Understanding mental illness

How can we understand the biological basis of mental illness? How can we leverage clinical studies in genuinely innovative ways? And how can we create new forms of therapy and above all new medical training methods at the interface between the neurosciences and psychiatry that would enable an appropriate response to the dramatic increase in mental illnesses such as depression.

These questions are driving the research of the new Swiss national research center (NCCR) entitled “SYNAPSY – Synaptic Mechanisms of Mental Illness”, officially launched on 1 October 2010, whose objectives have been welcomed by international experts in this field. This project – which was announced by the Federal Department of the Interior of Federal Counsellor Didier Burkhalter – has been financed for a duration of four years by the Swiss National Science Foundation, with a total budget of 17.4 million Swiss francs. NCCR Synapsy comprises four significant research programs to be conducted at EPFL (NCCR leading house), at the University of Lausanne (UNIL), at the University of Geneva (UNIGE) and the University of Basel, and also four cooperating clinics in close cooperation with the cantonal hospitals of Lausanne (CHUV) and Geneva (HUG).

The concept of the plasticity of the synapses, discovered in the 1970s and extended to the rest of the brain over the last 10 years, has obliged researchers and clinicians to take a totally fresh look at the causes of mental illness. Daily experience, various therapies, and even the use of speech fundamentally modify the brain to the point where it is increasingly inappropriate to speak about a given mental illness without considering the state of that illness at a given moment. And this is one of the results of the convergence of neuroscience and psychiatry. By referring back to the genetic bases of a mental illness, and by identifying the biological markers of these pathologies (endophenotypes), it becomes easier for clinical researchers to categorize the illnesses, to identify them earlier, and to understand the mechanisms of their evolution. The approach from clinical to biological – for example, through the analysis of significant numbers of patients – confronted in turn with neuroscientific studies performed on animals, spark off a continuous toing and froing between theory and practice. These iterations constitute the originality and unique nature of the project. To achieve this, NCCR Synapsy will therefore base its work on state-of-the-art genetic sequencing and medical imaging (CIBM) technology platforms. Schizophrenia, autism, anxiety and depression will be the focus of these studies.

The project thus represents an important turning point within the medical and neuroscientific community. As a result, the actual categorization of these illnesses could be reviewed and corrected. Obviously, new therapeutic initiatives could be identified, but above all new teaching courses – currently being discussed – and new psychiatric profiles could emerge.

For Pierre Magistretti, Director of NCCR Synapsy and author recently of a publication * with the psychiatrist François Ansermet of the University of Geneva: “The choice of this research program by the Department of the Interior represents for us a clear indication of the importance that Switzerland attaches to the research and treatment of mental illness, which has grown in importance in our daily lives, and also of course in terms of healthcare costs".

* Les énigmes du plaisir, Odile Jacob, Paris