Impact

Dr. Nicholas Neufeld – a clinician-scientist at the Centre for Addiction and Mental Health and an assistant professor in Temerty Medicine’s Department of Psychiatry – and his team of researchers are studying the relationship between sleep and psychosis during inpatient admissions, when patients are experiencing some of their most challenging symptoms. This study will have participants (all of whom are between 16 and 35 years of age) wear a Fitbit during their admission to the hospital. The sleep data from the Fitbits will then be compared to their clinical symptoms. This novel study will provide important data for future studies focusing on early detection and prevention of relapse as participants transition from inpatient to outpatient settings. It will also inform future studies in the treatment of sleep problems in young people with psychosis. 

Suicide is a leading cause of death among young people, and inadequately treated depression is a risk factor, especially during the time soon after a patient’s discharge from hospital. Dr. Enoch Ng –  a staff psychiatrist at Sunnybrook Health Sciences Centre and an assistant professor at Temerty Medicine’s Department of Psychiatry – and his team are looking to understand if combining repetitive transcranial magnetic stimulation (rTMS, a non-invasive brain stimulation technique) with day treatment can reduce suicide risk in depressed youth recently discharged from the hospital. This study is unique as few brain stimulation programs accept youth.

Dr. Alexa Polillo – a staff scientist with the Slaight Family Centre for Youth in Transition at the Centre for Addiction and Mental Health and an assistant professor at Temerty Medicine’s Department of Psychiatry – and her team are studying how social media usage impacts sleep, emotion and mental health symptoms in youth with mental illness. Using mobile apps to track social media usage and daily mood, as well as Fitbit watches to monitor sleep, the team aims to understand the links between social media usage, mood and sleep, and to identify new social media usage markers for the early detection of mental illness.

Dr. Saadia Sediqzadah – a clinician-investigator and Continuing Medical Education Lead in the Department of Psychiatry at St. Michael’s Hospital and an assistant professor in Temerty Medicine’s Department of Psychiatry – together with a team of psychiatrists and family doctors, are working to develop a tool that helps young patients with psychosis make informed, personalized health decisions, while also reducing self-stigma and decreasing the risk of future episodes. This Patient Decision Aid will be the first tool of its kind for early-phase psychosis in patients aged 14-35 and will be co-designed by patients, families and health-care providers to guide treatment decisions.

Dr. Elisabeth Wright – a psychiatrist and clinician-teacher at Women’s College Hospital, a psychiatrist at SickKids and an assistant professor at Temerty Medicine’s Department of Psychiatry – together with her team are working to find the best ways to support the mental health of siblings of children with medical complexity. They have created a support model that screens for mental health difficulties in siblings aged 10-18 through online surveys and provides access to supports like social workers and child psychiatrists, where appropriate. This pilot study will test if the model is feasible, if siblings will use it, and will gather information on sibling mental health patterns.

Dr. Andreea Diaconescu is a scientist with the Krembil Centre for Neuroinformatics at the Centre for Addiction and Mental Health (CAMH) and an assistant professor in the Department of Psychiatry at U of T.

Dr. Diaconecu and her team are working to identify neural signals that could predict the onset of psychosis — giving clinicians the tools they need to better diagnose and manage symptoms in young people with a high risk for schizophrenia. This study will examine electrical activity in participants’ brains, recording signals set off by the brain in response to different stimuli. By observing participants over time, researchers will evaluate specific signals to determine if they are reliable indicators of psychosis, while also deciphering the mechanisms involved. Ultimately, the project seeks to enhance early intervention strategies and improve outcomes for young people living with schizophrenia by offering more precise, personalized therapies.

Dr. Lisa Hawke is a staff scientist with Education Research at the Centre for Addiction and Mental Health and an assistant professor in psychiatry at U of T.

Dr. Hawke is leading a team that is piloting a particular therapeutic model that includes peer support for reducing self-stigma in youth with multiple mental health challenges. Youth with multiple mental illness have a high risk of holding negative attitudes and perceptions about their illness, their abilities and their worth. The team has adapted narrative enhancement and cognitive therapy (NECT) group treatment – which has been shown to reduce self-stigma in adult patients with psychosis – for youth. They will assess the approach to determine its feasibility and impact – ultimately seeking to confirm whether NECT group therapy can be used to help young people with multiple mental health challenges build a healthy identity in their personal recovery journeys.

