Mary V. Seeman

University of Toronto | U of T · Department of Psychiatry

Views about schizophrenia can change dramatically, even within one lifetime. In order to illustrate such changes over last forty-five years, this article uses the example of 'Mandy', a composite woman patient with a diagnosis of schizophrenia. It shows that, although there have been many advances over this period, understanding of schizophrenia con...

As you progress through life, you gather honours and recognition, symbolized by the size of your office. You meet successful older people who have reached their peak and, as your space gets larger, theirs gets smaller. Then yours starts to get smaller too. That's aging.

The story of a relationship.

Exhibitionism has been viewed through many lenses, from the perspectives of sexual deviance, forensic psychiatry, psychopathology, psychological dynamics, feminism, behaviorism, and psychopharmacology. Starting from the description of one psychotherapy patient, the aim of this paper is to synthesize this disparate literature. The findings of the sy...

As I grow old and struggle to cope with the infirmities of age, I marvel at the resilience of my patients who grapple with and overcome the indignities of schizophrenia. Schizophrenia research is mainly about the deficits, about the many difficulties patients face. It rarely celebrates the accomplishments of patients, their ability, on the whole, t...

Biphasic sleep, characterized by nighttime sleep plus daytime napping, has demonstrated some cognitive, health and performance impacts when compared with consolidated monophasic sleep. This motivated the development and validation of the Biphasic Sleep Scale, reported in this paper. Scale development involved a literature review, expert input and i...

Background Ghosting refers to the sudden cessation of communication in interpersonal relationships. Ghosting has gained attention as a phenomenon commonly encountered in the context of digital communication. Earlier studies on ghosting mostly focused on Western societies while, in Arab societies, research into this practice has yet to be initiated....

Introduction Artificial intelligence (AI) and virtual reality (VR) are useful tools that can improve precision medicine and can prove useful in the clinical care of patients with psychosis. Objectives Our aim was to determine whether AI and VR have been applied to the prediction of clinical response in women with schizophrenia. Methods A systemat...

Introduction There are many theoretical reasons to implement gender-specific care for schizophrenia. For all these reasons, the Mutua Terrassa-Functional Unit for Women with Schizophrenia was inaugurated in January 2023 in the context of a community mental health service. Objectives Our aim today is to describe the health care model applied in thi...

Objective To prevent eating disorders in future physicians, this umbrella review and meta-analysis of previous meta-analyses estimates the prevalence of disordered eating (DE) among medical students worldwide and identifies key risk factors. Methods Four databases were searched electronically between their inception and February 1, 2023. The searc...

Introduction Artificial intelligence (AI) and virtual reality (VR) are useful tools involved in precision medicine, even in the clinical care of patients with psychosis. Objectives We aimed to provide an overview of potential applications of AI and VR in the prediction of clinical response in women with schizophrenia. Methods A systematic review...

Introduction There are many theoretical reasons to implement gender-specific care for schizophrenia. The Mutua Terrassa-Functional Unit for Women with Schizophrenia was inaugurated in January 2023 in the context of community mental health services. Objectives We aimed to describe the health care model applied in our newly initiated unit. Methods...

1.Objectius: El nostre principal objectiu és descriure els 5 observatoris de salut i risc psicosocial de la recentment creada UFDE i les intervencions específiques dissenyades per a dones amb esquizofrènia. 2.Mètodes: L’any 2022, als Centres de Salut Mental d’Adults (CSMAs) de Mútua Terrassa es van atendre 399 dones amb esquizofrènia. Al gener de...

General food frequency questionnaires (FFQs) have not been tailored for or validated in individuals with psychiatric disorders. Given the unique eating behaviors of patients with serious mental illnesses (SMIs), custom-made tools are needed. Therefore, we developed and validated an FFQ customized to individuals with SMIs. A total of 150 adults with...

Background: “Ghosting” refers to the practice of abruptly cutting off all contact with a person with whom you have been in constant correspondence. The break comes without warning and without understandable provocation. The term most commonly applies to online romantic relationships. The motives for and effects of ghosting have been studied, and va...

Background There are relatively few data about the association between locus of control and weight loss in Arabic populations. A tool does exist, the Dieting Belief Scale (DBS), that was designed to measure individuals’ beliefs regarding their ability to control their body weight. The aim of this study was to translate this tool into Arabic and to...

Background The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence. Methods Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The propor...

