Following the launch of Research Directions: Depression by Cambridge University Press, Editor-in-Chief Ian Hickie explains why a question-led and global approach will reveal new insights into mood disorders

The launch of Research Directions: Depression represents ‘a chance to co-ordinate a real global effort in the field’, according to Editor-in-Chief Ian Hickie. ‘This journal’s aims are really different and the social and scientific relevance is high.’

Ian is an academic psychiatrist with a medical degree, specialist psychiatrist qualifications and a doctoral degree in interpersonal predictors of the course of common depressive disorders. Now Co-Director of Health and Policy at The University of Sydney’s Brain and Mind Centre, he has a 30-year history of investigating the causes, best treatments, medical complications and delivering optimal outcomes for people with depression and other common mood disorders, including bipolar disorder.

In recent years, much of his focus has been on the genetic, biomedical and environmental causes of the adolescent-onset of these disorders, developing early intervention strategies, and building high-quality and personalised health services for young people with mood disorders.

He explains: ‘Mental Health is the most fascinating, challenging and intensely human area of clinical medicine, and in the 21^st Century we now have many tools to investigate more directly the brain changes that accompany these conditions. The area is filled with wildly differing opinions, often unconstrained by science. Genuine science delivers key insights and new roads to effective prevention and personalised treatments.

The science around depression – as explained in Ian’s recent book The Devil you Knew – is very similar to the science around many other major psychiatric, neurological and other brain-based disorders. It uses similar methods (epidemiology, genetics, brain imaging, clinical trials, pharmacology that targets brain messenger systems and new brain stimulation techniques).

‘What makes it different, intriguing and challenging,’ Ian continues, ‘is the highly personal nature of many of the experiences and the extent to which the social and environmental context (including the ongoing stigma, discrimination and promotion of non-science) have such a large influence on the way that science is conducted. 

‘Additionally, the complexity of brain systems (compared with hearts, kidneys or lungs) makes very simplistic explanations – however appealing – unlikely to be true.’

Creating new pathways to insight

Research Directions: Depression focuses squarely on the major scientific questions that should be the focus on most effort to enhance prevention, early intervention and development of more effective treatments. Ian says: ‘These are also the questions that are most relevant to those individuals and families most affected. It does not simply go down those well-worn paths that dominated research from the mid-1990s to now (namely, genetic determinants, brain imaging techniques and copy-cat pharmacology).

‘Instead, it deals with much more exciting areas – the role of new immune therapies, the place of new brain circuit maps and direct brain stimulation techniques, whether diet really matters, preventing metabolic complications, whether new psychedelics are worth the risk – focusing on the circadian and body clock as core targets for depression treatment.’

He continues: ‘All of this will be placed within the context of changing societies where the rate of anxiety and depression appears to be rapidly rising in young people, digital tools are transforming health care, and those affected are playing a much larger role in setting the research agenda. Drawing on studies from across the globe, and particularly including developing countries, we seek to learn more about how different social settings affect the onset and outcomes of these disorders.

‘We will be encouraging new research methods and rapid reporting of key findings that actually answer questions and don’t just repeat what is already widely known.’

The ethos of the journal is a global collaborative effort to answer the most important questions. To do this, disciplines beyond the traditional ones that have dominated brain and cognitive science (neuropharmacology, cognitive psychology, descriptive psychopathology, brain imaging, population health) will be recruited.

Broader medical disciplines including immunology, sleep and circadian medicine, endocrinology and cardiology are critical. Further afield, the key areas include computational and data science, engineering and information technology, social and anthropological sciences, economics and simulation modelling.

The ‘question-led’ approach of the Research Directions journals is key here, explains Ian: ‘Much of the current academic literature in this field is very derivative and simply repeats efforts that have been long described in epidemiology, genetics, brain imaging and neuropharmacology. Frequently, it adds little to our capacity to answer the questions that are most relevant to either enhanced prevention or delivery of more effective treatments for depression and related disorders.

‘The question format dispenses with the usual approach of just reporting what a research team has done and directly asking whether it provides any new knowledge that genuinely helps to resolve the key questions that we have identified.’

Fostering global engagement

Ian describes his appointment as Editor-in-Chief of Research Directions: Depression as ‘thrilling’: ‘I’m not normally interested in such roles – but this journal’s aims are really different and the social and scientific relevance is high. There is a chance to co-ordinate a real global effort.

‘Key readers will be those engaged directly in depression-focused research, those whose disciplines are relevant to our aims but have not been attracted by more single discipline-based approaches and those directly living with these disabling (and often life-threatening) conditions.’

The engagement of leading figures in the field – not only in North America, UK and Europe but particularly in the Asia-Pacific and South America – has particularly delighted Ian: ‘It has been a busy time to explain the unique purpose here and capitalise on the enthusiasm of both older and younger colleagues, who are very keen to make a real difference in the field.

‘The longer-term aims are to use the unique approach of the journal to change the way in which depression research proceeds, capitalising on multi-disciplinary insights and methods – fostering on answering hard but important questions and, crucially, bringing new scientific insights rapidly into the public domain.’