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Diagnosis, treatments and well-beinggenetics

Meet the Researcher – Dr Adam Cunningham, ECHO Study Team, MRC CNGG

27 September 2018

I have always been interested in the brain and the mind, and how we perceive and understand the world around us.

I could have gone into more basic research about how the brain processes information, or how neurons work but found it much more interesting to work on a subject that has clear relevance to people and has the potential to help improve people’s lives.

I’m always inspired by my colleagues in the department. Every day I am amazed by the work that is done here, and everyone’s determination to better understand some of the big problems in mental health and brain disorders.

Currently, I am working on movement and coordination problems in children with the genetic variant 22q11.2 deletion. About 1 in 4,000 people have the deletion and it is associated with many physical health issues like a poor immune system, thyroid problems, heart problems, a cleft palate, along with many others. In addition, it increases the risk that an individual will develop mental health problems such as anxiety, ADHD, and autism.

It is also one of the strongest genetic risk factors that we know of for the development of schizophrenia, with about a quarter of people with the deletion developing a schizophrenia spectrum disorder. We don’t know why only one quarter will develop schizophrenia, and much of the research the lab I am a member of is trying to identify what other factors, apart from the deletion, affect the risk for developing mental health problems.

A few years ago, we began thinking that difficulties with movement and coordinated movement in childhood might be something that would increase risk, or even be an early marker of later problems. My research has found that lots of children (maybe as much as 80 %) with the deletion have difficulties with coordination, but many families do not get help for their child’s coordination difficulties.

While not a clinician myself, a large part of my work is trying to inform clinicians about the deletion and the symptoms that are associated with it so that they can give the best advice and treatment to patients. Coordination problems are under-researched and under recognised in people with the deletion, so I am trying to get the message out that this is something to be aware of.

Over the past few years, I think people have become much more comfortable talking about mental health, which is undeniably a good thing. I also think people are becoming generally more aware of the importance of mental health, not only for themselves but for their friends and family, so are more likely to try and help if they notice someone might be having a hard time.


At the moment, I think the key challenges in mental health research are funding and capitalising on the renewed and increasing interest in the field. Second, I think we need to improve our diagnostic techniques and processes, as many current diagnoses are restrictive. Co-occurring symptoms and problems are very common, and not dealt with well with current diagnostic processes.

There is a movement towards focusing on dimensional classification of symptoms that may help, but ideally, we would want to be diagnosing mental health disorders based on a biological problem or cause, as we do for most physical health problems like diabetes or heart disease. Finally, I think developing new treatments, both pharmaceutical and non-pharmaceutical, and refining when it is best to use a certain treatment is extremely important.

Any advice?

For those starting out in their career in mental health research remember to keep an open mind. Opportunities can come from unexpected places.

Make sure your research is grounded in some way by what patients might want or need. Try and engage with patient and clinical networks to get the results of your research to who will need and use it. It can be easy to lose sight of why we are doing our research.