This entry is adapted from the peer-reviewed paper 10.3390/healthcare11212882 Being a good parent is a very difficult task, made more difficult in the context of serious psychiatric illness such as schizophrenia. The symptoms of the disorder are aggravated by the associated stigma, by poverty, social isolation, and adverse life circumstances. Mot...

A diagnosis of schizophrenia implies severe lifelong symptoms and significant disability.The aim of this chapter is to discuss aspects of life lived with schizophrenia that are important to address clinically in order for that life to be experienced as meaningful and valued. The chapter covers the definition of schizophrenia, its causes and its tre...

This entry synthesizes the multidisciplinary literature on ghosting published through late 2023 across psychological and social science journals. Search terms include "ghosting" and "online dating." Both quantitative and qualitative studies are included. The rise in ghosting can be attributed to advancements in technology and the increased populari...

Effective clinical management of women with schizophrenia is therapeutically challenging. While there have been recent advances in the understanding of neurobiological, hormonal, and female reproductive cycle factors that play a decisive role in the development and progression of schizophrenia in women, this knowledge has not yet been fully transla...

Resumen: En los Centros de Salud Mental de Adultos (CSMAs) del Hospital Universitari Mutua Terrassa, en enero de 2023, iniciamos un proyecto piloto de innovación asistencial denominado Unidad Funcional para Mujeres con Esquizofrenia. El objetivo principal de esta comunicación es describir el proceso de designación de las mujeres diana en la unidad...

Introduction: Active learning methods (ALM) are teaching methods aiming to actively engage students in the learning process. In healthcare systems, AL is critical to good practice and useful for updating and sharing medical evidence. Aims We aimed to describe two ALM as applied to the clinical care of women with schizophrenia-spectrum disorders (S...

Introduction: The Mutua Terrassa-Functional Unit for Women with Schizophrenia is a community mental health services pilot project initiated in January 2023 with the aim of improving physical and mental health as well as social risk in women with schizophrenia-related disorders. Aims: Our goal was to describe the implementation of five newly initi...

Background and Aims: There has been no previous investigation into the relationship between serum β-carotene levels and metabolic syndrome in patients with schizophrenia. This research aims to explore the association between schizophrenia, metabolic syndrome, and serum β-carotene levels. Specifically, this study addresses this knowledge gap and ex...

Severe psychiatric disorders such as schizophrenia are inevitably linked to unemployment, meagre per capita income, and residence in disadvantaged, poorly resourced neighbourhoods. This means difficult access to healthy food and is particularly problematic for pregnant women and mothers with children to feed. The necessity of taking antipsychotic d...

Despite the fact that most persons with schizophrenia find steady employment difficult to sustain, many women with this diagnosis embrace and fulfill the most difficult task of all—motherhood. The aim of this paper is to specify the challenges of motherhood in this population and review the treatment strategies needed to keep mothers and children s...

Introduction: Active learning methods (ALM) are teaching methods meant to actively engage students in the learning process. In healthcare systems, AL is critical to good practice and useful for updating and sharing medical evidence. Aims: We aimed to describe two ALM as applied to the clinical care of women with schizophrenia-spectrum disorders (SS...

Introduction: The Mutua Terrassa-Functional Unit for Women with Schizophrenia is a pilot project of the community mental health services that was initiated in January 2023 with the aim of improving physical and mental health as well as reducing social risk in women with schizophrenia and related disorders. Aims: Our goal is to describe the five n...

Introduction: Several factors have been identified as potential contributors of mental health service underusage in people suffering from schizophrenia and related disorders [1]. Travel distance to care provision and restricted service hours are recognized deterrents. Personality features, perception of adverse treatment effects and cognitive defic...

Introduction: There are many theoretical reasons to implement gender-specific care for schizophrenia. For instance, women with this disorder require physical health interventions that differ, in many ways, from those of men [1,2]. Because guidelines are written with men in mind, the vast majority of the literature indicates that women with schizoph...

In comparison to the general population, trauma-related disorders have been reported with more frequency in patients who suffer from severe mental illness (SMI). Moreover, several studies have found that sexual abuse in more prevalent in women with schizophrenia than in their male peers. We found that women suffering from schizophrenia were at high...

The presentation of schizophrenia differs significantly between men and women, and this influences treatment strategies. The major differentiating factors include age of onset, symptom differences, parenting responsibilities, response to antipsychotic medications, and care during the transition to menopause.

