Chiara Fabbri

Education

14/11/2018 Doctor of Philosophy (pharmacogenetics of antidepressants), Maastricht University, The Netherlands

05/07/2017 Specialization in Psychiatry, University of Bologna, Italy

11/07/2011 Degree in Medicine and Surgery, University of Bologna, Italy

Positions

13/09/2021 – currenat: Lecturer in Psychiatry, University of Bologna, Italy

15/06/2021 – 11/09/21: Research Fellow, San Raffaele Scientific Hospital, Milan, Italy

01/04/21-12/09/21: Research Grant “Fondazione Veronesi”, University of Bologna (Clinical and genetic determinants of long-term functioning and wellbeing in 47,000 individuals with depression)

01/04/20-31/03/21: Research Grant “Fondazione Veronesi”, University of Bologna (Dissecting the genetic heterogeneity of depression and its relationship with treatment response)

01/12/2020 – 01/12/2023: Visiting researcher, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK

01/04/20-30/11-20: Part-time research fellow, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK

1/10/18-31/03/20: Marie Skłodowska-Curie Individual Fellowship, Institute of Psychiatry, Psychology & Neuroscience, King’s College London (Exome Sequencing in Treatment Resistance to Antidepressants)

01/04/18-30/09/18: Research Fellow, King’s College London (Travel Grant “Fondazione Veronesi”)

01/11/17-31/03/18: Research Fellow, University of Bologna, Italy

08/08/17-31/12/17: Consultant in Psychiatry, “Maggiore” Hospital, Bologna, Italy

01/09/17-31/03/18: Consultant in Psychiatry, outpatient clinic, Bologna, Italy

05/07/12-05/07/17: Resident in Psychiatry, University of Bologna (05/07/2015-04/07/2016: visiting researcher, King’s College London)

Scientific activity

Research focused on pharmacogenomics of psychotropic drugs and psychiatric genetics. Author or co-author of 110 peer-reviewed publications in international journals, 11 book chapters, 19 oral presentations at international conferences and over 70 congress abstracts.

H index: 35 (Google Scholar), 28 (Scopus).

Main Research Topics

Pharmacogenetics of antidepressants

The inter-individual variability in response to pharmacological therapies in depressive disorders requires a better definition of the factors involved at the individual level, including genetic polymorphisms.

I contributed to research in this area through meta-analyses of the literature and several experimental studies that used different methodological approaches, innovative with respect to previous studies, which integrated the analysis of common genetic variants (genome-wide genotypes) and rare variants (exome sequencing), or that used big data (electronic health records at population level). I also considered treatment-resistant depression, i.e., those cases that did not respond to at least two pharmaco-therapies, a phenotype poorly taken in account in the previous literature, but of particular interest due to the heavy burden in terms of disability for the individual and costs for the society.

Examples of publications in this field:

1. Fabbri C, Hagenaars SP, John C, Williams AT, Shrine N, Moles L, et al. Genetic and clinical characteristics of treatment-resistant depression using primary care records in two UK cohorts. Mol Psychiatry 26, 3363–3373 (2021). https://doi.org/10.1038/s41380-021-01062-9
2. Fabbri C, Kasper S, Kautzky A, Zohar J, Souery D, Montgomery S, et al. A polygenic predictor of treatment-resistant depression using whole exome sequencing and genome-wide genotyping. Transl Psychiatry. 2020 Feb 3;10(1):50.
3. Fabbri C, Kasper S, Kautzky A, Bartova L, Dold M, Zohar J, et al. Genome-wide association study of treatment-resistance in depression and meta-analysis of three independent samples. Br J Psychiatry. 2019;214(1):36–41.
4. Fabbri C, Tansey KE, Perlis RH, Hauser J, Henigsberg N, Maier W, et al. Effect of cytochrome CYP2C19 metabolizing activity on antidepressant response and side effects: Meta-analysis of data from genome-wide association studies. Eur Neuropsychopharmacol. 2018;28(8):945–54.
5. García-González J, Tansey KE, Hauser J, Henigsberg N, Maier W, Mors O, Placentino A, Rietschel M, Souery D, Žagar T, Czerski PM, Jerman B, Buttenschøn HN, Schulze TG, Zobel A, Farmer A, Aitchison KJ, Craig I, McGuffin P, Giupponi M, Perroud N, Bondolfi G, Evans D, O'Donovan M, Peters TJ, Wendland JR, Lewis G, Kapur S, Perlis R, Arolt V, Domschke K; Major Depressive Disorder Working Group of the Psychiatric Genomic Consortium, Breen G, Curtis C, Sang-Hyuk L, Kan C, Newhouse S, Patel H, Baune BT, Uher R, Lewis CM, Fabbri C. Pharmacogenetics of antidepressant response: A polygenic approach. Prog Neuropsychopharmacol Biol Psychiatry. 2017 03;75:128–34.
6. Niitsu T, Fabbri C, Bentini F, Serretti A. Pharmacogenetics in major depression: a comprehensive meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2013;45:183–94.

