Longitudinal outcomes in psychoses, and beneficial and harmful effects of antipsychotics in psychoses and off-label use
Research group leader
Research group description
Mental disorders and psychoses are important public health problems and antipsychotics (APs) are common treatments in these disorders. The Northern Finland Birth Cohort 1966 (NFBC 1966) psychosis subproject has had major contribution in studying schizophrenia. Though recovery is possible, the prognosis of schizophrenia is still relatively poor. There is very little information on prognosis and course of illness in other, non-schizophrenia psychoses. Regarding antipsychotic, the effectiveness and adverse effects of APs in psychoses after the first two years, and their effectiveness and adverse effects in off-label use are poorly understood. NFBC 1966 and 1986 offers a unique possibility to study these topics by prospectively collected data since mid-pregnancy and large national registers.
During years 2018-2023 our group will explore the effectiveness and adverse effects of antipsychotics in psychoses and in off-label use (i.e. in use for non-psychotic disorders and symptoms) in naturalistic samples collected form primary and secondary care in Oulu area and NFBC 1966. Many studies on APs use are biased to randomized controlled trials and case series with recent onset, selected, small samples and short follow-ups. The scientific study of long-term effects of APs has been neglected, and the naturalistic studies on APs in off label use are very rare. The long-term (several years) effects of medications are difficult to study in clinical trials. The cohort design and naturalistic sample adopted here are preferred when studying the long-term effectiveness and side effects of medication.
Docent, Academy Research Fellow Erika Jääskeläinen works as a researcher in University of Oulu and psychiatrist as Oulu University Hospital. She has studied course of illness in schizophrenia for several years. During last years she has focused on studies of effects of antipsychotics, and I the future she aims to investigate the effects of antipsychotics in psychoses and especially in non-psychotics conditions i.e. in off label use.
Where are we headed
During next years, the overarching aim of this project is to explore the effectiveness and adverse effects of APs in psychoses and in off-label use (i.e. in use for non-psychotic disorders and symptoms). This will be done via examining the associations between AP use and psychiatric symptomatology, suicidality, cognition, occupational functioning, and metabolics. In addition, the predictors of effectiveness and adverse effects will be analysed. We hope that our results would clarify the harm-benefit ratio of using antipsychotics in off-label use and contribute to knowledge and future guidelines on adequate use of antipsychotics. Beside this, studies on long-term outcomes of psychoses will continue.
Our main collaborators
- Jouko Miettunen, Professor, University of Oulu, Finland
- Hannu Koponen, Professor, Dept. Psychiatry, University of Helsinki
- Matti Isohanni, Professor (emeritus), University of Oulu, Finland
- Jennifer Barnett, PhD, University of Cambridge, UK
- Graham Murray, MD, PhD, University of Cambridge, UK
- Anthony Ahmed, PhD, Assistant Professor, Weill Cornell Medical College, US
- Peter Jones, Professor, University of Cambridge, UK
- Heli Koivumaa-Honkanen, University of Eastern Finland
- Jussi Seppälä, MD, PhD, University of Oulu, Finland
- Kristiina Moilanen, MD, PhD, University of Oulu, Finland
- M-RESIST Group (www.mresist.eu)
How to find us
Research Unit of Population Health, University of Oulu.
Email: erika.jaaskelainen[at]oulu.fi, Tel. +358 40 7191146