Cohort studies are large-scale research projects that track a group of people over time to examine how a number of genetic, societal and environmental factors may affect health. As a leader in both mental health research and clinical care, these large-scale studies are providing important insights to better understand who CAMH patients are, how they navigate the mental health system, how we can better support them now and also anticipate their future mental health care needs.
The Discovery Fund—made possible by anonymous $100-million donation to research at CAMH in 2018—is a key driver behind these research initiatives aimed at better treating, diagnosing and preventing mental illness.
Right now at CAMH, five major cohort studies are currently underway bringing together patients, researchers, clinicians and families in powerful new ways to develop new personalized treatments for the right people, right when they need them.
Toronto Adolescent and Youth Cohort Study (TAY)
The TAY Cohort study involves 1500 youth accessing mental health services. “Because most mental illness begins in youth, we hope to ultimately prevent worsening of mental illness, and ideally prevent more severe mental illnesses such as schizophrenia or bipolar disorder that begin in late adolescence or early adulthood,” says CAMH VP of Research Dr. Aristotle Voineskos, one of the leads of the Toronto Adolescent & Youth (TAY) Cohort Study.
Learn more about the TAY Cohort study here.
The CAMH Suicide Prevention Cohort Study (CAMH-SPCS)
This study led by a team of CAMH Scientists, including Dr. Juveria Zaheer and Dr. Albert Wong, will involve up to 500 patients who present to the CAMH Emergency Department experiencing suicidal ideation and will follow them closely for a year afterwards. By collecting a range of clinical, qualitative, biological, and health service utilization data for each individual, the team will be able to develop and test future interventions for suicide prevention.
“Suicide is one of the leading causes of preventable death worldwide,” says Dr. Zaheer. “In Canada, 10 people die by suicide every day. Almost 15 per cent of Canadians have had suicidal thoughts at some point in their lives, and recent Canadian data shows evidence of higher rates of suicidal ideation over the course of the COVID-19 pandemic. The Mental Health Commission of Canada has identified suicide rate reduction as a key priority and this study will help provide crucial infrastructure to develop and test future suicide prevention interventions.”
Cognitive Dysfunction in the Addictions (CDiA): A Neuron to Neighbourhood collaborative research program on executive dysfunction for functional recovery and sustained health in adults seeking treatment for addiction.
Led by CAMH Senior ScientistDr. Lena Quilty and Scientific Director of Neurobiology of Depression and Aging Dr. Etienne Sibille, this study will enroll up to 600 participants, all of whom are seeking or receiving treatment for a substance use disorder. Through a combination of blood samples, brain imaging, intensive cognitive testing, and detailed clinical assessments, the main goal of the study is to identify cognitive skills and associated biological markers most predictive of recovery and sustained health in adults seeking treatment for addiction.
“For a lot of our patients, mental skills like attention and problem-solving can be very much impaired while in treatment for their substance use health,” says Dr. Quilty. People have told us, ‘I’ve got this brain fog. At this point, I can’t do anything. I can’t work.’ This study will help us better understand how people with substance use disorder experience difficulty thinking during their journey. If we have a better understanding of what causes these debilitating symptoms and how they change over time, it will give us new ways to help treat them.”
Characterization and Prediction of Individual Functional Outcome Trajectories in Schizophrenia Spectrum Disorders (PREDICTS)
The PREDICTS study is led by Senior Scientists Dr. Margaret Hahn and Dr. George Foussias, Co-Director of the Slaight Family Centre for Youth in Transition and Chief of the Schizophrenia Division. The study will follow 1,000 patients with schizophrenia spectrum disorders (SSD) for five years to understand how each person's journey with the condition is different and to focus on how their daily life, well-being, and ability to be part of the community are affected. The study also aims to identify unique biological markers—including those related physical health—that can lead to the development of more precision-based treatments with people with SSD.
“In our mental health system we tend to focus on symptoms that we have treatments for while not paying as much attention to other important environmental aspects associated with this disease, like changes in social relationships, housing, school engagement and work opportunities that negatively impact peoples’ quality of life,” says Dr. Foussias. “What we hear from patients and families is that those are the things they care about the most, which is why this study is designed so we can personalize and tailor treatments for each individual’s needs and priorities.”
Disentangling heterogeneity across neuropsychiatric disorders (HetNP): bridging longitudinal clinical assessments with biobanking and basic sciences
Led by CAMH Scientist Dr. Shreejoy Tripathy, Scientist Dr. Thomas Prevot and Dr. James Kennedy, Scientific Director of the Molecular Science department and Head of the Tanenbaum Centre for Pharmacogenetics, this study is the “interactive glue” that will look for patterns of symptoms and biological markers across multiple CAMH cohort studies in order to aid in the development of future treatments.
“This research is enabled by the BrainHealth Databank, a secure and cutting-edge repository of patient data, such as research records, biological samples and brain images,” says Dr. Tripathy. “HetNP makes use powerful tools like AI and machine learning to identify patterns across the other cohort studies in order to better understand biological similarities and differences in various mental illness and addictions. We’ve never been able to look at mental illness so holistically before. The more deeply we can understand the data generated from these cohort studies, the better we can analyze it to better help our patients.”
Involving people with lived experience every step of the way
“We have become very good at partnering with patients and families in our research efforts,” says Dr. Voineskos about their participation in CAMH cohort studies.
“It’s been really rewarding to see patients and families thoroughly integrated into these studies at every step in really authentic ways,” saysFamily Engagement in Research Coordinator Connie Putterman. “Their commitment has been genuine and heartfelt. We heard that from them in their own words at our CAMH research day when they talked about how important and meaningful this work was to them.”
Get involved!
By participating in one of our studies, not only is it possible to improve your own care right now and get access to new treatments –you can also help transform care in the future for other people with lived experience of mental illness. If you want to learn more about research study participation opportunities at CAMH, click here.
