A 1994 alumnus of the University of Nebraska-Lincoln Department of Psychology is at the forefront of new research that could revolutionize the treatment of schizophrenia in the United States.
David Penn first began working with patients with schizophrenia as a doctoral student at UNL in the early 1990s.
Penn was a key participant in a recent landmark study that found significantly better results for schizophrenia patients who receive psychotherapy as well as drug treatment, particularly if treatment begins soon after a patient’s first psychotic episode.
The study, recently published in The American Journal of Psychiatry, was nationally touted as a “game changer.” The New York Times, Washington Post, CBS News and other major media outlets covered the findings.
“The individual psychotherapy that David designed for the national multi-site study of early intervention is the product of more than a decade of work he began at UNL,” said Will Spaulding, a psychology professor at UNL who was Penn’s dissertation adviser.
Penn is now director of psychological services at the Outreach and Support Intervention Services program, a clinic at the University of North Carolina Chapel Hill for patients experiencing a first psychotic episode. He has devoted much of his career to working with those with schizophrenia and credits UNL psychology faculty members Will Spaulding, Mary Sullivan and Debra Hope for influencing the direction of his career.
Before earning his doctorate from UNL, Penn conducted research at the Lincoln Regional Center, a state psychiatric hospital.
“I was first exposed to people with schizophrenia during my training at UNL,” he said. “I found they were people I really liked working with.”
Spaulding said Penn brought important new perspective to understanding schizophrenia.
“When David came to UNL and joined the Serious Mental Illness Research Group, we were developing the new idea that impaired cognition was a key unrecognized problem in schizophrenia,” he said. “We were focused on the elements of cognition – memory, attention, perception. David saw beyond that early work and was the first ever to propose, in a published journal article, that our focus should be social cognition, the more complex levels unique to humans.”
Penn continued to develop his idea after he finished graduate school and it became widely accepted, Spaulding said. His work was heavily influential when the National Institute of Mental Health standardized assessment of cognitive impairment in schizophrenia in the early 2000s.
“When the time came to design a new approach to treatment, early in the course of the illness, David was the go-to guy,” Spaulding said.
More than two million Americans have a diagnosis of schizophrenia. Treatment for most involves heavy doses of antipsychotic drugs to reduce hallucinations and delusions. However, many patients are reluctant to take the drugs because of side effects, such as weight gain, drowsiness and tremors.
Penn and a colleague designed a major component of the new treatment approach tested in the study, Individual Resiliency Training. He also was on the executive committee for the study.
The first nationwide, multi-site, randomized controlled trial of an early intervention method to be conducted in the nation, the study involved 404 patients at 34 clinics in 21 states, including the Lincoln-based Community Mental Health Center of Lancaster County.
Half the clinics used the specialized early intervention program developed by Penn, former UNC colleague Piper Meyer, now affiliated with the University of Minnesota; , psychologists Kim Mueser and Jennifer Gottlieb of Boston University; and Susan Gingerich, a consultant and trainer who works with people with schizophrenia and their families. The experimental treatment included family support and educational and vocational services along with medication and psychotherapy. The other half accessed typical services available in their communities, which could include medication management and case management.
Penn said the approach is intended to help patients build upon their strengths rather than focus only on symptoms. He said it can be heartbreaking to meet the family of someone who has been diagnosed with schizophrenia.
“Families look shell-shocked, as they try to come to grips with what has happened to their loved one,” he said.
“We can’t say that we’ve cured schizophrenia,” Penn said. “But we’re going to make a difference in individuals’ quality of life and reduce the likelihood that schizophrenia becomes a chronic illness. It gives individuals a better chance of leading more productive lives in the future.”