A new project getting underway at the Montreal General Hospital could allow psychiatry to catch up with other specialties when it comes to precision medicine, potentially reducing the "trial and error" approach that is now often the norm before finding the right therapy.
Over the next few years, Dr. Simon Ducharme will lead a team of researchers and collect data to advance knowledge on the subject, such as biological markers from the patients they see.
"The goal of all this is to make a huge research database that we can then use to use artificial intelligence or other models to predict things like who will respond to treatment X rather than Y, who will have a poor prognosis or a good prognosis, to come up with methods to personalize treatment," said Ducharme.
Precision medicine is a very hot topic in areas such as cancer and cardiovascular disease at the moment. Essentially, it involves analyzing a patient's genetic profile, and sometimes their disease profile as well, to identify the treatment that will have the best chance of success.
To achieve the goal for psychiatry, researchers need large amounts of data collected over the long term from countless patients. That's why researchers at the Montreal General Hospital hope to follow some patients for up to 10 years.
"And while hemato-oncologists can, for example, analyze the tumour to determine the best strategy, psychiatrists don't have that luxury," said Ducharme. "In psychiatry, I would say it's even more complex because you don't start with diagnoses that are as clear as in cancer. In psychiatry, we work with diagnoses that are clinical, whether we're talking about bipolar disorder, schizophrenia, these are clinical diagnoses that are not based on biological markers."
At this point, Ducharme admitted, psychiatrists can't say why antidepressant A worked in patient B but not in patient C, or predict with certainty which treatment will help which patient. He hopes that the research project will minimize this reliance on trial and error in a few years.
The precision psychiatry project is made possible by the Montreal General Hospital Foundation's CODE ViE campaign, which has raised $110 million since October 2018 and will initially spend about $2 million.
The funded projects are organized around five main themes: trauma, personalized cancer treatment, clinical innovation, aging well, brain health and mental health.
-- This report by The Canadian Press was first published in French on Feb. 22, 2022.