Mary V. Seeman

Mary V. Seeman
University of Toronto | U of T · Department of Psychiatry

Mary V. Seeman OC MDCM FRCPC DSc

About

639
Publications
282,180
Reads
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10,223
Citations
Introduction
Additional affiliations
July 1985 - July 1993
Mount Sinai Hospital, Toronto
Position
  • Psychiatrist
Description
  • Psychiatrist-in-Chief
July 1975 - July 2013
Centre for Addiction and Mental Health
Position
  • psychiatrist
Description
  • At Mt. Sinai Hospital between 1985 and 1993
September 1967 - present
University of Toronto
Description
  • Research in schizophrenia with clinical populations
Education
July 1951 - June 1961
McGill University
Field of study
  • Romance Languages

Publications

Publications (639)
Article
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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, their gets smaller. Then yours starts to get smaller too. That's aging.
Article
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Psychosocial programs that introduce young people with psychosis to each other encourage bonding and, perhaps, marriage. By providing such programs, are we unwittingly promoting assortative mating, with ill effects for offspring? Or, on the other hand, are we ensuring better health for young people with psychosis and perhaps laying the groundwork f...
Data
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The story of a relationship.
Article
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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...
Article
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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...
Chapter
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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...
Chapter
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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...
Preprint
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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...
Article
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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...
Article
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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...
Article
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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...
Article
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...
Conference Paper
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...
Article
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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...
Article
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From the time of conception and until old age, sex and gender shape humans in a multitude of ways, leading to marked gender differences across most mental disorders. Women have higher rates of internalizing disorders (e.g. depression, anxiety, eating disorders, OCD, borderline personality disorder) and a higher risk of suicide attempts, whereas men...
Article
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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.
Article
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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...
Poster
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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...
Article
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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...
Article
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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...
Article
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...
Poster
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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...
Poster
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Background: For many decades, delusional disorder (DD) has been considered a difficult-to-treat disorder with poor clinical outcome. Prior research indicates that antipsychotics and antidepressants are the main treatments used for DD [1,2], while psychotherapy, particularly cognitive behavioral therapy (CBT), is the treatment based on the best effi...
Article
Full-text available
Women present a second peak of incidence of psychosis during the menopausal transition, partially explained by the loss of estrogen protection conferred during the reproductive years. In view of the lack of studies comparing sociodemographic, biological, and clinical variables and neurocognitive performance between women with early onset of psychos...
Article
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The current Russian war against Ukraine is of global concern. It builds on the annexation of Crimea in 2014 and subsequently the war in the Donbas region of Ukraine, and has become a large-scale Russian invasion of Ukraine from three directions, Crimea in the south, Russia in the east, and Belarus in the north. Despite the geopolitical background t...
Article
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Background: Adherence to medication regimens is of great importance in psychiatry because drugs sometimes need to be taken for long durations in order to maintain health and function. Objective: To review influences on adherence to antipsychotic medications, the treatment of choice for delusional disorder (DD), and to focus on adherence in women w...
Article
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Some research suggests that distress, secondary to isolation and fear following COVID-19 infection, can negatively affect the long-term more than the COVID-19 infection itself. This narrative review aims to provide a global view on the neuropsychiatric consequences of COVID-19 that can be ascribed to several factors, ranging from the direct effect...
Article
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This annual International Holocaust Remembrance Day marks the rise in anti-Semitism across the world. Can psychiatry help to prevent the scapegoating of innocent individuals for irrational reasons?
Article
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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.
Article
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The recent hostage situation at a synagogue in Texas in indicative of an underlying social problem. To overcome the problem of hatred, we need to live the messages of the holidays we celebrate at this time of the year. In an unusual confluence, January 17 is the annual Martin Luther King Jr. Day, the Jewish Tu B’Shivat celebration of environmental...
Article
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Sex and age are important factors influencing physical and mental health in schizophrenia. Our goal was to review the recent literature for associations between gynecological conditions and psychotic illness and to propose integrated strategies for their management in order to improve overall health outcomes in women. We addressed the following que...
