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TRR 393:  Trajectories of Affective Disorders: Cognitive-emotional Mechanisms of Symptom Change

Subject Area Medicine
Social and Behavioural Sciences
Term since 2024
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 521379614
 
Affective disorders (AD), which include major depressive and bipolar disorders, usually begin in the 20-30 age range. They vary widely in how they progress, with episodes lasting for months, recurring approximately every 5 years. With a lifetime prevalence of 20%, they significantly contribute to global disability and lost life years. Beyond acute symptoms, the long-term illness over decades affects well-being, psychosocial functioning, and socio-economic burden. There is a profound lack of understanding about mechanisms involved in recurrences and remissions, chronicity and psychosocial decline. A better understanding of these factors and mechanisms is crucial for improving the treatment of AD. The goal of our research initiative is to identify the triggers for new episodes, to determine cognitive-emotional mechanisms and neurobiological correlates of symptom changes, and to probe mechanism-based therapies. These goals will be achieved by using a threefold approach: (i) we will use continuous mobile assessment in a prospective cohort, combining in-depth clinical characterization of individual courses of illness with neuroimaging, biobanking and -omics analyses in n=1,500 AD patients and healthy subjects over a two-year follow-up with multiple assessments. The participants will stem from the existing DFG FOR 2107 and BMBF Early-BipoLife cohorts with their wealth of available data (Domain A); (ii) we will identify key cognitive-emotional mechanisms (emotion regulation, expectation, social cognition, cognitive-behavioural rhythms) and their neurobiological correlates that mediate the effects of stressors on symptom changes in parallelized human studies and animal experiments (tandem projects; Domain B); and (iii) we will apply interventions that target the cognitive-emotional mechanisms associated with recurrences and remissions (Domain C). The innovative potential of our proposal is based on three recent developments in AD research: (i) advances in continuous, real-time mobile assessment (via mobile phones) will enable us to detect symptom changes, behaviour, cognitive-emotional states and environmental stressors under real-life conditions; (ii) the modelling of complex, dynamic systems and machine learning approaches allow the integration of human data regarding cognitive-emotional mechanisms and their interaction with stressors and modifying factors across time, which will help to ultimately predict symptom changes and course of illness in AD patients; (iii) based on the mechanisms and individual risk profiles, we will apply novel therapeutic interventions. We will capitalize on these innovative potentials to elucidate – in a 12-year perspective – (i) environmental, psychosocial and (neuro)biological factors that predict the course of illness in AD; (ii) cognitive-emotional and neuro-behavioural mechanisms that underlie the cycle of recurrences and remissions in real life; and (iii) targeted, mechanism-based therapeutic interventions.
DFG Programme CRC/Transregios

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Applicant Institution Philipps-Universität Marburg
 
 

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