Project Summary

Understanding mechanisms underlying comorbid disorders poses a challenge for developing precision medicine tools. Psychiatric disorders are highly comorbid, and are among the last areas of medicine where disease classification is driven by phenomenology rather than pathophysiology. CoCA studies comorbidity between the most frequent psychiatric conditions, ADHD, mood / anxiety and substance use disorders, and a highly prevalent somatic disease, obesity.

ADHD is the entry route into a (preventable) negative developmental trajectory later in life.

ADHD is our starting point, as this disorder starts in childhood preceding the other conditions, and thus can provide important insights in the mechanisms underlying comorbid disorders: ADHD is the entry route into a (preventable) negative developmental trajectory later in life. Importantly, more than 80% of adult ADHD patients suffer from a comorbid disorder, which significantly contributes to disease burden. This means that pathophysiological mechanisms underlying ADHD must also be important in its comorbid disorders, which is another good reason to put ADHD in the centre of our research efforts. Importantly, improved understanding of pathophysiological mechanisms leading to ADHD with comorbid disorders will greatly empower prevention and therapy; given the high prevalence of the disorders studied, this has huge potential for improving public health throughout Europe. Our overarching goal is thus to deliver to professionals and society new knowledge and tools to prevent adolescent and young adult ADHD from escalating into detrimental comorbidities with mood and anxiety disorders, substance abuse, and obesity. By combining the most highly recognized experts in pre-clinical and clinical research of ADHD and its comorbidities across the EU with leading epidemiologists and geneticists, backed up by the availability of extremely large samples and registries, our consortium is ideally suited to integrate pre-clinical and clinical research to identify mechanisms common to ADHD and its comorbidities.

• CoCA will determine disease burden of comorbidity, calculate its socioeconomic impact, and reveal risk factors.
• The project will study the biological pathways of comorbidity and derive biomarkers, prioritizing two candidate mechanisms (circadian rhythm and dopaminergic neurotransmission), but also leveraging existing data sets to identify new ones.
• A pilot randomized clinical trial to study non-pharmacologic, dopamine-based and chronobiological treatments, i.e. physical exercise and bright light therapy, will be rolled out, employing innovative mHealth to monitor and support patients’ daily life. Find out how to participate here
• Integration of findings will lead to prediction algorithms enhancing early diagnosis and prevention of comorbidity.
• We will screen for repurposing existing pharmacological compounds

Through the research approaches taken CoCA aims to raise awareness for ADHD, reduce the stigma associated with this disorder, and empower prevention and therapy approaches.