THE BIOLOGY OF PSYCHOPATHOLOGY RESEARCH GROUP: University of Nigeria
Location: Department of Psychological Medicine, College of Medicine & UNTH, Enugu
The group will focus on the interface of the clinical manifestations and long-term outcome of mental disorders, with molecular genetic, metabolic, neuroendocrine, neurophysiologic, immunologic, pharmacodynamic, pharmacokinetic, neuro-cognitive and psychosocial variables – as biopsychosocial risk factors and correlates of psychopathology. Of particular interest are the severe mental disorders (SMDs) or psychoses (schizophrenia, bipolar disorder and severe/psychotic depression). Consideration will also be given to the mild-moderately severe mental disorders, focusing on somatization disorders and their relationship with anxiety and depressive disorders.
This research group will bring together mental health specialists (psychiatrists and psychologists), in collaboration with colleagues in the laboratory sciences (biochemistry, chemical pathology, physiology, molecular biology/ genetics), neurosciences (neurology and neurosurgery), neuro-radiology and medical rehabilitation. In addition, the group is in the process of developing international collaboration with the Queensland Centre for Schizophrenia Research, Brisbane, Australia.
The group proposes to start with the first series of studies, titled:
LONGITUDINAL STUDY OF PSYCHOPATHOLOGY AND LONG-TERM OUTCOME OF SCHIZOPHRENIA, BIPOLAR DISORDER AND MAJOR DEPRESSION: Relationship with biological, psychological, cognitive, and social factors
Rationale for the study
Numerous controversies surrounded work on the fifth revision of the American Diagnostic and Statistical Manual of Mental Disorders (DSM-5), officially launched in May 2013 (Frances & Nardo, 2013; Dowrick & Frances 2013). These controversies support the view that, despite over 100 years of efforts, issues of the descriptive psychopathology (or clinical manifestations), prodromal features, long-term outcome, and pathophysiology of severe mental disorders (SMDs), as well as their relationship with biological, psychological, socio-environmental risk factors, are yet to be settled (Addington et al, 2012a;). This is more so in developing countries like Nigeria where the controversies raised in cross-cultural studies (Merikangas et al, 2011 ) about differences in clinical manifestation and outcome across cultures for schizophrenia, bipolar disorders and major depression have not been addressed in longitudinal studies (Ohaeri, 1994; Otote & Ohaeri, 2000). The African studies on the psychopathology of SMDs have been mostly descriptive and cross-sectional. There is a paucity of longitudinal studies on the genetic and biochemical risk factors. Hence, there are no home – grown biologic data to systematically inform preventive measures.
With the availability of technology for biological research in Nigeria, the time seems ripe for an integrated study that links psychopathology and clinical outcome of these SMDs, with biological, psychological, neuro-cognitive, and social factors.
The research questions are: (i) what are the patterns of clinical manifestations and outcome of naturalistic treatment for subjects with either first episodes or new episodes (i.e., relapsed cases who are within 1 year of disease onset) of SMDs, attending some psychiatric care facilities in Nigeria over a 5-10-year period; (ii) are these patterns significantly associated with the biological, psychological, cognitive, and social risk factors of interest?; (iii) how far are these factors predictive of patterns of outcome in naturalistic follow-up?; (iv) how do the patients differ from their first degree relatives and the normal healthy general population group in the metabolic, molecular and other parameters?
The specific objectives are: (i) to describe the pattern of symptoms among subjects with either first episodes or relapsed new episodes (within 1 year of disease onset) of schizophrenia, bipolar disorder and major depression (SMDs), attending some psychiatric care facilities in Nigeria, in comparison with the patterns in the international literature; (ii) to examine the evolution and stability of these patterns over a long-term period (5-10 years) of naturalistic follow-up; (iii) to assess the morbid risk of SMDs; (iv) to examine the relationship of the pattern of symptoms, clinical outcome and morbid risk, with the biological, psychological, neuro-cognitive, and social risk factors of interest; (v) in consideration of heritability issues for the inflammatory and oxidative stress biomarkers, as well as the molecular (genetic/SNP), neuro-cognitive and neuro-radiological parameters, to investigate how patients and their first degree relatives differ from socio-demographically matched normal healthy subjects in the general population.
Method: Location: The study will take place at the outpatient and inpatient services of psychiatric care facilities in Enugu, Portharcourt, Owerri, Yaba (Lagos) and Kaduna
Subjects’ characteristics: Participants will be consecutive attendees at the general outpatient/medical outpatient clinic, emergency units and inpatient wards, aged >10 years. Diagnosis will be based on the DSM IV/V. Their first degree relatives (aged >16 years) and a socio-demographically matched (i.e., matched with patients) normal healthy subjects in the general population will also be invited to participate.
J. U. Ohaeri (PI); F. Okwaraji; G. Onyebueke
I. Okpala; E. Nna;
Basic medical sciences:
D. Nwachukwu; S. Ibeneme