These severe mental disorders usually strike at a young age. In Norway, some 40 000 people are affected.
“The costs are high, at both the individual and the societal levels,” says Ole A. Andreassen, a professor of psychiatry and director of the NORMENT centre at the University of Oslo.
But why do some people develop hallucinations or delusions? And why do others experience a deep depression or an ecstatic, manic phase?
“The disease mechanisms are complex, and we have limited knowledge about their causes,” explains Dr Andreassen.
Photo: Elin Fugelsnes Ole A. Andreassen (Photo: Elin Fugelsnes) Strong connection between the mind and biology
At an early stage in his career Dr Andreassen was awarded a grant under the Research Council of Norway’s Outstanding Young Investigators scheme to conduct research on genes and mental disorders.
“The connection between the mind and biology is fascinating. We do not yet fully understand the healthy brain, and we know even less about what goes wrong when a mental disorder develops,” explains Dr Andreassen.
He believes that psychiatry in general has been regarded as a field that is difficult to study and lacking in knowledge. Now this trend is about to change. More people have come to recognise the importance of learning more about mental disorders. At the same time, new technology such as brain imaging and genetic analysis makes it much easier to conduct research in the field.
One key objective of the NORMENT centre is to compile an overview of genetic and environmental causal relationships.
“We no longer think there is a single gene for schizophrenia – there are many. And it is important to remember that genes work together with environmental and social factors,” says Dr Andreassen.
Specialists working towards the same goal
According to the psychiatry professor, interdisciplinary cooperation is needed to get to the bottom of these complex disorders.
“At NORMENT, it is not the case that one group will work with one research question and another group with a different question. A variety of researchers will combine their special expertise and work towards the same goals,” he says. Important topics at the centre include brain functioning, genetics, medications and how to predict the course of a patient’s illness.
Problematic side effects from medication
“Antipsychotic medications are effective against schizophrenia, and in recent years they have also been used to treat bipolar disorder. However, the medications do not work equally well for everyone and they often produce problematic side effects,” explains Dr Andreassen.
This may be related to the immune system or fatty substances in the body. The researchers will use animal models to study the mechanisms at play in treatment involving antipsychotic medications.
“We hope this will help to increase the desirable effects and reduce the side effects,” says Dr Andreassen.
Photo: Filmweb Mediaserver A BEAUTIFUL MIND: The American mathematician John Forbes Nash, Jr.suffered from paranoid schizophrenia. He was subject of the Hollywood movie A Beautiful Mind, starring Russell Crowe. (Photo: Filmweb Mediaserver) Searching for new genes
Both schizophrenia and bipolar disorder encompass a major hereditary component. Multiple genes are probably involved, but the varieties found so far explain only a small part of an individual’s susceptibility to these disorders.
Dr Andreassen and his colleagues intend to find new, uncommon gene variants and compile more detailed individual overviews of the variants that have little effect. Among other things, they will employ new methods of gene sequencing.
Using brain imaging, the researchers will also investigate whether changes in the structure of the brain that are often seen in patients with schizophrenia and bipolar disorder are hereditary. “The aim is to obtain more knowledge about susceptibility and heredity.”
Follow patients over time
People with schizophrenia live about 20 years less on average than the population as a whole, but there is wide variation in how severe mental disorders develop. As of today, clinicians can only make generalisations.
“By combining brain imaging with knowledge about genetics and environmental risk factors and clinical characteristics, we hope to provide better tools for prognoses of individual patients,” explains Dr Andreassen.
The centre will follow patients over time and study them at regular intervals with regard to degree of illness, abnormal conditions in the brain and stressful life events.
Inviting doctoral students
Dr Andreassen is eager to recruit new, young talent to the research field. His goal is no less than to make NORMENT into Norway’s leading centre for educating doctoral students.
“Until now there have been far fewer doctoral degrees in psychology and psychiatry than in most other health science fields. We want a lot of doctoral students at NORMENT, as this will quickly enhance the research and increase knowledge,” he states.
“We will also help to disseminate knowledge to clinical environments so that new knowledge benefits the patients immediately.”
Norwegian Centre for Mental Disorders Research (NORMENT)
Objective: To learn more about the causes of serious mental disorders by compiling an overview of genetic and environmental causal relationships and how these disorders develop over time.
Centre director: Ole A. Andreassen
Partners: University of Oslo, University of Bergen and Oslo University Hospital
Annual allocation from the Research Council: NOK 17.5 million
Total person-years: 60
No. of doctoral degrees planned: 5-10 per year
Elin Fugelsnes/Else Lie. Translation: Connie Stultz/Carol B. Eckmann