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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

Preventing multimorbidity in severe mental disorders with a multidisciplinary approach

Alternative title: Preventing multimorbidity in severe mental disorders with a multidisciplinary approach

Awarded: NOK 15.7 mill.

The main objective of the project is to improve preventative measures of comorbid cardiovascular disease (CVD) risk in patients with severe mental disorders (SMD; i.e. schizophrenia, bipolar disorders and severe depression), by evaluating interventions targeting the modifiable life-style risk factors physical exercise and smoking and investigate if grouping/sorting based on underlying causes can improve outcome. SMDs, chronic disorders frequently seen in socially disadvantaged populations, have high disease burden and costs for the individual patient, municipality health care services and society. SMDs develop in adolescence and often involve comorbidities leading to accelerated ageing and a significantly shortened life expectancy due to comorbidity (e.g CVD). Novel preventative interventions to counter these debilitating issues, in combination with novel approaches to how data is assessed over time, is important to narrow the health gap. This project aims to 1) evaluate the effects of different physical training interventions by measuring exercise adherence, CVD risk factors and morbidity in the short and long term in two RCTs; 2) test the effect of group-based smoking cessation program on smoking cessation in an RCT; 3) evaluate if underlying causes can facilitate prevention and improve treatment outcome, by using registry and biobank data in hospitals and municipalities. The preventative interventions and data models proposed will improve our understanding of comorbidity in SMDs. Identifying the underlying disease mechanisms behind morbidity/mortality in SMDs is essential and may lead to major health benefits through new treatment/prevention. The outcomes of the project will promote reduced inequalities in terms of life expectancy and physical comorbidity for patients with SMDs.

Main focus: prevention of somatic comorbidity in severe mental disorders (SMD), i.e. schizophrenia, bipolar disorders and severe depression; chronic disorders frequently seen in socially disadvantaged populations, with high disease burden and costs for the individual patient, municipality health care services and society. SMDs develop in adolescence and often involve comorbidities leading to accelerated ageing and a significantly shortened life expectancy. The topic is thus relevant for the RESEARCH ON EFFECTIVE AND PREVENTATIVE PUBLIC HEALTH MEASURES call. The project 1) aims at preventing illnesses with large disease burdens and more severe courses of disease and reducing the likelihood of new conditions by improving preventative measures of somatic comorbidity in SMD, and 2) it targets adolescents and young adults, utilizing existing health data (registry, medical records, biobanks) available across Nordic countries from collaborators, and leverages the advantages in Norway for research on SMD, including a public health care system and close collaboration between hospitals and municipalities for conducting intervention studies. This enable 3) a focus on knowledge-building at the municipal level and to research-based policy development in SMD. As comorbidity in SMD is complex, the project is 4) interdisciplinary, integrating studies of underlying etiological aspects, including environmental (social sciences) and genetic (life science) risk factors. A sub aim focuses on legal aspects (social sciences/humanities) in relation to how coercive measures in SMD may influence cardiovascular comorbidity and treatment. Overall aim: gain new knowledge about preventative measures for cardiovascular comorbidities in SMD at the municipality level, by testing clinical interventions and precision medicine approaches that can promote health and quality of life, and reduce health related social inequalities, together contributing to the population living healthier lives.

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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering