Only 14 - 20 percent of people with psychosis will have a full recovery with the majority
having recurrent episodes and relapses similarly only 25 percent of people with depression
will receive full remission and response to pharmalogical treatments I'm Paris Alexandros Lalousis
and I'm a Priestley PhD fellow at the University of Birmingham and the University of Melbourne,
based at the Institute for Mental Health and the Centre for Human Brain Health the comorbidity
between psychosis and depression is exceptionally high 40 - 80 percent of people with psychosis
have depression and this is indicative of a poor prognosis conversely, psychotic symptoms
occur in 14 to 19 percent of people diagnosed with a major depressive disorder such heterogeneity
presents challenges to existing diagnosis and some symptoms have been proposed as transdiagnostic
what we mean by transdiagnostic means that different disorders share common causal and
maintenance processes and that treatments designed to treat specific disorders overlook
comorbidity machine learning is a branch of artificial intelligence that uses data to
automatically learn and improve from experience and also detect patterns without being explicitly
programmed an example of machine learning is when you upload a picture of a person on
social media and a machine learning algorithm uses data to detect whether that person is
someone you know and who it is so that you can tag them so these machine learning approaches
could aid diagnostic and treatment challenges by disentangling complex symptomatology and
providing a deeper understanding of what it is that is particular about the brains and
symptoms of people who present with comorbidity this will potentially help the development
of new therapies for new targets that were previously unidentified my research uses a
combination of supervised and unsupervised machine learning techniques utilising clinical
neuroimaging and neurocognitive data from the multisite premiere study to investigate
the heterogeneity of depression and psychosis and the importance of transdiagnostic symptoms
results so far have shown that transdiagnostic symptoms show very good ability to accurately
classify categorical diagnoses in symptomatologic pure groups only meaning that the majority
of psychosis and depression patients have a transdiagnostic profile the brain structure
and symptoms reveal a similar picture and have potentially similar causes traditional
diagnostic groups show a mis match between the clinical picture and the brain structure
meaning that the current diagnoses that we have do not reflect the biological reality
of patients this highlights the need to do research that uses neurobiological data to
define potentially new diagnoses using a semi supervised machine learning approach models
built on brain imaging data suggest the presence of distinct structures or patients who have
both depression and psychosis each cluster of patients was formed based on the similarity
of the brain structure what this shows us is that there is a big number of people for
a clinically characterised as having different disorders but show similar brain structure
such biologically informed clusters could potentially aid with diagnoses and prognoses
of these disorders indeed in the next step of my analyses I aim to build predictive machine
learning models using these biologically informed clusters and compare their ability to produce
a successful and accurate prognosis compared to traditional diagnoses recent work at the
university of Birmingham on disfunctions of the immune system the bodily system that controls
monitors and responds to environmental challenges highlights that it maybe causally related
to depression and psychosis Professor Rachel Upthegrove's lab which I am part of leads
the psychosis immune mechanism stratified medicine study (PIMS) which investigates the
role of the immune system in psychosis not all young people with psychosis show immune
dysfunction and we need to better understand how to stratify groups into those who may
and may not benefit from immune bases treatments ultimately the mental health research that
we do here at the University of Birmingham paves the way for precision personalised medicine
in psychiatry if you are interested and to find out more about the research that we do
you can find me on twitter @P_Lalousis and on Research Gate if you search for my name
thank you.