Prevention in schizophrenia and bipolar disorder from neuroscience to the community: a multiphase, multimodal and translational platform for research and intervention

Abstract

Schizophrenia and bipolar disorder (BD) are neurodevelopmental illnesses that cause an enormous burden of suffering, high morbidity and mortality rates. Only preventive strategies that include promotion of mental health, identification of risk factors across the life cycle, and appropriate early interventions may reduce these rates. This project focuses in primary, secondary, and tertiary prevention and to do so it incorporates a multiphasic platform to study individuals longitudinally: a) at risk mental state (ARMS), b) first psychotic/manic episode, c) with schizophrenia (treatment responders or refractory). In Module 1 we investigate biological markers through a wide range of neuroscience methods (genetics, structural and molecular imaging, neuropsychology, inflammatory markers, neuroenzymes and neurotrophyns) in humans and in an animal model of schizophrenia, investigating behavioral and biochemical aspects of the prodromal phases and testing early effects of new neuroprotective therapies to prevent psychosis. In Module 2 we evaluate the efficacy of an intervention in public health testing specialized management of mental health disorder people followed in the Family Hea1th Programs. In Module 3 we perform studies evaluating stigma and pschoeducational anti-stigma interventions in the community that help recruiting ARMS subjects. The project breaks the current illness-normality dichotomy using multimodal investigation strategies and a translational approach to clinical, neurobiological and populational aspects of the disorders. The project is a product of the fruitful collaboration between the three most productive psychosis research groups in Brazil that encompass a group of top clinicians and neuroscientists. This research platform is radically innovative since it allows the generation and testing of hypotheses from premorbid to late schizophrenia and BD focused in the identification of risk factors and in the evaluation of primary, secondary and tertiary prevention. (AU)