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

Elise Koch; Antonio F Pardiñas; Kevin S O'Connell; Pierluigi Selvaggi; José Camacho Collados; Aleksandar Babic; Serena E Marshall; Erik Van der Eycken; Cecilia Angulo; Yi Lu; Patrick F Sullivan; Anders M Dale; Espen Molden; Danielle Posthuma; Nathan White; Alexander Schubert; Srdjan Djurovic; Hakon Heimer; Hreinn Stefánsson; Kári Stefánsson; Thomas Werge; Ida Sønderby; Michael C O'Donovan; James T R Walters; Lili Milani; Ole A Andreassen

doi:10.1016/j.biopsych.2024.01.001

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

Biol Psychiatry. 2024 Jan 5:S0006-3223(24)00003-9. doi: 10.1016/j.biopsych.2024.01.001. Online ahead of print.

Authors

Elise Koch¹, Antonio F Pardiñas², Kevin S O'Connell³, Pierluigi Selvaggi⁴, José Camacho Collados⁵, Aleksandar Babic⁶, Serena E Marshall⁶, Erik Van der Eycken⁷, Cecilia Angulo⁷, Yi Lu⁸, Patrick F Sullivan⁹, Anders M Dale¹⁰, Espen Molden¹¹, Danielle Posthuma¹², Nathan White¹³, Alexander Schubert¹⁴, Srdjan Djurovic¹⁵, Hakon Heimer¹⁶, Hreinn Stefánsson¹⁷, Kári Stefánsson¹⁷, Thomas Werge¹⁸, Ida Sønderby¹⁹, Michael C O'Donovan², James T R Walters², Lili Milani²⁰, Ole A Andreassen²¹

Affiliations

¹ Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: e.m.koch@medisin.uio.no.
² Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom.
³ Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁴ Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy.
⁵ CardiffNLP, School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom.
⁶ Det Norske Veritas, Oslo, Norway.
⁷ Global Alliance of Mental Illness Advocacy Networks-Europe, Brussels, Belgium.
⁸ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
⁹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
¹⁰ Multimodal Imaging Laboratory, University of California San Diego, La Jolla, California; Departments of Radiology, Psychiatry, and Neurosciences, University of California, San Diego, La Jolla, California.
¹¹ Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway.
¹² Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
¹³ CorTechs Laboratories, Inc., San Diego, California.
¹⁴ European College of Neuropsychopharmacology, Utrecht, the Netherlands.
¹⁵ Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; The Norwegian Centre for Mental Disorders Research Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.
¹⁶ Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Nordic Society of Human Genetics and Precision Medicine, Copenhagen, Denmark.
¹⁷ deCODE Genetics, Reykjavik, Iceland.
¹⁸ Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; Lundbeck Foundation GeoGenetics Centre, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark.
¹⁹ Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway.
²⁰ Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia; Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia.
²¹ Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway. Electronic address: ole.andreassen@medisin.uio.no.

PMID: 38185234
DOI: 10.1016/j.biopsych.2024.01.001

Abstract

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.

Keywords: Drug treatment outcomes; Genomics; Precision medicine; Prediction algorithms; Psychiatry; Real-world data.

Publication types

Review