Genetic heterogeneity of mood disorders

The clinical heterogeneity of mood disorders represents an obstacle to the effective use of current diagnostic classification systems and the corresponding clinical guidelines; the lack of a known etiopathogenetic substrate for the various subtypes of unipolar and bipolar disorders reduces the clinical utility of the current classifications, which generally only partially capture the relevant symptoms and have little impact for guiding the choice of therapy.

The definition of homogeneous diagnostic groups using a dimensional approach can therefore be useful to overcome these obstacles. I contributed to clarifying the genetic factors involved in specific psychopathological dimensions, such as the typical and atypical autonomic symptoms of major depression, suicidal ideation, psychotic symptoms, anhedonia. A related topic is represented by the study of factors associated with the level of subjective wellbeing in individuals with depression, as the disease can have different course and different impact on quality of life and functioning.

Examples of publications on this research topic:

1. Fabbri C, Mutz J, Lewis C, & Serretti A. (2021). Depressive symptoms and neuroticism-related traits are the main factors associated with wellbeing independent of the history of lifetime depression in the UK Biobank. Psychological Medicine, 1-9. doi:10.1017/S003329172100502X
2. Badini I, Coleman JRI, Hagenaars SP, Hotopf M, Breen G, Lewis CM, Fabbri C. Depression with atypical neurovegetative symptoms shares genetic predisposition with immuno-metabolic traits and alcohol consumption. Psychol Med. 2020 Jul 6;1–11.
3. Calabrò M, Porcelli S, Crisafulli C, Albani D, Kasper S, Zohar J, Souery D, Montgomery S, Mantovani V, Mendlewicz J, Bonassi S, Vieta E, Frustaci A, Ducci G, Landi S, Boccia S, Bellomo A, Di Nicola M, Janiri L, Colombo R, Benedetti F, Mandelli L, Fabbri C, Serretti A. Genetic variants associated with psychotic symptoms across psychiatric disorders. Neurosci Lett. 2020 Feb 16;720:134754.
4. Corponi F, Bonassi S, Vieta E, Albani D, Serretti A, Ducci G, Landi S, Boccia S, Serretti A, Fabbri C. Genetic basis of psychopathological dimensions shared between schizophrenia and bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2019 08;89:23–9.
5. Ren H, Fabbri C, Uher R, Rietschel M, Mors O, Henigsberg N, et al. Genes associated with anhedonia: a new analysis in a large clinical trial (GENDEP). Transl Psychiatry. 2018 13;8(1):150.

Personalisation of therapies

The prescription of personalised therapies for the individual patient has fundamental importance for the improvement of the quality of psychiatric care. In addition to personalisation based on genetic profiles, I contributed to the identification of the efficacy profile of specific drugs with respect to certain individual characteristics, and also to the estimate of the cost-effectiveness of using clinical characteristics or a combination of clinical and genetic characteristics for the personalisation of therapy. Furthermore, I investigated aspects related to the predictors of manic switch in bipolar disorder and to clinical predictors of early response to antidepressants. Recently, I studied the use of genetic variants to pursue drug repurposing for treatment-resistant depression and depression subtypes associated with poor response to standard treatments for depression.

