Talk:'Fascinating' and 'provocative' research examines genetic elements of bipolar, schizophrenia

OR notes
All email repostings etc have been edited for format but not for content, except to redact personal data. All this material has already gone through scoop.

Pablo Gejman
Pablo was contacted by email, and we arranged a telephone interview.

Emails
Thanks very much. Best. Pablo

Sent via BlackBerry by AT&T From: [Removed - Pablo Gejman] Date: Wed, 21 Sep 2011 21:01:25 +0000 To: [Removed - me (Iain Macdonald)] ReplyTo: [Removed - Pablo Gejman] Subject: Re: [PRESS] Bipolar/schizophrenia research

From the taxi: mir137 locus suggests an abnormality of gene regulation...

Sent via BlackBerry by AT&T From: [Removed - me (Iain Macdonald)] Date: Wed, 21 Sep 2011 13:57:12 -0700 To: [Removed - Pablo Gejman] Subject: RE: [PRESS] Bipolar/schizophrenia research

Hi. I've just been typing up my notes from the interview; I want to be absoultuely sure I've got this right as I don't want to misquote you - when you said the data suggested chain regulation to be at the heart of the illness, am I correct in thinking you described this as "provocative data"? I was certain you did as I took notes, but now I'm not so sure and want to check.

Thanks again for this, you were very helpful!

Original Message Subject: Re: [PRESS] Bipolar/schizophrenia research From: [Removed - Pablo Gejman] Date: Wed, September 21, 2011 6:02 pm To: [Removed - me (Iain Macdonald)]

Terrific! Sent via BlackBerry by AT&T From: [Removed - me (Iain Macdonald)] Date: Wed, 21 Sep 2011 10:01:36 -0700 To: [Removed - Pablo Gejman] Subject: RE: [PRESS] Bipolar/schizophrenia research

So, that's 9:00 my time. Works fine for me. Talk to you then!

Iain

Original Message Subject: Re: [PRESS] Bipolar/schizophrenia research From: [Removed - Pablo Gejman] Date: Wed, September 21, 2011 5:57 pm To: [Removed - me (Iain Macdonald)]

Hi Iain. Thank you! Perhaps 5 pm (Wed;today) would be perfect. 6 pm is also possible but I will probably be in a taxi driving to the airport. Would this work for you?

Best,

Pablo Sent via BlackBerry by AT&T From: [Removed - me (Iain Macdonald)] Date: Wed, 21 Sep 2011 09:47:48 -0700 To: [Removed - Pablo Gejman] Subject: RE: [PRESS] Bipolar/schizophrenia research

I'm jealous! My email client dated this article about a half-hour into today, but I assume you mean to call today (Wednesday).

If I've got my timezones correct, Argentina is UTC-3 and UK is currently UTC+1. So, if I rang at 9:00 UTC that would be 6:00 your time (10:00 my time). Does that suit you?

Iain

Original Message Subject: Re: [PRESS] Bipolar/schizophrenia research From: [Removed - Pablo Gejman] Date: Wed, September 21, 2011 12:31 am To: [Removed - me (Iain Macdonald)]

Hello. I am traveling and currently in Buenos Aires. Please, call me tomorrow before 7 pm Argentina time at [telephone number redacted] (this is a US phone). Look forward to talking with you,=

On Tue, Sep 20, 2011 at 5:32 PM, [Removed - me (Iain Macdonald)] wrote: Gejman,

I'm a UK-based journalist researching a feature on the new twin papers on genetic factors to bipolar disorder and schizophrenia. I've read of your involvement here and I'd like to ask you a few questions for inclusion in the piece:
 * How reliable would you consider the results of the study?
 * Could this lead to potential new treatments for either of the disorders?
 * How strongly does the presence of two common "genetic loci" support the theory that the disorders are linked?
 * Is the cost of such large studies prohibitive? How difficult or easy was it to secure funding?
 * These are highly variable and complex disorders. Do you think this could be explained by different genetic factors being at play in different cases? Might this be a good target for future research?
 * A UK-based study earlier this month concluded sufferers of these linked disorders continue to have a raised mortality rate - and, not merely from self-harm. Might these illnesses be associated with increased risk of other hereditary conditions, e.g. cardiovascular disease?
 * Has this research raised any new questions about bipolar disorder, schizophrenia, or both?