Poster
Introduction: Since Kraepelin's time, the nosology of delusional disorder (DD) has been a subject of debate. The condition has been considered by some to be a form of affective illness. More recently, various studies report the prevalence of affective comorbidity in DD to range between 21-55.8%. This explains why many patients are treated with a co...
Article
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Despite significant advances in antiretroviral therapy, unmet basic needs can negatively impact health-related quality of life (HRQoL) in people living with HIV, especially as they age. We aimed to examine the effect of unmet basic needs across age groups on changes in HRQoL over a 4-year period in persons with HIV. Physical and mental HRQoL scores...
Article
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Although blockade of dopamine receptors D2 and D3 appears to be the main mechanism of antipsychotic action, treatment response variability calls for an examination of other biological systems. Our aim is to systematically review reports of treatment response in delusional disorder (DD) in order to help determine its biological bases. Computerized s...
Article
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This brief article summarizes the contributions of Philip Seeman to the understanding of the role of dopamine receptors in the etiology of schizophrenia and in the mode of action of antipsychotic drugs.
Article
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Delusional disorder (DD) is an underresearched psychotic disorder characterized by the presence of monosymptomatic delusions on a background of relatively well-preserved global functioning. Prominent hallucinations and significant affective symptoms are absent and response to treatment is poor due at least partially to a lack of adherence to antips...
Article
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Background: Sex and gender differences have been reported in the prevalence, expression, treatment response, and outcome of schizophrenia, but most reports are based on relatively small samples that have not been stratified for the impact of sex hormone levels. This literature review aims to show how women's hormone levels can impact the results o...
Article
Objective: This study used meta-analysis to assess disparities in cardiovascular disease (CVD) screening and treatment in people with mental disorders, a group that has elevated CVD incidence and mortality. Methods: The authors searched PubMed and PsycInfo through July 31, 2020, and conducted a random-effect meta-analysis of observational studies c...
Article
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What can be done about Afghanistan? Individual mental health professionals can write to politicians and speak publicly about the issues. They can raise awareness about the far-reaching effects of trauma. They can advocate for urgent evacuations of Americans, Coalition Forces, Afghan allies, and vulnerable women and children. The World Psychiatric A...
Article
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A delusion of parasitosis is defined as the fixed, false belief of infestation by invisible organisms or fibrous material of unknown origin. The differential diagnosis is true infection, substance use disorder, dementia or other neuropsychiatric disease. Our goal was to characterize delusions of parasitosis, classically named Ekbom syndrome, among...
Article
The dopamine hypothesis of how antipsychotic drugs exert their beneficial effect in psychotic illness has an interesting history that dates back to 1950. This hypothesis is not to be confused with the dopamine hypothesis of schizophrenia; the aim of the latter is to explain the etiology of schizophrenia. The present review does not deal with schizo...
Article
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In all cultures there is a place for illness that is not easily explained by individual pathology. It is usually attributed to larger societal unrest, with some individuals responding to that unrest with somatic or psychological symptoms. When a community is stressed, by natural disasters or by wars, by feelings of powerlessness, loss, or insecurit...
Article
Background: Alcohol use disorders, defined as the maintenance of alcohol use for at least a 12-month period despite negative psychological, biological, behavioral and social consequences, are frequently associated with psychotic symptoms. Objective: Our aim in this paper is to review alcohol-related clinical conditions that are accompanied by psych...
Article
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Promotion of good mental health, prevention, and early intervention before/at the onset of mental disorders improve outcomes. However, the range and peak ages at onset for mental disorders are not fully established. To provide robust, global epidemiological estimates of age at onset for mental disorders, we conducted a PRISMA/MOOSE-compliant system...
Article
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Social distancing, also referred to as physical distancing, means creating a safe distance of at least two metres (six feet) between yourself and others. This is a term popularized during the COVID-19 pandemic, as it is one of the most important measures to prevent the spread of this virus. However, the term “social distancing” can be misleading, a...
