The Psychiatrist

Eve Johnstone looks at images of the brains of her schizophrenia patients to learn more about the condition.

I have been working on schizophrenia – an extremely disabling and distressing condition – for 33 years, trying to understand its biological basis. The main method we use is a brain scanner which gives a view of people’s brains. In 1976 we were the first to demonstrate that there were actual structural faults in the brains of schizophrenic patients.

Recently, our experiments showed that brain scanning can predict that someone will develop schizophrenia even before they develop any symptoms. For 10 years, we monitored 200 young people at risk of the illness.

‘There’s a huge amount of work and cost in the projects we do.’

I work in the University of Edinburgh’s Department of Psychiatry; a nine-storey tower block standing in the grounds of a hospital. I begin and end each day by checking on my hospital ward. Throughout the week, my routine includes seeing the inpatients and organising their treatment, meeting colleagues about plans for research and a whole day in the clinic on Thursdays. Every day, I see my junior medical staff, my secretaries and research team, including a collaborator who has worked with me for 30 years.

There is a huge amount of work and cost in the large projects that we do. While they are in progress, patients come in three or four days a week and I see them at lunchtimes. I enjoy it very much, but there are good and bad points. I’m pleased if one of the patients who has not been doing well begins to improve, or if one of the outpatients returns to work. I’m pleased if one of our papers is accepted in a top-class scientific journal. It’s marvellous when we get to the end of a big project and it has worked.

The bad points: it’s annoying if the brain scanner breaks down when we have patients in, or if the computers crash towards the end of a long calculation. The worst thing, of course, is if something goes wrong with one of the patients; if they wander away and no-one knows where they are, or if they seriously harm themselves. But this research is very important – as yet, there is no cure for schizophrenia. The situation is getting very much better but we still do not fully understand it.

Eve Johnstone, professor of psychiatry, University of Edinburgh

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