Scientists from Yale School of Medicine, Yale School of Public Health, and the Graduate School of Arts and Sciences have been awarded a $20.6 million federal grant for a five-year study of people with a wide range of mental illnesses.
The project seeks to identify new and better ways to identify groups of people with similar underlying conditions, even if they have different diagnoses, and to move toward an individualized understanding of how symptoms evolve over time.
The Yale IMPACT-MH program will include researchers from across the medical school, including 16 different diagnosis-focused research and clinical groups from across the Yale Department of Psychiatry and Yale Child Study Center.
The researchers will use traditional assessments of mental health, new behavioral tools that measure different aspects of brain function, artificial intelligence-driven analysis of participants’ own descriptions of their experience, and electronic health records to follow 1,800 people who suffer from mental illness, and 600 controls who do not.
Each participant’s information will be analyzed to predict treatment outcome, to characterize how symptoms change over time at the individual and group level, and to identify subgroups of patients with differences in outcomes two years after diagnosis. Importantly, these groups may not map onto our current diagnostic framework – indeed, the researchers hypothesize that, in important cases, they will not.
The goal is to devise more comprehensive, personalized treatment plans for individual patients based upon a better understanding of how people with similar conditions have responded to care.
“This is an exciting project. It will advance important science that we hope will have a real impact on our ability to identify which patients most need our care, and how best to treat them,” said Christopher Pittenger, MD, PhD, Elizabeth Mears and House Jameson Professor of Psychiatry, and one of the project’s leaders. “At the same time, we will bring together research groups across the psychiatry community in a way that has not been done before, and that is sure to spark new collaborations. We’re excited to get started.”
Sarah Yip, PhD, MSc, associate professor of psychiatry and in the Child Study Center, and director of the Yale Imaging and Psychopharmacology Lab, is co-principal investigator with Pittenger and Godfrey Pearlson, MD, MA, professor of psychiatry and of neuroscience.
Other Yale collaborators include Robb Rutledge, PhD, assistant professor of psychology; Yize Zhao, PhD, associate professor of biostatistics; Daniella Meeker, PhD, associate professor of biomedical informatics & data science; and Hua Xu, PhD, Robert T. McCluskey Professor of Biomedical Informatics and Data Science.
Yip said the study’s long-term goal is to begin to identify trajectories of mental health, focusing on both disorder-specific and transdiagnostic features, as measured using a combination of behavioral, clinical, and computational assessments and analysis approaches.
“By focusing on assessing features that may change over time within individual participants it moves away from a traditional focus on variables that, on average, differ between groups,” she said. “This longitudinal, within-person approach is ideally suited to understand the complexity of psychiatric disorders, the majority of which are characterized by dynamic symptom changes over time. This also builds on an emerging machine learning literature indicating that variables that distinguish an individual with a given psychiatric disorder from one without that disorder are often different from those that predict treatment outcomes.”
In addition to its primary aims, the Yale IMPACT-MH study will amass a huge amount of clinical and behavioral data. Pittenger notes that participating investigators will be able to use this new information in conjunction with other studies they are performing with the same participants, creating new opportunities for unexpected findings and the development of new ideas.
“I’m almost as excited about that possibility as I am about the grant itself,” he said.
The Yale IMPACT-MH project is organized through the Center for Brain & Mind Health. Funding is from the National Institute of Mental Health.