Uppsala Psychiatric Patient samples (UPP)
Uppsala Psychiatric Patient samples (UPP): Prospective Collection of Samples for the Study of Biological Mechanisms in Clinical Psychiatry.
Current clinical practice in psychiatry is conducted through subjective evaluation of phenotypes. Diagnostic instruments, such as structured interviews and questionnaires, greatly improve the sorting of patients into valid diagnostic groups where generalizations about etiology and appropriate treatment can be made reliably. Biological markers are, however, absent and an important dimension of diagnostics is missing. There has been an exponential increase in publications that demonstrate correlations between circulating levels of signaling substances such as hormones and cytokines to psychiatric symptom. Recent studies, for example, demonstrate elevated cytokine-levels in acutely suicidal patients and changes in cytokine levels can be followed to monitor treatment response(Lindqvist et al., 2009). Other results demonstrate autoimmune processes with targets in neural tissue that manifest with psychiatric symptoms (Sabin et al., 2008). Although these findings are still young and must be verified before widespread clinical is feasible, they imply the presence of a whole new frontier where genetics, endocrinology, immunology and psychiatry meet.
Ethical approval for the following project was obtained in spring, 2012. “Uppsala psykiatrisk provsamling” or Uppsala Psychiatric Patient samples (UPP) was launched in October as a pilot project.
The first aim is to create an infrastructure for the collection of biological material from patients with psychiatric symptoms. The infrastructure would enable systematic collection of material from patients before treatment start and regularly during treatment. This step is essential to:
-identify diagnostic biological markers (including genetic, hormonal, inflammatory markers) for disease
-identify differences between diagnosis groups
-follow biological changes induced by treatment.
-conduct case studies on selected patients (see below)
The second aim is to improve collaboration in biological research within psychiatry by increased knowledge about how to optimize patient’s integrity.