Doctoral (PhD) student position in Precision Psychiatry

📣 We are looking for a PhD student interested in Precision Psychiatry to join our team! 📣

The overarching purpose of your PhD project is to improve routine-care predictions of post cognitive behaviour therapy (CBT) outcomes for common mental disorders. Our developed prediction models will be focused on avoiding unnecessary treatment failures, minimizing adverse long-term health and socioeconomic events, and promoting effective use of psychiatric resources. Today, there is a general lack of accurate prognostic risk tools implemented in routine psychiatric care, which directly hampers our possibilities for timely and cost-effective tailored intervention and care. The main objective of your PhD project is thus to construct and validate prediction models for both clinical CBT outcomes and long-term register outcomes using the world’s largest multimodal database in the field (clinical, register-linked, and genetic data) including 5,000 individuals treated with CBT.

You will be supervised by John Wallert and co-supervised by Christian Rück.

Click here to read more and apply.

Two grants to research program about suicide prevention

In the end of 2021, project Saving lives received two grants: 4.9 million kronor from Forte (Swedish Research Council for Health, Working Life and Welfare) and 2.4 million kronor from The Swedish Research Council. The research program involves several members from the research group, and the principal investigator of the project is Christian Rück.

Congratulations! 🎯

Saving lives: Constructing a nationwide cohort with multimodal data to improve precision in prediction and prevention of suicide

Project summary:

Suicide is a major public health issue, causing severe impact on individuals and families, as well as relevant societal costs. In Sweden alone, ~70,000 years of potential life are lost each year due to suicide. Despite dedicated research efforts and prevention strategies, suicide-related outcomes are still difficult to predict and prevent. The goal of this research program is to utilize unique resources in Sweden to improve prediction of suicide by integrating environmental factors captured by national registers and genetic information using multi-modal modelling. 

In aim 1, we will create the world’s largest suicide biobank by collecting neonatal blood spots stored at the Swedish PKU biobank from 4,000 individuals that died by suicide, i.e. total coverage of all suicides in Sweden from 1975 and onwards. DNA will be extracted from each of these blood spots. Data from the national registers will be added, covering major risk factors across the lifetime (socioeconomic, demographic and medical). Further, blood spots and register data from 8000 matched controls with no suicidal outcomes will be available through collaboration. 

In aim 2, we will identify register-based risk factors and genetic variants associated with suicide by genotyping all DNA samples from cases and matched controls and performing a case-control genome-wide association study meta-analysis. 

In aim 3, we will combine hundreds of candidate suicide predictors from the national registers (covering demographics, socioeconomic status, In aim 3, we will combine hundreds of candidate suicide predictors from the national registers (covering demographics, socioeconomic status, electronic medical records, criminality) with genetic predictors (polygenic risk scores for suicide, depression, impulsivity, and substance misuse) using both established quantitative modelling and newer machine learning approaches.

Om utmattningssyndrom i senaste Filter

I senaste numret av magasinet Filter granskas framtagningen av diagnosen utmattningssyndrom. Artikeln ”Brännmärkta  – Diagnosen utmattningssyndrom har främst gynnat en grupp i samhället: vårdbolagen.tar upp den för Sverige unika diagnosen utmattningssyndrom, dess historia och kontrovers. Artikeln kritiserar diagnosens tillblivelse, som skedde utan det vetenskapliga underlag som brukar krävas för nya diagnoser, och även hur den spretiga behandlingen av utmattningssyndrom har blivit en kostsam historia som dragit in stora pengar till vårdbolagen.

Intervjuade i artikeln är bland andra Elin Lindsäter, som pratar om sin forskning på behandling av utmattningssyndrom, och Christian Rück, som kommenterar kritiken mot diagnosen utifrån sin bok Olyckliga i Paradiset (2020). De berättar även om sitt nya forskningsnätverk relaterat till stress och utmattning, samt den nyligen genomförda systematiska litteraturöversikten av samtliga vetenskapliga artiklar om utmattningssyndrom. 

English translation: Elin Lindsäter and Christian Rück are interviewed in the latest edition of Swedish magazine Filter, commenting on the critics of the formation of the Swedish diagnosis “exhaustion disorder”, a Swedish diagnosis called “utmattningssyndrom” that corresponds to clinical burnout.

Rücklab 2021 summary

Today we had the last research group meeting of the year, the first one in a long while in person at Psykiatri Sydväst. We summarized the year that has gone by and looked ahead to 2022.

This year, new research tracks have been added to the group. In addition to OCD and related disorders, we now work with projects about “exhaustion disorder” (Swedish diagnosis utmattningssyndrom), trauma and suicide.

Apart from this, the research group’s members ongoing projects involve:

  • Trichotillomania and skin-picking disorder
  • Body dysphoric disorder, focused on dissatisfaction of genitals
  • Hoarding disorder
  • Tics and tourettes
  • Internet delivered psychological treatment
  • Statistical modelling
  • Genetics and microbiome in patients with OCD
  • Transcranial magnetic stimulation for major depression
  • Deep brain stimulation for OCD

The group is now extensive and well equipped for exciting new research!

Grant from the Swedish Research Council

A member of our Research Group, John Wallert, recently received a 4.5 million SEK grant from the Swedish Research Council (Vetenskapsrådet, VR) for his project about suicide among compulsory mental care

The project is a collaboration with Oxford University and involves studying risk factors for suicide in a cohort of more than 100 000 compulsory mental Care acts (Lagen om psykiatrisk tvångsvård, LPT, in Swedish), using 40 years of unique national register data.

