The Neuropsychiatric Genetics in African Populations (Neuro-GAP) programme is an ambitious, multi-country project aiming to improve and achieve equity in mental health by expanding the infrastructure and research findings from large-scale psychiatric genetic epidemiology to Africa (click for more information). As there have been no large-scale studies on the genetics of neuropsychiatric disorders in African populations to date, this project addresses a key gap in the field. Specific research objectives are:

- To expand knowledge of the genetic and environmental risk factors for schizophrenia, bipolar disorder and autism in Africa through large-scale sample collection, analysis and follow-up.

- To increase understanding of the genetics of African populations.

- To enhance neuropsychiatric genetic research capacity in Africa through the training of scientists and to support the development of locally led research programs.

The Psychiatry Neuroimaging Group (PNG) (http://dev.png.uct.ac.za) was recently established to help raise the profile of psychiatric neuroimaging research at UCT. The PNG’s core team includes investigators with expertise in a variety of neuroimaging techniques, including functional magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), structural MRI, diffusion tensor imaging, and resting state fMRI.

Large collections of brain imaging data are increasingly being made available to the global neuroimaging community as part of international research collaborations. The PNG aims to foster true “bench-to-bedside” clinically relevant research by helping investigators take advantage of these datasets. This will also add value to pre-existing collaborations between PNG members and projects such as the Enhancing Neuroimaging Genetics Through Meta-Analysis (ENIGMA) initiative (http://enigma.ini.usc.edu/). By facilitating access to these data, local researchers will for the first time be able to investigate common imaging markers across multiple psychiatric disorders, including schizophrenia, obsessive-compulsive disorder and neuroHIV. Within the context of the BBU, greater collaboration with initiatives such as ENIGMA will help pave the way for future studies that are relevant to the diverse clinical population in South Africa.

The Translational Neuroscience (TNS) group studies mechanisms involved in the neuropsychobiology of non-communicable and communicable disease. This group uses a translational research approach that includes the use of animal models and clinical research studies. A wide range of cutting-edge techniques are applied to address research aims, including multimodal imaging as well as laboratory-based neurochemical and neuroimmunological markers. Ultimately, this group aims to improve diagnostics and prognosis of individuals with mental disease/disorder by understanding the relevant neuropsychobiological underpinnings.

Current research includes the application of diverse translational neuroscience techniques to endemic and severe mental disorders, including psychotic disorders such methamphetamine-induced psychosis, schizophrenia, and bipolar disorder; infectious diseases such as neuroHIV; and early developmental stressors (eg. maternal distress and pre-natal exposure to illicit substances) that are known to increase the likelihood of mental disorders.

Evidence based psychopharm:

Although there have been important advances in effective and cost-efficient treatments for mental disorders, clinician-friendly syntheses of the evidence are needed, and in particular, in low- and middle-income countries. The evidence based psychopharm project extends this work by expanding and synthesizing this evidence-base to increase the representivity of such work and management; busy clinicians cannot digest all the literature and must rely on rigorous evidence-based reviews and guidelines.

Working with researchers from Uganda, the specific research objectives are:

1) To strengthen knowledge about and the ethos of evidence-based mental health;

2) To build capacity in evidence-based innovative methodologies; and

3) To provide training to clinicians and front-line workers in South Africa and Uganda. 

The Division of Addiction Psychiatry currently benefits from a few key sources of funding, thus being the home of the US Department of State INL-funded South Africa International Technology Transfer Centre (ITTC) (https://ittcnetwork.org/ITTC/ittc-south-africa.aspx), the Western Cape Department of Social Development-funded Postgraduate Diploma in Addictions Care, and the NGAP Senior Lecturer post occupied by Amy Adams.  The ITTC provides key links for Division and Department to International teaching and research networks under the International Consortium of Universities for Drug demand Reduction (ICUDDR) (https://icuddr.org), the International Society of Substance Use Professionals (ISSUP) (https://www.issup.net), and the Columbo Plan Drug Advisory Programme (DAP), all of which have seen the Division play a major role in the recent inaugural ADDICTION 2021 Conference. Current research focusses on implementation science investigations for provider capacitation in community-level addictions care around the country, alongside other MMed and MPhil Projects.

The Division provides clinical services and teaching

• Clinical Services largely led by A/Prof Henk Temmingh and Dr Lisa Dannatt: Consultation-Liaison; Addiction Psychiatry; Dual Diagnosis
• Teaching: Undergraduate teaching of medical students; Psychiatry Registrar training; The Postgraduate Diploma in Addictions headed by Fergus Ashburner; MPhil for specialist psychiatrists, PhD (Addictions)

Division members participate in the provision of Technical Assistance through individual and group contributions at local, national, and international level and through the ITTC which is tasked with:

• Supporting the development of national and regional drug and alcohol policies that promote the implementation of evidence-based best practices for substance use prevention, treatment, and recovery services in South Africa;
• Facilitating the uptake of evidence-based best practices for substance use prevention, treatment and recovery services including related health conditions in South Africa through various capacity building interventions across cadre levels and sectors; and
• Assessing and removing barriers to evidence-based best practices for substance use prevention, treatment, and recovery services in South Africa.

Neuroethics is an increasingly prominent interdisciplinary field that considers the moral, legal and social implications of neuroscience and neurotechnologies. Advances in our understanding of the brain, and our ability to observe and influence it, raise a series of essential ethical and philosophical questions, including debates about personal identity, moral responsibility, consciousness and autonomy, among others. Separately, neuroethics considers responses to, and interpretations of, emerging neuroscientific understanding and neurotechnological interventions among different communities, as well as exploring the distinct ethical issues that arise with regard to brain-related research.

Within the BBU, prominent neuroethical research areas include:

• • The intersection of global mental health & neuroethics: exploring ethical challenges associated with global mental health research and global mental health care.
  • The ethics of enhancement: considering the social and moral implications of pharmacological and other forms of human enhancement.
  • Dimensions of moral responsibility: exploring the implications of evolving neuroscientific and genetic understandings of behaviour for questions of personal and legal responsibility.
  • Advancing neuroethics in Africa: advancing both the need for, and unique contributions of, neuroethics research concerning and emerging from Africa.