‘Our Future Health is a uniquely powerful resource for mental health research’
Is there a link between mental and physical health? And do sleep patterns have an impact on mental health conditions? Both subjects have gained traction in recent years – but they remain under-researched.
Professor Daniel Smith, Chair of Psychiatry and Head of the Division of Psychiatry at the University of Edinburgh, has dedicated his career to changing this.
“I’ve been fortunate to be able to do research alongside being clinically active,” says Daniel. “Much of that research has been around mood disorders, such as bipolar disorder and major depression.”
A decade ago, Daniel was part of a research group that was one of the first to use UK Biobank’s data set.
“This proved to be incredibly helpful for my career, and sparked my interest in large-scale population health research,” he says. “When I was invited to be an Our Future Health Early Adopter and Research Ambassador and access this data set, I was extremely excited.
“I’ve had two key areas of interest in recent years. One is the impact of sleep and circadian rhythms on mental health problems. The other is the overlap between mental health and physical conditions, such as diabetes and heart disease.
“The incredible depth and breadth of Our Future Health’s resource will allow researchers like me to examine the links between mental and physical health in a way that’s never been possible before.”
Generating hypotheses
Daniel’s first academic publication using our data set will be a descriptive, hypotheses generating one.
“It’ll explain how common mood disorders, such as depression and bipolar disorder, are within the Our Future Health cohort. Then, we’ll look at how common co-morbidities such as obesity, diabetes, and heart disease are.
“We will then investigate whether these things are more common in people with a mood disorder compared to people without one. We expect the answer to be yes, because we know this from previous work, but there are other aspects that we don’t fully understand yet.
“We’ll also do some analysis of the lifestyle, genetic, and demographic predictors for higher rates of diabetes if you have bipolar disorder, for example.
“So, this first paper will draw a broad picture and allow us to highlight what we think the priorities for more targeted investigations should be. These early descriptive studies can be foundational for subsequent work, which is a very exciting position to be in.”
1.3 million people have already signed up to Our Future Health, given a blood sample, and completed their health and lifestyle questionnaire. Of these people, approximately 7,000 have bipolar disorder, says Daniel.
“That’s a very large sample for us to work with. The size of Our Future Health already and its overall goal is fantastically ambitious. It’s going to be immensely helpful for the mood disorders field.”
Digging deeper
The Our Future Health data set includes a high level of detail about participant’s sleep habits and lifestyle, which they will have shared in their online questionnaire.
“Sleep habits and lifestyle are important contributing factors when it comes to the risk of overlap between disorders,” says Daniel. “This detail will allow us to dig deeper into our initial hypotheses.
“The long-term, prospective nature of Our Future Health’s resource is also important because it will allow researchers to track the trajectory of co-morbidities developing over time. This will help us to better understand what predicates someone developing additional health problems.
“Genomic information in the data set is incredibly useful, too. We can use some very interesting statistical approaches, such as Mendelian randomisation, to look at where observed associations might be causal.
“Working out the causal pathway between a risk factor and a disease, rather than two things merely being associated, will be extremely powerful at helping us to work out links between mental and physical health, and for developing new approaches to diagnosis and treatment.”
Our Future Health also plans to develop statistical weights to help researchers like Daniel make robust inferences on population health in their studies.
Breaking down biases in health research
The lack of diversity in health research in the past has been a big issue, says Daniel.
“In health research generally, you tend to get a bias towards the mentally and physically healthy. There are still stigmas around having a mental health condition, and that can stop people from coming forwards and taking part in something like Our Future Health.
“But I think this is changing, and attitudes are shifting. I’m hopeful that Our Future Health will play a part in this and recruit a cohort that’s more representative of people with mental health conditions.
“Our Future Health clinics are open to adults all around the country, which reduces some barriers to taking part. And so far, it seems to be recruiting a relatively diverse cohort.
“Having access to more data from younger participants, for example, is particularly important when it comes to researching serious mental health conditions, such as schizophrenia. This is because many people with the condition sadly don’t live to see middle or older age.
“By having people as young as 18 represented in the data set, we will hopefully be able to diagnose conditions like bipolar disorder and schizophrenia sooner and make discoveries that benefit everyone.”
‘A unique, British success story’
Looking 20 years’ down the line – what is Daniel’s vision for public health in the UK?
“I hope that Our Future Health helps us move towards a healthcare system that’s more nuanced and targeted. We should consider factors like the stage of illness someone is at, their age, their ethnicity, their sex, their social background, and their lifestyle.
“In the future, I think we’ll be able to predict health outcomes in a more reliable way. We’ll be able to answer questions like, at what point should we intervene in someone’s health? When should we prescribe someone with bipolar disorder certain medications? What can we do at the population level to prevent illness?
“Our Future Health is a unique, British success story. This is science that is relevant to people living in the UK, and globally.
“It has the potential to have a hugely positive impact on science, on researchers’ careers, on patients’ lives, and on public health.
“This is a fantastic opportunity for collective endeavour and something to be very proud of.”
Let’s prevent disease together
By volunteering for Our Future Health, you can help health researchers discover new ways to prevent, detect and treat common conditions such as diabetes, cancer, heart disease, stroke and Alzheimer’s.