Schizophrenia is a serious mental illness, that typically begins when the person is young (in their late teens or early adulthood). It disrupts the person’s ability to think clearly, with one of the more frequent symptoms being auditory hallucinations (hearing noises). Listen in as Dr. Mo Alsuwaidan discusses this disabling disorder and a potential digital treatment for schizophrenia with special guests Dr. Louise Birkedal Glenthøj and patient advocate, Ms. Vibeke Andersen. The guests offer their insights from both a medical perspective and lived experience.
Schizophrenia is a serious mental illness, that typically begins when the person is young (in their late teens or early adulthood). It disrupts the person’s ability to think clearly, with one of the more frequent symptoms being auditory hallucinations (hearing noises). Listen in as Dr. Mo Alsuwaidan discusses this disabling disorder and a potential digital treatment for schizophrenia with special guests Dr. Louise Birkedal Glenthøj and patient advocate, Ms. Vibeke Andersen. The guests offer their insights from both a medical perspective and lived experience. Learn more by tuning in at listenwellpodcast.com or watch the full video episode here.
Disclaimer: This podcast is provided for educational purposes and is not intended to replace discussions with your healthcare provider. All decisions regarding your care must be made with a healthcare professional, considering the unique characteristics of your personal situation. The opinions expressed are the opinions of the individuals recorded and not the opinions of Viatris. Individuals featured in this podcast may have participated in the past as or may be current members of an advisory group for Viatris.
Mo Alsuwaidan (00:14 - 00:37)
Welcome back to Listen Well, I'm Dr. Mo Alsuwaidan. Today we'll be talking about schizophrenia, which in my view is one of the most poorly understood illnesses in the world. I've worked in psychiatry and mental health for many years, and yet one of the questions most people have around psychiatry is what is schizophrenia? Is it the same as having different personalities?
Mo Alsuwaidan (00:37 - 01:01)
What are the symptoms? Is it dangerous? And so we're going to highlight a lot about what schizophrenia is, both from a medical perspective and also from a lived experience perspective. The other thing we'll cover today is some very innovative uses of technology to treat schizophrenia. And I think these uses of technology could be used more widely in mental health and in well-being.
Mo Alsuwaidan (01:02 - 01:32)
We're very lucky today to have two wonderful guests. Dr. Louise Glenthøj is the head of the VIRTU Research Group at the University of Copenhagen in Denmark. She's a psychologist with specializations in psychiatry and psychotherapy. VIRTU is evaluating the effectiveness of virtual reality based treatments for psychiatric disorders. Welcome, Louise. We're also very honored to have Miss Vibeke Anderson, who's sharing her story about schizophrenia that she suffered from for many, many years.
Mo Alsuwaidan (01:32 - 01:57)
And it was isolating, affected her life and her relationships and was difficult to treat until she's tried some of these new technologies, including virtual reality therapy. Miss Vibeke is also a patient advocate at many levels, both for patients, for doctors and also in health care governance. So we're very honored to have her and we will be listening well to her story.
Mo Alsuwaidan (01:57 - 02:08)
Doctor Louise, Vibeke, thank you for joining us. Dr. Louise, if I can, let me start with a question to you. Can you briefly explain to our audience what is schizophrenia?
Louise Glenthøj (02:08 – 02:20)
Right. Yeah. So schizophrenia is a serious mental health disorder, perhaps the most enigmatic of mental health disorders. And it kind of affects many aspects of a person's life.
Louise Glenthøj (02:20 - 02:56)
For example, the ability to think clearly. And one of the most frequently occurring symptoms in schizophrenia is what we call auditory hallucinations, that is hearing voices. And that can be very distressing and disabling for the person experiencing this. So schizophrenia typically begins in early adulthood, when the person is young in their teens. And it, well, we don't really understand the cause of schizophrenia yet. But a few decades ago, people living with schizophrenia had a very poor prognosis.
