Young people’s mental health under the lens
Mental illness is increasing among young people, but there is a great lack of diagnostic tools and resources in the area. At the Department of Neuroscience, a longitudinal study is being conducted to increase knowledge on the biochemistry behind the diseases.
The project studies 800 young participants who have been recruited in cooperation with schools in Uppsala. As part of their initial visit at age 14–15, they fill in a questionnaire and provide blood samples.
“We then do a follow-up to see how things have gone for them, says Helgi Schiöth, Professor of Functional Pharmacology, who heads the project. “The study is population-based, so these are not patients but rather healthy individuals. However, it is unfortunately likely that some of them will seek care later on.”
In the blood sample, the researchers measure genotypes – the young participants’ DNA – and how the genes are expressed. They also look for microRNA, which are present in the blood and which do not code for proteins like other RNA molecules but instead help regulate the genes.
“What makes microRNA interesting is that they can be biomarkers,” says Schiöth. “That is the purpose of the entire project – to identify biomarkers in the blood associated with mental health.”
Act like hormones
He explains that microRNA can act in a similar way as hormones, where the concentration in the blood goes up and down depending on the state of health. With increased knowledge on how this connects to mental illness, more people can get better and more targeted care.
“There are very many people who need help and turn to healthcare services,” says Schiöth. “But the resources aren’t always there to take care of them. Assessment is difficult. We have good questionnaires to rate anxiety and depression and other mental disorders, but have no biological markers to support the findings.”
Such biomarkers could show which neurobiological system is affected and in what way, and could help support care in the future. The researchers have some candidates that they will investigate more closely.
“Other research teams have shown that there are biomarkers linked to suicide risk,” says Schiöth. “It could be an effective tool if a simple blood test could indicate an increased risk for suicide, which could justify greater support initiatives for the individual.”
Is this the sort of thing that can otherwise be missed on a questionnaire?
“Yes, it happens all the time,” says Schiöth. “Someone comes to a clinic, and even if the assessment is not incorrect, it is difficult to judge from the outside. And then something happens that should not happen.”
Difference before and after treatment
The researchers also study how subjects respond to drug therapy and cognitive treatment. In another study on anorexia nervosa, they performed a brain scan with MRI before and after treatment. First, when the subjects come to the clinic for care and then several years later, after cognitive treatment.
“What we have seen is that there are actually changes in the brain structures, how the different regions are connected, and in the activity paths,” says Schiöth.
In anorexia, these concern hunger impulses and control. Eating is a basic need, but there are regions in the brain that can depress feelings of hunger.
“People with anorexia often have a bit too much cognitive control,” says Schiöth. “Anorexia can be triggered by social pressure with appearance fixation and other issues, but also by an ability to depress the hunger need, which is often genetically conditioned.”
Interaction between heredity and environment
Like anorexia nervosa, many mental illnesses have a genetic component, but Schiöth and his colleagues are primarily interested in epigenetics, which deals with the interaction between heritable and environmental effects. This could concern a trauma during childhood or in youth that leads to mental illness. The advantage of a longitudinal study of young people is that samples from when the subjects are healthy can be compared with samples when they are mentally ill, and then with new samples when they feel better again.
“We want to find subjects before they develop their mental disorders,” says Schiöth. “It makes it easier to find a connection and draw conclusions on the consequences and causes of the illness.”
But a longitudinal study is difficult to conduct and not all of the 800 participants have returned for new samples. Schiöth still believes that he has been met with a great deal of understanding, though.
“Luckily, many people in Uppsala want to participate in this study,” he says. “We are very thankful to all of the young people, and to the parents who have given their consent, for their willingness to participate and to return for testing.”