Flourish is a comprehensive innovative research program aimed at maintaining optimal mental health of young people at variable risk of developing psychiatric disorders. The program is based in Ottawa, with study participants primarily located across South-Eastern Ontario and the Maritimes. Research is funded by national and international organizations and has produced many important scientific publications advancing understanding of how mood, anxiety and related disorders including substance use and suicidality emerge in young people at identified familial risk. We collaborate with key stakeholders and leaders in related research fields in order to better understand the biological, psychological and social factors that influence the onset and progression of these disorders in susceptible youth. This work has informed a new branch of research aimed at understanding why some students transitioning to university flourish and other do not. These research initiatives have profound life-changing potential, leading to the development of effective early interventions to prevent mental illness, restore health and potentiate well-being.
Major psychiatric disorders such as major depression and bipolar disorder onset in adolescence and recur lifelong. Untreated illness is associated with a high risk of developing psychiatric and medical complications including addictions, suicide and cardiovascular and other inflammatory disorders contributing to premature death. Major psychiatric disorders run in families like other medical illnesses (ie. cancer). Therefore, we have devoted our efforts to studying prevention, early detection and intervention in high-risk children and adolescents from families with an affected parent. Children of psychiatrically ill parents not only share genetic risk factors for illness, but are exposed to other illness related risk factors including separation from the ill parent (due severe illness and/or hospitalization), financial hardship, family breakdown, along with other sources of familial illness-related stress.
The Flourish Model seamlessly integrates clinical, research, education and knowledge translation efforts collectively aimed at improving outcomes for high-risk youth and their families. Traditionally, adults and their children are seen in different clinical centres that do not communicate or collaborate. In our model, we identify families based on a diagnosis of a recurrent major mood disorder (unipolar or bipolar disorder) in a parent. All affected family members are welcome to receive an expert comprehensive psychiatric assessment and treatment recommendations according to the best evidence. Consenting/assenting parents and their children participate in various research ethic board approved research initiatives. By studying families (generations of related individuals) we can better understand the transmission and early indicators of illness, and provide early detection and intervention strategies. Further, by having well-characterized families, the research is enriched with a wealth of important clinical and family information.
“to advance understanding of the onset of mood and related disorders in youth”
“to identify sources of resilience important to illness prevention in high-risk youth”
“to develop effective early stage treatments to restore mental health in young people”
“to reduce the burden of illness for high-risk youth, their families and society”
Depression is the commonly diagnosed illness and is the leading cause of disability worldwide (http://www.who.int/mediacentre/factsheets/fs369/en/index.html). While short-lived sadness and despair in the face of loss or disappointment is a normal human experience, prolonged depression associated with impairment in functioning and morbid preoccupation is not normal and can be associated with a very high risk of suicidal behaviour and other psychiatric (ie. substance use disorders) and medical illnesses (cardiovascular, immunological).
Depression has a heritable component, and typically is thought of as a complex trait with genetic factors interacting with important psychosocial influences.
Clinical major depression has an estimated lifetime prevalence of up to 15% with women at an estimated 2-fold increased risk compared to men.
The first line of treatment for mild to moderate depression is psychological therapy, stress reduction, exercise and optimal nutrition; while medication in combination with these is recommended for the treatment of moderate to severe depression
Bipolar Disorder (formerly known as Manic Depressive Illness) is a type of mood disorder (http://www.cmha.ca/mental-health/understanding-mental-illness/bipolar-disorder/). The illness involves episodes of depression, and at least one or more episodes of hypomania or mania. Estimates of lifetime prevalence in the general population varies, but generally about 2% of the population are estimated to suffer from full-blown bipolar episodes, while an additional 5% are thought to suffer from milder versions of the illness.
The most characteristic aspects of Bipolar Disorder include that it is recurrent and typically the mood episodes onset in adolescence or early adulthood. Bipolar disorder affects both sexes equally. The illness runs in families…