Body & Mind
Several of the researchers in Region Zealand Mental Health Service collaborate with the Region's general hospitals to create clinical intervention studies that either concern patients shared between the different hospitals or common challenges. Research into prevention and interventions that can improve treatment outcomes is important, but also research into care procedures, culture and workflows and digital solutions that can improve collaboration around patients with both mental and physical illness.
Research projects
BU-LOFUS is the child- and adolescent part of the Lolland-Falster Health Study (LOFUS). It is a cross-sectional population-based study in a rural area, characterized by a population with low socio-economic status compared to other areas in Denmark. Bio- and psychometric data were collected in 2016-2020 by medical examinations and questionnaires to children, adolescents and their parents.This includes information on mental wellbeing (SDQ), autism- and psychosis-like experiences and eating behavior. We investigate correlations between mental health indicators and protecting and adverse factors in parents or in children and adolescent’s themselves (anxiety, depression, lifestyle factors, leisure activities, loneliness etc.). The aim is to find target points for early intervention in order to prevent development of mental health problems in children and adolescents.
Background: Life expectancy of people with schizophrenia is reduced by 10-20 years compared to the general population. Mortality ratio due to cardiovascular disease (CVD) is increased two- to three- fold regardless of gender. The prevalence of metabolic syndrome and prediabetes is high, which is part due to antipsychotic treatment. Gaining weight or being obese is associated with reduced quality of life. Weight gain and metabolic syndrome are among the most frequently reported reasons for the discontinuation of treatment. Of the Glucagon-Like Peptide 1 receptor agonists, Semaglutide seems to be the most efficient at inducing a weight-loss.
Objective: The HISTORI Trial aims to reduce risk of developing diabetes and CVD in people with schizophrenia, prediabetes and overweight. This pre-specified secondary analysis of the HISTORI trial aims to investigate for an effect of Semaglutide on psychotic symptoms and quality of life through potential mediators.
Methods: A 30 weeks randomized, placebo-controlled, double-blinded study with injections of Semaglutide. Primary inclusion criteria are age 18-60 years, schizophrenia or schizoaffective disorder, pre-diabetes and overweight. Questionnaires and interviews regarding psychotic symptoms, quality of life, medication adherence and physical activity will be applied either monthly or every third month.
Perspective: Semaglutide could provide a new line of treatment in people with schizophrenia who are also overweight and have prediabetes. Through weight-loss, Semaglutide might be able to improve quality of life, to improve medication adherence and to improve psychotic symptoms via complex pathways.
Patients with mental illness and coexisting diabetes are at risk of polypharmacy, which increases the risk of adverse side effects and drug interactions. Treating this patient group requires an interdisciplinary collaboration which clinical pharmacologist can facilitate by providing interdisciplinary expertise.
Clinical pharmacologists, employed at the psychiatric department, contributes in optimizing treatment of psychiatric patients with multiple comorbidities. Besides offering an extensive medication review, the clinical pharmacologists can, through dialog with the clinicians, improve the tolerability of the pharmacological treatment by reducing adverse side effects, drug interaction as well as facilitate measures to reduce polypharmacy. To our knowledge, the current evidence of the effects of a clinical pharmacological medication review in this setting is scarce. Furthermore, the economic aspects of this expertise has not yet reached a consensus.
The aim of our study is to investigate whether adding a clinical pharmacologist can improve the efficacy and tolerability of the pharmacological treatment for patients with mental illness and coexisting diabetes. In addition, we seek to elucidate obstacles and facilitators in implementing the clinical pharmacological recommendations as well as to quantify the economic impact of adding the clinical pharmacologist in treatment of this patient group.
Contact Johan Frederik Mebus Meyer Christensen for more information
The aim of my PhD-project is to identify potential predictors of mental health service use to explore windows of opportunities to change the trajectories for youths with mental health problems. The project will combine observational studies based on two different cohorts, Mind My Mind (MMM) and Copenhagen Child Cohort 2000 (CCC2000). The first study examines the utility of a stage-based stepped care approach in a municipal setting in Denmark by exploring register-based outcomes following the stage-based visitation process of the MMM study prior to randomization. The second study examines the predictors of later need for specialized psychiatric care among youths who were deemed eligible for indicated prevention in the MMM randomized controlled trial. We will explore a range of factors as potential predictors of poor long-term outcome, including both questionnaire data and research diagnoses of mental disorders using the Development and Well-Being Assessment (DAWBA). The third study will be a 10-year follow-up on CCC2000, a large, prospective cohort study where we will examine the predictive capacities of the DAWBA by examining clinically important outcomes through the Danish registers until the age of 21. The hope is to contribute with knowledge, which enables the formation base of a proportionate visitation process.
Various projects predominantly using data from Danish patient registries to describe predictive factors for development of eating disorders and maintaining factors for longstanding or complicated disease courses of eating disorders. Currently we investigate predictive factors for admittance and duration of inpatient treatment for children and adolescents with eating disorders and referral to adult psychiatric services.
The different projects are done in collaboration with researchers at UC, UAA and MHS in the Capital Region.
The overall topic of my Ph.D.-project is early motor development in children with Autism Spectrum Disorder (ASD) and other neurodevelopmental disorders. My study is conducted a part of a large, pragmatic, multicenter, randomized clinical trial (DAN-PACT) of “paediatric autism communication therapy” (PACT) combined with usual care and compared to usual care alone in children aged 2-6 years with autism.
My study focuses on a new concept called Motor Postural Variability, which is the ability to switch and adapt posture in daily life. This skill is necessary for the child’s ability to explore the surroundings and develop new adaptive functions. Postural variability will be measured by a new, innovative video-based tool (Child Posture Variability Coding), applied to video-recordings of the child. The aim is to investigate the link between the degree of postural variability and autism core symptoms and adaptive functioning. I will also examine the presence of abnormalities in motor development in the first year of life based on health nurse data, and the risk of a later diagnosis of autism or other neurodevelopmental disorder by using data from the longitudinal Copenhagen Child Cohort 2000 birth cohort.
HISTORI Experience - a qualitative study of HISTORI patients´ experiences with Semaglutide or placebo.
The project Home-based Intervention with Semaglutide Treatment of Neuroleptica-Related Prediabetes, HISTORI, is a blinded, randomized control trial where people with schizophrenia and prediabetes have either had Semaglutide or placebo. A possible outcome of Semaglutide is weight loss.
In HISTORI Experience approximately 20 qualitative, semi structured interviews will be conducted. Focused is on the patients´ mindset while participating in HISTORI, their experiences and thoughts regarding weight and exercise, eating behaviors, psychotic symptoms and their interactions with HISTORI staff. Both within the period that they had injections and the time after they received an answer of whether they had Semaglutide or placebo.
A user panel consisting of 2 target group patients who, for various reasons could not be included in HISTORI, contributes to the preparation of a phenomenological grounded interview guide and thematic analysis.
The results of the study are expected in April 2025. It is expected that the results of the study will contribute to new knowledge regarding Semaglutide and placebo, the effect on their weight, exercise habits, eating patterns, possible effects on their psychotic symptoms and to which degree interactions with staff are of significance to the mentioned subjects.
The results of HISTORI and HISTORI Experience can for example be of use when developing treatment for the target group.
Contact Belinda Sewohl Rasmussen for more information
Contact
Adresse
Psykiatrien Region Sjælland
Psykiatrisk Forskningsenhed
Bygning 3
Fælledvej 6, 4. sal
4200 Slagelse
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Opdateret torsdag den 14. nov. 2024