The road ahead for ECNP
Wednesday 26 April 2023

Professor Martien Kas took over as the president of ECNP at the 35th ECNP Congress in Vienna in October 2022. He is professor of behavioural neuroscience at the University of Groningen in the Netherlands. He recently spoke to ECNP press officer Tom Parkhill about his hopes for the College for the next few years.

TP: Martien, congratulations on taking over as ECNP president. How did this all begin, what where your early contacts with ECNP?
MK: My first contacts were around 2001 or 2002, when I attended an ECNP Congress in Barcelona. Then around 2004 I was asked to give a lecture at the spring Workshop in Nice. I started talking to some board members, from whom I learned about the larger scope of the College, and I started to get some invitations to join various committees. I really enjoyed the atmosphere and the topics which the College was pursuing, so I started to commit more time to it.

How has the College changed in the time you have been associated with it?
Well, there has been a lot of changes in the research that people are doing, and that has informed the field. It has changed our perception of how we look at patients, at diagnosis, and potentially at treatment. And I think that the translational aspect of the College has really come to the fore – “neuroscience applied”, as we say. This is very clearly reflected in the way we organise the Congress and the sessions. So I think that we are getting to the point where this is now at the core of what we do.

At the 35th ECNP Congress last year in Vienna I spoke to a researcher from London who was very involved in the study of consciousness. I asked her why she was there, and she said she had been invited to give a talk. She was really pleased and surprised at the breadth of topics covered at the ECNP Congress – she had sort of assumed that ECNP would be about drugs, and of course we see that while that is still important, it’s about much more than that.
This is just what I wanted to say in the recent Message of the President. I have a feeling that in the last 20 years ECNP has been changing. When I first started working with ECNP it was focused on full-on pharmacology, on clinical studies. The College is now addressing the broad area of applied neuroscience research.

Yes, I was looking at the message. You highlighted several ways you want to see the College developing.
One of the things I want to highlight is the way technological advances in big data analysis can open possibilities to strengthen collaboration. There’s a lot happening in data analysis, and in the collection of very large data sets, in for example imaging, genetics, etc. Global groups are now forming, creating the resources to probe this information. And of course, there is a gradual synthesis of these data sets – multiple large data sets being brought together. I think that is really changing our view on how the brain develops, and how we can potentially alter behaviours. Often people actually dealing with the patients don’t know enough about the recent scientific advances. So on one hand the science is accelerating tremendously, but this is also creating a gap in the understanding and clinical application of new findings. This is an area where ECNP has an important role, to reduce that gap.

In some respect this brings us back to the PRISM project, where you are the academic lead. PRISM of course is designed to put diagnosis on a more scientific footing. And I see that the French government has just funded a large project in precision psychiatry. Suddenly precision psychiatry seems central to the work.
Yes, we were pioneers eight years ago in launching this transdiagnostic quantitative biology approach, but it now really seems to be taking off. People are beginning to recognise and appreciate the work. It’s not always easy, but it brings a whole different framework to psychiatry and neurology. I think that’s what the field needs to move forward.

More generally, the discipline has focused a lot on pharmacology, and that remains extremely relevant to ECNP. But there are other emerging technologies, which may address similar concepts in different ways. So for example if we can start to identify neural circuits for specific phenotypes, then we need ways to stimulate or activate these circuits. This may be for example combined therapies between drugs and psychotherapy, which may have a greater combined impact on the help of individuals. There’s a lot to discover about the health of our brain and how to keep it healthy, and there may be various routes to follow.

You also said that you hope for a greater role for patients. How can ECNP get more involved with patients?
That’s a good question. We discussed this in the recent Executive Committee meeting. Of course, there are already several European patient organisations, such as EUFAMI and GAMIAN-Europe. We need to work more with these organisations and support them more. We are also looking at whether to develop a patient advocacy group. We need to look at which symptoms are most important to the patient. For example, if someone finds that social isolation is a major problem, then we should be looking at alleviating that. If on the other hand someone finds that their quality of life is significantly reduced because they can’t work, and if that is what is hampering them most, then we should take that into account. That may need a different intervention, but we can only understand that by talking to patients.

I guess that mental health problems are not a single problem: schizophrenia is not the same as OCD, the patients are different, whereas a condition like diabetes may have an underlying coherence and similarity within the patient group. It must be difficult to listen to such a diverse patient group.
It’s not easy, and we are not there yet, but it is important that we listen. This is also important in designing clinical studies. It’s important to know that you are designing a clinical study that the patient wants to participate in. So it’s useful to know in advance how much the group you are trying to help really would appreciate what you are trying to do. That can increase that sense of participation. We need to find better ways to improve that interaction and work towards common goals.

You are also interested in the inadequacy of the current classification scheme.
This is something we are all experiencing. Our whole system is based on giving patients a certain diagnosis, based on very clear descriptions. And we have created silos where a diagnosis leads to a certain treatment, and that’s it! But we know from the biological studies we are doing that these silos are not really silos. Within these groups there is patient heterogeneity, and across these diagnoses there is some overlap between patients. So clearly we need to view this in a different way. I think as a college we should start opening up this discussion. In January, I announced the idea in a global colleges of neuropsychopharmacology leadership meeting with the presidents of the various neuropsychopharmacology organisations – CINP, the African, Asian and American Colleges, and ECNP. This has to be a broadly supported initiative, and they were very supportive of what I put forward and would like to join us in this effort. One of the first things we will be doing is to start building an agenda for the 2024 New Frontiers Meeting on this topic, and they are very keen to have some input in setting the agenda.

So the DSM will eventually become history?
We will have to see how this develops over time. DSM remains an extremely important clinical tool, but for advancing the underlying science something for sure has to change. We need to start slowly, but we need these new topics to be on the table.

And if you had a wish for the next few years?
We would hope to enhance the sense of community. There is a great ambience at the Congress, and I’d like in some way to extend that. We can perhaps do this by broadening the extent and reach of our educational programmes, and to let more people make use of these programmes. I also want to see us inspire the field. We have seen a decade where a lot of pharmaceutical companies have dropped out of the mental health field, but I hope that by bringing in these new views I have been talking about, we can inspire young people to move forward and find applied neuroscience solutions. In the end, we want to improve the quality of life of the many patients who are out there.

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