NIMH Director Outlines Institute’s Top Priorities at APA Session

Suicide prevention, neural circuits, and computational psychiatry are at the forefront of the priorities of the National Institute of Mental Health (NIMH), director Joshua A. Gordon, MD, PhD, said at the American Psychiatric Association (APA) Spring Highlights Meeting.

Dr. Gordon delivered a talk at the virtual meeting, organized after the COVID-19 pandemic prompted the cancellation of the APA Annual Meeting in Philadelphia, Pennsylvania.

Suicide prevention is a high priority of the NIMH because suicide rates among both men and women have been consistently increasing in the United States for the past 20 years, Dr. Gordon said, noting that the reasons for the increase are unclear.

The institute is funding research to better identify those who are at risk for dying by suicide, determine ways to evaluate and quantify that risk, and develop interventions to reduce the risk, he said.

COVID-19 Colors Opening of APA Virtual Spring Highlights Meeting

One technique which could increase the identification of suicide risk is implementing universal screening procedures used by psychiatrists into emergency departments, Dr. Gordon said. The standard practice of emergency room physicians is to ask about suicide only if they suspect it, he noted.

“We know that a majority of individuals who die by suicide will have visited emergency rooms over the past few months before they attempt suicide, he said.

While bringing down suicide rates is a near-term initiative, work involving neural circuits and computational psychiatry are longer-term efforts.

Researchers have made a lot of progress in recent years in understanding how different parts of the brain, such as the hippocampus, amygdala, and prefrontal cortex, influence behavior, he said. In addition, animal studies have shown that manipulating activity in such parts of the brain can have “tremendous effects on animal behavior,” Dr. Gordon said.

Research is underway to further understand—in animals and in humans—the parts of the brain that are important for governing psychiatrically relevant behavior, to develop technologies for recording and modulating activities in those parts of the brain, and to dissect the circuits in the brain that drive the behaviors, he explained.

“We have lots of initiatives to try to take what we’re learning about the neurocircuitry that underlies behavior of relevance to our illnesses and help translate that into better approaches to treatment,” Dr. Gordon said.

The institute also wants to apply what Dr. Gordon called a recent “revolution” in data science and artificial intelligence (AI) to the field of psychiatry. Approaches being studied include computational phenotyping, biophysical modeling, and data mining.

He said the greatest promise of AI is currently in the research area, for sifting through large data sets, identifying characteristics of patients who might respond to one medication or another, and using that knowledge to develop biomarkers that could eventually be used in clinical practice.

—Terri Airov

Reference

“The NIMH: Programs, Plans and Priorities.” Presented at: the American Psychiatric Association Spring Highlights Meeting; April 25, 2020.