Dr. Yuliya Nikolova is an assistant professor in psychiatry at U of T and a scientist in the Neurobiology of Depression and Aging Program at the Centre for Addiction and Mental Health (CAMH).

Dr. Nikolova is exploring a new brain pathway centered on the FREM3 gene that may be an effective target for the treatment of depression. Human brain studies suggest that depression (which is typically first diagnosed in young adulthood) is associated with fewer connections in brain regions supporting mood and thought regulation. This may be due to reduced plasticity – the ability of the brain to wire and rewire itself in response to experiences. This study will explore the role of the FREM3 gene in shaping brain plasticity and depression risk.

Dr. Abigail Ortiz is a senior scientist at the Centre for Addiction and Mental Health (CAMH) and an associate professor in the Department of Psychiatry, Division of Neurosciences and Clinical Translation, at U of T.

Dr. Ortiz is working to improve treatment “precision” (i.e., prescribing the right treatment for a specific patient at the right time) and thus improve the quality of life of youth with complex mood disorders. In this project, she and her team will build Digital Twins for each study participant. Then, using several data sources (e.g., clinical and wearable data), they will employ an algorithm to weigh factors that predict the trajectory of response to specific treatments. It is ultimately hoped that this effort can contribute to the development of more personalized, early treatments in youth with complex mood disorders.

Dr. Mark Sinyor is a staff psychiatrist at the Sunnybrook Health Sciences Centre and an associate professor, Neurosciences and Clinical Translation, in U of T’s Department of Psychiatry.

Dr. Sinyor is continuing his novel use of the popular children’s Harry Potter novels in a new study that aims to improve youth’s experience of cognitive behaviour therapy and keep them in care longer to maximize benefits. He and his team will expand upon their previously developed MyOWL intervention that seeks to teach youth coping skills and emotional resiliency while reading the third novel in the Harry Potter series. With early results showing that the program, when delivered during school helps young people manage distress – including lowering symptoms of depression and anxiety – the team is now looking to understand whether it can also be used to help with hospital-based patient care engagement (i.e. how many youth stay in treatment and for how long, the degree to which they like each treatment, and the program’s impact on their mood and anxiety symptoms.)

Dr. Albert Wong is a senior scientist and a psychiatrist at the Centre for Addiction and Mental Health (CAMH). He is also a professor in the departments of Psychiatry, and Pharmacology and Toxicology at the University of Toronto.

Dr. Wong is leading a study to develop and evaluate a novel, early-detection method for schizophrenia. Schizophrenia typically emerges in late adolescence to early adulthood and its initial symptoms are subtle and non-specific – making early diagnosis and treatment challenging. This study will employ the electroencephalogram and a novel test of event timing perception to measure aspects of brain dysfunction that may contribute to the formation of delusions, a core schizophrenia symptom. This study could help to better understand how schizophrenia arises, which could lead to ways of predicting who will develop the illness, and novel treatments. 

Dr. Venkat Bhat is leading a landmark feasibility study to determine the real-world utility of digital interventions for patients receiving ketamine treatment for treatment-resistant depression (TRD) — rates of which are increasing in young populations. His pilot study will monitor young patients with TRD in real-time and collect data to explore and predict treatment outcomes. Dr. Bhat hopes this study will provide the necessary feasibility data that can translate into digital interventions, preventing remission and relapse, as well as improve treatment outcomes for young adults with TRD.

Dr. Margaret Hahn’s innovative case-control study design measures insulin resistance (IR) and blood-brain barrier (BBB) leakage in first episode psychosis (FEP) young patients. This new work could help identify vitally important early biomarkers of this disease and may also predict clinical, functional and cognitive outcomes in young patients experiencing FEP — ultimately providing insights into mechanisms that may serve as early targets for FEP intervention.

Dr. Omair Husain is developing the Optimal Health Program which will deliver evidence-based comprehensive psychosocial and mental health supports to Clinical High Risk (CHR) youths — a population which is particularly vulnerable to developing psychosis. The program will focus on appropriate interventions that can reduce a lifetime risk of self-harm and attempted suicide. With the new Optimal Health Program, Dr. Husain hopes to improve functioning, reduce distress and build resiliency in CHR individuals through virtual care provided via a web-based portal and a digital toolkit that seeks to facilitate ongoing skills development and intervention delivery.

