Luca Sforzini: “Research is the most powerful instrument available to improve the way we approach mental health”

Luca Sforzini is M.D., Psychiatrist, Ph.D. student at Stress, Psychiatry & Immunology (SPI) Lab, Institute of Psychiatry, Psychology and Neuroscience, King’s College London (UK). As an early career investigator, he shares in this interview his views on mental health research and  his experience at EU-PEARL.  

 

What started your scientific vocation?

I have always been interested in science and research. I obtained my medical degree and completed my specialist training in psychiatry in Milan, Italy. During my clinical work, I experienced first-hand the complexities and pitfalls implicated in the management of psychiatric conditions. It was then that I decided to dedicate myself to psychiatric research. In my opinion, research is the most powerful instrument available to improve the way we approach mental health, ultimately helping people.

What is your area of expertise?

My research is mainly focussed on major depressive disorder (MDD) and treatment-resistant depression (TRD). MDD is a severe clinical condition which in about one third of individuals persists despite multiple antidepressant treatments – namely TRD. In my studies, I aim to understand how the organism reacts to MDD and TRD, and vice-versa, how MDD and TRD affect the organism. The biological alterations associated with MDD and TRD may represent a promising target for interventions. For example, inflammation, which is a biological response to potentially harmful stimuli (including infections), is critical in both MDD and TRD. I truly believe it is essential for psychiatric research to facilitate this ‘translation’ between clinical symptoms and biological findings. The recognition of biological markers associated with MDD and TRD may ultimately lead to a better diagnosis, treatment, and prevention of these conditions.

In my opinion, research is the most powerful instrument available to improve the way we approach mental health, ultimately helping people.

What attracted you to EU-PEARL?

I have been involved in the EU-PEARL project since the beginning. When my supervisor, Professor Pariante, offered me the opportunity to join EU-PEARL, I immediately agreed. I was following with great interest the development of platform trials in other medical fields, and I thought this was a unique opportunity to transform the way we conduct research in MDD and TRD. This is, in my opinion, a step which is absolutely needed.

Which main challenge are you contributing to address?

The first challenge we faced in the project was to develop consensus criteria to define TRD. The absence of clear TRD definitions still complicates the generalizability of results from research settings to the real-world, and hinders progress in this field, as there is no uniform population for clinical and biological investigations, including clinical trials. We therefore developed and published a Delphi-method-based consensus guideline on how to define TRD for inclusion in future clinical trials 1. We brought together a group of international experts, both within EU-PEARL and external. The group included clinicians, academics, researchers, employees of pharmaceutical companies, regulatory bodies representatives, and one person with lived experience. We finally provided recommendations on how to design clinical trials, and on how to guide research in unmet needs and knowledge gaps.

Our ultimate ambition is to advance tailored treatments and a truly ‘precision medicine’ for MDD and TRD, which in turn will finally help to deliver better care for people suffering.

What impact will the result of this research have? 

MDD is recognized as a leading cause of disability worldwide. Notably, about one third of individuals with MDD do not achieve full symptomatic remission even after multiple antidepressant treatments, and are therefore defined as having TRD. Despite this evidence, MDD research is still incomplete; no biomarker is currently available, TRD definitions are frequently inconsistent, and results are too often hardly comparable between different studies. Therefore, clinicians, researchers, and people with lived experience are all still struggling to find better treatments. I believe that the development of integrated research platforms in MDD/TRD will help to evolve research towards a more standardised and patient-centred approach. Our ultimate ambition is to advance tailored treatments and a truly ‘precision medicine’ for MDD and TRD, which in turn will finally help to deliver better care for people suffering.

Thinking about your personal experience in EU-PEARL, what learnings will you take away from your participation in the project?

The main lesson I learned from my participation in EU-PEARL is the fundamental importance of multidisciplinary collaboration in medical research. Successful research cannot prescind from a shared effort, in which different people with different areas of expertise provide their input to achieve a shared goal. In this cooperation, the role of people with lived experience is crucial; their point of view, including reported symptoms, outcomes, and expectations, must be necessarily pivotal in future studies.

The main lesson I learned from my participation in EU-PEARL is the fundamental importance of multidisciplinary collaboration in medical research.

 

Related articles:

Boosting drug development for depression with an integrated research platform

Is EU-PEARL making progress in tackling the scientific challenges of Major Depressive Disorder (MDD)?

A Delphi-method-based consensus guideline for definition of treatment-resistant depression for clinical trials 

When the name does matter 

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