Thanks in advance for your time, and congratulations on the research, which looks to be a big step forwards.

Iain Macdonald Wikinews administrator and accredited reporter

Interview transcript
As you might expect, quote marks denote exact utterances and the rest is paraphrase. I typed notes as I spoke with him, then typed them up properly after getting off the phone.

There is a silly typo in these, in which I've typed the wrong word; "druggable treatments" should of course be "druggable targets". I'd just change it but this has already gone through scoop.

How reliable would you consider the results of the study?

“Very reliable because of the sample size; that should provide robust results… [we] have worked with much a larger sample than before.”

Could this lead to potential new treatments for either of the disorders?

“We hope that this result will do it but we cannot be sure of that… One of the goals of genetic research is to find druggable treatments.”

“Current treatment is not satisfactory” because it does not always work and has “side effects” Aim is to “find treatments at the root of the problem”.

No evidence it is druggable

Calcium channel genetic code looks like a potentially druggable target.

How strongly does the presence of two common "genetic loci" support the theory that the disorders are linked?

“It is an excellent demonstration, because you have the same chains that are common to both disorders, in fact not just the same chains but also the same alleles”

Extent of relationship unknown [he was keen to stress this point – they may be linked, but how linked?]

'''Is the cost of such large studies prohibitive? How difficult or easy was it to secure funding?'''

“The research budget is not growing, which makes it difficult…”

Bodies in US and Europe aware of the importance of such research.

“It is not prohibitive because of the benefits.” Note; this sentence was begun with some variation upon ‘I think’.

“I think that it was money well invested” and “very well spent for the future”

'''These are highly variable and complex disorders. Do you think this could be explained by different genetic factors being at play in different cases? Might this be a good target for future research?'''

'''A UK-based study earlier this month concluded sufferers of these linked disorders continue to have a raised mortality rate - and, not merely from self-harm. Might these illnesses be associated with increased risk of other hereditary conditions, e.g. cardiovascular disease?'''

[though posed separately, he elected to answer these jointly]

We don’t have an answer yet. One distinction on genetic factors: “We will have the answer, probably, only when we sequence the whole genome.”

People will have many different variations.

Relationship between genotype and phenotype unclear.

“We know very little of the genetic architecture of schizophrenia and” other disorders.

Has this research raised any new questions about bipolar disorder, schizophrenia, or both?

“Yes for schizophrenia”; what is “interesting”: the significant loci identified were “not part of the pre-existant hypothesis.” [NOTE: Although he was careful to avoid saying the same for bipolar, he did recommend a researcher to contact on that subject – Pamela Sklar of Mount Sinai School of Medicine. I’ve already emailed her…]

'''Did not find dopamine receptors involved. Current drug treatments target dopamine receptors.'''

“Provocative data”: suggesting schizophrenia is to do with “chain regulation”.

“Fascinating result... [This has been] A mystery for a very long time and we are only starting to unravel the [genetic] puzzle.”

“Not related to anything we thought we knew [about the disease].”

Not directly related to any posed question

Something I thought was very cool: “these are very important questions… are you a geneticist?” With thanks to George Watson (dendodge) who helped me out on question-writing.

Rodney Scott
Rodney Scott was interviewed by email.

Emails
Iain,

Please see my answers next to your questions.

Professor Rodney J. Scott, PhD, PD, FRCPath, FHGSA, FFSc(RCPA) Head of the Discipline of Medical Genetics School of Biomedical Sciences Faculty of Health University of Newcastle

Phone (02) 4921 4974 Fax (02) 4921 4253 email: rodney.scott [AT] newcastle [DOT] edu [DOT] au [very publically available, broken to fool spambots]

>>> [Redacted - me (Iain Macdonald)] 21/09/2011 5:38 am >>>

Rodney,

I'm a UK-based journalist researching a feature on the new twin papers on genetic factors to bipolar disorder and schizophrenia. I've read of your involvement here and I'd like to ask you a few questions for inclusion in the piece:

How reliable would you consider the results of the study? This is a highly reliable study.

Could this lead to potential new treatments for either of the disorders? In the long term, potentially.

