Mogens Schou
Encyclopedia
Mogens Schou was a Danish
psychiatrist whose groundbreaking research into Lithium
led to its utilization as a treatment for bipolar illness. His work ultimately benefited thousands of patients worldwide.
, Denmark
, on 24 November 1918. His father was a psychiatrist and medical director of a large mental hospital. Schou chose to study medicine with a specific view to doing research on manic-depressive illness (now more commonly referred to as bipolar disorder
). He graduated with a degree in medicine from the University of Copenhagen
in 1944. After his training in clinical psychiatry he also studied experimental biology.
The psychopharmacological era began in earnest in 1949, with the article published by John Cade
about the observed antimanic action of Lithium
in Australia. Intrigued by these findings Schou, who in the meantime joined the Psychiatric Research Institute of the Aarhus University in Denmark, confirmed these findings in a double-blind placebo-controlled study with his co-workers. This marked the beginning of Schou's illustrious association with lithium.
Since then, there have been a number of interlinked research themes that run through Schou's work. In the 1960s, Schou and Poul Baastrup discovered that long-term lithium treatment prevents the recurrences of illness in bipolar and some unipolar patients and they were understandably exhilarated.
During the early 1960s, G. P. Hartigan, Poul Chr. Baastrup and Schou independently made sporadic observations that were suggestive of lithium also having prophylactic properties in manic-depressive illness. Subsequently, Baastrup and Schou joined together and in a non-blind lithium trial saw their preliminary observations confirmed. They even deemed the results so significant that they concluded that ‘lithium is the first drug demonstrated as a clear-cut prophylactic agent against one of the major psychoses’.
However, the Schou-Baastrup prophylaxis hypothesis was met with great resistance by British psychiatry. To Aubrey Lewis
and Michael Shepherd
, lithium was ‘dangerous nonsense’. Shepherd, seconded by Harry Blackwell, simply characterized it as ‘a therapeutic myth’, which, in their opinion, was based on ‘serious methodological shortcomings’ and ‘spurious claims’. Even terms such as unethical and unscientific were used. After painful consideration of the ethical aspects invoked, Schou and Baastrup undertook a unique double-blind trial of prospective-discontinuation design and with random allocation of manic-depressive patients (already on lithium) to lithium or placebo, unparalleled in psychiatry. It fully confirmed their hypothesis, published in The Lancet
in 1970. Thus, lithium prophylaxis had also become established as evidence based. Lithium became the first-choice mood stabilizer in bipolar affective disorder.
He was aware of some of the limitations of lithium treatment. He welcomed the introduction of other prophylactic agents into the market. From the available observations he concluded, however, that anti-epileptics and atypical anti-psychotics act on different kinds of bipolar patients to lithium.
After he discovered lithium's prophylactic action in mood disorders, he tirelessly researched all its aspects and did not spare any effort to make the treatment available to all those in need. Millions of patients with recurrent mood disorders benefited because of his research. In 1990, authorities on manic-depressive illness such as Fred Goodwin and Kay Redfield Jamison
characterized the ground-breaking discovery of lithium prophylaxis as ‘one of the most important advances in modern psychiatry’.
He was an author of more than 500 publications, including texts, research papers, articles and book chapters. He was Emeritus Professor of the Psychiatric Hospital in Risskov, Denmark.
He held several honorary doctorates and fellowships including an honorary doctorate from Charles University in Prague. In recognition of his accomplishments in bipolar medicine, he was made the Honorary President of the International Society for Bipolar Disorders. At the same time, the Mogens Schou awards were created for presentation at the Society’s biennial International Conference on Bipolar Disorder.
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
psychiatrist whose groundbreaking research into Lithium
Lithium pharmacology
Lithium pharmacology refers to use of the lithium ion, Li+, as a drug. A number of chemical salts of lithium are used medically as a mood stabilizing drug, primarily in the treatment of bipolar disorder, where they have a role in the treatment of depression and particularly of mania, both acutely...
led to its utilization as a treatment for bipolar illness. His work ultimately benefited thousands of patients worldwide.
Early years
Schou was born in CopenhagenCopenhagen
Copenhagen is the capital and largest city of Denmark, with an urban population of 1,199,224 and a metropolitan population of 1,930,260 . With the completion of the transnational Øresund Bridge in 2000, Copenhagen has become the centre of the increasingly integrating Øresund Region...
, Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
, on 24 November 1918. His father was a psychiatrist and medical director of a large mental hospital. Schou chose to study medicine with a specific view to doing research on manic-depressive illness (now more commonly referred to as bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
). He graduated with a degree in medicine from the University of Copenhagen
University of Copenhagen
The University of Copenhagen is the oldest and largest university and research institution in Denmark. Founded in 1479, it has more than 37,000 students, the majority of whom are female , and more than 7,000 employees. The university has several campuses located in and around Copenhagen, with the...
in 1944. After his training in clinical psychiatry he also studied experimental biology.