Dr. Albert Wong is a neuroscientist and psychiatrist at the Centre for Addiction and Mental Health and a Professor in U of T’s Department of Psychiatry. Dr. Fang Liu is a Senior Scientist and Head of Molecular Neuroscience in the Campbell Family Mental Health Research Institute at CAMH. She is also Professor in U of T’s Departments of Psychiatry, Physiology and Institute of Medical Science.

Together, Drs. Wong and Liu are researching a clinical test to identify schizophrenia early.  An earlier diagnosis would allow doctors to create better, more effective treatment plans. These researchers previously found that a particular protein complex was present in the brain tissue of schizophrenia patients. Now, they are investigating whether detecting this protein complex in the blood could be a way to diagnose schizophrenia early.

Dr. Daphne Korczak is a staff psychiatrist at the Hospital for Sick Children and an Associate Professor of Child and Adolescent Psychiatry in U of T’s Department of Psychiatry.

Using real-time data from 6,200 children and their families received throughout the COVID-19 pandemic and into the recovery period, Dr. Korczak and her team are evaluating the impact of loss of school time, as well as social and extracurricular activities, on mental health. This study will provide a much deeper understanding of young people’s tolerance for emergency measures, and can be used to inform future mental health care service planning and the implementation of new public health measures during the pandemic’s recovery phase.

Dr. Wanda Tempelaar is is a clinician-investigator at the Slaight Family Centre for Youth in Transition and a staff psychiatrist in the Slaight Early Intervention Clinic at the Centre for Addiction and Mental Health, as well as an Associate Professor in U of T’s Department of Psychiatry. Dr. Nicole Kozloff is a Child and Adolescent Psychiatrist and Clinician Scientist in the Slaight Family Centre for Youth in Transition in the Child, Youth and Emerging Adult Program at CAMH. She also consults to community agencies providing mental health services to youth and serves as an Associate Professor of Child and Youth Mental Health in U of T’s Department of Psychiatry. 

Together, Drs Tempelaar and Kozloff have proposed a new virtual care model, e-NAVIGATE. This model is based on the evidence-based NAVIGATE treatment program, which has been demonstrated to improve outcomes for people with early psychosis. They will modify existing materials and staff training modules for virtual delivery. E-NAVIGATE will then be deployed to approximately 600 CAMH patients and will be assessed and compared to the non-virtual model. By demonstrating that e-NAVIGATE is as successful as NAVIGATE, they will then be positioned to expand the virtual offering to other sites across Ontario.

Dr. Ishrat Husain is a clinician scientist and staff psychiatrist in the Division of General and Health Systems Psychiatry at CAMH, as well as an Assistant Professor of Brain and Therapeutics in U of T’s Department of Psychiatry.

For people living with bipolar disorder (BD), the illness’s tendency to recur over time can cause uncertainty and distress. Recent research has uncovered symptoms of advanced aging in those suffering from BD. Dr. Husain’s study aims to investigate these changes on the molecular level and will follow patients from a young age in order to determine if the physical changes are associated with more severe BD. From this study, Dr. Husain aims to discover a set of markers that would allow him to manage BD based on severity. By building a better understanding of the biological aspects of BD, it could allow scientists to predict recurrences and mitigate their worst affects for patients.

Dr. Jacob Vorstman is the SickKids Psychiatry Associates Chair in Developmental Psychopathology at the Hospital for Sick Children, and also serves as an Associate Professor, Consultation/Liaison Psychiatry, in the U of T’s Department of Psychiatry. 

Recurrences can cause patients with bipolar disorder (BD) to experience intense feelings of powerlessness and emotional fatigue. Dr. Vortsman is hoping to give his patients a greater sense of control by providing a way for them to monitor their own mental health through their smartphones. If successful, Dr. Vorstman’s study will give psychiatrists an opportunity to provide targeted and proactive treatment likely mitigating the worst impacts of BD recurrence. 

Dr. Farooq Naeem is Chief of General and Health Systems Psychiatry at CAMH and a Professor in U of T’s Department of Psychiatry.

Disturbances in speech and language are a hallmark of psychosis in patients with SSD. By analyzing the speed, tone, and number of pauses in a patient’s speech through an app, Dr. Naeem aims to identify when a relapse is imminent and develop a unique passive method to detect relapses before they happen. This app could revolutionize early detection and intervention for patients with SSD’s and, has the potential to transform the practice of psychiatry.