Louise Glenthøj (02:56- 03:24)
That is a very poor outcome. But now we got some medication called antipsychotic medication and some therapies showing some promise in helping people with schizophrenia live a kind of normal life. But what we also know is that not every person affected by schizophrenia respond or have an effect from these antipsychotic medications.
Mo Alsuwaidan (03:24 – 03:26)
So it's hard to predict who will respond and who won't?
Louise Glenthøj (03:27 - 03:45)
For sure it is. It is a very complicated mental health disorder. So we don't really know. What we have some indications or some clues, but we don't know how a person will respond to antipsychotic or the therapies we currently have for this disorder.
Mo Alsuwaidan (03:45- 04:00)
Right and as we often do on this podcast, we always want to get the patient or lived experience. So, Vibeke, thank you for joining us again. And if you can tell us your story, with schizophrenia, how it started, how it affected your life.
Vibeke Anderson (04:01 - 04:46)
Yes. I was 20 years old, and I was at school. I was hoping to be a nurse in my future.
But I had a very bad time in school. it was like at gymnasium I was, joining, And I felt very bad mentally. I couldn't sleep, I couldn't be with other people. I was isolated. I couldn't eat. I was depressed very much. And I didn't go to school for a long period because I couldn’t minutes.
Vibeke Anderson (04:46 - 05:28)
So I went to my GP and she sent me to a hospital. And I was there for a few months and they thought I had a depression, a very severe depression. And they kept me for about two years. I didn't go back to school because I couldn't cope with it. When I had been in a psychiatric ward for about two years, that gave me the diagnosis of paranoid schizophrenia.
Vibeke Anderson (05:28 - 06:11)
I was very very sad because I've heard all these comments about schizophrenia. You are stupid. You are not intelligent and all this kind of stuff. So it was very, what's it called? Distressing? Yes, it was very distressing to get this diagnosis. And because I got this diagnosis, it was because I heard voices in my head. And they told me what to wear when I was dressing in the morning.
Vibeke Anderson (06:11 - 06:40)
They told me what to say to other people. So they were commanding you? They were commanding me in every way, in every thing I did in my life. Is that why it was hard to sleep as well and eat? Yes, because that told me not to eat. They told me not to sleep. And they told me, if you are sleeping, you are dying. You will not wake up again.
Vibeke Anderson (06:40 - 07:10)
And if you're eating, you are dying. They have poisoned your food. That must have been very frightening. Very much. And for about 30 years ago, you were not allowed to talk about your voices. The caregivers at the hospital thought that if you're not mention your voices, they will just go away. So we are not allowed to talk about them.
Vibeke Anderson (07:10 - 07:46)
And I got this antipsychotic medicine very much and in long periods of my life. So I was very distressing and I didn't do any activity at all. I was just sitting in my chair or lying in my bed and doing nothing. my,
Mo Alsuwaidan (07:42 – 07:45)
Was the medicine helping at all or, partially?
Vibeke Anderson (07:45- 08:22)
No, not really. I was not responding at the medicine. And I was just getting very fat because I didn't do any activity. I could eat and eat and eat because something in my brain told me that I was hungry. So at one point my weight was 110 kilograms because I was not doing any activity at all. I was just sitting and lying in my bed.
Mo Alsuwaidan (08:23 – 08:25)
So there was no lifestyle treatment at that at that time?
Vibeke Anderson (08:26 – 08:55)
No, not at all. And when you have a lot of weight, you don't have any self-confidence. You really think that what your voices are telling you is the truth. You think they're right. You are stupid. You are not intelligent. And nobody likes you.
Mo Alsuwaidan (08:55 - 08:57)
It's a very lonely experience, it sounds like.
Vibeke Anderson (08:58 - 09:15)
Yes. And at some point I tried to commit suicide several times because I had no hope in my life. I had no future. I was a pain in the ass for other people. That's how I felt. You know?