The current development in the field of artificial intelligence and its applications has advantages and disadvantages in the digital age that we now live in. The state of the use of AI for mental health has to be assessed by stakeholders, which includes all of us. We must comprehend the trends, gaps, opportunities, challenges, and shortcomings of t...

Men and women, for biologic and sociocultural reasons, differ in the nature of their risks for schizophrenia and also in their care needs. Women with schizophrenia have several reproduction-associated risks and care needs that require special clinical consideration. They also have several specific risks related to antipsychotics and gender-associat...

Objective: Medical students frequently experience a range of stressors, such as demanding academic requirements, competition and rivalry, self-doubt, and financial distress. As a result, they are at risk for psychological and behavioral symptoms (PBS) including: depression, anxiety, and sleep difficulties as well as maladaptive substance use. Metho...

Women with schizophrenia have specific health needs that differ from those of men and that change through successive life stages. We aimed to review the biopsychosocial literature on schizophrenia that addresses clinically important questions related to the treatment of women, namely, somatic morbi-mortality, hyperprolactinemia, co-morbid substance...

Faith healing is a traditional healing method involving spiritual and faith-based practices performed by a religious medicine man, referred to here as a faith healer. The practice of faith healing is widespread in the Arab World for treating a range of mental disorders. This research aims to review the literature concerned with faith healing practi...

Background We explored the relationship between symptoms, cognitive performance, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) (three markers of inflammation), and antipsychotic dose (in chlorpromazine units) in male and female patients with schizophrenia. Methods We conducted a cr...

Several aspects of schizophrenia differ considerably between men and women and influence treatment strategies. The most important differentiating factors are the age of onset, symptom differences, response to antipsychotic medications, parenting responsibilities, and care during the menopausal transition. Age of Onset and Differences in Symptoms: T...

Introduction Women with schizophrenia require health interventions and safe spaces sufficiently different from those of men. Objectives To describe units in two mental health outpatient services specialized in the treatment of women with schizophrenia and related disorders. Methods Two units in Spain projected to treat women with schizophrenia an...

Introduction: The health impact of the COVID-19 pandemic has been widely recognized in both physical and mental health, but little specific attention has been paid to patients with delusional disorder (DD). Objectives: Our goal was to synthesize the known mental and physical health consequences of the COVID-19 pandemic in patients diagnosed with D...

Social risk factors are long-term or repeated environmental exposures in childhood and youth that change the brain and may, via epigenetic effects, change gene expression. They thus have the power to initiate or aggravate mental disorders. Because these effects can be mediated via hormonal or immune/inflammatory pathways that differ between men and...

Delusional disorder (DD), once entrenched, responds poorly to currently available treatment. This calls for community and individual preventive measures. Our goal was to conduct a literature review exploring the possibilities of prevention. This narrative review is based on a search of the PubMed database from its inception until July 2022. While n...

The topic of “ghosting” as a method of terminating a relationship has been discussed in both popular media and academic circles. Although research on this issue is scarce, the concept has acquired popularity and gained scholarly attention. A reliable and valid measure of this phenomenon does not, however, exist. GHOST (The Ghosting Questionnaire) w...

Introduction: The transition from reproductive to menopausal status constitutes a major rite of passage for women, biologically, psychologically, and socially. For women with a diagnosis of schizophrenia, this stage of life is complicated by worsening psychotic symptoms and diminished effectiveness of antipsychotic drugs. This frequently leads to...

The presence of medical co-morbidities in women with psychotic disorders can lead to poor medical and psychiatric outcomes. Of all co-morbidities, cardiovascular disease is the most frequent, and the one most likely to cause early death. We set out to review the evidence for cardiovascular risk factors (CRFs) in women with schizophrenia-related dis...

There are limitations to what can be learned from studies reporting on the effect of antipsychotic drugs (AP) on the gut microbiome. The specific results of most studies await replication. It is known, however, that the gut and the brain are in constant communication and that many brain diseases are associated with changes in the gut microbiome. So...

Introduction: The health impact of the COVID-19 pandemic has been widely recognized in both physical and mental health. Relatively little attention has been paid to patients with delusional disorder (DD). Aims: Our goal was to synthesize the known mental and physical health consequences of the COVID-19 pandemic in patients diagnosed with DD. Meth...

Introduction: Delusional memories or retrospective delusions have been extensively reported in post-critical study participants during or after intensive care stays . Patients report unreal experiences, unexplained feelings, or panic attacks. In major psychoses, classical authors have observed delusional memories impacting prognosis and mental well...