Examples of publications in this research field:

1. Fabbri C, Pain O, Hagenaars SP et al. Transcriptome-wide association study of treatment-resistant depression and depression subtypes for drug repurposing. Neuropsychopharmacol 2021; 46, 1821–1829. https://doi.org/10.1038/s41386-021-01059-6
2. Fabbri C, Kasper S, Zohar J, Souery D, Montgomery S, Albani D, et al. Drug repositioning for treatment-resistant depression: Hypotheses from a pharmacogenomic study. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2021; 104: 110050. https://doi.org/10.1016/j.pnpbp.2020.110050.
3. Fabbri C, Kasper S, Zohar J, Souery D, Montgomery S, Albani D, et al. Cost-effectiveness of genetic and clinical predictors for choosing combined psychotherapy and pharmacotherapy in major depression. Journal of Affective Disorders. 2021;279:722–9.
4. Serretti A, Fabbri C. The search for personalized antidepressant treatments: what have we learned and where are we going. Pharmacogenomics. 2020 Oct;21(15):1095–100.
5. Corponi F, Fabbri C, Bitter I, Montgomery S, Vieta E, Kasper S, et al. Novel antipsychotics specificity profile: A clinically oriented review of lurasidone, brexpiprazole, cariprazine and lumateperone. Eur Neuropsychopharmacol. 2019 Sep;29(9):971–85.
6. Fabbri C, Serretti A. How to Utilize Clinical and Genetic Information for Personalized Treatment of Major Depressive Disorder: Step by Step Strategic Approach. Clinical Psychopharmacology and Neuroscience. 2020 Nov 30;18(4):484–92.
7. Corponi F, Serretti A, Montgomery S, Fabbri C. Cariprazine specificity profile in the treatment of acute schizophrenia: a meta-analysis and meta-regression of randomized-controlled trials. Int Clin Psychopharmacol. 2017;32(6):309–18.
8. Niitsu T, Fabbri C, Serretti A. Predictors of switch from depression to mania in bipolar disorder. J Psychiatr Res. 2015 Aug;66–67:45–53.
9. Fabbri C, Marsano A, Balestri M, De Ronchi D, Serretti A. Clinical features and drug induced side effects in early versus late antidepressant responders. J Psychiatr Res. 2013 Oct;47(10):1309–18.

Reviewer and editorial activity

Reviewer for 54 international journals in the field of biological psychiatry (e.g., Molecular Psychiatry, https://publons.com/researcher/1239956/chiara-fabbri/peer-review/). Reviewer for research agencies (e.g., European Research Council, MQ Foundation, ZonMw - The Netherlands Organisation for Health Research and Development, National Science Centre Poland).

Member of the editorial board of four international journals (International Journal of Psychiatry in Clinical Practice; International Clinical Psychopharmacology; Frontiers in Psychiatry; Neuropsychopharmacology Reports).

International society membership

2015 - present International Society of Psychiatric Genetics (ISPG)

2021 - present ISPG Genetic Testing Committee

2016 – present UK Pharmacogenetic & Stratified Medicine Network (UKPGx)

2018 – present Pharmacogenomics Research Network (PGRN), also member of the Communication Committee

2020 – present European College of Neuropsychopharmacology (ECNP)

International scholarships

• ECNP School of Neuropsychopharmacology, 24-29 June 2018, St Catherine's College, Oxford, UK.
• ECNP Research Internship at the Institute of Pharmacology of the Polish Academy of Sciences, Krakow, 17-28 June 2019.

Grants/fellowships

• A Stratified Treatment Algorithm in Psychiatry: A program on stratified pharmacogenomics in severe mental illness (Psych-STRATA, project 101057454), work package co-leader. HORIZON-HLTH-2021-STAYHLTH-01-02. University of Bologna,2022-2027.
• Improving health care in major depressive disorder: a new prognostic tool based on gene-environment and neuroimaging signatures (principal investigator). “Ricerca Finalizzata 2019”, Italian Ministry of Health; San Raffaele Hospital, Milan. 2021-2024. 
• Clinical and genetic determinants of long-term functioning and wellbeing in 47,000 individuals with depression. Fellowship “Fondazione Veronesi” 2021; University of Bologna. 2021, 30,000 euro.
• Dissecting the genetic heterogeneity of depression and its relationship with treatment response. Fellowship “Fondazione Veronesi” 2020; University of Bologna. 2020.
• Exome Sequencing in Treatment Resistance to Antidepressants (ESTREA). Marie Skłodowska-Curie Individual Fellowship (2018-2020), European Community; King’s College London. 2018-2020.
• Travel Grant “Fondazione Veronesi” 2018; King’s College London.

