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DRAFT UCLA School of Dentistry receives $3.8 million to develop a saliva test to predict the onset of post-traumatic stress disorders Each year, more than a million individuals in the United States are at-risk for developing significant mental health problems after experiencing a terrifying event or serious physical injury – a leading cause of disability in civilian, military, and minority populations. Once established, these psychiatric illnesses, such as post-traumatic stress disorder and depression, are extremely crippling and difficult to treat. Timely recognition of emerging mental disorders provide health care professionals the best opportunity for preventive interventions. A team of researchers, led by Dr. Vivek Shetty, a professor at the UCLA School of Dentistry, has received a $3.8 million research grant to develop a salivary biomarker approach for identifying individuals at future risk of developing post-traumatic stress disorder (PTSD) and suffering from depression following a traumatic event. Co-funded by the National Institute of Dental and Craniofacial Research (NIDCR) and the NIH Office of Behavioral and Social Sciences Research (OBSSR), the 5-year study seeks to develop a panel of salivary stress biomarkers that will allow early recognition of emerging mental health disorders and permit preemptive psychological care. “Current assessment strategies rely on subjective reports of symptoms by trauma survivors. The symptom-based nature of psychological assessments presents significant challenges for trauma care specialists attempting to differentiate between temporary distress and the early stages of mental health illnesses,” says Shetty. “Moreover, the time and resource constraints of the acute care setting do not allow for the structured screening required for psychological assessments. If successful, our salivary stress biomarker panel will allow the development of practical decision-aid tools to complement subjective clinical evaluation and allow timely referrals of ‘at-risk’ individuals.” In the new study, Shetty and his colleagues will repeatedly conduct psychological assessments and obtain corresponding saliva samples over a 6-month period among a group of 600 individuals following a serious physical injury or sexual assault. The team will use sophisticated analytical techniques to determine the levels of the individual salivary biomarkers at different points over the six months and compare the biomarker patterns of individuals who subsequently develop PTSD and/or depression with those who did not. The association of the biomarkers with mental disease would be used to develop mathematical models that utilize early stress biomarker levels to predict later development of traumatic psychopathology. “Utilizing easily accessible saliva for evaluating stress reactions would allow front-line care providers to become more involved and proactive in the management of post-traumatic stress disorders, moving the focus away from treatment of unmanageable, late-stage conditions towards early identification and targeted interventions of vulnerable individuals,” reveals Shetty. “Enabling health care providers to objectively and readily assess the risk for future psychological problems will set the stage for integrated post-trauma care that provides for essential and tailored mental health interventions in trauma care centers as well as timely referrals for psychological aftercare.” The current research study builds on and complements Shetty’s ongoing development of mobile devices for point-of-care assessment and management of post-traumatic stress disorders – a program funded through NIH’s Transdisciplinary Gene and Environment Initiative. “Beyond the civilian population, post-traumatic mental health disorders are a significant problem for our military. The scope of the mental health problem is increasingly manifest as thousands of soldiers are coming back from Iraq and Afghanistan,” says Dr. No-Hee Park, dean of the School of Dentistry. “This grant allows Dr. Shetty to focus the skills and abilities of his team to help solve a very serious problem with advanced technology in the cutting-edge area of salivary diagnostics. I am hopeful that the results of this research will inform mental health efforts not only in civilian populations but also in military settings.” The UCLA School of Dentistry is dedicated to improving the oral health of the people of California, the nation and the world through its teaching, research, patient care and public service initiatives. The school provides education and training programs that develop leaders in dental education, research, the profession and the community; conducts research programs that generate new knowledge, promote oral health and investigate the cause, prevention, diagnosis and treatment of oral disease in an individualized disease-prevention and management model; and delivers patient-centered oral health care to the community and the state.