Introduction: Women with schizophrenia require health interventions and safe spaces somewhat different from those of men. Objectives: To describe units in two mental health outpatient services specialized in the treatment of women with schizophrenia and related disorders. Methods: Two units in Spain have organized to treat women with schizophreni...

Introduction: The accurate examination of attributional patterns and cognitive biases in delusional patients is relevant to the explanation of the externalizing tendency in paranoid schizophrenia patients. In subjects with delusional disorder (DD), attributional styles and other cognitive bias have, in the past, been poorly investigated. Objective...

Schizophrenia is a mental disorder with sex bias in disease onset and symptom severity. Recently, it was observed that females present more severe symptoms in the perimenstrual phase of the menstrual cycle. The administration of estrogen also alleviates schizophrenia symptoms. Despite this, little is known about symptom fluctuation over the menstru...

Introduction: Women with high illness severity, low social support, and children at home, require home-based services to promote clinical engagement, prevent re-hospitalization, and manage complex life events.Visiting clinicians are given the opportunity to observe daily routines, evaluate family safety, and housing adequacy, as well as solidify th...

Women with schizophrenia require health interventions that differ, in many ways, from those of men. The aim of this paper is to review male and female care needs and describe a newly established care unit for the treatment of women with schizophrenia. After reviewing the literature on the differentiated needs of men and women with schizophrenia, we...

Background: Compared to other psychotic disorders, there is little information about staging care in delusional disorder (DD). Unlike schizophrenia, this is a disorder that begins in middle age, a time at which chronic medical comorbidities have already begun to impact global functioning. With age, the combination of psychological and somatic condi...

Background: The way how technology addiction relates to psychosis remains inconclusive and uncertain. The present study aimed to test the hypothesis of a mediating role of depression, anxiety and stress in the association between three technology (behavioral) addictions (i.e., Addiction to the Internet, smartphones and Facebook) and psychosis prone...

The words one chooses to describe personal pain mirror current usage, but may also hold echoes of an individual’s lived experience. They may provide clues to the origin of physical symptoms that are medically hard to explain. The aim of this commentary is to propose, on the basis of the available literature, that verbal metaphors can prove effectiv...

Arvid Carlsson was clairvoyant in many of his educated guesses in 1983. He foresaw the importance of the role of the dopamine autoreceptor. He realized that the efficacy of antipsychotic drugs would require the involvement of several neurotransmitters and he appreciated the fact that schizophrenia would turn out to be a heterogeneous disorder. In 1...

Several factors have been identified as potential contributors of mental health service underusage in people suffering from schizophrenia and related disorders. Travel distance to care provision and restricted service hours are recognized deterrents to seeking care. Personality features, perception of adverse treatment effects and cognitive deficie...

Schizophrenia, like many other human diseases, particularly neuropsychiatric diseases, shows evidence of accelerated brain aging. The molecular nature of the process of aging is unknown but several potential indicators have been used in research. The concept of accelerated aging in schizophrenia took hold in 2008 and its timing, pace, determinants...

Introduction: Bipolar disorder (BD) is a serious mood disorder characterized by the occurrence of episodes of both mania and major depression [1]. This disorder has long been associated with the concept that creativity is associated with manic phases. In studies of the biographies of well-known artists with BD, time periods of productivity positive...

This article is an attempt to provide a current and comprehensive definition of schizophrenia. El artículo presenta la definición actual y comprehensible de la Esquizofrenia, incluyendo todos los aspectos que involucran al concepto.

Gender-specific services for women with schizophrenia and related disorders are an important resource that can, by providing optimal care, improve patient well-being, function, and quality of life.

For many decades, delusional disorder (DD) has been considered a treatment-resistant disorder, with antipsychotics acknowledged as the best, though imperfect, treatment. It is possible that the discovery of the right drug could turn treatment resistance into treatment response. The goal of this narrative review is to provide a historical perspectiv...

NOMOPHOBIA, or NO MObile PHone Phobia, refers to a psychological condition in which people fear being disconnected from their mobile phones. The purpose of this review was to establish the prevalence of nomophobia symptoms in youth and adulthood according to severity, country, culture, population, measurement tool, and year of data collection. An e...

Background: Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to con...

Introduction Bipolar disorder (BD) is a serious mood disorder characterized by the occurrence of episodes of both mania and major depression [1]. This disorder has long been associated with the concept of creativity being associated with manic phases. Essentially, studying the biographies of well-known artists with BD, time periods of productivity...

