Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - ClinGen-PsychTx (Identifying Clinical, Demographic, and Genomic Risk Factors for Treatment-Resistant Psychiatric Disorders)

Teaser

Severe mental health disorders like schizophrenia have an enormous impact on quality of life. Up to 40% of people with schizophrenia will not respond to drug treatments. These individuals have high rates of death and can be in the hospital for very long periods of time. We...

Summary

Severe mental health disorders like schizophrenia have an enormous impact on quality of life. Up to 40% of people with schizophrenia will not respond to drug treatments. These individuals have high rates of death and can be in the hospital for very long periods of time. We need more information about the following with respect to schizophrenia treatment: are there certain factors (for example, gender, age or genetics) that contribute to not responding to treatment? To answer this question, we studied individuals with schizophrenia. In these individuals, we will look for factors that are linked with not responding to treatment.
An example of a potential finding might be that people with schizophrenia who are female, of an older age, or have a certain genetic marker, may be more likely to not respond to treatment. This information can be used to develop tests that will help identify people at risk of not responding to a treatment before it is ever given, in order to tailor more aggressive (or different) treatment plans.
Successful completion of this proposal will highly impact our understanding of treatments in mental health, and could reduce health care costs and most importantly, reduce the suffering in individuals with these disorders. There are millions of Europeans with a mental health disorder and a high proportion of them will not respond to treatment. If we can figure out earlier that someone will not respond to a treatment, we can give them a better or different treatment sooner.

Work performed

We sought to understand whether there are certain factors (for example, gender, age or genetics) that contribute to not responding to treatment in schizophrenia. First, we used health and social data on around 24,000 individuals from Sweden who had schizophrenia. We found that those with schizophrenia who did not respond to drug treatment were more likely to have a higher degree of family history for schizophrenia (i.e. more people in their family had schizophrenia). In males with schizophrenia, we identified that those with treatment non-response had indications of lower intelligence scores before schizophrenia was diagnosed, in comparison to males who responded to treatment (this type of data was only available in males). These findings are significant as it might mean that those with lower intelligence scores should be monitored more closely in follow-up appointments. Secondly, we looked at whether treatment non-response in schizophrenia was related to genomic (DNA) information within a subset of around 5,000 Swedish individuals with schizophrenia. Here, we found that no genomic factors could be linked with an increased risk of treatment non-response in schizophrenia, and this could be because we did not have enough people with genetic data or that different types of genomic data should be considered in future studies. The results of this study will be communicated in the form of scientific publications and at conferences and also via specific psychiatric disorder societies.

Final results

Schizophrenia has an enormous impact on worldwide health. Further knowledge on how clinical, demographic, and genomic factors may be linked with treatment non-response in psychiatry is urgently needed. Expected future results from this work could result in the creation of a predictive test to identify people with schizophrenia who are at the highest risk for treatment non-response prior to therapy and individualize their treatment plan accordingly. Successful completion of the proposed work could highly impact our understanding of treatment non-response in psychiatry and has the potential to directly reduce morbidity, mortality and suffering in individuals with these disorders.