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Commonwealth Research Center

Commonwealth Research Center

History

The CRC was created in 1987 at the MMHC by the Massachusetts Department of Mental Health (DMH) to address the need for cutting edge clinical research on schizophrenia and related psychotic disorders. This continued a long-standing tradition of the study of psychosis at MMHC. In the early phase of the CRC, under the leadership of Alan I. Green, M.D., the CRC mission was defined by focusing on areas that were the strengths of MMHC: psychopharmacology, neurophysiology, service research and family studies. The focus later broadened to include comorbid medical disorders, first episode schizophrenia and other psychoses, neuroimaging, and substance use disorders in schizophrenia, and research on children with severe mental illness.

In 1993, the DMH expanded its commitment to support clinical research by designating two Centers of Excellence. The CRC, with a focus on neurobiology and psychopharmacology, was awarded a six-year contract in research support. A second center, at the University of Massachusetts Medical School, focused on mental health services and forensic studies.

The creation of an infrastructure to foster the growth of clinical investigation was critical to the mission of the CRC. The infrastructure that was developed included: staff to provide diagnostic assessment, subject recruitment, clinical and cognitive ratings, database management, statistical consultation, and biological assays through the Psychiatric Chemistry Laboratory at MMHC.

The research studies of the CRC have been conducted in both inpatient and outpatient settings. The CRC Center of Excellence also had a 12-bed inpatient unit, called the Commonwealth Research and Evaluation Unit (CREU), from 1993 to 2001. The CREU was responsible for the evaluation of more than 300 patients, who participated in over 15 different research projects. Outpatient studies of the CRC have been conducted at MMHC, local hospital outpatient departments, as well as at DMH hospitals and mental health centers.

In March 1999, the CRC was again awarded a contract for a Center of Excellence by the DMH. The DMH, in its consideration of proposals for the two Centers of Excellence, required application under the auspices of a medical school. Affiliated with the Department of Psychiatry at Harvard Medical School, the CRC was designated a Center of Excellence with Dr. Joseph Coyle as the Principal Investigator and Dr. Green as the Center Director.

Dr. Alan I. Green was the Center Director from the initiation of the CRC until 2002 before leaving to become Chair of the Department of Psychiatry at Dartmouth Medical School. Dr. Larry J. Seidman, an investigator of the CRC and principal investigator of other Harvard and MGH neuropsychological studies and genetic studies on schizophrenia, and attention-deficit/hyperactivity disorder, has been the Center Director since 2002. Other notable researchers have a long-standing relationship with the CRC. Dr. Joseph Schildkraut has served in a leadership and advisory role in the CRC since its inception. The CRC Harvard advisory board is composed of Dr. James Beck, Acting Chair of the HMS Department of Psychiatry at MMHC, Dr. Gary Gottlieb, President of the Brigham and Women’s Hospital, Dr. Stuart Hauser, President of the Judge Baker Guidance Center, and Dr. Robert McCarley, Chair of the HMS Department of Psychiatry at the Brockton VA Medical Center. Dr. Kenneth Duckworth, Acting Commissioner of Mental Health in Massachusetts, provides oversight and advice from DMH.

The CRC and collaborative research groups (headed by Drs. Barbara Dickey, Alan Green, Robert McCarley and Ming Tsuang) have acquired substantial outside support from federal, industry and foundation sources over the years, underscoring the value of the CRC to the citizens of the Commonwealth.

In affiliation with Harvard Medical School, the CRC has sought to widen its focus beyond MMHC and the DMH community to also serve as a base for research of numerous investigators within the Harvard Department of Psychiatry. In 2000, the CRC received funding for the Silvio Conte Neuroscience Center for the Study of Serious Mental Illness, with Dr. Joseph Coyle as the Principal Investigator. The Conte Center focuses on basic and clinical investigations on the role of glutamate in psychotic disorders. The CRC also provides a base of support for the researchers of the Harvard Department of Psychiatry located in the Southeast region of Massachusetts. This research, largely psychopharmacological in nature, is headed by Dr. Theo Manschreck, at Corrigan Mental Health Center, and Dr. Ileana Berman at Taunton State Hospital. First episode studies are done in collaboration with Dr. Alan Green of Dartmouth Medical School and with Drs. Robert McCarley, Martha Shenton, Margaret Niznikiewicz and Melissa Frumin from the Brockton-West Roxbury VA Medical Center.

Current Projects

In collaboration with other Harvard-wide research groups, the CRC is currently conducting cutting edge clinical research in five primary areas:

  • Longitudinal exploration of clinical symptoms, cognition, and brain structure and function in patients experiencing their first episode of psychosis.

  • Early intervention and treatment during the prodromal period, the time just prior to the onset of psychotic symptoms.

  • The effects of GABA on normalization of neural circuitry dysfunction in early-onset schizophrenia.

  • Studies of brain reward circuits (linking neurobehavioral probes and fMRI) to further elucidate the basis of the use of substances in patients with schizophrenia, and the ability of clozapine to limit substance use in this population.

  • Studies of medical comorbidity in patients with severe mental illness.

All of these research studies are related to our overall goal of gaining a better understanding of the nature of psychosis, providing early intervention and prevention of long-term clinical deterioration.

During the summer of 2003, the CRC expects to open a comprehensive evaluation service and developmentally-geared treatment program at MMHC for young people who are experiencing a first episode of psychosis.