Rücklab – Psychiatry research at Karolinska Institutet
Research on OCD and related disorders, precision psychiatry, psychiatric genetics, suicide prevention, stress and PTSD
In a recent episode of SVT’s Idébyrån, Christian participates on the theme “Why do you feel like shit?”. The subject perhaps raises more questions than answers.
Are most people unhappy or happy today? Or something in between? Is a happiness project or adventure project needed, or is it enough to eat hot dogs at a football game and be satisfied?
Joining the studio are Victoria Larm, author, Bengt Brülde, professor of practical philosophy and presenter Anna Lindman.
Due to TV4’s feature that a large number of calls do not reach the suicide telephone line, Christian comments on the importance of getting the right help and possible ways to deal with suicide. Watch the clip (in Swedish) here.
Jesper took part in a Dagens Nyheter article about the importance of hair for men, in relation to body dysmorphic disorder and the role hair plays in the identity.
We are looking for a new doctoral student to join our computational team!
Do you want to contribute to top quality medical research?
In the research group we work to improve the lives of individuals with psychiatric conditions. A core theme of our research is to develop more accurate prediction models for both the risk of, and also consequences of, psychiatric conditions.
The main scientific objective of your PhD project is to advance knowledge in suicide prediction. Suicide is a catastrophic event for the individual, close relatives, colleagues, and society. Your project is focused on statistical modelling in two different studies. In both studies you will collaborate with colleagues at Oxford University (UK), University of North Carolina Chapel Hill (US) and Sweden.
🎯Research project 1 is a registry study of risk factors for suicide among psychiatric patients that have experienced compulsive mental care.
🎯Research project 2 you will be working with multimodal data (including genetic data) in a nationwide suicide cohort with the purpose of improving present prediction of suicide aiming to derive and validate better risk models for suicide in the total population.
The position is a part of the Rücklab computational team, led by John Wallert.
We look forward to receiving your application!
Last week, Oskar Flygare, Volen Ivanov and Christian Rück visited our collaborators in São Paulo, Brazil to work on current projects and discuss new ones. This was the third meeting in person between the two collaborating groups, the previous ones being Alice de Mathis’ visit to Stockholm and a visit by Oskar and Christian to São Paulo in 2019. The OCD research group at São Paulo is led by professor Euripedes Constantino Miguel and our visits always involve a rich exchange of ideas relating to our research.
One ongoing research project is a pilot study of an internet-delivered treatment for obsessive-compulsive disorder (OCD-NET) which has been translated to Portuguese and is now being evaluated in Brazil. After a brief suspension due to the pandemic, the project is now well underway with ongoing recruitment and treatment of patients. So far the feedback from both therapists and patients has been encouraging. In addition to discussing the ongoing project, Oskar presented results and lessons learned from two recent clinical trials on OCD-NET in Sweden and England.
Volen shared his knowledge about hoarding disorder, from research projects and clinical work. Expertise in diagnosing and treating hoarding disorder is sorely lacking in Brazil, and our colleagues were eager to learn as much as possible in order to provide effective care. Interestingly, just months before our visit a podcast about an individual with likely hoarding disorder in São Paulo has stoked public interest and increased awareness about the condition. It is clear that our research groups have plenty of opportunities for collaboration on projects related to hoarding.
The visit was also an opportunity to plan an upcoming project led by Arthur Caye that will evaluate internet-delivered treatments for OCD, depression, insomnia and anxiety in two municipalities outside of São Paulo: Jaguariúna and Indaiatuba. The access to psychotherapy in these cities is limited and the project is an opportunity to increase access to effective treatments for common disorders. The project will evaluate the feasibility of using internet-delivered treatments in primary care, where most of the patients with mental disorders are seen.
We were once again moved by the hospitality and warmth our hosts showed us. There was a rich social programme outside the work activities and we had the opportunity to enjoy samba with Daniel Costa, soccer with Rodolfo Furlan Damiano and several restaurants together with our Brazilian colleagues Nil Morales, Sonia Borcato and Roseli Shavitt. Thanks to their generosity with their time, we got a true taste of Brazilian culture!
📣 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.
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.
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.
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”.
In a recent study published in Molecular Psychiatry, members of our group and colleagues at Karolinska Institutet have looked at suicide in obsessive-compulsive disorder (OCD). The study compared rates of suicide among 36 788 patients with OCD and matched controls without an OCD diagnosis.
The risk of dying by suicide was found to be about 10 times higher in patients with OCD (OR = 9.83 (95% CI, 8.72-11.08). Patients with OCD were also about 5 times more likely to attempt suicide (OR = 5.45 (05% CI, 5.24-5.67). The risk was marginally attenuated in women compared to men.
Lorena Fernández de la Cruz and her co-authors also note that the increased risk of death by suicide
“… remained substantial after adjusting for different groups of psychiatric comorbidities that are already known to be associated with suicide. In fact, 43% of the individuals from the OCD cohort who died by suicide did not have any other recorded psychiatric comorbidity.” (p. 4)
They argue that OCD is associated with an increased risk of death by suicide in its own right. The main predictor for dying by suicide was a previous suicide attempt.
The message for clinicians is clear:
“OCD should be added to the list of psychiatric disorders that are known to increase the risk of suicide in their own right. Suicide risk needs to be carefully monitored in these patients, particularly in those who have previously attempted suicide.” (p. 6)
The paper is freely available here.
The leading scientific journal Nature writes about our work on internet-based CBT for BDD today. Read it all here: http://www.nature.com/nature/journal/v526/n7572_supp/full/526S14a.html#close
Rücklab - Psychiatry research at Karolinska Institutet 