“One in six people will experience a mental health condition at some point in their lives,” says Bralten. “That’s millions of people worldwide. So we’re not talking about an exception, but about an essential part of our society.” Psychiatric disorders are caused by multiple factors; they arise from an interplay of genetic and environmental factors. And that combination is different for every individual. These disorders have an enormous impact, not only on the daily life of the person affected, but also on family, friends, studies and work.
Comorbidity
We still do not fully understand what exactly happens in the brain and body in conditions such as depression, ADHD or schizophrenia. Furthermore, the symptoms of different disorders overlap significantly. There is also considerable genetic overlap between different psychiatric disorders. For example, the genetic variants that contribute to ADHD overlap significantly with those associated with depression or obsessive-compulsive disorder. When conditions occur together, this is referred to as comorbidity.
Previous research by Bralten and colleagues showed that there is genetic overlap between psychiatric disorders and physical illnesses in which insulin plays a role. ‘We saw that genetic variants that contribute to ADHD or depression, for example, are also associated with insulin resistance. This suggests a shared biological basis,’ she says. ‘And that offers an opportunity to define subgroups within psychiatry.’
With her Vidi grant, Bralten wants to apply methods from diabetes research to psychiatry. She compares genetic variants that are important for insulin processes with those for psychiatric disorders and looks for clusters of people who share the same genetic profile. ‘I then want to use large datasets to examine how these groups develop over time. Do they respond differently to medication or lifestyle choices? Do they have a different disease progression?’
The ultimate goal is to tailor treatments more closely to the patient's biology. ‘We hope to work towards more personalised psychiatric care, where we no longer look only at symptoms, but also at underlying biological mechanisms.’
Donders Institute
The Donders Institute plays an important role in this. ‘The Donders Institute network has been very important to me in the run-up to this grant,’ emphasises Bralten. ‘I work with researchers from different disciplines – from genetics to cognition, for example. That broad perspective is exactly what is needed to unravel these complex issues. If we better understand what is happening biologically, we can not only improve treatments, but also reduce the stigma surrounding mental health.’
