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UT Southwestern Researcher Receives National Award for Creating New Method of Classifying Psychosis

Carol Tamminga (photo), M.D., Chairman of Psychiatry at the University of Texas (UT) Southwestern Medical Center, has received the American Psychiatric Association’s top research award for creating a new system of classifying various forms of psychosis based on biological indicators, and contributing to better understanding their neural mechanisms. The award marks the second straight year a UT Southwestern faculty member has received the American Psychiatric Association Award for Research, the group’s most significant research accolade for a contribution that has had a major impact on the field or altered the practice of psychiatry. Dr. Tamminga was recognized for leading a groundbreaking study that established biologically distinct groups of psychosis patients based on factors such as brain waves, cognitive ability, and damage to brain tissue. The finding, published in the American Journal of Psychiatry, provides new methods of identifying schizophrenia, schizoaffective, and bipolar disorders, and goes beyond the traditional standard of diagnosing through clinical observation. Dr. Tamminga said it’s likely these groups will have their own genetic profile and that unique medications might eventually be developed to treat each. “There is a strong enthusiasm throughout our field, and now optimism, for a neural understanding of psychotic illnesses,” said Dr. Tamminga, who holds the Lou and Ellen McGinley Distinguished Chair in Psychiatric Research and the Communities Foundation of Texas, Inc. Chair in Brain Science. Participants in the study, conducted through UT Southwestern’s Peter O’Donnell Jr. Brain Institute, underwent various tests that measured cognition, eye-tracking, brain waves, and loss of brain tissue. By analyzing statistics from these tests, Dr. Tamminga’s group identified three distinct groups, or biotypes, of psychosis.

Biotype 1 was the most impaired group, demonstrating poor cognition and eye-tracking capabilities, and the most brain tissue damage, primarily distributed over frontal, temporal, and parietal regions of the brain. Although all the usual psychosis diagnoses appear in Biotype 1, there was a slight predominance (59 percent) of schizophrenia cases in this most impaired biotype, and they tended to have more severe psychotic symptoms (hallucinations and delusions).

Biotype 2 demonstrated cognitive impairment and poor eye-tracking, but exhibited high brain wave response, something neuroscientists often call “noisy brain.” These individuals are often rated as overstimulated, hyperactive, or hypersensitive. Biotype 2 also had gray matter loss in frontal and temporal regions, but less than that found in Biotype 1. Biotype 2 cases also had worse scores on mood scales, such as depression and mania.

Biotype 3 was the least impaired, with near-normal evaluations of cognition, brain wave function, and brain structure. Their symptoms were of moderate severity. Subjects in this group were slightly more likely to be diagnosed with bipolar disorder (60 percent).

“Dr. Tamminga’s identification of three neuro-biologically distinct biotypes holds the promise of moving beyond historical empiric clinical impressions toward mechanism-based diagnosis and treatment of psychosis,” said Dr. Daniel K. Podolsky, President of UT Southwestern, who holds the Philip O'Bryan Montgomery, Jr., M.D., Distinguished Presidential Chair in Academic Administration, and the Doris and Bryan Wildenthal Distinguished Chair in Medical Science.

“We are proud that this national leader in the translation of behavioral and neuroscience discoveries into innovative clinical care is a member of our faculty.”

Dr. Tamminga, an elected member of the National Academy of Medicine, is also Chief of the Translational Neuroscience Division in Schizophrenia, focused on understanding the biological basis of schizophrenia and identifying new treatments for the several domains of symptoms using imaging and tissue, and testing early treatments for cognitive dysfunctions in the illness.

The 2015 recipient of the American Psychiatric Association’s research award was Dr. Madhukar Trivedi, Director of the Center for Depression Research and Clinical Care, Chief of the Division of Mood Disorders, and Professor of Psychiatry, who holds the Betty Jo Hay Distinguished Chair in Mental Health and the Julie K. Hersh Chair for Depression Research and Clinical Care. Dr. Trivedi was recognized for his body of work, which has helped establish benchmarks now used for treating depression and other mood disorders

[Press release] [Psychiatric News article]