Wednesday 24 April 2013

Seriously Italy, WTF?


Sometimes Nature News makes me sad. Recently has been one such time, and frankly there’s only one country to blame: Italy. In the past three weeks there have been two stories that make me somewhat sad, and more than a little concerned for the state of science in the azure nation.

The first was frankly bizarre. At the start of March, some cock decided it was a good idea to set fire to the Città della Scienza in Naples (read the Science Museum), utterly destroying Italy’s biggest science communication complex. That, in of itself, is bad news. What was far worse, however, was the response of Il Foglio (read Daily Mail… actually don’t, no-one should have to do that), which proclaimed the fire a “purification against the scourge of evolutionism”, in the words of one correspondent. Crackpots on the internet is one thing, but when a national newspaper is glorying in the destruction of a centre of learning, it rather demonstrates the need to NOT BURN DOWN THE CENTRES OF LEARNING!

The second, just last week, is sadly not isolated to the fair shores of Italia. Last weekend, animal rights activists broke into a Milanese lab. They chained themselves to the doors to prevent them being opened, mixed up cards and animals, stole several animals and broadcast the names of researchers on Facebook. Eventually they were evicted, with the promise of being allowed to return and remove more animals (it is unclear if this is actually going to happen). Setting aside the debate on animal rights, the actions of this group are totally negative and irresponsible on three counts. Firstly, by destroying the experiments within the lab, they have set the work of the lab (on correlates of autism and schizophrenia) back years. These are distressing conditions that new techniques, including those in animals, offer a real chance of alleviating. By removing these animals, the activists have indirectly harmed human beings. Not that they care; their disregard both for the work of the scientists (students who had lost their entire PhD’s work were seen crying in the corridors – frankly I don’t blame them) and for their privacy shows that the ‘compassion’ of these protestors is a sick hypocrisy. The final irony would be delicious if it wasn’t so sad; the mice removed by the animal rights group were genetically modified to be immuno-compromised, and therefore were kept in very favourable and tightly controlled conditions in the lab. Their removal has been their death sentence.

Obviously this isn’t Italy’s fault; there are many fine people in Italy, of all creeds, and both of these incidents have led to outrage in the country. However, there is a disturbing undercurrent in the view of science in Italy, and it is this undercurrent being shown to the world. Several of the comments on these articles expressed a similar concern – the intelligent majority in Italy needs to become more vociferous and drown these absurd retrogrades.             

Wednesday 10 April 2013

Anxious Times


I’ve been intending to write this piece for a while, but I have to confess to some trepidation. I started working in anxiety genetics in October, knowing that it was somewhat of a backwater compared to spearhead fields such as schizophrenia. It’s not that no-one cares about anxiety – there are some incredibly clever people working in the field – but there is a definite feeling that it is understudied. With this in mind, it was with some reticence that I told people what I was to do in my PhD. To my surprise, nearly everyone I’ve spoken to, from those who’ve known me since before I was born, to the drunk woman singing Les Miserables on the train, has responded incredibly positively; folk really think anxiety is important, and the value of improving treatments of the disorder is seemingly obvious.

Which is wonderful. Obviously. I mean, anxiety IS important, and improving treatment will benefit a hell of a lot of people. It’s just… I need to actually understand it now! I’m not a psychologist by any means but if I’m going to really sell my stuff to the world at large (which is the whole point of science, as far as I’m concerned, and arguably one of the things it does least well), then I have to be able to offer insight on the disorder.

One thing I can try to explain is why anxiety is understudied, and why it’s probably always going to be a challenge. Historically, work in psychiatry tended to focus on studies using inpatients of psychiatric hospitals; to be blunt, such patients tended to be those separated from society out of fear, and hence the dominance of schizophrenia and bipolar disorder. In comparison, anxiety and depression, though widespread, are viewed as much more normative; tell someone you refused to fly because you’re scared of planes, and they’ll regale you with their own ‘quirky’ fears; tell them you don’t like to fly because the plane talks to you while you’re trying to sleep, and they’ll back away… slowly.

The divide still exists, and it is likely to remain. As psychiatric genetics has progressed to the current trend for genome-wide studies of association (basically “is this bit of DNA found in patients more often than in non-patients?), it has become clear that most psychiatric disorders have complex causation at a genetic level. However, anxiety and depression may be the most complex of the lot. In schizophrenia, there are now tens of genetic variants that have cropped up in multiple studies, and which we can be relatively confident are playing a role in predisposing their carriers to developing the disorder (quite how they are doing this is an entirely different kettle of fish, or possibly a lake of whale sharks). In depression, no finding has proved consistent. Not a one; and that’s taking into account a lot of data being analysed by the best minds in the business. The story is likely to be the same for anxiety, although that’s not clear because the necessary study size just hasn’t been reached yet.

Therein lies a crucial point; anxiety and depression are common – the chances are you know multiple people who’ve suffered, or are suffering from one or the other. Why, then, are the sample sizes not big enough to make firm conclusions?. You could say that the question is a silly one, that there’s no such thing as a big enough sample size, that bigger is always better (I’ll avoid the crude sexual pun, not least because there’s the suggestion it’s untrue - Paper abstract (aptly enough from PNAS)). You’d be quite right; we can make a conclusion from the study sizes we’ve got, and it is that none of the bits of DNA we’ve looked at has a big enough effect to be greater than chance in the samples we’ve used. This is one probable reason why anxiety and depression genetics has had fewer positive results than schizophrenia genetics; the relevant genes have smaller effects.

There is another problem; there’s too much variation. Anxiety and depression can be categorised into a plethora of different forms, and even within those forms two presentations might involve quite different symptoms and require diverse approaches to treat. This is a general issue of psychiatry (and arguably of medicine), but it does appear to affect anxiety and depression rather a lot . It’s also a big sticking point for the studies being done. If the patient group being looked at is made up not of one disorder, but of several sub-disorders, each sub-disorder may have specific genetic bases, and, because they are all mixed together, none of them can be found. Imagine you have two baskets, and two sets of balls with slightly different colours. If you have equal numbers of balls, and you separate them such that almost all the lighter balls are in one basket, it is easy to split the baskets. If you only have a few lighter balls, however, it becomes very difficult to tell the baskets apart; without examining every ball, the baskets look essentially identical. That, in a nutshell, is the current situation for anxiety and depression genetics. They’re a load of balls.