The Psychosis Research Program (PRP), formerly the Commonwealth Research Center, was created in 1987 at the Massachusetts Mental Health Center (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 1993, the DMH expanded its commitment to support clinical research by designating two Centers of Excellence. The PRP, 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 PRP 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. In March 1999, the PRP was again awarded a contract for a Center of Excellence by the DMH under the auspices of the Department of Psychiatry at Harvard Medical School. In June 2005, the PRP and the rest of the MMHC Department of Psychiatry of HMS were transferred to the Beth Israel Deaconess Medical Center (BIDMC), also a HMS teaching hospital, and became the MMHC Public Psychiatry Division of the BIDMC. In May 2007, the PRP was again awarded the DMH grant through the BIDMC Department of Psychiatry, under the direction of Mary Anne Badaracco, M.D. and Harvard Medical School.
Under the leadership of Alan I. Green, M.D., (until November 2002), the PRP mission was focused 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, substance use disorders in schizophrenia, and research on children with severe mental illness. Dr. Green continues to work collaboratively with the PRP.
In November 2002, Larry J. Seidman, Ph.D., became the Director of the PRP with a central goal to develop new knowledge about psychosis in order to reduce the significant morbidity associated with psychotic illnesses. The Center specifically focuses on research designed to further understand the underlying mechanisms and manifestations of psychotic illnesses and the optimal treatments for persons with severe and persistent mental illness. In addition to his PRP related work, Dr. Seidman was the principal investigator of other neuropsychological studies, genetic studies on schizophrenia, and attention-deficit/hyperactivity disorder at BIDMC and other Harvard Medical School sites.
The PRP directs programs for the early intervention and prevention of psychotic disorders and is engaged in the ongoing development of additional studies and programs. The Program particularly emphasizes the early phases of psychotic illnesses (including the "prodromal" period before frank psychosis develops) in order to have the best opportunity to prevent or delay the onset of psychosis or to attenuate the symptoms and improve life style through early intervention. A second focus has been on understanding the progression of schizophrenia spectrum illnesses in people at three different phases, prodrome, first episode of psychosis and persistent psychotic disorders. A third focus has been on cognitive impairment and its treatment, as it is now known that cognitive impairment is the single best predictor of residual disability in schizophrenia.
The new contract with DMH, awarded to the PRP in May 2007, will include the development of several new programs. There will be a health and wellness program under the direction of David Henderson, M.D. of Massachusetts General Hospital at Massachusetts Mental Health Center. (Link to H&W). There will be a multicultural research program to better understand racial and ethnic disparities in mental health care and ensure the research at the PRP includes a multicultural perspective and presence in the design and implementation of research projects. Finally, the PRP will be disseminating current research findings from the literature and PRP projects to DMH providers and consumers to assist in the delivery of evidence-based clinical care through written abstracts from the literature, workshops and clinical conferences.
The PRP has continued 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 and across the country. The PRP has become known as a center for the study of cognition in psychosis, and in the assessment of risk and protection factors in mental illness. For these reasons, the PRP now participates in a number of multi-site studies with investigators across the country (see family-genetic studies and cognition studies- below). The PRP recruitment core helps recruit for PRP studies per se, as well as for studies with collaborating scientists at other Harvard institutions including Dr. Robert McCarley at the Brockton Veterans Administration Medical Center, Dr. Jean Frazier at The Cambridge Hospital, and Drs. Don Goff, David Henderson and Anthony Weiss at Massachusetts General Hospital. 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, and Margaret Niznikiewicz from the Brockton-West Roxbury VA Medical Center.
The current PRP leadership works closely with several advisory committees including a Consumer/Family Advisory Board in collaboration with Consumer Quality Initiatives, Inc.; the Harvard Medical School (HMS) Psychiatry Executive Committee Board of Advisors; and a Scientific Advisory Board made up of a number of senior faculty from several HMS-affiliated hospitals.
The PRP and collaborative research groups (headed by Drs. Barbara Dickey, Jill Goldstein, 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 PRP to the citizens of the Commonwealth.
The creation of an infrastructure to foster the growth of clinical investigation was critical to the mission of the PRP. The infrastructure that was developed included staff to provide diagnostic assessments, subject recruitment, clinical and cognitive ratings, database management, and statistical consultation.
The research studies of the PRP have been conducted in both inpatient and outpatient settings. The PRP 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 PRP have been conducted at MMHC, local hospital outpatient departments, as well as at DMH hospitals and mental health centers.
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