How strongly does the presence of two common"genetic loci" support the theory that the disorders are linked? Until more information is available it is really only suggestive. Strong enough to say there may be potentially a common pathway that bifurcates to give rise to two diseases.

Is the cost of such large studies prohibitive? How difficult or easy was it to secure funding? If any single centre tried to undertake such a study, it would require millions of pounds. Since it was a collection of data from across the world the costs were spread. In this era of financial difficulty it will become increasingly difficult to secure funding for this type of project even though the pay-offs will be significant.

These are highly variable and complex disorders. Do you think this could be explained by different genetic factors being at play in different cases? Might this be a good target for future research? It is not known how many genetic factors contribute to either of these diseases but it is likely that not all are necessary to trigger disease. It certainly is a good target for future research.

A UK-based study earlier this month concluded sufferers of these linked disorders continue to have a raised mortality rate - and, not merely from self-harm. Might these illnesses be associated with increased risk of other hereditary conditions, e.g. cardiovascular disease? Possibly. The continued raised mortality rates may be associated with the diseases themselves.

Has this research raised any new questions about bipolar disorder, schizophrenia, or both? New questions will always arise from any major study. Certainly, new questions about bipolar and schizophrenia are now able to be formulated on the basis of the results presented in the two reports.

Thanks in advance for your time, and congratulations on the research, which looks to be a big step forwards.

Iain Macdonald Wikinews administrator and accredited reporter

Michael Berk
Michael Berk was interviewed by email.

Emails
Hi Please see my comments below:

-Original Message- From: [Redacted - me (Iain Macdonald)] Sent: Thursday, 22 September 2011 3:59 AM To: michael [DOT] berk [AT] deakin[DOT edu [DOT] au Subject: [PRESS] Bipolar research

Michael,

I'm a freelance UK journalist researching a feature that will look at bipolar disorder research, and my eye was caught by your recent work. I've a few questions I'd appreciate answers to.

Your work has called into question the effectiveness of currently-used drugs upon more advanced cases of bipolar. Would you say prescribing such potent drugs can, in some cases, do more harm than good?
 * [MICHAEL BERK] No, what I am saying is that it appears that our best treatments work best earlier in the illness course; and that seems to apply to psychotherapy and pharmacotherapy.

MDF The Bipolar Organisation, a British charity, claims it can take individuals here an average of ten years to get a diagnosis. What effect might such a delay have?

I was interested to note from your research that simple aspirin and/or statins may serve as an alternative treatment. How beneficial might this be - cheaper? Safer?
 * T[MICHAEL BERK] This clearly is an issue, if we believe that earlier diagnosis and treatment facilitate better outcomes.
 * [MICHAEL BERK] This is an area of research promise, however it is too early to make any clinical treatment claims; al we can say is that this needs to be studied in properly designed trials capable of giving a more definitive answer..

A UK-based study concluded this month that bipolar individuals still have a greatly increased mortality rate - and not simply from self-harm/suicide. Might this be because bipolar disorder actually affects more than just the brain; or, could it be evidence of a link to other illnesses with genetic factors? Might this be a good target for future research?
 * [MICHAEL BERK] For sure. There is new evidence that similar pathways contribute to the risk for both medical and psychiatric illness, both in terms of lifestyle factors, and biomarkers of risk.

What has your experience been in terms of getting funding for bipolar research? Is this easy to do, or difficult, and has the recession had an impact?
 * [MICHAEL BERK] The best answer I can think of is that psychiatric disorders comprise between 16% and 22% of the burden of disability (depending on who measures it), attracts just over 6% of the clinical budget at least in Australia and 3% of the research budget. Research as a discretionary spending item is at great risk.

I thank you in advance for your time. Good luck with your ongoing research.

Iain Macdonald Wikinews administrator and accredited reporter

Suzanne Hudson
Suzanne was interviewd via email (her answers came in yesterday, Thursday).

Emails
Dear Iain

Hopefully you find the following of assistance. If within your article you could provide a link to MDF Bipolar (telephone number and website) that would be great.

A genetic test for bipolar would be a useful tool but the science and ethics are very complex. Just because someone has 'bipolar genes' does not mean they might go on to develop it. Family studies of bipolar show that this is a likely outcome of genetics research in this area. Even if it were possible to accurately predict bipolar in this way, questions about how you treat that person are difficult. For example do you start medication that is not necessary at that point in time?

