“e-Science to facilitate clinical trials and longitudinal studies in first episode psychosis.”

Funded by MRC and the Department of Health Supported by MHRN and the Northwest Institute for BioHealth Informatics Based at: The University of Manchester with another 8 current sites across England

What will we do… PsyGrid will track a large, representative cohort of individuals with first episode psychosis to enable epidemiological and intervention research. The results will be applied to preventing and predicting adverse outcomes. Our vision for 2015…

1. Janet is a University student. Her grades have slipped and so too has her attendance. Janet’s GP is concerned she may be developing psychosis. 2. Jo, the case manager, arranges to see her. Jo has been trained in the latest “At Risk” tool available through PsyGrid. 3. Jo downloads a copy of the latest “At Risk” tool to her PDA and assesses Janet. 10 mins later the results are ed to PsyGrid. An automatic reply is returned containing the analysis. Janet has an 80% chance of developing psychosis within the next 6 months. A Psychiatric emergency! 4. PsyGrid allows an appointment to be booked with the early intervention team. Scans and tests are performed utilising the services offered by PsyGrid. The results are mixed, but treatment is required. 5. DNA tests are performed to search for SNP’s. Janet doesn’t have any, but does still require emergency cognitive therapy. Janet attends twice weekly appointments for 2 months and almost returns to normal. 6. Unfortunately, Janet suffers a set back due to family bereavement. She is able to remain in contact with PsyGrid through their messaging service and informs them she needs help. A consultant nurse examines Janet and books an emergency appointment with a psychiatrist. Cognitions Emotions Schema 7. Although confused about the situation, Janet is able to gain further help from the nurse because she has a joint crisis plan placed with PsyGrid. This states she would like to receive medication if her situation became serious. The nurse is able to prescribe neuroleptics to help the situation. 8. At the appointment Janet admits that she smokes cannabis. A buccal swab is taken and the gene CNR1 is identified. This is not a cause of schizophrenia, but if you smoke cannabis it can contribute to the effects. Janet is persuaded to give up her habit, for the sake of her mental health, by the facts and figures available through PsyGrid. 9. A year later things are going very well. Janet is back in full time education and her follow up appointments show a return to normality. Contact with PsyGrid is still maintained as they monitor her future appointments – just in case!

How will we enable this… PsyGrid will be a system for secure collection and analysis of patient data (Psychiatry is not the only domain) We will construct the architecture in a manner to enable application to wider fields of epidemiology It will contain: frameworks, plug-in, provide tools for customisation Interoperable –Standards based –Interoperable with IT NHS systems (e.g. user federation) PsyGrid Connectivity Architecture

Development team - 7 members Aims To design and construct the software required for the workbench, including: –Portals and portlets; –Data repositories; –Trial management systems; –Security issues; –Research facilitators Clinical team – 10 members Aims To assess and study candidates with FEP. –Recruitment of candidates –Assessment –Collection of data –Intervention –Recommendations –Trial management PsyGrid is an e-Science project that will uniquely connect the skills of computer scientists and psychiatrists. There are approximately 15 PIs involved from both disciplines. The project is split into 2 areas: Who will do what….

Why our work is important… –1.5% of the population of the UK will suffer from psychosis at some point in their life –The illness can be devastating for them and their families –The outcome of a high proportion of the cases is poor –This produces a huge burden on the NHS We aim to provide a service that will: –help those suffering from psychosis; –prevent cases arising/developing; –reduce costs for the NHS; –provide support for the research/care interface that is required to progress Mental Health Research