Is schizophrenia written in our genes? Can psychological therapies cure the sort of delusions seen in schizophrenia? In the future, would doctors test their patients’ genes before prescribing personalised treatments for mental health conditions?
These are some of the questions which will be explored in a free public talk by Oxford University scientists collaborating with the NHS to understand and improve the treatment of mental health problems.
Professors Elizabeth Tunbridge and Daniel Freeman will be discussing the latest developments in mental healthcare on Thursday 13th October at the Nuffield Orthopaedic Centre in Oxford. The event is free to attend, but booking at is strongly advised.
The talk is jointly organised by Oxford Health NHS Foundation Trust and the NIHR Oxford Biomedical Research Centre.
Professor Daniel Freeman, a clinical consultant psychologist at Oxford Health NHS Foundation Trust and NIHR Research Professor at the Department of Oxford University Department of Psychiatry, has successfully used personalised psychological therapy, known as the Feeling Safe Programme, to treat serious delusions of persecution found in conditions such as schizophrenia.
“Persecutory delusions cause enormous distress,” says Professor Freeman. “Almost half of these patients also suffer from clinical depression, and their level of psychological wellbeing rank in the lowest 2% of the population.”
“This is hardly surprising, given the torment of thinking, for example, that your friends and family are out to get you, or that the government is plotting to do away with you.”
Patients with persecutory delusions are more likely to commit suicide or need admission to a psychiatric hospital.
However, there is as yet no fully effective treatment for the condition: medication does not work for all patients, and side-effects can be so severe that many people abandon the treatment.
The Feeling Safe programme of psychological therapy, which is funded by the UK Medical Research Council, identifies factors (such as low self-esteem, poor sleep and focussing only on events that confirm paranoid thoughts) that help maintain the persecutory delusion. Targeted psychological therapy first tackles the individual maintenance factors for each patient. Patients are then supported as they go back into situations they fear to find that things are different now.
“The key aim of the Feeling Safe Programme is to relearn safety. When they do that, their threatening beliefs about the world begin to melt away,” says Professor Freeman.
Professor Elizabeth Tunbridge’s research also aims to find new and improved therapies, by understanding the role of genetics in illnesses such as schizophrenia.
“I believe that understanding these links will help to explain why some people respond to treatments while others do not,” she said. “Ultimately, we hope that this will lead to new and improved therapies.”
Professor Tunbridge, from the Oxford University Department of Psychiatry and the National Institute of Health Research (NIHR) Oxford Health Biomedical Research Centre (BRC), had shown that a person’s individual genetic make-up can determine whether they will respond to a drug that can improve memory. Memory and attention are affected in diseases such as schizophrenia.
“These results show that genetic factors can dramatically influence the response to a specific drug,” Professor Tunbridge says. “They suggest that in future, successful therapies may need to take a person’s individual genetic make-up into account.”
Her research is now investigating the brain mechanisms linking genetic factors with mental health conditions. “My long-term goal is to use this knowledge to improve the lives of patients with psychiatric disorders,” Professor Tunbridge says.
Both Daniel Freeman and Elizabeth Tunbridge are part of the new NIHR Oxford Health BRC, which has been awarded £12.8 million in funding to help translate latest discoveries into fundamentally new treatments for patients. Oxford Health NHS Foundation Trust and the University of Oxford are collaborating to establish this new BRC, one of only two across the country dedicated to mental health and dementia.