Understanding the neuropsychological mechanisms of clozapine-induced Obsessive Compulsive Symptoms in Schizophrenia

First Year PhD Report (summary) Candidate: Marjan Biria Degree: PhD Psychology

Funded by Mental Health Research UK Supervisor: Professor Trevor W. Robbins

Date: 07/07/2018 2

During the first year of my PhD I have applied for two NHS ethics applications to recruit schizophrenia, OCD, and healthy volunteers (separate applications for OCD and schizophrenia patients as they will be recruited from separate trusts). I have also obtained a research passport and two letters of access to recruit patients through the Cambridge and Petersborough Foundation Trust (CPFT, for schizophrenia patients) and the Hertfordshire Partnership NHS Foundation Trust (HPFT, for OCD patients). The research passport and the letters of access allowed me to attend the clozapine and OCD clinics on a regular basis and be present during the patients’ consultations with their consultant psychiatrists (Dr Emilio Fernandez and Dr Naomi Fineberg). This has been a great opportunity to spend time with patients outside the research context and understand their problems on a deeper and more personal level. I had also applied for NIHR CRN Portfolio for our study to be advertised in more trusts which was approved as well. This way the trusts that are working with OCD or schizophrenia patients and are interested in our research can contact us and help us with the recruitment. The whole process for all the applications mentioned above took about six months.

While waiting for the ethical approval and before being able to recruit participants, I have completed the following courses: How to Conduct Clinical Research Studies within CPFT, Graduate Core Skills Training, Good Governance, Deprivation of Liberty Safeguards (DoLS), Mental Capacity Act Module 1: Awareness for Researchers, Mental Capacity Act Module 2: Best Interests Decisions, MRI Safety course and Graduate Methods class. I have also analysed anonymised patients’ data from the clozapine clinic registers about the association of patients’ demographic information and their OCD symptoms induced by clozapine in collaboration with Dr Emilio Fernandez. I am now preparing the results for publication. I have also been helping with an ongoing project in our lab involving MRI scans, which besides being an educational experience for my MRS (Magnetic Resonance Spectroscopy) project, will make me a co-author of their publication.

I have developed a computerised task to look at the reactions of our patient groups to positive and negative feedback and whether they will show perseverative responding. I also have developed a second task to measure perseverative repetitions or stereotyped responding which we expect to see in our schizophrenia patients. I have written several Matlab script to extract the data for both tasks and to analyse their outputs.

I have been attending the 7T MRS meetings in University of Cambridge to inform myself more about the technique and build useful connections before we start our 7T MRS project. I was able to gather most people working with the new Siemens 7T MRS scanner (we will be working with) and created a group with whom we can have regular meetings to help each other with our knowledge and experience. At the same time, I am attending the 7T MRS sessions of an ongoing project to learn how to prepare and conduct our project later on this summer. I have examined my test batteries in a group of healthy and OCD volunteers. The healthy volunteers’ findings are presented in the long version of my report, see below, while the OCD results are still being analysed.

First_year_report_MHRUK_MarjanBiria .pdf