University of Bristol: £3.6M funding for research into the link between physical and mental health problems

The £3,632,000 grant from the Medical Research Council and The National Institute for Health Research will enable research teams across the UK and Denmark to work together over the next four years as part of the LIfespaN multimorbidity research Collaborative (LINC).

Multimorbidity refers to the presence of multiple chronic health conditions within the same individual. The Research Collaborative will study why people with mental health disorders are more likely to develop physical health conditions and vice versa, that is, it will study physical and mental health multimorbidity. In particular, LINC will focus on multimorbidity between internalizing disorders (depression and anxiety) and cardiometabolic disorders (such as cardiovascular disease and type 2 diabetes) and explore the early life factors that can be changed to prevent these diseases.

LINC will bring together five large research cohorts, in which close to 760,000 people are participating. These cohorts are diverse in nature. They include participants of different ages (children, adolescents and different stages of adulthood). They also include participants of different ethnic backgrounds and different socio-economic positions.

The health of these participants is followed over time, with information available from medical notes (primary and secondary care) as well as study interviews and questionnaires and laboratory-based assessments (for example blood pressure and glucose and lipid levels). Rich information on risk and protective factors is also obtained regularly (for example on deprivation or stressful experiences).

The availability of DNA across all five cohorts will allow the study of the role of genes in multimorbidity development. The research will shine a light on some of the factors that cause children to have special educational needs and disability (SEND) and help identify approaches to support these children in school settings to improve their health in the long term.

Professor Marianne van den Bree at the MRC CNGG, who will lead the Research Collaborative, said of the grant, “I am absolutely delighted to have the opportunity to work together with the fantastic multidisciplinary team we have brought together under the LINC umbrella.”

“LINC can make real strides in understanding the genetic and environmental causes for physical and mental health multimorbidity. Our unique data resource will allow us to track multimorbidity development throughout the lifespan and to identify factors early in life that increase the risk of later development of multimorbidity of internalizing and cardiometabolic disorders.”

LINC aims to improve the understanding of factors contributing to the early preclinical risk stages of multimorbidity in young people. This can inform prevention strategies early in life aiming to reduce later risk of multimorbidity development.

The research is expected to yield new insights into why some people develop physical and mental health multimorbidity, while others do not, and to explain differences in risk between men and women, people of different ethnic backgrounds and people of different socio-economic positions. These insights can contribute towards efforts to reduce health inequalities in society.

Professor Mark Mon-Williams from the University of Leeds, Co-investigator and Impact Lead added, “LINC offers an incredible opportunity to connect health and education services early in a child’s life so they can enjoy better long-term physical and mental health. The research opens up the exciting possibility of revolutionising the support provided to children with Special Educational Needs and Disability (SEND) and transforming service provision for children and young people.”

In addition to Cardiff University, research teams from the University of Bristol, the University of Leeds, Queen Mary University of London, the Mental Health Services Capital Region of Denmark Roskilde University, the University of Exeter and Wellcome Sanger Institute will collaborate on the project.

Dr Rupert Payne from the University of Bristol’s Centre for Academic Primary Care and Co-Investigator said: “Multimorbidity is a huge and growing challenge for health services, but most of the research to date has focused on older people. The LINC project is a fantastic opportunity to find out much earlier in life which individuals are particularly at risk of developing future mental health and cardiovascular problems, and to work out how we can reduce the risks of ill health for these people.”

Researchers at Bristol (Professor Golam Khandaker, Profesor Nicholas Timpson, Dr Rupert Payne and Professor John Macleod) will lead on work on the development of early markers of psychiatric and cardiometabolic multimorbidity in young people using data from the Avon Longitudinal Study of Parents and Children (Children of the 90s) and other cohorts.

Bristol will also lead on the patient and public involvement elements of the LINC project, ensuring that the research is as relevant as possible to those affected most by multimorbidity.

The new large-scale award will begin in the autumn of 2021.