The Treatment Research Program has been dedicated to the study and treatment of people with schizophrenia since 1989. The Program incorporates a diverse range of treatment relevant research and provides numerous opportunities including clinical trials of new medications and strategies to help move people with schizophrenia on the path to recovery.
While there have many significant and meaningful advances in the field of schizophrenia in the past decade, the development of novel treatments for people with this illness has been a slower process. Translating new findings to the level of medication development is less than ideal and optimizing outcomes for patients are hindered by a lack of personalized strategies.
Most treatments available currently have been studied without regard to the heterogeneity of schizophrenia. This means that treatments we currently use have not been tailored to specific patient groups or populations but rather based on the diagnostic criteria of the DSM-5 and studied in everyone the same way.
We know that schizophrenia presents very differently and that there is a wide range of different levels of treatment response and different adverse effects, with many people not achieving optimal outcomes. This drives us to strive for better personalized treatments.
Components of the Treatment Research Program
A cornerstone program of the TRP is the Treatment Research Unit (TRU). Originally established in 1989, the TRU is operated by the Spring Grove Hospital Center in a collaborative effort with the Maryland Psychiatric Research Center. The TRU is viewed as a primary resource for Maryland's Behavioral Health Administration to improve treatment for people with schizophrenia throughout the state. It is supported by both research and clinical staff in a uniquely collaborative program.
The TRU consists of one 24 bed fully staffed inpatient unit. When admitted to the program, each patient will receive a comprehensive physical and psychiatric assessment. Dr. Charles Richardson, Spring Grove Hospital Center Unit Director and Dr. Gopal Vyas, both adjunct faculty at the University of Maryland lead the medical care provided at the TRU along with Dr. Heather Adams, the lead psychologist. Each patient will receive an individualized treatment plan which integrates appropriate therapeutic modalities and specific treatment goals.
The TRP also houses a Brief Stay Unit (BSU), a research specific short stay 3 bed unit that is dedicated to challenge and early phase studies. It is fully equipped with emergency equipment and trained research staff.
The TRP also provides select consultation and referral for treatment. The faculty are involved at the national level in programs such as clozapine initiatives to overcome barriers.
The TRP collaborates with many clinics, community health centers and private practices to allow the opportunity for research to as many people as possible with schizophrenia living in the community.
The TRP is accepting new research candidates and has a variety of opportunities available include medication and treatment studies but also several other opportunities for minimal risk research. We offer study opportunities for a wide variety of participants including people without history of mental illness.
Dr. Deanna Kelly and her Treatment Research Program team at the Maryland Psychiatric Research Center have focused on treatment-oriented research that strives to optimize and best treat patients in a more personalized way. Specifically, this team has been one of the few clinical trial researchers focused specifically on the biologic differences and side effects of women with schizophrenia.
They also working on a large multinational clinical trial targeted at treating people with the medication clozapine, where they are focused on better using this medication and safely showing its efficacy in a population of African descent patients who may have a genetic predisposition to certain side effects.
Additionally, the group has been working with a collaborative team from Johns Hopkins University and Harvard to examine a subgroup of people with schizophrenia who have a high degree of inflammation and have a unique immune response to gliadin, a protein found in wheat and other foods. Dr. Kelly and her colleagues have shown that certain antibodies formed in response to gliadin are high in some, but not all people with schizophrenia and these same people may have improvements in inflammation and psychiatric symptoms with removal of gluten from the diet. Dr. Kelly and her colleagues are working on a large confirmatory study where they hope to prove the effectiveness in the specific schizophrenia population having this antibody biomarker and they hope to better understand the reasons why it may be effective.
The TRP is also a leader in new technologies with opportunities to be involved with language and social media collection, new ways to detect medications in the body, and new biomarkers.
Clinical Research Assistant
Clinical Research Assistant
Treatment Research Unit
Kelly DL, Demyanovich HK, Rodriguez KM, Ciháková D, Talor MV, McMahon RP, Richardson CM, Vyas G, Adams HA, August SM, Fasano A, Cascella NG, Feldman SM, Liu F, Sayer MA, Powell MM, Wehring HJ, Buchanan RW, Gold JM, Carpenter WT, Eaton WW. Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study. J Psychiatry Neurosci. 2019 Jul 1;44(4):269-276. doi: 10.1503/jpn.180174. PMID: 30938127; PMCID: PMC6606425.
Approximately one-third of people with schizophrenia have elevated levels of anti-gliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG...https://doi.org/10.1503/jpn.180174
Kelly DL, Li X, Kilday C, Feldman S, Clark S, Liu F, Buchanan RW, Tonelli LH. Increased circulating regulatory T cells in medicated people with schizophrenia. Psychiatry Res. 2018 Nov;269:517-523. doi: 10.1016/j.psychres.2018.09.006. Epub 2018 Sep 5. PMID: 30195746; PMCID: PMC6207456.
Immunological abnormalities are increasingly reported in people with schizophrenia, but no clear functional biomarkers associated with genetic correlates of the disease have been found. Regulatory T cells (Tregs) are key immunoregulatory cells involved in the control of inflammatory processes and their functions are directly related to the human leucocyte antigen (HLA) gene, which has been implicated in schizophrenia genetic studies. However, there is a lack of studies reporting Treg status in people with schizophrenia. In the current study, the proportion of circulating Tregs was examined using flow cytometry in 26 medicated participants with schizophrenia and 17 healthy controls...https://doi.org/10.1016/j.psychres.2018.09.006