Mo Alsuwaidan (09:15 – 09:22)
Yeah. You know that's a very profound way of putting it.
Mo Alsuwaidan (09:22- 09:42)
And, you know, I, I wanted to come back to you in a bit. But let me come to Dr. Louise because you've worked with patients with schizophrenia, as have I, as a practicing psychiatrist. And what Vibike is telling us, I think, echoes the experience of many patients. Some respond to medications. Some don't.
Mo Alsuwaidan (09:42 - 10:00)
And it can be a very lonely, frightening experience. Tell me and our viewers a bit about how your work with patients with schizophrenia led to the study we're talking about today with virtual reality-based therapy.
Louise Glenthøj (10:00 – 10:13)
Yeah. So what we experienced was that not all patients benefited from antipsychotic medication. And some had severe side effects, kind of making them go off medication.
Louise Glenthøj (10:13 - 10:48)
And we saw that we needed to have some alternative, some therapeutic alternative. And at least in Denmark, therapies for psychotic disorders are not that prominent. We haven't got many treatment options that are non-pharmacological or non-medication. So we were inspired by some studies conducted in the UK, led by the late Professor Julian Leff, in which they actually exposed the patient to their distressing voice.
Louise Glenthøj (10:48 - 11:19)
And we found that to be a very compelling approach in treating auditory hallucinations, some of the most prominent symptoms in psychosis. So that kind of made us think that we could do something with this therapy approach. Instead of just having the patient try to distract from their voices or make them do other kind of activities that would make the voices turn into the background, because that didn't really help our patients.
Louise Glenthøj (11:19 - 11:32)
We thought that perhaps this is a very interesting and helpful approach to get in a dialogue with their commanding voices to make them achieve a better control over the voices.
Mo Alsuwaidan (11:32 - 11:39)
It's very outside the box thinking and kind of, you know, if you just listen to it the first time, it sounds counterintuitive.
Louise Glenthøj (11:39 - 12:02)
It does. And that was also the prominent way of working with voices in Denmark that you wouldn't go into this. Because the clinicians were so afraid that they would increase the voices if they had the patient engage in dialogue with them or even talk about them. But what we experienced in our studies is that it's so helpful for the patients to get in the dialog with their voice or to even just tell about the voices.
Louise Glenthøj (12:02 - 12:25)
This is what is going on inside my head, because it is an invisible kind of symptom, you could say it's going on in the person’s head and nobody’s really kind of relating to it. So it's an isolated phenomenon, you could say. But the patients tell us that it's so helpful to talk about the voices. They haven't really done so previously to entering our study.
Louise Glenthøj (12:25 - 12:36 )
But they really find it helpful to talk about how the voice sounds, what it's saying to them, how it's kind of, interfering with their daily life activities.
Mo Alsuwaidan (12:37 - 12:44)
Sorry, I was going to say can you tell us a bit about how it actually works? How does the technology work and how it was used in the study?
Louise Glenthøj (12:45 - 13:07)
So what we do is that we have the patient create an avatar that is to represent their dominant voice. So we do a customized version. So we make it totally resemble the voice they hear and see often they have an image of the voice. It could be the devil or some kind of old feature or younger person.
Louise Glenthøj (13:07 - 13:34)
And we make that in virtual reality. So we make this avatar that is to represent their image of the voice. And then we have a program that transform the therapist's voice into sounding like the dominant voice that they hear. So a therapist, a young female therapist could sound like an old male voice. So we can make an individualized representation of the voice.
Louise Glenthøj (13:34 - 13:55)
And we often get quite close to the actual experience of hearing the voice. We have the patient grade it from one to 10 and 10 would be a total resemblance and one would be not at all resembling the voice. And we often end up with an 8, 9 or 10. So we can actually get quite close to what the voice sounds like.
