Precision Health for Depression

Precision Health for Depression: There is no chest x-ray for depression

Nelson Freimer, director of UCLA's Center for Neurobehavioral Genetics and Associate Director for Research Programs of the Semel Institute for Neuroscience and Human Behavior, works on what he calls "the greatest health problem of our time": depression. As a researcher he has studied the genetics of bipolar disorder, a condition in which patients cycle between episodes of intense euphoria or mania and depression. Much of his work explores the effect of inherited mutations on depression-related behaviors and how neuroanatomical changes in brain may correlate with both.

"What has stopped us in depression is that our assessment diagnostics are entirely based on subjective information," he says. "You see a doc who asks you questions and you say you feel depressed," he says. "It's entirely based on your recall rather than objective tools: there is no chest xray for depression." Nelson Freimer, director of UCLA's Center for Neurobehavioral Genetics

A Bold Initiative

A bold initiative at UCLA aims to change all this. In 2015 UCLA launched its Depression Grand Challenge (DGC), an effort that will recruit 100,000 subjects from UCLA's health system willing to undergo genetic screening, among other biological tests, for genes potentially mutant or deregulated in depression. Freimer is the initiative's director. The goal of the DGC, which expects to raise $500 million dollars in the first 10 years, is lofty: to decrease the health and economic impact of depression in half by 2050. Project organizers are buoyed by the 2013 launch of UCLA's equally ambitious "Sustainable L.A. Grand Challenge," whose mission is develop a blueprint to transition Los Angeles County to 100 percent renewable energy, 100 percent locally sourced water and enhanced ecosystem health by 2050.

DNA sequencing technology coupled with bioinformatics analysis will of course play a big part in the DGC, given the ambitious goal of initially sequencing 100,000 genomes, making this a unique project in the world. Freimer says UCLA is on target to succeed as it has access to the required large patient population and the infrastructure to generate and analyze DNA sequence data. But the real goal of the project is to then match up those genomic results up with depression-related behaviors, as reported by patients. Behavioral analysis could require data gathering by a device more commonplace than a DNA sequencing machine.