Stress-related psychiatric disorders across the life span

Prof. dr. A.M. van Hemert, prof. dr. R.C. van der Mast, prof. dr. N.J. van der Wee, prof. dr. R.R. Vermeiren, prof. dr. E.F. van Furth, prof. dr. J.M.A. van Gerven, prof. dr. H.G.J.M. Vermetten, prof. dr. V.M. Hendriks

Aim and focus

The aim of our research is to better understand the onset, course and chronicity of stress-related psychiatric disorders across the life span and to translate our findings into personalised treatment and prevention for our patients and their families.

As a general background for our research we assume that the broad categories of mood, anxiety and trauma and stressor-related disorders in adults, as well as certain disruptive disorders in adolescents, share a dysregulation of psychobiological stress-regulation systems in interaction with the environment. The capacity to adapt to a wide range of psychosocial stressors shows considerable variation from one person to another. This is partly due to skills and experiences that are acquired in a caring and structured upbringing and partly due to biological (genetic) vulnerability or resilience of the stress-regulation systems. The transdiagnostic point of view entails that many of the stress-related disorders, that are considered separately in the common classification systems, are likely to share similar dysregulations.

In our programme we focus on this group of “stress-related disorders”, which include mood, anxiety, and somatoform disorders, trauma and stressor related disorders, obsessive-compulsive disorders and eating disorders and certain behaviour disorders in adolescents. We study these disorders across the life span from early adolescence into adulthood and old age. Over the lifespan, different disorders from this stress-related spectrum may alternate within the same person, shifting from behaviour disorders in early adolescence towards alternating affective and anxiety disorders in adulthood and sometimes mainly apathy in old age. In addition to frequent co-morbidity, there is considerable overlap in treatment approaches between these disorders and often simultaneous improvement.

In our Centre for Mood and Anxiety disorders, we connect clinical and neurobiological research with top clinical care. We share working alliances in clinical research with the Regional Mental Health providers GGZ Rivierduinen, Parnassia Group and Curium-LUMC. In these clinical settings we develop and apply techniques of Routine Outcome Monitoring to evaluate and improve personalised patient care. In the Centre for Child and Adolescent Psychiatry (Curium-LUMC), we focus on the early identification of stress related disorders within community mental health centres, (forensic) youth care centres, and youth addiction centres, in order to optimise referral and accurate personalised intervention. We are partner in the regional Academic Workplace SAMEN (‘Together’) and Risk Youth. Next, the Centre focusses on monitoring outcome and improving personalised patient care in specialist child mental health services, which is done in close collaboration with the Knowledge center Child and Adolescent Psychiatry (Kenniscentrum Kinder- en Jeugdpsychiatrie) and other child mental health institutes as part of the e-KJP (expert network Child and Adolescent Psychiatry.

In our Centre for Neuropsychiatry and Ageing, we focus on (clinical) research of stress-related psychiatric disorders and the complex relation between psychopathology and ageing, with specific attention to neurodegeneration and the (cardiovascular) heart-brain-axis (i.e. heart failure, brain perfusion, and neuropsychiatry in aging). Aetiology and manifestations of stress-related psychiatric disorders in old age are particularly influenced by age-related phenomena such incident neurodegenerative and cerebrovascular diseases (with or without cognitive decline), other somatic morbidity, loss of hearing and sight, functional decline and social isolation. The Centre is affiliated to the LUMC Research Profile ‘Ageing’ and the Leyden Academy for Vitality and Ageing (LAVA).

Using a transdiagnostic life time approach, we aim to elucidate the shared biological underpinnings of vulnerability and resilience for stress and “trauma” related psychiatric disorders, using a translational and multidisciplinary lifespan approach. To translate fundamental findings into personalised approaches, we collaborate locally with various groups in the LUMC Research Profile ‘Translational Neuroscience’ , Biomedical imaging and in the university Research Profiles ‘Brain function and dysfunction across the life span’ and ‘Health, prevention and the human life cycle’.