The recurrence of mental illnesses is linked to numerous factors, with seasonality being a significant one. During autumn-winter or winter-spring transitions, the incidence and relapse rates of such disorders rise markedly.
Currently, as seasons shift, not only do physical illnesses enter a high-incidence period, but mental disorders also experience a new surge.
Patient Xiao Zhao was diagnosed with schizophrenia seven years ago. After inpatient treatment, his symptoms improved. However, during the following seasonal transition, his symptoms recurred, manifesting as auditory hallucinations, restlessness, poor nighttime sleep, and irritability. His family then readmitted him to a psychiatric hospital, where he stabilized and was discharged.Since then, his symptoms worsened during autumn-winter or winter-spring transitions, sometimes leading to self-harm or self-mutilation...
At their wits' end, his family sought a friend's recommendation and brought him to the Functional Neurology Department at Shanghai East Hospital, affiliated with Tongji University.Dr. Wu Jingwen, the department director, conducted a thorough psychiatric assessment and physical examination. With guardian consent, he performed minimally invasive surgery on Xiao Zhao. On the seventh postoperative day, Xiao Zhao was discharged fully recovered.His family noted the most significant changes: his speech became clear and fluent, his thinking returned to normal, and his previous psychotic symptoms—auditory hallucinations, persecutory delusions, hostility toward relatives, and irritability—had completely vanished. His emotional bonds with family restored, he now showed concern for his parents, proactively checking on their well-being, and felt profound remorse for past acts of violence toward them. Post-surgery, he developed a fondness for music and reading, embraced life with renewed hope, and no longer entertained thoughts of pessimism, despair, or self-harm.
Why are mental illnesses more prevalent in certain seasons?
Research indicates that fluctuations in temperature, humidity, and atmospheric pressure can disrupt neurotransmitter secretion in the brain, triggering various psychiatric symptoms and even exacerbating existing conditions.For instance, bipolar disorder often peaks during the transition from autumn to winter. Patients may experience alternating phases of elevated mood, hyperactivity, impulsive spending, irritability, and aggressive tendencies; followed by periods of depression, insomnia, loss of appetite, guilt, and even refusal to eat or drink, or suicidal thoughts.Schizophrenia patients frequently experience hallucinations, delusions, emotional numbness, and disorganized behavior or thinking. In severe cases, suicidal tendencies or actions may emerge. Here, Director Wu Jingwen, an expert in the Functional Neurology Department at Tongji University Affiliated Dongfang Hospital, reminds family members of patients: During the autumn-winter or winter-spring transitions, it is crucial to closely monitor emotional and symptomatic changes in individuals with mental illnesses. Encourage them to take medication regularly and attend medical appointments on time to prevent relapse.Should a relapse occur, prompt hospitalization for treatment is essential. With timely intervention, most patients achieve favorable outcomes. For individuals with medication-resistant psychiatric conditions—such as schizophrenia, bipolar disorder, depression, or anxiety disorders—where symptoms persistently recur during seasonal transitions and become particularly severe or resistant, posing risks to personal or public safety, families should consider minimally invasive surgical treatment options.
How does surgery address the dilemma of severe medication side effects?
Schizophrenia is a recurrent or chronic mental disorder. Similar to chronic conditions like hypertension or diabetes, patients require long-term medication to manage symptoms. Discontinuing medication not only increases relapse risk but also intensifies symptoms with each recurrence, progressively complicating treatment.
While medication remains the primary treatment for psychiatric disorders, it presents a double-edged sword with both benefits and drawbacks. Most patients experience suppression of psychotic symptoms but also encounter side effects. For instance, some patients develop increased appetite, weight gain, or abnormal liver and kidney function after taking medication;Others develop extrapyramidal symptoms like akathisia (restlessness), tremors, and neck/back stiffness. Some even experience endocrine dysfunction, such as amenorrhea, lactation in women, or gynecomastia and pronounced feminization in men. Medication can also alter cognition and emotions, leading to loss of interests, diminished empathy, lack of willpower, and memory decline.Severe cases may involve somnolence, constipation, dizziness, and orthostatic hypotension. When psychiatric patients exhibit these adverse drug reactions, clinicians typically administer anticholinergic medications to counteract the side effects. However, some patients experience acute psychotic episodes, such as delirium, after taking anticholinergics. These additional psychiatric symptoms induced by the drugs cause family members to question the treatment's efficacy and may even erode their confidence in continuing therapy.
The longer a patient's psychiatric history, the worse the medication response and the greater the side effects. Yet discontinuing medication leads to relapse. This therapeutic dilemma leaves guardians and families at a loss, urgently seeking new treatment approaches.
Extensive clinical practice confirms that neurosurgical interventions serve as a vital adjunct to pharmacological treatment and a corrective measure. Advances in neuroimaging technology, particularly the widespread application of functional magnetic resonance imaging (fMRI), have provided diagnostic insights into the pathological basis of schizophrenia. Neuroimaging studies reveal significant differences in brain structure, function, and neurotransmitter metabolism between schizophrenic patients and healthy individuals.Symptoms of schizophrenia correlate with functional abnormalities in specific nuclei within the limbic system. For instance, abnormal neurotransmitter secretion and metabolic disorders in nuclei such as the amygdala, cingulate gyrus, anterior limb of the internal capsule, central septum, nucleus accumbens, inferior caudate nucleus, orbital tract, and frontal tract manifest as corresponding psychiatric symptoms.Research confirms that neurotransmitter dysfunction forms the biological basis for schizophrenia. Functional neurology specialists utilize robotic stereotactic technology to deliver control electrodes to specific targets within neuropathological circuitry. This induces radiofrequency ablation or inhibition (DBS modulation) of neural cells at the contact site. Such interventions regulate neurotransmitter metabolism and suppress abnormal neural signaling pathways, thereby eliminating or controlling psychotic symptoms.Once these psychiatric symptoms are eliminated or controlled, patients achieve clinical remission; their medication dosage can then be reduced, indirectly minimizing drug-related side effects.
Experts emphasize that treating psychiatric disorders is a long-term process, and families should avoid expecting immediate results. For patients with psychiatric conditions who show poor response to long-term medication or refuse to take drugs, surgical intervention has become a necessary follow-up treatment option. Patients undergoing minimally invasive surgery must undergo rigorous clinical evaluation and screening prior to the procedure, which is essential for achieving stable therapeutic outcomes.