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Understanding and predicting the intergenerational transmission of mental illness

Despite ample evidence that mental illness runs in families, how and when risk for mental illness is passed from parents to children is still poorly understood.

To answer these questions, we not only need to identify the underlying risk factors and mediating mechanisms, but also when these factors operate, e.g. during foetal development, early childhood, adolescence, and into adulthood.

At the same time, resilience factors that counteract existing risks and elucidate their mechanisms of actions need to be identified. Only then can we advance our understanding of the onset of mental illness and uncover new targets for the development of preventive strategies to break the intergenerational cycle of mental illness and to support family’s strengths.

Risk prediction models for mental disorders have been developed, but current models have severe limitations:

  • They are restricted to the individual and do not take parental and family information into account;
  • They predict outcomes primarily from emerging or subclinical psychiatric symptoms and level of functioning and thus at a relatively late stage before disease manifestation, leaving little to no time to intervene;
  • They focus largely on psychotic disorders;
  • Most models focus on one single biomarker modality and few models integrate biomarkers;
  • They include only risk factors and do not consider resilience factors;
  • Most have not been replicated or validated in independent samples and are thus not translatable to clinical practice.

These current limitations will be broken by the FAMILY project, leading to the overall aim to systematically integrate the family context in the study of mental disorders. We will identify mechanisms underlying the transmission of disease risk from affected parent to child, establish how resilience factors moderate risk factors and take a biomarker and resilience assessment approach to improve risk prediction.

Predicting the risk of mental disorders in children of affected parents will fundamentally change the clinical approach to mental illness.

The FAMILY project aims to help affected families and children to better understand the causes of mental illness and its biological background, and thus contribute to the destigmatisation of mental illness in the long term.