Louise Glenthøj (13:55 - 14:20)
And then when we have the image of the voice, the avatar, and we have the voice transformation, we engage the patient in a virtual dialogue. So they put on this VR headset and in that headset, they would see the avatar. And they would have the therapist talking as the avatar saying all this demeaning, hostile content that the voice would normally be saying as the voice.
Louise Glenthøj (14:20 - 14:29)
But at the same time, the therapist can kind of jump in and be a supportive therapist, encouraging the patient to stand up towards the voice, to talk back to the voice.
Mo Alsuwaidan (14:29 - 14:33)
So it's the kind of real time exposure and then coaching at the same time.
Louise Glenthøj (14:33 - 14:36)
Exactly. That's a nice way of putting it. Yeah.
Mo Alsuwaidan (14:36 - 14:43)
I want to come back to you in a bit to talk about the, the actual trial and what the findings were of the trial.
Mo Alsuwaidan (14:44 - 14:56)
But let me ask Vibeke what her experience was in the trial. What was it like for you using the technology and just to walk us through your journey there?
Vibeke Anderson (14:57 - 15:15)
Yes. My psychiatrist asked me in 2020 if I wanted to try this trial CHALLENGE, as it is called. I was not responding at the medicine at all.
Vibeke Anderson (15:15 - 15:50)
And I thought at first it was too modern for me. I was too old for this kind of stuff. I was about 50 years old at that time. And otherwise I was thinking that it could not get any worse. It was like the bottom of my life.
Vibeke Anderson (15:50 - 16:26)
I have turned down to the bottom of my life and I thought it could only get better. So I had everything to win and nothing to lose. I gave it a try. I met my psychiatrist who was sitting next to me in the trial and I gave her a picture of a relative. And this picture she made into my voice as an avatar. And I saw my voice.
Vibeke Anderson (16:26 - 16:58)
For the first time and we were adjusting the voice in my headphones and it was very, very scary. I was so anxious. And when we came into the treatment, at some point she thought, the psychiatrist thought I had to stop because I was really, really, I was so anxious. I was so sad. I was so depressed.
Vibeke Anderson (16:58 - 17:32)
I didn't know what I was going to, what it was going to be in the future. And she asked me to stop the treatment because it affected me so much. But I was thinking at one point quite clearly and I thought I have to see the next corner on this path. I didn't want to stop the treatment.
Vibeke Anderson (17:32 - 17:48)
So I told her that I would like to continue the treatment. And she said, it's your decision. You know yourself better than I do. So I continued to treatment.
Mo Alsuwaidan (17:48 - 17:51)
You decided to face the fear.
Vibeke Anderson (17:51 – 18:02)
Yes, I did. And I had some breathing methods I could use when I got too anxious.
Vibeke Anderson (18:02 - 18:36)
And I came through this period of my life. And for the first time, when I have been in virtual reality for eight times, I was starting to telling my voice off. And it was amazing. It just made me feel confident that I had the power to tell my voice off who have been in my life for 27 years.
Vibeke Anderson (18:36 - 18:47)
And it was just amazing. And this happened in Christmas time 2020. So I was just so pleased.
Mo Alsuwaidan (18:47 - 18:49)
What a wonderful Christmas gift.
Ravi Shankar (18:52 - 19:34)
I am Ravi Shankar at Viatris. I lead a dedicated team of medical office professionals who are passionate about building robust scientific evidence and work towards scientific communication. Digital therapeutics is poised to play a transformative role in building a more accessible, personalized, and data driven future for mental health. At Viatris, we believe in the power of technology to transform patient care, our principles of access, leadership and partnership help guide us as we strive to bring not just medicines, but a more comprehensive solution for better patient care.
Ravi Shankar (19:34 - 20:16)
So we have been working on several innovative digital medicine and digital therapeutic solutions covering a variety of disease segments which have high unmet needs. And these beyond pill solutions complement our traditional offerings, fostering a holistic patient care that addresses the full spectrum of the well-being. Our unwavering commitment to improving patient care through advanced technology and collaborative partnerships remain steadfast. At Viatris our mission is to empower people worldwide to live healthier at every stage of life.
