Advances and emerging concepts in psychiatry

She has worked with early intervention in psychosis since 1996, when she started to plan the first OPUS I trial. She successfully achieved state funding for this trial, which was the hitherto largest RCT testing the effect of specialised assertive Early Intervention Services.

OPUS treatment was clearly superior to standard treatment with regard to psychotic and negative symptoms, substance abuse, level of functioning, adherence to medication, user’s and caregiver’s satisfaction with treatment, and use of bed days. A health economic analyses showed that treatment was cheaper and better and that the savings were clear even when taking the costs of the intensive out-patients treatment into account.

The OPUS I trial was the largest study in the meta-analysis (Correll et al), Jama Psych 2018. Participants in the OPUS trial were followed up after one, two, five and 10 years, and a 20 years follow-up is currently conducted. The long-term follow-up studies gave new insight in the long-term prognosis of patients with first episode psychosis.

Besides the OPUS trials she was PI for many large randomised clinical trials, evaluating the effect of lifestyle interventions, neurocognitive and social cognitive remediation, individual placement and support, dialectic behavioural therapy, assertive outreach to people who attempted suicide. She has worked with suicide prevention at a national level since 1997, focusing especially on suicide in schizophrenia, and suicides shortly after discharge from inpatient stay. Together with a group of epidemiologists from Nordic countries, she has proved that life expectancy in schizophrenia is 15 to 20 years shorter than in the general population.She initiated the large Danish High Risk and Resilience Study VIA 7, and the first follow-up wave VIA 11 are important parts of iPSYCH. She made an important contribution to the field by investigating the difficulties for children born to parents with schizophrenia. The results of the VIA 7 study showed that already at age seven, children of parents with schizophrenia were more likely to have poor neurocognitive performance, poor social performance, poor motor function, more externalizing and internalizing symptoms and more psychotic experiences. They also more often lived in inappropriate home environment.

Brenda Penninx, PhD, is Professor at the Department of Psychiatry of the Amsterdam UMC, Vrije Universiteit, the Netherlands.Penninx is widely acknowledged for her cross-disciplinary approach to mental health research in which she integrates psychiatry, psychology, neuroimaging, genomics, psychoneuroendocrinology, sociology and behavioural medicine. She is the principal investigator of the multi-site, longitudinal Netherlands Study of Depression and Anxiety (www.nesda.nl), an invaluable research resource for psychiatry which so far yielded >68 PhD-theses and >600 publications. She recently initiated the MARIO cohort that follows high-risk children and young adults in their stress and psychopathology patterns during life (www.mario-study.nl).

The themes of her research program encompass: 1) examination of the role of psychosocial, neurobiological and genetic factors in the etiology and course of depression and anxiety disorders; 2) understanding treatment response variability from biological and psychosocial perspectives and applying that understanding to the development and testing of new ways to manage depression. In terms of leadership Penninx has been able to weld a highly successful research group. Dr. Penninx currently supervises 4 Assistant Professors, 6 Post-docs, and 21 PhD students. More than 50 PhD students have obtained their PhD-degree under her supervision. In 2016, she has been elected member of the Royal Dutch Academy of Sciences and Arts.

Penninx has over 800 PubMed publications, mostly in high-ranking international journals. Her H-index is 117 with a total number of 56.393 citations (Web of science, 1-9-2018).

Robin Murray is Professor of Psychiatric Research at the Institute of Psychiatry, Psychology and Neuroscience, King's College, and indeed has spent most of his working life there apart from one year at NIMH in the USA. His particular interest is in psychosis. He was one of the first to suggest that schizophrenia was in part a neurodevelopmental disorder, and he and his colleagues have contributed to the understanding that environmental factors such as obstetric events, drug abuse and social adversity dysregulate striatal dopamine and thus increase the risk of psychosis. He also cares for people with psychosis at the South London and Maudsley NHS Trust. He has written over 800 articles, not all of them boring!  He is the most frequently cited psychosis researcher outside the USA, has supervised 72 PhDs and 12 MD Theses, and 40 of his students have become full professors. He was elected a Fellow of the Royal Society in 2010 and received a knighthood in 2011.

Catherine is the director of the Psychopharmacology and Emotional Research Lab (PERL) based at the University Department of Psychiatry in Oxford. This forms a multi-disciplinary team and includes graduate research assistants, DPhil students, post-doctoral researchers, Psychiatrists and Pharmacologists. The research of the group focuses on the psychological mechanisms of antidepressant drug action by exploring drug effects on human models of emotional processing. A range of methodologies are used, including neuropsychological testing, transcranial magnetic stimulation and functional neuroimaging with fMRI and PET in healthy volunteers and patient samples. This research has the potential to integrate psychological and pharmacological views of depression and treatment and has challenged the way in which we typically consider drug treatment for depression to work (see Harmer et al 2009). In addition, this research has led to the development of human experimental models to explore the effects of established and novel drugs for the treatment of depression and anxiety. Such results, therefore, have implications both for how we understand antidepressants to work but also in the identification and development of new treatments for depression and anxiety.