Why is this research important?
Depression is a common mood disorder but can have serious consequences for patients’ quality of life. The symptoms can be severe, profoundly affecting how people feel, think, and cope with daily activities, such as sleeping, eating, or working. Depression is caused by a range of genetic, biological, environmental and psychological factors – singly or in combination. In the UK alone, 3 million people live with depression today and 1 in 10 of us will be affected by it during our lifetimes. Every year, nearly 10 million working days are lost to depression.
And yet, there are many proven treatments for depression out there and we know that they can be highly effective. The problem is that there is currently no way of quickly and accurately finding the right medication for individual patients. Clinicians assess how individual patients respond to different medications and change their medication accordingly. But with 50-60% of patients not improving on the first antidepressant they try – and each new treatment taking around 6 weeks to show whether or not it’s effective – this can be a lengthy and distressing, delay and an inefficient use of time and resources. What’s needed is a quicker, more accurate way of knowing which medication will work best for any specific patient.
What are we doing?
Pioneering work by Professor Catherine Harmer and her team has given us a new understanding of the ways antidepressants work. They have developed a unique test to measure how patients respond to negative, positive and ambiguous images of human facial expression within the first week of antidepressant medication.
People with depression demonstrate a negative bias in their assessments of these images, interpreting them more negatively than people who are not depressed. Further, antidepressants act to make people more positive in their interpretations of the faces. We’ve seen that these changes in how people assess the faces occur quickly after starting antidepressants and are a highly promising indication of whether the patient will go on to respond to the antidepressant in the longer term.
This research forms the basis of a very large RCT (Randomised Controlled Trial) called the PReDicT trial which is assessing the effectiveness of the test. This study has been running for 3 years to date by our industrial collaborators, P1vital Ltd. It has assessed 900 patients across Europe, each of whom was part of the study for 12 months.
“This project is immensely exciting. It is testing the possibility that we can use cutting-edge advances in cognitive neuroscience to improve the treatment of patients with depression.”Michael Browning: Chief Investigator – RCT
What do we hope to achieve?
Traditionally, to measure the effectiveness of antidepressants, clinicians would have to wait for up to 6 weeks before patients felt able confidently to say whether or not they felt more or less depressed. If our study reveals that the test helps match specific patients to the best medication for them faster, then we’ll have taken a major step forwards in shortening recovery times, improving outcomes and reducing the burden depression imposes on so many people.