Mo Alsuwaidan (20:16 - 20:40)
Let me come back to you, Dr. Louise. So that was quite wonderful, the outcome, even though in the beginning it was scary. Can you walk us technically through the CHALLENGE trial, how it was designed? And maybe in general terms for our general audience. And then what was the outcome of the trial, actually? So what was the finding that was published from the trial?
Louise Glenthøj (20:40 - 21:01)
Yes, so the CHALLENGE trial is what we call a randomized clinical trial. So that would be the gold standard of clinical trials, the way we get the most solid evidence if a therapy or intervention is working. So what we do is that we include patients with what we call treatment-resistant auditory hallucinations.
Louise Glenthøj (21:01 - 21:37)
That would be patients having tried several medications without any effect on their voices. And then we allocate them. So we have one group receiving this avatar therapy, virtual reality-based therapy, seven sessions of this therapy, and another group receiving standard treatment. And then we do a follow-up assessment at three months. So that would be when the therapy has terminated. And then again at six months, follow-up.
Louise Glenthøj (21:37 - 22:01)
And that is assessment of all the participants. So then we can kind of compare if the group receiving the VR-based therapy would improve more than the group receiving standard treatment. So we haven't got the final data in yet. So the study has terminated and we have had all the follow-up assessments conducted. But we haven't really looked at the data yet.
Louise Glenthøj (22:01 - 22:27)
That is what we are in the process of doing. So I can't reveal or I can't tell you the final data, the results of the trial, because we haven't really got them yet. But what we see in more general terms, and that is based on cases or what the clinical experience is that we have patients’ kind of having three main responses.
Louise Glenthøj (22:27 - 22:53)
So we do have a group responding in this remarkable way that Vibeke did. So experiencing a full cessation of voices. So they kind of get a total control of their voices and then the voices just disappear. Then we have a middle group, you could call it, that benefits from the treatment. So they do have a response. The voices do not fully disappear, but they are not that bothered by them.
Louise Glenthøj (22:53 - 23:12)
So they can kind of tell the voices off or have them give them a pause or something like that in the daily life when they show up. And then we have the third group. So they would show minimal or no response to this treatment. And that is kind of what we expected because schizophrenia is a very complicated disorder.
Louise Glenthøj (23:12 - 23:22)
So having a therapy that would work on all patients, that is too good to be true. But we are quite satisfied with this result.
Mo Alsuwaidan (23:22 – 23:36)
Yeah, I mean, again, I can tell you as a clinician that works with patients with schizophrenia, having one more tool in the toolbox is important. And as you said, some patients will respond amazingly well and some in the middle.
Mo Alsuwaidan (23:36 - 23:55)
Now, in the study, you mentioned that it was used in patients that were having treatment resistance. In other words, the voices were not going away with any of the standard therapies. But if we were to think in the future, could this therapy actually be used as an add-on where someone, for example, partially responded and then you add on the VR therapy?
Louise Glenthøj (23:55 - 24:17)
Sure, it could be. Yeah, we can see many ways of applying this therapy in clinical practice. So what we did in the study was to include patients receiving antipsychotic and not responding. But I can also see it being applied to patients with the first episode psychosis, kind of being reluctant to try an antipsychotic medication or that might have this as a first line of treatment.
Louise Glenthøj (24:17 - 24:33)
And if it doesn't work, it's a so short-term therapy. So it would only be like three months. And if they don't respond, then go on to initiating the antipsychotic treatment. So there could be many ways of applying this therapy also to other diagnosis than schizophrenia.
Mo Alsuwaidan (24:33 - 24:40)
And one more question about the study. So as Vibeke mentioned that sometimes it can be challenging in the beginning of the study.