Dr. Philip Gerretsen  is a clinician-scientist with the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH), and at the University Health Network (UHN). He is an Associate Professor in U of T’s Department of Psychiatry.

Dr. Gerretsen is exploring whether a technique known as transcranial direct-current stimulation — a non-invasive method that uses electrodes on the scalp to modulate nervous system activity — could help schizophrenia patients stick to their treatment plans. A recent study has shown that this stimulation may improve insight into illness among those suffering from schizophrenia. Dr. Gerretsen wants to find out if this could also help patients maintain their treatment plans and continue taking their prescribed medications.

Dr. Vanessa Gonçalves is a Project Scientist, Molecular Brain Sciences at the Centre for Addiction and Mental Health and an Assistant Professor in U of T’s Department of Psychiatry.

Mitochondria are a part of the cell that are particularly notable because they have their own DNA, distinct from the genetic code that shapes the rest of the body. There is compelling evidence that mitochondrial genes play a role in both schizophrenia and bipolar disorder. Dr. Gonçalves wants to explore that link. Her research will focus on youth diagnosed with major psychoses, and will look for a connection between mitochondrial DNA and several features of psychosis. She will sequence the mitochondrial DNA of 550 individuals, searching for genes associated with traits such as cognition and responsiveness to medication. DNA tests based on these findings could one day determine if patients are at risk for severe psychosis, or if they will respond well to specific treatments.

Dr. Aristotle Voineskos is Associate Professor of Psychiatry at U of T, Director of the Slaight Family Centre for Youth in Transition at the Centre for Addiction and Mental Health and Head of the Kimel Family Translational Imaging-Genetics Laboratory, CAMH. He is a Canada Research Chair in Neuroimaging of Schizophrenia. Dr. Joanna Henderson is an Associate Professor in the Department of Psychiatry at U of T, Director of the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Interim Implementation Director of the Cundill Centre for Child and Youth Depression at CAMH. She is also a Clinician Scientist in the Child, Youth and Emerging Adult Program at CAMH.

Together, Drs. Henderson and Voineskos are studying new approaches to identifying early signs of psychosis spectrum symptoms.

Dr. Vincenzo De Luca is an Associate Professor in the Department of Psychiatry at the U of T, a Psychiatrist and Clinician Scientist in the Complex Mental Illness Program/Schizophrenia Services, the Geriatric Psychiatry Division and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health.

Dr. De Luca is studying the interaction of early life adversities and schizophrenia vulnerability genes in young people, focusing on how this relates to suicide risk.

Dr. Benjamin Goldstein is a child and adolescent psychiatrist and Full Professor of Psychiatry, Pharmacology, and Psychological Clinical Science at U of T. He is Director of the Centre for Youth Bipolar Disorder and Director of Research in the Department of Psychiatry at Sunnybrook Health Sciences Centre.

Dr. Goldstein’s study will yield important advances regarding microvascular pathology as an underlying biological contributor to bipolar disorder, and may provide a new approach to early treatment and prevention of the illness.

Dr. Michael Kiang is an Associate Professor in the Department of Psychiatry at the U of T, a Clinician-Scientist in the Temerty Centre for Therapeutic Brain Intervention at the Centre for Addiction and Mental Health (CAMH) and a Psychiatrist in the Schizophrenia Division of CAMH’s Complex Mental Illness Program.

Dr. Kiang’s study focuses on auditory steady-state response (ASR) abnormalities within individuals with clinical high risk (CHR) for schizophrenia. It could yield an objective, rapidly-administered prognostic test for psychosis and thus help target treatment trials to those most at risk.

Dr. Nathan Kolla is an Assistant Professor of Psychiatry with U of T’s Temerty Faculty of Medicine and holds a number of other academic appointments with the university. He is Vice-President of Research and Academics of Waypoint Centre for Mental Health Care. He is a staff psychiatrist at the Centre for Addiction and Mental Health in the Minimum Secure Forensic Ward and a Clinician Scientist in CAMH’s Research Imaging Centre.

Dr. Kolla’s study explores whether it may be possible to prospectively identify young individuals who are at ultra-high risk for schizophrenia and violence. Findings of key biomarkers would also help reduce the stigmatization of all patients with schizophrenia as habitually violent.