Research
Schou had a long and distinguished career dedicated to research on therapeutic uses of lithium rooted in his deep concern for all patients with mood disorders, initially inspired by the depression and manic-depressive illness that afflicted many of his relatives.The psychopharmacological era began in earnest in 1949, with the article published by John Cade
John Cade
For the former Maryland State Senator, see John A. CadeFor the Louisiana Republican state chairman, see John H. Cade, Jr.Dr John Frederick Joseph Cade AO was an Australian psychiatrist credited with discovering the effects of lithium carbonate as a mood stabilizer in the treatment of bipolar...
about the observed antimanic action of Lithium
Lithium pharmacology
Lithium pharmacology refers to use of the lithium ion, Li+, as a drug. A number of chemical salts of lithium are used medically as a mood stabilizing drug, primarily in the treatment of bipolar disorder, where they have a role in the treatment of depression and particularly of mania, both acutely...
in Australia. Intrigued by these findings Schou, who in the meantime joined the Psychiatric Research Institute of the Aarhus University in Denmark, confirmed these findings in a double-blind placebo-controlled study with his co-workers. This marked the beginning of Schou's illustrious association with lithium.
Since then, there have been a number of interlinked research themes that run through Schou's work. In the 1960s, Schou and Poul Baastrup discovered that long-term lithium treatment prevents the recurrences of illness in bipolar and some unipolar patients and they were understandably exhilarated.
During the early 1960s, G. P. Hartigan, Poul Chr. Baastrup and Schou independently made sporadic observations that were suggestive of lithium also having prophylactic properties in manic-depressive illness. Subsequently, Baastrup and Schou joined together and in a non-blind lithium trial saw their preliminary observations confirmed. They even deemed the results so significant that they concluded that ‘lithium is the first drug demonstrated as a clear-cut prophylactic agent against one of the major psychoses’.
However, the Schou-Baastrup prophylaxis hypothesis was met with great resistance by British psychiatry. To Aubrey Lewis
Aubrey Lewis
Sir Aubrey Julian Lewis, FRCP, FRCPsych , was the first Professor of Psychiatry at the Institute of Psychiatry, London, and is credited with being a driving force behind the flowering of British psychiatry after World War II as well as raising the profile of the profession worldwide.-Early...
and Michael Shepherd
Michael Shepherd (psychiatrist)
Michael Shepherd, CBE, FRCP, FRCPsych , FAPA , FAPHA was one of the most influential and internationally respected psychiatrists of his time, formerly Professor of Epidemiological Psychiatry, Institute of Psychiatry and Consultant Psychiatrist, The Maudsley Hospital, London and author of a number...
, lithium was ‘dangerous nonsense’. Shepherd, seconded by Harry Blackwell, simply characterized it as ‘a therapeutic myth’, which, in their opinion, was based on ‘serious methodological shortcomings’ and ‘spurious claims’. Even terms such as unethical and unscientific were used. After painful consideration of the ethical aspects invoked, Schou and Baastrup undertook a unique double-blind trial of prospective-discontinuation design and with random allocation of manic-depressive patients (already on lithium) to lithium or placebo, unparalleled in psychiatry. It fully confirmed their hypothesis, published in The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
in 1970. Thus, lithium prophylaxis had also become established as evidence based. Lithium became the first-choice mood stabilizer in bipolar affective disorder.
He was aware of some of the limitations of lithium treatment. He welcomed the introduction of other prophylactic agents into the market. From the available observations he concluded, however, that anti-epileptics and atypical anti-psychotics act on different kinds of bipolar patients to lithium.
After he discovered lithium's prophylactic action in mood disorders, he tirelessly researched all its aspects and did not spare any effort to make the treatment available to all those in need. Millions of patients with recurrent mood disorders benefited because of his research. In 1990, authorities on manic-depressive illness such as Fred Goodwin and Kay Redfield Jamison
Kay Redfield Jamison
Kay Redfield Jamison is an American clinical psychologist and writer whose work has centered on bipolar disorder which she has suffered from since her early adulthood...
characterized the ground-breaking discovery of lithium prophylaxis as ‘one of the most important advances in modern psychiatry’.
He was an author of more than 500 publications, including texts, research papers, articles and book chapters. He was Emeritus Professor of the Psychiatric Hospital in Risskov, Denmark.
Awards and honors
Schou had received many awards and honors. Schou published approximately 540 works on lithium and lithium therapy. Many international awards and honors were conferred on him:- In 1974 he received the International Scientific Kitty Foundation Award (shared with Cade).
- In 1982 he received the John Cade Memorial Award.
- In 1987 he received the Albert Lasker Clinical Medical Research Award.
- In 1995 he received the International Society of Lithium Research’s Mogens Schou Prize for Lifetime Achievement.
- In 2000 he received the C.I.N.P’s Pioneers in Psychopharmacology Award.
- In 2001 he was the first recipient of The International Society For Bipolars’ Mogens Schou Award For Distinguished Contributions.
- In 2004 he received the NARSAD Lifetime Achievement Award.
He held several honorary doctorates and fellowships including an honorary doctorate from Charles University in Prague. In recognition of his accomplishments in bipolar medicine, he was made the Honorary President of the International Society for Bipolar Disorders. At the same time, the Mogens Schou awards were created for presentation at the Society’s biennial International Conference on Bipolar Disorder.