Søren Dinesen Østergaard, professor at Aarhus University, is receiving the Lundbeck Foundation Young Investigator Prize. The prize comes with a monetary award of DKK 1 million and is recognition of his exceedingly talented and creative efforts to develop new tools for measuring the severity of mental illness
When a science prize does its job, the recognition it represents inspires the recipient to concentrate even harder on their research – and the funding accompanying the prize gives prizewinners the means to pursue their exciting ideas and ambitions.
This was exactly what happened when Professor Østergaard received a Lundbeck Foundation Talent Prize in 2010: ‘It gave me a kick start, and I hope this prize will have the same effect,’ says the 40-year-old professor from Aarhus University.
By ‘this prize’ he means the Lundbeck Foundation Young Investigator Prize. It is worth DKK 1 million: DKK 300,000 is a personal honorary prize, and the rest is to spend on his research.
Jan Egebjerg, Director of Research at the Lundbeck Foundation, explains that Professor Østergaard is receiving this year’s Young Investigator Prize in recognition of numerous significant research results in the field of psychiatric disorders:
‘From a research point of view, psychiatry is a difficult field because there’s so much we’ve yet to understand. Among other things, Professor Østergaard has successfully developed rating scales to measure the effect of treatment of disorders such as psychotic depression and schizophrenia – and, what’s more, these tools can be used in clinical practice. This is the reason why he thoroughly deserves this year’s Young Investigator Prize.’
VERY TRICKY DEPRESSION
Søren Dinesen Østergaard qualified as a doctor from Aarhus University in 2009. Afterwards, during his basic clinical training, he worked in psychiatry, and his experiences there ended up having a huge impact on his research career.
‘I met many patients suffering from psychotic depression,’ Professor Dinesen explains. ‘This is an extremely serious condition. In addition to the usual symptoms of depression, patients often have notions which are quite out of touch with reality. For example, they may think they’ve done something terrible and are therefore plagued by extreme feelings of guilt. Or they may have hallucinations or hear voices.’
Psychotic depression is an agonising condition and is especially tricky to treat. In hospital psychiatry, it is recognised that the risk of suicide is high in such patients.
After Professor Østergaard had been working with patients suffering from psychotic depression for some time, he realised that something was missing: ‘I could see that we needed a rating tool, a scale that would give us an idea of the degree of psychotic depression in a given patient. And I decided to try to develop this tool as part of my PhD.’
He succeeded, and this rating scale – the Psychotic Depression Assessment Scale (PDAS) – has now been translated into a number of languages and is used in clinical practice around the world.
Since then, Søren Dinesen Østergaard – who today is a professor at the Department for Depression and Anxiety Disorders, Department of Clinical Medicine, Aarhus University – and his colleagues have designed other clinical tools for use in psychiatry. One of these is PANSS-6, a revised version of a classic test to assess the severity of symptoms in patients with schizophrenia. Professor Østergaard explains:
‘The problem with the classic version of the test is that it can take up to an hour to perform, and this is a long time for a patient who’s in a bad way. PANSS-6, on the other hand, can be completed in 15 minutes, and it gives us the information we need. Our revised version is now available in almost 20 languages, including Japanese, French, Italian, Spanish, English and Korean. This presumably means that it will be broadly used, and of course we’re delighted about that.’
ANALYSIS OF JOURNALS
Mental illness is often accompanied by other vulnerabilities. This means that, statistically, the extent of excess mortality in people who have a psychological disorder is significant compared with the rest of the population.
One of the projects on which Professor Dinesen is currently working concerns mapping the factors underlying this mortality rate. It involves analyses of large volumes of DNA and registry health data from Danish patients, and the study was conducted in collaboration with iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research.
The psychiatric patient journals are another vital source of data. These often include a lot of text and a wealth of valuable information which can be used to design better therapies for, for instance, depression and schizophrenia. However, as Professor Østergaard says, the problem is that it is very difficult, and extremely time-consuming, to extract the relevant data from thousands of journals:
‘In this case, it makes a lot of sense to use artificial intelligence. Computer algorithms can ‘chew through’ large volumes of text and identify specific patterns and contexts. And we’ve already started developing these algorithms at the Department for Depression and Anxiety Disorders.’
One of these algorithms – designed by one of Professor Østergaard’s former PhD students, Andreas Aalkjær Danielsen – is about to be applied in treatment of patients in Central Denmark Region.
The algorithm analyses a wide range of parameters from the patient journals and then makes an overall assessment of whether a patient’s condition may indicate a need for belt fixation. If this is the case, attempts can be made to modify the treatment so that this type of force can be avoided altogether.
‘In the same way, we’ll try to design algorithms that will indicate whether a patient who, for example, is being treated for depression, is actually in the process of developing schizophrenia – even though the patient in question doesn’t yet meet the clinical criteria for this diagnosis. In such situations, we’ll be able to keep an extra good eye on the progression of the disease,’ Professor Østergaard explains, and he continues:
‘My research is about designing tools which could ultimately help psychiatric services offer individual patients the exact treatment they need.’