From data to diagnosis

From data to diagnosis

Early detection of mental illness offers a fighting chance for a normal and productive life
January 16, 2006
For the one in every 100 Canadians suffering from schizophrenia, a proper diagnosis often arrives in the aftermath of debilitating delusions, life-threatening hallucinations, and emotional withdrawal. But what if there’s a way to identify the early onset of schizophrenia and treat the disease before it wreaks havoc on an individual’s well-being?
 

That’s just one of the countless medical mysteries researchers at the Centre for Research and Innovation in Mental Health (CRIMH) are slowly unraveling. Housed in Montreal’s Douglas Hospital, a McGill University teaching affiliate, the CRIMH heralds a daring departure from today’s typical research facilities. Rather than simply churn out data, the CRIMH bridges the realms of academia and medical practice by transforming scientific findings into key industry partnerships, training opportunities, and community programs.

“The CRIMH promotes the transfer of research findings from the academic world to commercialization, the general public, and the overall medical community in hopes of improving the practice of medicine,” says Rémi Quirion, a McGill University professor and scientific director of the CRIMH. In 2004, he received the Wilder-Penfield Award, Prix du Québec, the highest distinction in Biomedical Research in Quebec.

The CRIMH’s research on schizophrenia is certainly no exception. While, traditionally, schizophrenia has been linked to devastating outcomes such as homelessness and suicide, Ashok Malla’s work indicates that the early treatment of psychosis may greatly improve a person’s chances for living a full and productive life. In an effort to prevent delays in treatment, Malla has developed an intensive early case detection and intervention program for individuals experiencing their first psychotic episode. This one-of-a-kind research program focuses on developing strategies for relapse prevention, as well as creating sophisticated screening systems to identify symptoms such as disorganized behaviour and blunted emotions.

But that’s not all. In hopes of raising the awareness of the importance of early detection, Malla has also launched a first-episode clinic in Quebec where doctors and nurses are trained in the cognitive testing methodology and screening systems developed at the CRIMH. Here, patients are diagnosed and treated immediately, granting them a fighting chance for a normal and productive life.

“It’s imperative to recognize and treat schizophrenia early because many young people suffer from this disorder. Many of them simply don’t have access to the proper expertise and treatment,” says Quirion.

Malla isn’t the only CRIMH researcher whose scientific discoveries have reached beyond the confines of academia to directly impact everyday Canadians. Judes Poirier, named ‘Neuroscientist of the Year’ by Quebec Science, made discoveries about Alzheimer’s disease, which landed him on the front page of the Wall Street Journal. Poirier found that apolipoprotein E, a protein that transports cholesterol to the brain, is also genetically linked to the most common form of Alzheimer’s disease. According to his research, 80 percent of people with sporadic Alzheimer’s had low levels of Apo E4, one of the forms in which apolipoprotein appears in the human body. By finding a susceptibility gene for Alzheimer’s, Poirier has made it easier to track people who carry the gene and assess their chances of contracting the disease.

In addition to its work on schizophrenia and Alzheimer’s disease, the CRIMH is also studying chronic pain and how the analgesic effects of drugs such as morphine fade over time. By understanding how human cells eventually become non-responsive to pain medication, Quirion says that researchers can find ways to treat pain without increasing drug dosages which can lead to dependency.

Benefits

There’s no underestimating the devastating impact of mental illness. For the over 300,000 Canadians suffering from schizophrenia—many of whom enter early adolescence as high-functioning and intelligent human beings—the onset of the disease is nothing short of catastrophic. “They literally watch their entire life disintegrate in front of their eyes,” says Joan Montgomery, CEO of the Schizophrenic Society of Canada. Perhaps most disturbing is the fact that the onset typically occurs in young people between the ages of 14 and 30. It’s a harsh reality that only makes Malla’s prevention and early intervention program all the more critical in its attempt to stave off psychotic episodes.

“Dr. Malla’s work with regard to assisting with the early diagnosis of schizophrenia is a huge development in our field, absolutely huge,” says Montgomery. “The more research that can provide us with the ability to diagnose earlier and earlier, the more helpful it’s going to be [in treating patients].”

While Malla helps Canadians map the progression of disease, Poirier is putting Montreal on the map with his scientific findings. Given that approximately 509,000 Canadians over 65 will be diagnosed with Alzheimer’s disease by the year 2031, Poirier’s exploration of a susceptibility gene has fast garnered international attention and accolades from the global scientific community. “We are represented well in the field [of Alzheimer’s research] by Judes Poirier,” says Jack Diamond, Scientific Director of the Alzheimer Society of Canada.

Partners

The scientific findings, accolades, and applications all work to attract international talent to the CRIMH in Montreal. According to Quirion, scientists hailing from the United States, South America, Europe, Japan, and China have all found a home at the CRIMH, citing its “collaborative environment” and cutting-edge research as main attractions. Also luring talented clinicians to the facility is its relatively youthful team of clinicians: the average age of a CRIMH researcher is 38 years old, 14 years shy of the national average, according to Quirion.

And seasoned clinicians aren’t the only ones sitting up and taking notice of the CRIMH. Pharmaceutical giants such as Pfizer Canada and AstraZeneca have partnered with the facility by funding the training of young scientists. For example, medical students completing a residency at the Douglas Hospital may simultaneously conduct research training in the diagnosis of mental illnesses at the CRIMH. Through research grants and the funding of educational endeavours, Quirion says that this partnership is helping “to train the country’s next generation of scientists.”