How Real-World Data Can Facilitate the Development of Precision Medicine Treatment in Psychiatry.

Precision medicine has the ambition to improve treatment response and clinical outcomes through patient stratification and holds great potential for the treatment of mental disorders. However, several important factors are needed to transform current practice into a precision psychiatry framework. Most important are 1) the generation of accessible large real-world training and test data including genomic data integrated from multiple sources, 2) the development and validation of advanced analytical tools for stratification and prediction, and 3) the development of clinically useful management platforms for patient monitoring that can be integrated into health care systems in real-life settings. This narrative review summarizes strategies for obtaining the key elements-well-powered samples from large biobanks integrated with electronic health records and health registry data using novel artificial intelligence algorithms-to predict outcomes in severe mental disorders and translate these models into clinical management and treatment approaches. Key elements are massive mental health data and novel artificial intelligence algorithms. For the clinical translation of these strategies, we discuss a precision medicine platform for improved management of mental disorders. We use cases to illustrate how precision medicine interventions could be brought into psychiatry to improve the clinical outcomes of mental disorders.

Exploring static and dynamic relationships between burden of disease and research funding in the United States.

BACKGROUND: The relationship between burden of disease and research funding has been examined cross-sectionally, but temporal patterns have not been investigated. It is logical to assume that temporal improvements in disability-adjusted life-years (DALYs) reflect benefits from research funding; such assumptions are tempered by an unknown lag time for emergence of benefits from research. METHODS: We studied National Institutes of Health (NIH) research fund allocations and United States DALY estimates for overlapping disease categories (matched disease categories, MDC, N = 38). Using a general linear model, we separately analysed DALYs for MDCs in 2017 in relation to NIH research allocations in 2017 and 2007. We also examined how changes in DALYs were related to cumulative NIH research funding (2006-2017). After regressing DALY change on summed funding, we obtained model residuals as estimates of the discrepancy for each MDC between observed and expected change in burden, given funding. RESULTS: In 2017, there was a positive association between NIH research fund allocations and DALYs for the same year (F1,36 = 16.087, p = 0.0002921; slope = 0.35020; model R2 = 0.3088), suggesting proportionate allocation. There was a positive association between 2017 DALYs and 2007 NIH research allocation, implying a beneficial impact of research (F1,36 = 15.754, p = 0.0003; slope = 0.8845; model R2 = 0.3044). In contrast, there was a nonsignificant association between summed NIH funding and percent change in DALYs over 2006-2017 (F1,36 = 0.199; p = 0.65; beta coefficient = -1.144). When MDCs were ordered based on residuals, HIV/AIDS ranked first. Mental, neurologic or substance abuse (MNS) disorders comprised most residuals in the lower half. CONCLUSIONS: NIH fund allocation is proportional to DALYs for MDCs. Temporal changes in DALYs vary by MDCs, but they are not significantly related to cumulative research outlays. Further analysis of temporal changes in DALYs could help to inform research outlays for MDCs and to study the impact of research.

Meeting Report: Can We Make Animal Models of Human Mental Illness?

Modeling aspects of the human condition in animals has provided invaluable information on the physiology of all organ systems and has assisted in the development of virtually all new therapeutics. Research in cardiovascular disease, cancer, immunology, and other disciplines has benefited substantially from the availability of animal models that capture aspects of specific human diseases and that have been used effectively to advance new treatments. By comparison, animal models for neurological and psychiatric disorders have faced several unique obstacles. This paper highlights topics covered in a recent Cold Spring Harbor Laboratory meeting charged with examining the status of animal models for mental illness. The consensus of the conference is that despite the difficulties inherent with modeling brain disorders in animals, when used judiciously-fully cognizant that models of specific behavioral or biological aspects cannot completely recapitulate the human disorder-animal research is crucial for advancing our understanding of neuropsychiatric disease.

Highlights from the Biennial International Congress on Schizophrenia Research (ICOSR), March 24-March 28, 2017.

The 2017 International Congress on Schizophrenia Research, held in San Diego, California (March 24-28, 2017), attracted over 900 attendees from 34 countries. With the gracious assistance of Congress president James Meador-Woodruff, we bring you the following reports on the prospects for new drugs to treat schizophrenia.

Highlights from the 2012 Schizophrenia International Research Society Conference, April 14-18, 2012.

The 2012 Schizophrenia International Research Society (SIRS) Conference, held in Florence, Italy, attracted more than 1,600 attendees from 53 countries to the stately Firenze Fiera Conference Center from April 14-18, 2012. Providing four major plenary sessions, thirty-five symposia sessions and six workshops, this 3rd Biennial SIRS Conference was jointly sponsored by Vanderbilt University School of Medicine, Department of Psychiatry and SIRS. In conjunction with the Schizophrenia Research Forum, a Web project of the Brain and Behavior Research Foundation, and with our thanks to the SIRS organizers and staff, we bring you the following report on the meeting's discussions concerning drug therapy development for schizophrenia, psychological and social treatment for schizophrenia, and the challenges of predicting psychosis with brain imaging.

Highlights from the new drug session at the Biennial International Congress On Schizophrenia Research, April 2-6, 2011.

The 2011 International Congress on Schizophrenia Research, held in Colorado Springs, Colorado, attracted nearly 1,200 attendees to the Broadmoor Hotel from 2-6 April 2011, not to mention the satellite meetings on cognition and the schizophrenia prodrome. With the gracious assistance of Congress directors Carol Tamminga and Chuck Schulz, as well as meeting staff Dorothy Denton and Cristan Tamminga, we bring you the following report on the Congress' "New Drug Session: Advances in Medication Development and Assessment."