Ramsay Newsroom

The aim of the GLAD study is to investigate the roles of genes and clinical factors in the large numbers of clinically well-assessed patients being treated for depression at Ramsay Clinic Northside and Ramsay Clinic Cremorne.

Chief Investigator and Ramsay Health Care psychiatrist, Professor Philip Mitchell, said there was a very limited understanding of the factors that determine outcome in depression.

“While there are some known clinical factors that account for poor outcomes, there is growing evidence that genetic factors may play an important role,” Professor Mitchell said.

“In recent years, research has identified over 100 genetic regions that make people at increased risk of depression, and over 60 for risk to bipolar disorder. Researchers are now able to determine the sum of these genetic risk areas in the genome – the so-called “polygenic risk score” (PRS) for a range of psychiatric disorders such as depression, schizophrenia and bipolar disorder.”

Depression is a common condition, affecting at least one in four people at some stage of their life. While most with depression respond well to treatment (either psychological and/or medications), about a third do not respond to current therapies.

Through the GLAD study, researchers hope to develop a clinically useful algorithm – using both the PRS and clinical factors – that will assist clinicians in identifying important relevant factors contributing to the outcome of their patients with depression.

No other PRS studies of large highly clinically assessed samples have been undertaken worldwide.

The development of the algorithm is designed to assist clinicians in understanding the factors leading to any poor outcome in their patients, and in tailoring their treatments more accurately.

Since 2018, more than 300 patients from Ramsay Clinic Northside and Ramsay Clinic Cremorne have been assessed in detail and given genetic samples via “spit kits”.

Genetic samples from the first 250 patients have now been successfully genotyped by the Australian Genome Research Facility (AGRF) and correlations of PRS with clinical measures of outcome are due to be statistically analysed in collaboration with Associate Professor Jan Fullerton of the Neuroscience Research Australia institute.

“We are aiming for a final sample of at least 500 depressed patients,” said Professor Mitchell.

“We have extended the age range of the study sample to include adolescents after interest from the Adolescent Service at Ramsay Clinic Northside. The study will also be extended to Ramsay Clinic Wentworthville this year, and possibly also Ramsay services in Melbourne.”

These genetic samples will also be used in international research consortia for the study of genetics in depression, and the genetics of response to electroconvulsive therapy. The GLAD study has shown that it is possible to undertake high quality mental health research studies in the private setting.

“It is not possible to recruit large numbers of depressed patients in the public sector,” said Professor Mitchell. “We have been delighted at the enthusiastic response of the Ramsay wards to this research program from both nursing and medical staff.”

The GLAD study was one of the first projects to be funded by the Ramsay Hospital Research Foundation in 2017.