Article
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FIRST MAN: We should defend ourselves. An eye for an eye, a tooth for a tooth. TEVYE: Very good. And that way, the whole world will be blind and toothless. - From 1970 script of the play “Fiddler on the Roof” and often attributed to Mohandas Gandhi
Article
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The World Health Organization (WHO) developed a 7-year Mental Health Action Plan in 2013, which recommends integration of health and social care services into community-based settings, implementation of strategies for health promotion and prevention of illness, and support of research. In this review, we highlight partial hospitalization programs (...
Poster
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Introduction A delusion of parasitosis is defined as the fixed, false belief of infestation by invisible organisms or fibrous material of unknown origin. The differential diagnosis is true infection, substance use disorder, dementia or other neuropsychiatric disease. Aims Our goal was to characterize delusions of parasitosis, classically named Ekb...
Poster
Full-text available
Introduction In order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up. Aims This poster describes a sample of DD patients referred to a specialized unit for DD...
Conference Paper
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Introduction: Treatment response in schizophrenia can be influenced by cultural and ethno-biological factors. However, in delusional disorder (DD), these potential influences have been poorly investigated. Aims: This review aims to synthesize what is known about the influence that cultural and biological factors may have on treatment response in DD...
Poster
Full-text available
Introduction Antipsychotics have been classically considered the treatment of choice for delusional disorder (DD) and antidepressant medications have been restricted to patients with comorbid depression. Objectives Our aim is to describe the case of a patient with DD with delusions of parasitosis, who responded to paroxetine as monotherapy. We als...
Article
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Background: Animal and human experiments have confirmed sex differences in the expression of hepatic enzymes that metabolize antipsychotic drugs and that may, in this way, be partly responsible for the clinical sex/gender differences observed in the efficacy and tolerability of antipsychotic treatment. Aim: The aim of this mini review is to synthes...
Article
Introduction: Treatment response in schizophrenia can be influenced by cultural and ethno-biological factors. However, in delusional disorder (DD), these potential influences have been poorly investigated. Objectives: This review aims to synthesize what is known about the influence that cultural and biological factors may have on treatment respons...
Article
Introduction Antipsychotics have been classically considered the treatment of choice for delusional disorder (DD) and antidepressant medications have been restricted to patients with comorbid depression. Objectives Our aim is to describe the case of a patient with DD with delusions of parasitosis, who responded to paroxetine as monotherapy. We als...
Article
Introduction In order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up. Objectives This poster describes a sample of DD patients referred to a specialized unit f...
Poster
Objectives The main goal of our study is to describe the “matchbox sign” in patients with delusions of infestation attending our emergency department. In a second step, we aimed to compare clinical features between patients who presented the “matchbox sign” and those who did not and whether they differed in attendance rates to other medical service...
Article
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Introduction: Most medical diagnoses present somewhat differently in men and women, more so at specific periods of life. Treatment effects may also differ. This is true for schizophrenia, where premorbid effects are experienced earlier in life in boys than in girls, and where symptoms and outcomes differ. Areas covered: This review does not cove...
Article
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It is time for a new comprehensive journal about women [...]
Article
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Many patients with schizophrenia seem relatively immune to physical pain while others complain of constant pain. This may result from disturbances or alterations of the sensory threshold for pain in populations with psychosis, a possibility for which there is some preliminary evidence. The inconsistency in pain perception may, in part, be explained...
Article
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Delusional disorder is a difficult-to-treat clinical condition with health needs that are often undertreated. Although individuals with delusional disorder may be high functioning in daily life, they suffer from serious health complaints that may be sex-specific. The main aim of this narrative review is to address these sex-specific health needs an...
Article
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Patients with psychosis usually respond to one antipsychotic drug and not to another; one third fail to respond to any. Some patients, who initially do well, stop responding. Some develop serious side effects even at low doses. While several of the reasons for this variability are known, many are not. The aim of this review is to explore the potent...
Article
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A first step towards personalized medicine is to consider whether, for some disorders, the safest and most effective treatment of women needs to differ from standard guideline recommendations developed on the basis of clinical trials conducted, for the most part, in men. A second step is to consider how women’s reproductive stages—pre-pubertal year...
