characteristic known as a ‘biomarker,’ that could help identify and intervene early.
Previous studies have established that gut microbiota can influence the brain and mental health, but investigations into oral microbiota were limited, particularly in treatment resistant schizophrenia.
“Microbiota basically means micro-organisms such as bacteria that live in our body; depending on the area you study, you refer to them as gut microbiome (in the human gut) or oral microbiome (in the oral cavity),” Anoop said.
Anoop’s study looked at whether microbiota in the mouth of patients with treatment-resistant schizophrenia was different to patients who did respond to treatment.
“This is a group of people with worst treatment outcomes, poor physical health, multiple comorbidities, and early mortality,” Anoop said.
The research found that the treatment resistant patients had higher alpha diversity (or within group differences) within specific families of micro-organisms.
“The most exciting finding was that even in a small subset of patients, we could identify differences in the oral microbiome of people with treatment resistant schizophrenia versus non-treatment-resistant schizophrenia,” Anoop said.
Schizophrenia is a long-term mental illness that impacts approximately 1 in every 500 people in Australia.
“Schizophrenia is a severe mental illness that is associated with significant disability, suffering, and burden.”
While acknowledging the limitations of the study, the results could encourage further investigation.
“We hope our research can help to identify those at risk of treatment resistance early and develop strategies to improve the outcome in this group.”
For the individual, the impact of offering alternate treatments for schizophrenia are enormous.
“This could translate to improved functioning, improved independence, improved health outcomes, improved longevity, improved quality of life and satisfaction.”