Mo Alsuwaidan (24:40 - 24:55)
And I'm sure you saw some of these challenges with other patients that in the beginning it can be frightening. So did you have some strategies to deal with this in the trial? For example, you know, Vibeke used some of these breathing or relaxation techniques. Did that work for other patients or did they use other techniques?
Louise Glenthøj (24:55 - 25:15)
Yeah, so we built in a kind of a safety strategy in the treatment manual because we were expecting people to be very frightened by this therapy. And we have a lot of procedures in the manual that the therapists are to do in terms of helping the patient overcome this anxiety. So we have this safety call.
Louise Glenthøj (25:15 - 25:41)
So after being to therapy, then the next day they would have a call from the therapist just checking in. Are you okay? Could we do anything to help you if you're kind of distressed by therapy or the level of anxiety? We would have these breathing exercises we have in Denmark. It's called tangles. It would be kind of toys you could fiddle with that some people find comforting.
Louise Glenthøj (25:41 - 25:57)
We also work very closely with their relatives or their network if they're in supported housing facilities. We would have them engaged in the therapy and have them look in on the patient, now he or she has been to therapy could you kind of check in? Could you follow up? Yeah.
Louise Glenthøj (25:57 - 26:03)
So we haven't had any serious adverse events relating to therapy, and that's very nice.
Mo Alsuwaidan (26:03 - 26:25)
Yeah, that's great. Vibeke, coming back to you, you know, we've chatted in the past about some of your efforts with advocacy. Obviously you've had an excellent experience with VR therapy, and it helped you a lot. Can you tell us about your efforts to advocate, whether it's for VR therapy or in general for patients with schizophrenia?
Vibeke Anderson (26:26 - 27:04)
Yes. Last year I went to the Netherlands to make a speech about VR, virtual reality, at a conference, and I also contribute to suicide prevention in Denmark, where I'm sitting in the government's health authority to give them some advice how to prevent suicide at hospital when patients have schizophrenia or other diseases.
Vibeke Anderson (27:05 - 27:41)
So I'm in some group with other patients who gives advice to the Danish health authority. I'm also a part of the global network of patients for patient safety. It's a thing under WHO. In Denmark, the network is run by the Society for Patient Safety. For them, I give speech to young doctors how to listen.
Vibeke Anderson (27:41 - 28:13)
So that's some of my work, and I have made a lot of speeches in Denmark, at psychiatric wards, at the care, at the personal care assistants, who is very keen on listening to my story about getting rid of these voices, which I've heard for 27 years.
Vibeke Anderson (28:13 - 28:32)
So I'm trying to get out and tell my story to others, because I would very much like to give other patients hope for the future and for their lives.
Mo Alsuwaidan (28:33 – 28:43)
That's quite wonderful, and it keeps you, I think, very busy. Yes. The thing that strikes me is how much things have changed in the world.
Mo Alsuwaidan (28:43 - 29:13)
You know, I'm thinking back to my early days of training. Patients were patients, and now, across the world, and it's wonderful what's happening in Denmark. I think we can all learn a lesson from it. But to have patients included in some of these groups, including at the health governance level, at the research level, through participatory action research, and through education. Because you know, I've always said this to my trainees. We learn as much from our patients, if not more, than we do from books or studies.
Mo Alsuwaidan (29:13 – 29:36)
So I think what you're doing is very very important and should be done more and more. Just coming back to Dr. Louise, maybe you've worked with patients with schizophrenia, whether generally in the healthcare system or with this amazing new technology that you're working on. What's your advice for a person with schizophrenia at the personal level?
Mo Alsuwaidan (29:36 - 29:43)
And then what advice would you have at the healthcare system level to help people with schizophrenia?
Louise Glenthøj (29:44 - 30:21)
Yes, so at the healthcare system level, I think that embracing new technologies, new therapy approaches. You said it yourself, thinking outside the box, that sometimes we can do things differently. And in Denmark, at least, kind of changing practices is very difficult, so. But we were very well received by the clinicians and at the wards. But kind of thinking in terms of new ways of conducting therapies, not being so afraid of listening to the patient, asking about their psychotic symptoms.