Introduction Rational pharmacotherapy has been defined as the appropriate, safe, effective and economical prescription of medications [1]. In the context of first-episode of psychosis, evidence links this concept to the early detection and diagnosis, and the appropriate treatment at the initial stages of disease [2]. Differences in antipsychotic d...

Philip Seeman's isolation of the dopamine D2 receptor is an example of a small step that can lead to major change in the way that we conceptualize the etiology of schizophrenia.

Background: It has been hypothesized that, whenever estrogen levels decline, psychosis symptoms in women increase. At menopause, this can happen in two main ways: (a) the loss of estrogen (mainly estradiol) can directly affect central neurotransmission, leading to increase in schizophrenia-related symptoms, and (b) the loss of estrogen can decrease...

Telepsychiatry is a method of providing mental health care to patients in the community without service user and care provider needing to meet face-to-face. Because a substantial number of psychiatric patients prefer to remain socially isolated, treatment at a safe remove from human contact is, in most cases, very welcome. This is not a new concept...

Schizophrenia is a mental disorder with sex bias in disease onset and symptom severity. Recently, it was observed that females present more severe symptoms in the perimenstrual phase of the menstrual cycle. The administration of estrogen also alleviates schizophrenia symptoms. Despite this, little is known about symptom fluctuation over the menstru...

Background: There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age. Aims: The aim of this narrative review is to synthesize th...

It has been hypothesized since the 1960s that the etiology of schizophrenia is linked to dopamine. In the intervening 60 years, sophisticated brain imaging techniques, genetic/epigenetic advances, and new experimental animal models of schizophrenia have transformed schizophrenia research. The disease is now conceptualized as a heterogeneous neurode...

Introduction Women present a second peak of incidence of psychosis during menopausal transition, partially explained by the loss of estrogen protection conferred during the reproductive years. Despite this, few studies compare sociodemographic, biological, clinical varibles and neurocognitive performance between women with early onset of psychosis...

Introduction Delusional disorder (DD) has been traditionally considered a drug-resistant disorder, resistance being attributed to a number of moderating and mediating factors. Our objective was to identify these factors. Methods We conducted a literature search in PubMed and Google Scholar (1990-2021) to identify factors responsible for drug t...

Background: While sex differences and gonadal hormone levels are taken seriously in the understanding and treatment of schizophrenia, their influence in the psychopathology of delusional disorders (DD) remains unknown. Methods: Our strategy was to conduct a narrative review of the effects of (a) sex/gender difference and (b) menopause on delusional...

This commentary summarizes my view of my life's work in psychiatry, which has mainly been devoted to my obsessive interest in sex and gender differences in schizophrenia. I summarize the influences that guided my research and I take the opportunity to make some personal recommendations to future researchers.

The theme, strength, and duration of a delusion are considered important in distinguishing one psychosis of old age from another. Research results, however, are mostly based on studies conducted on one form of psychosis, namely schizophrenia. The aim of this hypothesis-driven narrative review is to gather clinically important information about the...

Sex differences are prevalent in multiple mental disorders. Internalizing disorders are more commonly diagnosed in women, whereas externalizing and neurodevelopmental disorders are more often diagnosed in men. Significant sex/gender differences are reported in prevalence, symptom profile, age of onset, comorbidities, functional impairment, prognosi...

This is a poster of a comparison between 294 1st episode psychosis women patients and 202 control women of similar age. We compared symptoms and cognitive scores between these two groups and also between 1st episode patients with early onset and those whose illness onset was over age 40. Women with later onset had less severe symptoms and higher co...

Psychotic syndromes are divided into affective and non-affective forms. Even among the non-affective forms, substantial differences exist. The aim of this relatively brief review is to synthesize what is known about the differences between two non-affective psychoses, schizophrenia and delusional disorder (DD), with respect to clinical, epidemiolog...

By exploring postsynaptic dopamine receptor sensitivity at the hypothalamic-pituitary level, neuroendocrine responsiveness to the apomorphine (APO) challenge test provides an indirect measure of central dopamine function. The goal of this narrative synthesis is to summarize recent evidence on hormonal response to APO in patients with affective and...

Introduction and Aims: Non-adherence to psychotropic medications has been associated with poor clinical outcomes in psychosis [1,2]. Although adherence research is highly developed in schizophrenia, few studies have addressed the important issue of adherence in delusional disorder (DD) patients [3,4]. Our main goal was to systematically review pote...