Rücklab – Psychiatry research at Karolinska Institutet

While the world around us may have had a perplexing year, we have in fact had a great year  when it comes to research.

Here is a review of some of what has happened in our group:

In our own humble opinion we have published some landmark studies:

A large randomised controlled trial of internet-based CBT for Body Dysmorphic Disorder, showing excellent results, published in the BMJ with Jesper Enander as lead author.

The largest study so far looking at risk factors around birth in Obsessive-Compulsive Disorder (OCD), published in JAMA Psychiatry with Gustaf Brander as lead and David Mataix-Cols as senior author. This study to me also shows the power of Swedish national registries.

The largest study so far looking at suicide in OCD and finding a much higher suicide rate than expected. Lead author is the brilliant Lorena Fernandez de la Cruz and this master piece out of the Mataix-Cols kitchen was published in Molecular Psychiatry. A similar study on tic disorders was also published in Biological Psychiatry.

Fabian Lenhard pioneered the first randomised study looking at ICBT for adolescents our neighbouring research group of Eva Serlachius. It was just published in JAACAP.

What else did we publish in 2016? Check https://rucklab.com/publications/

Genetics: major study started and harvest time for some

We have started a new big study trying to understand the complex genetical architecture of OCD and related disorders. You can read more about the study here. Good news is that data collection is going well (=lots of DNA) and that we in this year have built a lot of infrastructure to ensure a bright future for the project.

We are collecting samples at 8 centers in Sweden and this study is part of a larger Nordic effort called, yes, NORDiC! Read all about NORDiC here: http://www.crowleylab.org/nordic

We have DNA from about 2500 individuals who have undergone internet-CBT for other anxiety disorders and depression. It is now harvest time for some of that, data is being analysed at different sites in Europe with Evelyn Andersson as the coordinating PhD student.

New people

Oskar Flygare has secured a CSTP-grant and will start a PhD early next year in tight collaboration with Lina Lundström.

Annelie Porsborn, Julia Boberg and Susanne Alm are our new front-line soldiers, all employed in the OCD genetics project.

Long-Long Chen and Mia Asplund are both hang-arounds likely to go into a PhD next year on poo bacteria, Deep Brain Stimulation and skin-picking and hair-pulling. What a mix!

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A special shout out to Volen Ivanov who has tirelessly educated hundreds of people in the social services on Hoarding Disorder!

We wish you all a great 2017! Thank YOU to all our collaborators, research subjects, readers and funders!

Vi söker dig som vill vara med i en studie som jämför internetbaserad KBT med “vanlig” KBT vid tvångssyndrom. Läs mer på: http://web.internetpsykiatri.se/behandling/tvangssyndrom/

Last week we had the honor of being visited by a lab alumni, Erik Andersson. It was time to close and archive our trial where we tested the efficacy of d-cycloserine as an add on to CBT for OCD. You can read the results of that trial here in Jama Psychiatry. Now all the follow-ups are done and it was time to close the trial, send the end-of-trial forms to the Swedish Medical Products agency and to return the drugs to the pharmacy.

It was really a trip down memory lane, remembering how we got APL Pharmaceuticals to produce both the drug and placebo, the massive workload for all approvals and the task of actually get such a big trial done. Broke the bank and got us a few gray hairs. Good news is that the treatment with internet-based CBT in the trial was very helpful for the participants.

Vi söker en tredje forskningssjuksköterska i vårt stora genetikprojekt. Vill du vara med i världens största studie för att förstå tvångssyndromets genetiska bakgrund? Vi vill bli en till i vårt team! Läs mer på https://ki.mynetworkglobal.com/se/what:job/jobID:123067/where:4/

In this longitudinal cohort study of more than 1 million men in Sweden, a higher resting heart rate in late adolescence was associated with an increased risk for subsequent obsessive-compulsive disorder, schizophrenia, and anxiety disorders, whereas a lower resting heart rate in late adolescence was associated with an increased risk for substance use disorders and violent criminality. Similar associations were observed with systolic/diastolic blood pressure.

Read the full paper here. 

Latvala A, Kuja-Halkola R, Rück C, D’Onofrio BM, Jernberg T, Almqvist C, Mataix-Cols D, Larsson H, Lichtenstein P. Association of Resting Heart Rate and Blood Pressure in Late Adolescence With Subsequent Mental DisordersA Longitudinal Population Study of More Than 1 Million Men in Sweden. JAMA Psychiatry. Published online October 26, 2016. doi:10.1001/jamapsychiatry.2016.2717

A new study on risk factors at birth associated with developing OCD later has just been published in JAMA Psychiatry. Over 2 million children were followed and we studied perinatal data from the Swedish Medical Birth Register and included maternal smoking during pregnancy, labor presentation, obstetric delivery, gestational age (for preterm birth), birth weight, birth weight in relation to gestational age, 5-minute Apgar score, and head circumference. A range of perinatal risk factors were associated with a higher risk for OCD independent of shared familial confounders, suggesting that perinatal risk factors may be in the causal pathway to OCD.

Read the full story here.

Brander G, Rydell M, Kuja-Halkola R,  Fernández de la Cruz L, Lichtenstein P, Serlachius E, Rück C, Almqvist C, D’Onofrio BM, Larsson H, Mataix-Cols D. Association of Perinatal Risk Factors With Obsessive-Compulsive Disorder: A Population-Based Birth Cohort, Sibling Control Study. JAMA Psychiatry. Published online October 05, 2016. doi:10.1001/jamapsychiatry.2016.2095

Christian Rück is speaking Monday Sept 19 at 0900-1040 in the “Obsessive-compulsive disorder: clinical heterogeneity and innovative treatment approaches”-symposium. The title of his presentation is “How can psychological interventions for OCD patients be more accessible and outcomes improved?” Welcome.

EABCT, or European Association for Behaviourial and Cognitive Therapies, is hosting their 46th conference this weekend. The conference takes place at the Waterfront Congress Centre in Stockholm, Sweden. Representatives from our team will of course be present at the congress, see you there!

Thursday

Friday

Panel Discussion

Vård av Psykisk Ohälsa i Sverige – Aktuell Situation och Framtida Utmaningar

Group Leader Christian Rück participates in this discussion, which will be held in Swedish.

Saturday

Poster

Lina Lundström and Oskar Flygare will present their poster at Saturday’s poster session. Come talk to them and ask critical questions about their study protocol!

Symposium

Recent Advances on Cognitive-Behavioural Mechanisms and Treatment of Body Dysmorphic Disorder