Louise Glenthøj (30:21 - 31:12)
I don't really think we can make matters worse in terms of talking about their symptoms. And that's also what we experienced here in Denmark. So the Danish government were quite good at listening to the way we conducted our new therapy approaches. And they were actually financially supporting our efforts in kind of implementing and disseminating this new therapy approach. But also in terms of the patients and advice to the patients would be to, I think they're already reaching out for help. But they don't know how different or how many treatment options that are actually out there.
Louise Glenthøj (31:12- 31:45)
So I think we have a lot of the responsibility lies in terms of the clinicians to be better at kind of expanding the toolbox, telling the patients about the treatment option, trying out new therapies. And also what Vibeke experienced, that her psychiatrist were actually very open-minded in terms of working with her symptoms, even though she's been in treatment for 27 years.
Louise Glenthøj (31:46 - 32:11)
And I think there's also a lot of work to do with the relatives. So they are for sure struggling with having a person with psychotic symptoms in their family. And they're distressed and they don't know how to respond. And I think they are trying to tackle a system that is so difficult often to get the right help from.
Louise Glenthøj (32:11 - 32:25)
So, I think we could do a lot of work. We are already doing it in Denmark, but a lot of work with the relatives, helping them, supporting them and enabling them to support their the patient with the psychotic symptoms.
Mo Alsuwaidan (32:25 - 32:43)
Well, that's wonderful. So that's a good place to end on there. If I can ask you, Vibeke, any final thoughts for our audience? Any advice to someone who might be listening who is suffering from schizophrenia themselves or has a loved one or a friend who has schizophrenia?
Vibeke Anderson (32:45 - 33:21)
Yes. And I would just like to say there is hope, even after 32 years with mental health disorders. I have got a new life after the treatment. It saved my life, actually. I would like to give hope to others who are in the same situation as I have been. I think, virtual reality is the most powerful medication against schizophrenia.
Vibeke Anderson (33:21 - 33:59)
And in my head, it's like there's a candle lightning in the darkness. No one should have to live with the horror of constant voices. Everyone deserves a chance for a better life. And the last thing I would like to say that I believe that virtual reality treatment gives schizophrenia patients all over the world a whole new opportunity for a much higher quality of life.
Mo Alsuwaidan (33:59 - 34:20)
That's that's really amazing. Miss Vibeka Anderson and Dr. Louise Glenthøj, thank you so much for your time, for your effort. Really honor your experience and honor your amazing work that you're doing as advocates, as you know healthcare workers, really, both of you are. So thank you so much for your time and effort.
Mo Alsuwaidan (34:20 - 34:42)
Thank you. Thank you. And to wrap up, I'd like to say I've learned a lot from this episode. I work with patients with schizophrenia all the time. I've been in psychiatry for about 20 years now. And there's always something new happening. And I think the message, there's several messages from this episode.
Mo Alsuwaidan (34:42 - 35:05)
But one is that to never give up, to always have hope, not only at the individual level, but also at the healthcare level. And to think outside the box, to use technology as a tool for treatment, that medications are wonderful and they help a lot of patients. And I've seen medications save lives, but they are not all of treatment.
Mo Alsuwaidan (35:05 - 35:42)
There's many other aspects of treatment where we can use lifestyle, we can use technology. And it's wonderful that Dr. Louise and her group in Copenhagen have done this. And we're looking forward to seeing the results of the CHALLENGE trial and maybe having this type of therapy come into clinical practice at a wide scale. And I think if I want to emphasize one thing is really that through listening, for a patient kind of listening to that inner voice, not to lose hope. For us as healthcare providers to listen to our patients, including in how we do research, will lead to better outcomes for everyone.
Mo Alsuwaidan (35:42 - 35:56)
And that's a good note to end on. And I think for our listeners, it's really important to always listen well. Thank you.