Identifying the characteristics, treatments, and prevention strategies of post-infectious psychiatric conditions using electronic health records

Lead supervisor: Professor Rachel Upthegrove

Co-supervisor: Associate Professor Max Taquet

Commercial partner: Akrivia Health

Mental illness is a leading cause of disability worldwide, and the leading cause among people aged 5-49. Despite its enormous burden, the underlying mechanisms remain poorly understood, and current treatment options are often inadequate, with many patients not responding to available therapies.

There is increasing recognition that infectious diseases can increase the risk of developing severe mental illnesses such as psychosis, bipolar disorder, and major depression. Recent evidence from COVID-19 has further accelerated research into this link. However, key questions remain unanswered:

1. Are post-infectious psychiatric conditions clinically distinct from those that arise in the absence of infection, and what factors related to the infection itself (e.g. type, severity, or timing) influence the risk of developing such conditions?

2. Do post-infectious psychiatric conditions respond differently to treatment, either to standard psychiatric medications or to antimicrobial and anti-inflammatory agents?

3. Could childhood vaccines reduce the risk of psychiatric conditions that typically emerge in adolescence and early adulthood?

For the first time, these questions can be robustly addressed using the newly linked Akrivia Health–OPCRD dataset. This resource integrates secondary care mental health records curated by Akrivia Health (covering over 6 million patients across 20 NHS Trusts, including diagnoses, symptomatology, treatments, and hospitalisations) with primary care records for 500,000 of these patients from OPCRD (including infections, vaccinations, and prescribing). This unprecedented linkage enables the study of the interplay between infections, immune responses, and severe mental illness at scale.

The project will generate benefits across stakeholders. For the academic community, it will advance fundamental understanding of post-infectious psychiatric conditions and point to new avenues for prevention and treatment. It directly aligns with the supervisors’ research priorities: investigating immune mechanisms in severe mental illness and identifying opportunities for drug repurposing through large-scale data science.

For Akrivia Health, the collaboration provides three major advantages. First, it will demonstrate the research and commercial value of the newly linked dataset, highlighting its ability to define patient subtypes at the interface of physical and mental health. Second, it will characterise post-infectious psychiatric subtypes in ways that can inform development and targeting of new or repurposed treatments. This will be of direct relevance to their pharmaceutical clients seeking well-defined patient groups for clinical trials. Third, findings could support Akrivia’s work with NHS Trusts, for example by underpinning dashboards that identify patients with post-infectious profiles and suggest tailored management strategies.

For the student, this project offers rare and comprehensive training. They will develop expertise in large-scale data analysis, precision psychiatry, infectious disease epidemiology, and machine learning, alongside a detailed understanding of how electronic health records are generated, curated, and applied in both academic and industrial contexts. These skills will position them to lead future research and innovation at the interface of data science, psychiatry, and healthcare delivery.

In summary, this project sits squarely within the MRC remit by building high-quality capacity in several priority areas including novel target validation, precision medicine, data science, and interdisciplinary work while delivering benefits to academic research and commercial innovation.

Apply using course: DPhil in Psychiatry