McGill psychiatrist Ashley Wazana is leading a consortium to analyze data from around the world to better understand the origins of mental health disorders
A new parent cradles their newborn, dreaming of a bright and healthy future. Wanting to give their child every advantage, they sit down with their doctor and use an online tool to input details about their baby, the pregnancy, family history, genetics and their environment. The tool offers insights into possible mental health risks and practical steps to support their child’s development. It’s the start of a plan to help their child thrive.
Hard to imagine? The DREAM BIG Research Consortium is working to make this scenario, or a version of it, a reality.
“Among children, rates of behavioural disorders have never decreased while those for anxiety and depression continue to rise,” says DREAM BIG’s principal investigator Ashley Wazana, MD, a clinician-scientist at the Lady Davis Institute for Medical Research-Jewish General Hospital and an assistant professor of psychiatry at McGill University. “While we’ve seen real progress in other health areas, we won’t be able to do the same for mental health disorders without this kind of mental health calculator.”
To get there, DREAM BIG is bringing together data from long-term studies following groups of people as they age, some studies with several decades of data. DREAM BIG stands for Developmental Research in Environmental Adversity, Mental health, Biological vulnerabilities and Gender. The studies are from around the world—in Canada, the United Kingdom, the Netherlands, Singapore, Australia, Norway and Finland.
Because the studies collect data differently, DREAM BIG harmonizes the data, a major task that takes significant time and effort. Harmonizing the data enables researchers to compare the data and find patterns that apply beyond the local communities where the studies took place. When results hold true across populations worldwide, researchers can be confident they’re seeing meaningful and valid patterns in how and why mental health disorders develop.
From there, DREAM BIG is building models that combine factors like genetics, stress levels in pregnancy, sex and gender differences, and social environments. By studying how the factors interact and affect children across childhood, DREAM BIG aims to pinpoint what leads to a mental health disorder like anxiety or depression or behavioural conditions like Attention-Deficit Hyperactivity Disorder. The models will also help identify maternal, child, and dyadic mechanisms (interactions between a mother and child that influence each other’s health and behaviour) that can be influenced, and at what age, to help prevent or reduce the chance of a mental health disorder from developing. They may even reveal the factors that allow some kids to respond better to treatment than others.
“It’s one thing to know that a train is going to arrive at a station at a certain point in time,” Dr. Wazana says. “But it’s also good to know what track the train will take to get there and how you can adjust the track, so the train arrives at a different location. You change its trajectory.”
CIHR has helped fund DREAM BIG since it began in 2016. The research has already shown that stress during pregnancy, a child’s genes and tough social conditions can interact in ways that influence the development of mental health disorders. This research is a building block for the models being created for early childhood, school-age children and adolescents, which Dr. Wazana says should finally give the starting point needed to reduce mental health disorders worldwide.
“Mental health disorders are the leading cause of morbidity and health costs in Canadian society,” he says. “Any reduction in how much depression, anxiety or disruptive behaviours occur will be enormously beneficial.”