Miracles are close at hand Andrew Macintosh, Professor of Biological Psychiatry at the University of Edinburgh uses genomics and neuroimaging to better understand depression and common mental disorders. At the moment psychiatric illnesses are diagnosed by looking at which symptoms people have, and how long they have had them. But many psychiatric illnesses have similar symptoms, and these observations alone reveal little about the biology underlying the condition. It is not surprising that there is no universally effective medication for people with depression, and the development of new therapies has stalled. Current diagnosis does not predict how a condition will develop, what is going on biologically in the brains of different people presenting with similar symptoms and how people will respond to different treatments. The hope is that this research can help identify people with distinct diseases. New and distinct types of depression, for example. This would increase our chances of developing disease-modifying therapies that are targeted to the underlying changes in the brain. (Paraphrased from an interview with Professor Andrew Macintosh, recipient of a £4.7 million grant from The Wellcome Trust to conduct this research.)

Targeting miracles Currently, there are a myriad of treatments available on the NHS, if you can access them. Possible treatments for ‘depressed’ symptoms according to the National Institute of Clinical Excellence, include: Cognitive behavioural therapy(CBT), computerised CBT, group CBT, physical activity intervention, interpersonal therapy (IPT), behavioural activation, first line anti-depressant (several different selective serotonin reuptake inhibitors or tricyclic antidepressants), second line anti-depressants, mood stabilisers, antipsychotics or a combination of the above. There is a big opportunity to target these treatments more effectively whether this is as a result of genetics; neuroimaging or selecting demographic factors such as age, gender, ethnicity and type and severity of a condition.

Future miracles “We know very little about how best to deliver treatments to children with learning disabilities – even though we know that these children are at much higher risk of developing mental health problems.” “There is no evidence on how to treat the complex trauma-related problems of children who have experienced abuse and neglect.” “We know that child psychiatric disorders overlap very commonly yet very little research has focussed on children who have more than one problem.” Research is so underserved that there are too many research opportunities to mention. Finding solutions for; cyber-bullying; celebrity; abuse; neglect; academic pressure; social media and the myriad of illnesses singular and comorbid that they cause are all possibilities.