Riccardo De Giorgi
Wellcome Trust Doctoral Training Fellow
I am a Wellcome Trust Doctoral Training Fellow (DPhil in Biomedical and Clinical Sciences) at the University of Oxford, Department of Psychiatry, and a honorary Clinical Fellow (MRCPsych) at the Oxford Health NHS Foundation Trust.
My focus is on academic psychiatry and I am interested in the evidence-based treatment of mental illness, especially within the themes of psychopharmacology and mood disorders. I am fascinated by the problem of "treatment-resistance", i.e. when patients do not appear to respond to several lines of therapy. The physiopathological heterogeneity underlying treatment-resistance highlights the need for mechanistically dissimilar approaches to resolve this problem; in other words, I propose to apply the "precision medicine" paradigm to treatment-resistance.
For example, there is increasing evidence that inflammation plays a role in the pathophysiology of depression, especially in patients who are treatment-resistant. Indeed, part of the heterogeneous clinical responses to treatment in depression could be accounted for by a subgroup of patients with baseline inflammation. Therefore, anti-inflammatory treatments may particularly benefit those patients who respond poorly to conventional antidepressants and who might be identifiable a priori through measurement of inflammatory markers.
Currently, I am working on an experimental medicine study on the use of anti-inflammatory drugs in patients with treatment-resistant depression and elevated inflammation. I aim to use early markers of anti-depressant response, such as changes in emotional processing and reward measured by behavioural tasks and brain imaging, to validate the potential of these drugs in further clinical trials.
Stegen G. et al, (2018), BMJ Leader, 2, 46 - 48