Author Archive | Jenna Waldner

Sunny Tang, Feinstein Institutes for Medical Research

Sunny Tang, Feinstein for Medical Research

As a psychiatrist and scientist, I see the devastating toll taken by psychotic illnesses and the almost overwhelming gap between available and needed remedies. In my view, we can only achieve major leaps forward as a field by approaching problems with fresh perspectives and novel solutions. That is why I have dedicated my career to leveraging innovations in technology to better understand psychotic disorders and optimize treatment outcomes.

My presentations at the 2022 SIRS Annual Congress addressed this issue through three approaches.

While schizophrenia is related to significant functional impairment for some individuals, others are able to thrive socially and occupationally. In our talk on “Biopsychosocial Contributions to Functional Outcomes in Schizophrenia: A Data-Driven Machine Learning Approach,” we used machine learning methods to identify different patterns of functional outcomes in schizophrenia, and to relate these in reliable ways to biopsychosocial characteristics. We found that, in addition to a group of individuals who are resilient across the board, and a group who are more impaired, there is a cluster of people with schizophrenia who function well socially and with regards to independent living, but are impaired in occupational functioning. We would not have found this pattern without the machine learning approach, because we would not have known to look for it. We also found that the functioning pattern for each person was highly related to their internal sense of motivation and enjoyment, as well as the volume of some brain structures and cognitive ability. Importantly, race, sex, and socioeconomic status were not strong contributors to the functioning pattern of individuals with schizophrenia.

We know that social cognition – or the ability to process social information – is very important to functioning for people with schizophrenia. In our talk, “Speech and Language Disturbance in Schizophrenia are Related to Social Processing,” we showed that social cognitive is also related to how people with schizophrenia communicate. In particular, the ability of individuals to correctly identify emotions was closely related to how their speech was organized. This was found using traditional clinical ratings for speech, as well as with automated speech analysis – computerized methods for objectively quantifying speech characteristics.

One major roadblock in psychiatry is that treatment is often a guessing game. We have a variety of effective treatments available, but we do not yet know who will respond to standard care, and who will not. In our poster presentation on “Predicting Treatment Outcomes with Computational Speech Features in Hospitalized Patients with Schizophrenia,” we used an app developed by Winterlight Labs to record speech from hospitalized patients with schizophrenia just after they were admitted to the inpatient facility. The speech samples underwent automated processing. We found that speech features soon after admission significantly contributed to predicting how symptomatic people were when they were discharged (2 weeks later, on average).

We still have much to do before our research can tangibly benefit people with schizophrenia and their loved ones. However, I believe that taking advantage of advances in technology and machine learning has enormous potential for understanding what goes wrong in schizophrenia and for guiding personalized medical treatment to improve outcomes.

The Early Career Award program is intended to sponsor individuals who have, through their research, teaching or clinical activities, demonstrated a professional and scientific interest in the field of schizophrenia research. You can find out more by clicking here.

Sachin Nagendrappa, St. John’s Medical College Hospital

Sachin Nagendrappa, St. John's Medical College Hospital

My interest in psychiatry started in medical school. I was fortunate to get a teacher Dr. Sanjay, a Psychiatrist who sparked my interest in the field of psychosis. As Dr. Sanjay knew my interest in psychiatry, he would take me to government-run mental health rehabilitation centers where most people with untreated psychosis were admitted. During the visits, he taught me about Schizophrenia in detail and I saw the majority of patients with severe symptoms whom he treated were getting better and also realized the stigma they face and several other social factors associated with the illness. I decided to pursue my passion in the field of psychiatry to learn more. I joined as a resident to pursue my post-graduation in Psychiatry at the National Institute of Mental Health and Neurosciences(NIMHANS), where I began my research in Schizophrenia. I was privileged to get mentors at NIMHANS who are stalwarts in the field of Schizophrenia who taught me the basics of research and continue to help me grow as a researcher in the field of Schizophrenia. My initial research began with treatment-resistant Schizophrenia and the factors leading to ultra-resistance. This led me to work on the Clinical, cognitive and neurobiological effects of clozapine in treatment-resistant Schizophrenia. I used a functional near-infrared spectroscopic study to evaluate the pre-post effects of clozapine in patients with treatment-resistant Schizophrenia. Later worked briefly on the tele consultation model for improving outcomes in Schizophrenia, in people who lack access to treatment in India. Currently, I am working as an Assistant Professor of Psychiatry at St Johns Medical College Hospital, Bengaluru, India, and will be beginning my journey as a Ph. D Scholar this month and continue to work in the field of Schizophrenia.

The journey as a researcher in the field of Schizophrenia is personally satisfying and made me more curious to learn and understand various aspects of treatment resistance in Schizophrenia. I am also involved in several other research collaborations including collaborations with UNICEF, ETH Switzerland, the University of Pittsburgh, Global mental health International, and several other national collaborations. The major studies in which I’m involved currently are RCT evaluating the efficacy of a repurposed drug in Schizophrenia, a study on neurophysiological correlates of self-other distinction in Schizophrenia, etc.

After I joined St Johns Medical College hospital, a general hospital,  I’m seeing numerous patients with chronic medical illnesses with comorbid psychiatric illnesses who are not taking adequate care of themselves. They come with varying knowledge of their illnesses and vary in their ability to monitor internal sensations and thoughts that can serve to improve self-care. This has intrigued me. I found it interesting to know the factors, and I have chosen to explore if low awareness of bodily sensation in chronic medical illnesses is similar to a lack of awareness of chronic psychotic illnesses. I believe this will potentially help broaden the concept of awareness of the illness and support cognitively informed interventions on the one hand, and radically alter the concept of awareness of illness on the other. I will use my research in understanding the treatment resistance in Schizophrenia, looking forward to developing cognitively informed intervention models to gain better insight in patients with Schizophrenia and thus improve the outcomes

I am ever grateful for the guidance of excellent mentors throughout my career and especially SIRS. SIRS has always motivated early-career researchers like me. SIRS stands at the forefront in providing support and the opportunity to interact with and gain knowledge from the esteemed and eminent faculty who are much more experienced in Schizophrenia research. I always look forward to attending SIRS annual conferences. The experience to gain as an early career researcher will be enormous and this will give a great fillip to early-career researchers' desire to set up an independent career in research.

Yours Sincerely,

Sachin Nagendrappa

The Global Schizophrenia Award is to support a SIRS member in a low and middle income country to attend the annual SIRS congress. The intent of the award is to widen diversity and to bring a member from under-represented countries to a state-of-the-art meeting to establish collaborations with other SIRS members. Sachin Nagendrappa was named the SIRS 2022 Global Schizophrenia Awardee.

You can find more about Sachin Nagendrappa's research and accomplishments by clicking here.

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