Congratulations! 

Rücklab medverkar i UR Samtiden

Flera medlemmar ur forskargruppen deltog i Augusti i Utbildningsradions föreläsningsserie UR Samtiden. Åsa Anger berättade om projektet Braining, Elin Lindsäter diskuterade varför diagnosen utmattningssyndrom bara finns i Sverige, och Oskar Flygare pratade om tvångssyndrom.

Föreläsningarna kommer sändas senare i höst men finns redan nu att se online.

Här kan du se presentationerna om Braining

Här kan du se presentationen om utmattningssyndrom

Här kan du se presentationen om tvångssyndrom

Vi söker en post doc

Vill du bli post doc i vår grupp och vara med och leda en av de mest spännande studierna av psykologisk behandling? 4-dagars intensivbehandling med KBT utvecklad av Gerd Kvale och Bjarne Hansen från Bergen har fått stor uppmärksamhet och preliminära resultat ser mycket bra ut. De ser det som en helt ny sorts behandling, inte bara mer intensiv i tid. Om principen stämmer mer generellt skulle mycket ändras i hur KBT behandling ges. I Norge har det redan blivit standard för OCD. Men studien som jämför det med standardbehandling saknas. Vi vill göra den.En stor randomiserad prövning med fullt fokus på maximal kvalitet och reproducerbarhet (open science). Vill du vara med och leda den? Sök tjänsten! God finansiering, potentiell egen doktorand från start.

Läs mer och sök här: https://ki.varbi.com/what:job/jobID:419068/

Genetics of OCD

Julia Boberg – psychologist, PhD student and research group member – recently published a review article on the genetic epidemiology and molecular genetics studies of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms.

Results

OCD is a heritable, polygenic disorder with contributions from both common and rare variants, including de novo deleterious variations. Multiple studies have provided reliable support for a large additive genetic contribution to liability to OCD, with discrete OCD symptom dimensions having both shared and unique genetic risks. Genome-wide association studies have not produced significant results yet, likely because of small sample sizes, but larger meta-analyses are forthcoming. Both twin and genome-wide studies show that OCD shares genetic risk with its comorbid conditions (e.g. Tourette syndrome and anorexia nervosa).

Conclusions

Despite significant efforts to uncover the genetic basis of OCD, the mechanistic understanding of how genetic and environmental risk factors interact and converge at the molecular level to result in OCD’s heterogeneous phenotype is still mostly unknown. Future investigations should increase ancestral genetic diversity, explore age and/or sex differ- ences in genetic risk for OCD and expand the study of pharmacogenetics, gene expression, gene × environment interactions and epigenetic mechanisms for OCD.

Read the full article here.

Om psykoterapi, pandemi och utmattning – Christian Rück gästar podden Sinnessjukt

Christian Rück – psykiatriker, professor och forskargruppsledare – gästar de senaste två avsnitten av podcasten Sinnessjukt av Christian Dahlström. I avsnitten avhandlas allt från internetpsykiatri och den brittiska IAPT-modellen till diagnosen utmattningssyndrom, kritiken mot processen bakom den samt lovande studier med KBT-behandling mot utmattning.

Dessutom får han svara på frågan vilka forskningsområden han tycker är de mest under- respektive överskattade.

Avsnitten finns att lyssna på där poddar finns, eller i webbläsaren här och här!

English translation: Christian Rück, psychiatrist, professor and research group leader, is participating in the Swedish podcast Sinnessjukt, talking about internet psychiatry, the IAPT model and the Swedish diagnosis “exhaustion disorder”.

Two new publications:

On iCBT for Symptoms of Anxiety and Depression After Myocardial Infarction, and Cognitive Dedifferentiation in Abnormal Cognitive Decline

This week, John Wallert published not one but two articles! 🎉

  1. Internet-Based Cognitive Behavioral Therapy for Patients Reporting Symptoms of Anxiety and Depression After Myocardial Infarction: U-CARE Heart Randomized Controlled Trial Twelve-Month Follow-up

    The aim of this study was to evaluate the long-term effectiveness of internet-based cognitive behavioral therapy on self-reported symptoms of anxiety and depression in patients 12 months after a myocardial infarction and to explore subsequent occurrences of cardiovascular disease events. Shortly after acute myocardial infarction, 239 patients reporting mild-to-moderate symptoms of anxiety or depression were randomized to 14 weeks of therapist-guided internet-based cognitive behavioral therapy (n=117) or treatment as usual (n=122). 

    The study’s conclusions was that internet-based cognitive behavioral therapy was not superior in reducing self-reported symptoms of depression or anxiety compared to treatment as usual at the 1-year follow-up after myocardial infarction. A reduction in cardiac-related anxiety was observed but was not significant after adjusting for multiple comparisons. There was no difference in risk of cardiovascular events between the treatment groups. Low treatment adherence, which might have affected treatment engagement and outcomes, should be considered when interpreting these results.

  2. Cognitive dedifferentiation as a function of cognitive impairment in the ADNI and MemClin cohorts

    The cause of cognitive dedifferentiation has been suggested as specific to late-life abnormal cognitive decline rather than a general feature of aging. This hypothesis was tested in two large cohorts with different characteristics. The subjects came from two research databases in North America and Sweden. Dedifferentiation was explained by cognitive impairment when controlling for age, sex, and education. This finding replicated across two separate, large cohorts of older individuals. Knowledge that the structure of human cognition becomes less diversified and more dependent on general intelligence as a function of cognitive impairment should inform clinical assessment and care for these patients as their neurodegeneration progresses.