Immunopsychiatry Clinic
What is the Immunopsychiatry Clinic?
The Immunopsychiatry Clinic is a new approach for treating depression and bipolar disorder by optimizing treatment according to levels of inflammation in the body. The Clinic focuses on developing personalised therapies for people with treatment-resistant depression who have (or are believed to have) raised inflammation.
Recent studies have shown that people with raised inflammation tend to respond poorly to Selective Serotonin Reuptake Inhibiters (SSRIs), one of the most commonly prescribed types of antidepressants. On the other hand, they appear to respond better to medicines that act on noradrenaline or dopamine.
All patients who attend the Clinic will continue to receive their usual care from their Assessment and Treatment service. People will be seen for a period of up to six months and during this time blood tests may be used to guide choice of medications.
The Immunopsychiatry Clinic is based at the East Brighton Community Mental Health Centre and led by Dr Alessandro Colasanti.
What is Immunopsychiatry?
Immunopsychiatry is a new branch of psychiatry that focuses on the two-way relationship between the immune system (which is responsible for protecting the body from infections and injury) and the brain. Research suggests that the immune system (and a type of immune activation called inflammation) plays an important role in a number of common mental illnesses. It appears particularly important for people who suffer from depression, where as many as 1 in 3 people show raised inflammation on a simple blood test called CRP.
Typically, inflammation is associated with infections or illnesses such as rheumatoid arthritis that affect the immune system. However, it is now clear that many people have raised inflammation even without having one of these illnesses. This is important, as raised inflammation has been associated with a higher risk of developing cardiovascular illnesses as well as depression.
If you’re a patient and would like to be referred, speak to your psychiatrist or your care coordinator at the Assessment and Treatment Service.
If you are a clinician, speak to the patient you wish to refer and complete a referral form. You can download it here
Patients who meet the referral criteria will be contacted for an initial assessment appointment within four weeks of the referral.
You will have been referred to the clinic by either your doctor or your care coordinator. After we receive your referral, our clinic assistant will contact you to book your initial appointment and a one month follow up appointment. Before you attend your first appointment we will email you a link to some questionnaires - it's important that you complete the questionnaires before your first appointment so that we can get a clear picture of your current difficulties.
Your first appointment will have two parts:
- Part one: our clinic assistant will sit with you for the first part and give you an opportunity to describe your current circumstances
- Part two: you will see a doctor who will discuss treatment plans with you.
- Both parts will take place on the same day (all appointments are held on a Friday). It is important that you continue to see your current team throughout your treatment in the Immunopsychiatry Clinic.
Following modification of your treatment, which may take up to six months, you will continue to be seen by your current team who can continue any new treatments started in the clinic.
Participating in the clinic is entirely optional. If during the course of treatment you do not wish to continue, then you can leave the clinic at any time and continue to receive your usual care within the Assessment and Treatment Service.
- Initial assessment within eight weeks of referral
- Modification of treatment based on blood tests of inflammation
- Up to six months of supervised medical treatment
- Advice to your current team about continuing medication after discharge from the clinic
The clinic is available to all patients currently seen in any of the Brighton and Hove Assessment and Treatment Services who have either:
- Depression or Bipolar Disorder and evidence of raised inflammation (confirmed via a blood CRP > 3mg/L)
- Depression or Bipolar Disorder and a medical illness associated with inflammation e.g. rheumatoid arthritis, psoriasis, inflammatory bowel disease.
Research has found psychoeducation improves wellbeing, lower rates of relapse, informs patient care and improves recovery.
Our programme provides information to develop a better understanding of the interactions between inflammation and mental health, in order to
develop better coping techniques to manage symptoms.
The sessions will help attendees to adopt long-term behavioural strategies with long-lasting benefits for their overall health.
We have highlighted four areas of immunopsychiatry with the help of our Brain and Body patient and public involvement group;
- Understanding and managing psychiatric symptoms of inflammatory conditions and side effects of medications
- “mind-body therapies”
- Nutritional strategies to regulate inflammation and immunity
- Psychological strategies to cope with chronic inflammatory illness
This film that explains immunopsychiatry and biological causes of depression:
This booklet about Inflammation and Mental Health is produced by the McPin Foundation.
Our panel of people with lived experience have shaped our psychoeducation programme. If you are interested in using your lived experience to help shape the research and work of the clinic, please contact: involvementinresearch
For further information, please contact: immunopsychiatryclinic@spft.nhs.uk
Immunopsychiatry Clinic, Research and Development, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Mill View Hospital Site, Nevill Avenue, Hove BN3 7HZ.