  Participation to collaborative projects

• Psychiatric Ratings using Intermediate Stratified Markers 2 (PRISM2): Providing quantitative biological measures to facilitate the discovery and development of new treatments for social and cognitive deficits in Alzheimer’s disease, schizophrenia and depression - EU Innovative Medicines Initiative (IMI), 2021-2024, University of Bologna.
• Artificial intelligence for personalised medicine in depression - analysis and harmonization of clinical research data for robust multimodal patient profiling for the prediction of therapy outcome (ArtiPro). ERA PerMed JTC 2021, 2022-2025, IRCCS “Istituto delle Scienze Neurologiche”, Bologna.
• Psychiatric Ratings using Intermediate Stratified Markers (PRISM): Providing biological measures to facilitate the discovery of new treatments for social and cognitive deficits in neuropsychiatric disorders. EU Innovative Medicines Initiative, 2016-2019, University of Bologna.
• Dopamine – Dysbindin genetic interaction: a multidisciplinary approach to characterize cognitive phenotypes of schizophrenia and develop personalized treatments. “PRIN: Progetti di Ricerca di Rilevante Interesse Nazionale 2018”, 2019-2022, University of Bologna.

Awards

Travel awards

1. Fabbri C et al. Glutamatergic genes and early antidepressant efficacy in the STAR*D. 11th Annual Pharmacogenetics in Psychiatry Meeting, New York, March 30-31 2012.
2. Fabbri C et al. Clinical features and drug-induced side effects in early versus late antidepressant responders. ECNP Workshop on Neuropsychopharmacology for Young Scientists in Europe, 7-10 March 2013, Nice, France.
3. Fabbri C et al. CHL1 gene: a new promising antidepressant response marker in major depression. 26th ECNP Congress. 5-9 October 2013, Barcelona, Spain.
4. Fabbri C et al. New insights into the pharmacogenomics of antidepressant response from the GENDEP and STAR*D studies: results of high-density imputation. 29th ECNP Congress. 19-20 September 2016, Vienna, Austria.
5. Fabbri C et al. Meta-analysis of CYP2C19 association with efficacy and side effects of citalopram and escitalopram using data from genome-wide association studies. XXVth World Congress of Psychiatric Genetics. 13-17 October 2017, Orlando, Florida.
6. Journal of Personalized Medicine (JPM) Travel Award 2017 for attending the WPA XVII World Congress of Psychiatry. 8-12 October 2017, Berlin, Germany.

Best poster presentation award

1. Fabbri C et al. Neuroplasticity and Second Messenger Pathways in Antidepressant Efficacy: Pharmacogenetic Results from a Prospective Trial Investigating Treatment Resistance. 15th International Forum on Mood and Anxiety Disorders. 2-4 December 2015. Prague, Czech Republic.
2. Fabbri C et al. Major depressive disorder and treatment-resistant depression from UK Biobank primary care data. World Congress of Psychiatric Genetics (WCPG), 19-21 October 2020, Virtual.

Other awards

ECNP Excellence Award 2021, 34^th ECNP Congress, 2-5 October 2021, hybrid.

Invited lectures

• Progress in antidepressant pharmacogenetics: genome-wide association studies and beyond. North Estonia Medical Centre, Tallin, 2 February 2018.
• Pharmacogenetics in Psychiatry: clinical applications and future perspectives. University of Parma, Italy, 22 November 2018.
• Genetics and psychotropic drugs: what clinicians need to know. Special lectures series, Division of Psychiatry, University of Edinburgh, 22 July 2020.
• Polygenic risk scores in psychiatry: current and future perspectives. Education day, World Congress of Psychiatric Genetics, 16 October 2020.
• The use of genetic information for drug repurposing in depression. Maj Institute of Pharmacology of the Polish Academy of Sciences, 25 November 2021.
• Treatment-resistant depression genetics. Exceed scientific symposium, University of Leicester, 6 September 2023.