We believe the NHS and Department of Health need to do more to support research and service development for people with bipolar disorder. The provision of specialist services for bipolar is very limited in the UK and the demand for our services is unprecedented.

There is a need for greater education for mental health professionals and GPs about bipolar. As the national bipolar charity we receive many, many calls and requests from GPs and other health professionals for our leaflets and information sheets which is fantastic. We very much welcome opportunities to work together for the benefit of individuals affected by bipolar.

The link between inflammation and mood disorders has been known for sometime and the use of aspirin and other drugs in depression is now becoming more common in the literature. Any new treatments for bipolar, which is a very complex and co-morbid illness, has to be a good thing.

We believe it is important pharmaceutical companies continue to invest in the development of new medications for bipolar. This is how it works in all other health specialities and mental health should be no different.

With regards

Suzanne Suzanne Hudson Chief Executive MDF The Bipolar Organisation T 0207 931 6480

11 Belgrave Road London SW1V 1RB T 0207 931 6480 Charity No: 293340 www.mdf.org.uk

MDF The Bipolar Organisation is the national charity dedicated to supporting individuals with the much misunderstood and devastating condition of bipolar, their families and carers. If you would like to find out more or make a donation, please ring 0207 931 6480 or visit the website www.mdf.org.uk

-Original Message- From: [Redacted - me (Iain Macdonald)] Sent: 21 September 2011 19:18 To: MDF Subject: Press request

Hi,

I'm a freelance journalist researching a feature on bipolar disorder. I have a few points that I'd love MDF's stance on.

Recent research has built upon our knowledge of the genetic nature of bipolar. Would you support efforts to develop a genetic screening method for bipolar? If so, would you support that being made available to people who are related to diagnosed sufferers?

A study issued this month showed the sad news bipolar sufferers continue to have an increased mortality rate, and not merely from suicide. Should the government be doing more to better understand this condition, and to improve treatment?

Do you often get complaints that NHS professionals - especially GPs who may know little about mental health problems - are not understanding or supportive enough?

One possibility being researched is that bipolar is linked to inflammation, making statins and aspirin a possibility for treatment. Would this be an improvement on the current mix of drugs?

Do you feel it's appropriate for drugs companies to fund bipolar research?

Thank you in advance for your time; and, more importantly, thank you for the wonderful work you do to help bipolar sufferers.

Iain Macdonald Wikinews administrator and accredited reporter

NICE
A NICE press contact was emailed. He failed to respond. This was sent to him:

Email
Paul,

I'm a freelance journalist researching a feature on these conditions. In the UK, sufferers continue to have an advanced mortality rate. Meanwhile, research continues to have identify new genetic factors - the long-presumed link between the two conditions was only very recently proved.

One organisation estimates it can take up to ten years to get a diagnosis of bipolar.

Bearing this in mind, what is NICE's position on the NHS starting to use - were research advances to make it possible - genetic screening to identify sufferers, or to screen the children of sufferers?

Is NICE currently looking at treatments, or other methods, to try and lower the mortality rate?

Thank you for your time.

Iain Macdonald Wikinews administrator and accredited reporter

Blood Red Sandman (Talk)   (Contribs) 23:06, 29 September 2011 (UTC)

Suggested move
Suggest 'Fascinating' and 'provocative' research examines genetic elements of bipolar disorder, schizophrenia "Bipolar" is not the name of manic-depressive illness--it's "bipolar disorder", as used in the article and in (e.g.) Wikipedia. Koavf (talk) 06:33, 25 March 2012 (UTC)


 * See headlinese. This headline is correct news style, and even if it weren't we wouldn't change it in the archives, months after publication, for a mere matter of style (though we might for, say, a spelling error).  --Pi zero (talk) 11:59, 25 March 2012 (UTC)

editprotected
editprotected May I request the admins to add the following category to this news piece: Category:King's College London. There are dozens of news articles on Wikinews related to King's College but, alas, there was no category for it earlier. I reckon I'll have to do this for each news piece...--Merlaysamuel (talk) 15:30, 6 June 2012 (UTC)
 * ✅ --Brian McNeil / talk 09:37, 5 July 2012 (UTC)