Article
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Stigma differentiates young men and women with psychosis. Young men are often feared and considered dangerous. Law enforcement is called when such men behave unpredictably; they are involuntarily admitted, placed in restraints, and maintained on long-acting injectable medication. Women who show similar behaviour are more gently treated, but are sti...
Article
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It is best to regard psychiatric diagnoses as nothing more than a name for a set of symptoms and signs at a given time.It rarely implies causation or prognosis, although recurrence of similar symptoms does predict further recurrence. What psychiatrists most want of a diagnosis – the ability to guide researchers back to risk factors and fundamental...
Chapter
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The Forum invited experts on the history of the Second World War, the Holocaust, and Nazi euthanasia to answer question about mass violence against patients in psychiatric clinics in Eastern Europe and about decision-making and participation in this crime by various groups. The authors generally agree with the thesis that events proceeded erratical...
Negative Results
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I read Jack R. Foucher et al.'s paper on WKL phenotypes with some difficulty. My brain these days doesn't take in so many details in one reading and this classification system is new to me. I am amazed that the 35 phenotypes described have good reliability and validity. The diagnosticians must have phenomenal memories to keep all the criteria strai...
Article
Full-text available
The Forum invited experts on the history of the Second World War, the Holocaust, and Nazi euthanasia to answer question about mass violence against patients in psychiatric clinics in Eastern Europe and about decision-making and participation in this crime by various groups. The authors generally agree with the thesis that events proceeded erratical...
Article
Full-text available
The dopamine hypothesis of schizophrenia is attributed to Jacques M. Van Rossum. Noticing that drugs such as L-dopa or amphetamine, which enhance dopaminergic activity, are able to induce or exacerbate psychosis, and that drugs such as chlorpromazine and related drugs (then called neuroleptics) reversed psychosis, Van Rossum (1967) wrote: “When the...
Article
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Many questions pertaining to delusional disorder (DD) remain unanswered. It is unclear what syndromes to include under this category of psychotic illness and when to treat with antidepressants, cognitive therapy, or antipsychotic medication. DD is associated with psychiatric comorbidity, especially depression, and rates of suicidal behavior are hig...
Article
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“Today, it is generally agreed that the initiation of the treatment of Parkinson's disease with L-dopa represented one of the triumphs of pharmacology of our time. L-dopa's unprecedented success proved, for the first time, that therapeutic neurotransmitter replacement in a chronic, progressive, degenerative brain disease (until then regarded as bas...
Article
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The observation that a person’s sex influences the onset age of schizophrenia, the course of the disease, and antipsychotic treatment response suggests a possible role for estrogen receptors in the pathophysiology of schizophrenia. Indeed, treatment with adjunctive estrogen or selective estrogen receptor modulators (SERMs) are known to reduce schiz...
Poster
Background The estrogen protection hypothesis in schizophrenia supports the notion that women are protected by estrogens from menarche until menopause. The loss of neuroprotection beginning in the run up to menopause may increase the risk of acute exacerbations. Case report A 47-year-old woman was referred to our day hospital because of delusions...
Poster
Background Although gender differences in psychopathological symptoms and clinical features of schizophrenia have been well-documented, they have been poorly investigated in delusional disorder (DD). Aims Our goal was to explore gender differences in sociodemographic and clinical variables in DD. Methods This narrative, non-systematic, critical r...
Negative Results
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In response to Persaud et al. (1), thank you for bringing the contributions of Thomas Augusta and Anderson Ruffin Abbott to the awareness of the medical community. Osler doesn’t need revisiting and revision because he made an indelible impression on his thousands of students that they, in turn, passed on to the generations of students that followed...
Article
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This Research Topic highlights the key role of neuroendocrinological and immune-inflammatory factors in the development, maintenance, and outcome of psychotic disorders. The papers in the issue summarized here clearly show that body and mind are one, and that a holistic approach is vital for the effective clinical management of patients with psycho...
Article
Aripiprazole is approved in different countries as treatment for several mental disorders, but its transdiagnostic potential has not yet been assessed according to established criteria such as the recently proposed TRANSD criteria. The present work aims to test whether aripiprazole monotherapy could be considered a transdiagnostic intervention. An...