Treatment resistance in mental health under the microscope

Researchers from the University of Adelaide will collaborate with European researchers to better understand and manage treatment resistance for mental health disorders such as depression, bipolar disorder and schizophrenia.

The PsychSTRATA study is being led by Professor Bernhard Baune at the University of Muenster in Germany, with 25 research groups across Europe participating in the analysis.

“Up to 60 per cent of people with a mental health disorder have little or no improvement when they are given an initial treatment,” said Associate Professor Oliver Schubert from the University of Adelaide’s Discipline of Psychiatry.

“This can lead to years of trial and error until a suitable treatment is eventually identified.

“The aim of this project is that every patient presenting with mental illness will be screened for risk of treatment resistance, using the blood tests and other measures identified in the study.

“This research will potentially lead to faster recovery and better long-term outcomes.”

Researchers will explore the biological underpinnings of treatment resistance using genomics and powerful bioinformatics techniques including machine learning.

From this analysis, biomarkers – such as blood tests – will be developed that can be used by psychiatrists to predict treatment resistance early and to better guide treatments.

“As part of PsychSTRATA, we will conduct a trial testing whether earlier access to intensified treatments will lead to faster and more sustained recovery,” said Associate Professor Schubert, who is also the clinical director of the early psychosis program at headspace Adelaide and head of the Northern Community Mental Health continuing care and youth streams at the Northern Adelaide Local Health Network (NALHN).

“The aim of this project is that every patient presenting with mental illness will be screened for risk of treatment resistance, using the blood tests and other measures identified in the study. This research will potentially lead to faster recovery and better long-term outcomes.”Associate Professor Oliver Schubert from the University of Adelaide’s Discipline of Psychiatry.

“Intensified treatments in the trial include the antipsychotic drug clozapine for schizophrenia, ketamine for major depressive disorder, and combination treatments for bipolar depression.

“In current clinical guidelines and practice, these treatments are strictly reserved for people who have not benefited from at least two courses of first-line medicines, a process taking many years in many patients.”

The Adelaide trial will be co-ordinated by the University of Adelaide’s Discipline of Psychiatry.

Treatments will be supervised at the Clinical Trials Unit at the Lyell McEwin Hospital in Adelaide’s northern suburbs.

The trial is expected to start midway through next year, and participants can register their interest in early 2023.

The project has been made possible through $498,335 of grant funding from the Australian Government’s National Health and Medical Research Council’s EU Collaborative Research Grant Scheme.

The Scheme supports Australian participation in leading international collaborative research under Horizon Europe, the EU’s key funding program for research and innovation.