Science seeks new ways to tackle depression: early detection of risks and personalized treatment

The EU-funded project WARN-D aims to predict who is at risk of depression and then develop a customised programme to prevent them from falling into it; the project's ultimate goal is to create an early warning system, which involves a smartphone application to monitor users’ mental health in real-time and detect when an individual is at risk of depression. By identifying people who are at risk of depression, the project hopes to help them stay mentally healthy for longer.

Depression is a chronic illness characterized by persistent low mood and people who suffer from it, after suffering a first episode that comes to alter their daily lives, often have recurrences. About half of people with depression suffer from it more than once. For many patients, this condition stays with them for life. In the European Union alone, 7.2% of the population suffers from chronic depression and the risk increases fourfold for women.

As the medical and scientific community works to get this global pandemic under control, one of the ideas that is gaining more traction is to find people who are at risk for depression, as it may affect their future. Protects the mental health of.

“It is becoming increasingly clear that a first episode of depression is a trigger for a second episode, so from a scientific point of view, there is a chance that preventing the first episode will prevent the next,” explains Eiko. Fried, Associate Professor of Psychology at Leiden University in the Netherlands. He is also the principal investigator of WARN-D, an EU-funded project that aims to predict who is at risk of “falling down the well” and then create a custom program to avoid it. . The project started in 2021 and will run till 2026.

First Symptoms

Although prevention programs already exist, including psychological interventions aimed at building resilience, these can only work if those at risk of suffering a depressive episode are identified early. WARN-D is the first study to attempt to develop a reliable early warning system.

This would involve an application for smartphones capable of monitoring a user’s mental health in real time and combining this information with data from their social, psychological and biological environments. Its purpose is to detect the moment in which the individual is reaching his personal limit, that is, the critical moment in which the accumulation of problems puts him at risk of collapse. The development of the application will start in the next two years. First, the research team had to sift through large amounts of data, looking for common symptoms among people with depression.

Its goal is to group people according to a complex set of traits including personality (eg extrovert versus introvert), factors that catalysed the development of their disorder (such as a traumatic childhood), and an individual’s innate potential. . To bounce back from setbacks (also known as resilience). Different groups are unlikely to respond to the same intervention, meaning that preventive programs must be tailored to each group for positive results.

Youth at Risk

The study sample consisted of 2,000 young adult students (recruited in successive cohorts of 500) living in the Netherlands. People in this demographic are disproportionately affected by depression and are therefore of particular interest to the research community. “Suffering from depression at an early age is associated with worse clinical outcomes throughout life,” says Fried. “Many youth will spend more than 20% of their lives in a state of depression.”

Another advantage of choosing young students is that it is easier to persuade them (with the help of cash incentives of up to 90 euros) to wear the smartwatch day and night for the first three months of study, which will last for two years. The watch records activity from steps taken to hours slept and detects stress levels through the heart rate sensor.

In addition, four times a day they were asked questions about aspects related to how they are at that time and believed to influence depression. Questions can be about how they slept, how happy or angry they are, or what they are doing at that exact moment. In addition, each Sunday they are asked more general questions about anxiety and depression; For example, what have been the best and worst events of the week.

“Our big goal is to find out how people differ and how they are similar with regard to their response to stress,” says Fried. “Once we find the commonalities, we can start working on systems that make people more resilient.”

Why This Sadness?

Symptoms of depression include intense sadness, fatigue, trouble sleeping, loss of appetite, and loss of interest in previously enjoyable activities.

Almost certainly, the causes of this disease are due to exposure to a number of factors, some biological and others environmental. Genes may also play a role to some extent, as a person is more likely to develop depression if someone in their family suffers from it. However, anyone can get into depression. Possible triggers include stress, poverty, illness, hormonal changes, and traumatic events, such as a difficult childhood or bereavement.

Although some studies suggest the drugs may help, right now, the effectiveness of antidepressants is usually a matter of chance, as only about half of patients respond positively to their first prescription. Getting medication off the ground early on would have a very positive impact on both people with depression and the economy, and would reduce the pressure on medical professionals.

Talia Cohen Solal is a neuroscientist and CEO of Genetica+, an Israeli company that develops tools to create personalized treatments for depression. “Currently, our strategy for finding the right drug is trial and error,” he explains. “As a result, 63% of patients try multiple drugs and a third do not respond to treatment after two rounds.”

Brain in a Petri Dish

In his EU-funded RxMine project, Cohen Solal uses the “brain in a petri dish” model (in the laboratory, using stem cell technology, human stem cells and brain networks are generated from patients’ blood samples). So that the optimal antidepressant can be determined. each patient.

In previous research, the researcher’s team looked for specific cellular changes in brain tissue called “biomarkers” that correlate with a patient’s response to a drug. For an individual to respond positively to an antidepressant, there must be a substantial change in the levels of the relevant biomarker in the generated brain model.

Research staff dream that one day everyone with depression will be tested to see which drug is most suitable for them. This could reduce health care costs related to depression by up to 43%, leading to annual savings of up to €6,500 per patient.

The team is expanding their study with new drugs, as well as ways to streamline their testing procedures. “We hope to have something that we can get up and running within two years,” says Cohen Solle. “Our main aspiration is to try to find the right treatment for each patient quickly and they don’t have to go through an unacceptable and dangerous process of trial and error to find their medicine.”