Project

Discipline

Genetics; Mental disorders; Cardiovascular risk factors ; Public Health ; Cardiovascular diseases ; Epidemiology

Lead
CoLaus/PsyCoLaus est une étude de cohorte prospective dans la population de Lausanne conçue pour investiguer les mécanismes qui sous-tendent la fréquente co-apparition des maladies cardiovasculaires (MCV), les facteurs de risque cardiovasculaires (FRCV) et des troubles psychiatriques.
Lay summary
Objectifs: Réévaluer ce large échantillon communautaire qui a déjà été investigué une première fois sur le plan somatique, psychiatrique et génétique entre 2003 et 2008 et une deuxième fois lors d’une évaluation de suivi entre 2009 et 2013. La récolte d’informations du deuxième suivi (prévu pour 2014-2018) sera cruciale pour répondre à 3 questions principales:  1)  Est-ce que les troubles psychiatriques augmentent la vulnérabilité aux MCV et FRCV?  2)  Est-ce que les MCV, les FRCV ou leur traitement augmentent le risque de développer des troubles psychiatriques?  3)  Est-ce que les MCV, les FRCV et les troubles psychiatriques ont des facteurs pathogéniques en commun?    Les résultats des deux premières investigations ont été publiés dans plus de 160 articles dans des revues scientifiques. Tous les sujets de l’échantillon de base (n=6733 sujets âgés de 35 à 75 ans au départ) seront invités à participer au deuxième examen de suivi physique et psychiatrique. En plus des évaluations déjà effectuées qui seront répétées, le deuxième suivi permettra de récolter de l’information sur l’utilisation des services de soin, l’activité physique mesurée de façon objective, l’activité cardiaque et pulmonaire, et l’activité cérébrale mesurée par imagerie résonance magnétique structurelle.    Contexte scientifique et social : Des connaissances plus avancées sur les liens entre ces troubles permettront le développement de stratégies de prévention et de traitement plus spécifiques et efficaces.

Direct link to Lay Summary

Last update: 06.03.2014

Natural persons

Number	Title	Start	Funding scheme

Background: The mechanisms underlying the frequent co-occurrence of cardio-vascular diseases (CVD) or risk factors (CVRF) and mental disorders still need to be elucidated. Aims: to re-assess a large population-based sample, which already underwent a comprehensive physical, biochemical, psychiatric and genetic (GWAS) baseline investigation as well as a first physical and psychiatric follow-up evaluation, in order to prospectively assess the complex associations between CVD, CVRF and mental disorders. The collection of additional follow-up information will be crucial to address these questions:Research questions: 1) Do mental disorders increase vulnerability to CVRF and CVD? 2) Do CVRF and CVD promote the development of mental disorders? 3) Do CVRF/CVD and mental disorders share common pathogenetic processes?Methods: We propose to perform a comprehensive second follow-up (FU2) assessment of CVRF and CVD as well as a psychiatric evaluation in all willing subjects of the original CoLaus sample (n=6'733 subjects, age range 35 to 75 years; 3’716 subjects with both a somatic and psychiatric evaluation). The baseline evaluation took place between 2003 and 2008 and a first physical and psychiatric follow-up (FU1) between 2009 and 2013. Among the subjects who had participated at both the physical and psychiatric baseline investigations 87% took part at the physical FU1. The results of these evaluations have already led to the publication of more than 150 peer-reviewed papers. The FU2 is planned for 2014 to 2018. Similar to the FU1, the physical FU2 (expected sample size: 4500 subjects) will include the collection of information on the incidence of CVRF or CVD since FU1 and on the course of CVRF diagnosed at previous assessments. In the case of a new CVD event or death, detailed information will be elicited from medical records or from the Swiss National Death Registry. The psychiatric FU2 (expected sample size: 3600 subjects) will include the collection of information on psychopathological manifestations since FU1 and a screen for cognitive impairment (subjects = 65 years). In addition to the measures of the previous evaluations, which will be repeated, the FU2 will allow us to add: a) more comprehensive data on service utilization and treatment, b) an objective measure of physical activity (accelerometer) in combination with an electronic diary, c) an EKG recording, d) a more accurate diabetes assessment (HbA1c), e) biological evaluations of the autonomous nervous system (salivary ?-amylase), f) novel markers of CVD events and biomarkers for Alzheimer’s or Parkinson’s disease, g) a measure of pulmonary function, h) an organic brain assessment (structural MRI), and i) measures of professional stress and burnout. Main expected outcome: The design of the CoLaus/PsyCoLaus study provides a unique opportunity to obtain prospective data on the interplay between CVRF/CVD and mental disorders, overcoming limitations of previous research. The proposed FU2 will allow us to 1) better disentangle the temporal relationship between CVRF/CVD and mental disorders and their longitudinal associations with biological, clinical, behavioral and environmental factors by gaining information on a third data point, 2) collect more data on relatively rare outcomes including CVD events or deaths, which will increase the statistical power to test the hypotheses regarding these outcomes and 3) add complementary or more accurate assessments. Additional information on the course of CVRF/CVD and mental disorders together with the available genetic, environmental and biological data will also improve the risk prediction for CVD/CVRF and mental disorders.Potential relevance: 1. Increased knowledge of the psychological, physiological and behavioral links between CVRF/CVD and mental disorders will result in the development of more specific and efficient strategies of prevention and treatment of both psychiatric disorders and CVD/CVRF. 2. The deeper understanding of the longitudinal course of mental disorders and CVD/CVRF and their determinants will increase prognostic accuracy and will provide an important empirical basis for nosology. 3. The assessment of service utilization patterns will provide important information for the development of health policy addressing prevention and care in aging populations.