National Science and Technology Forum (NSTF)

Prof Christine Lochner

For her research into neuropsychiatric disorders, including obsessive-compulsive and related disorders, which fosters a multi-disciplinary approach, incorporating a biopsychosocial focus.

The 2019/2020 NSTF-South32 for TW Kambule-NSTF Award Researcher was won by Prof Christine Lochner, Co-Director: South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University was awarded for her research into neuropsychiatric disorders. She has made important contributions in the area of obsessive-compulsive and related disorders. Her research aims to link the significant clinical aspects of these conditions with their neurobiological underpinnings.

It’s estimated that, in South Africa, there are 1.2 million people with obsessive-compulsive disorder (OCD) or obsessive-compulsive related disorders (OCRD). However, these conditions are underdiagnosed and undertreated.

“OCD is a neuropsychiatric disorder involving persistent, intrusive thoughts or urges to perform certain rituals, such as washing, arranging, and counting. These urges can’t be controlled for more than a small period of time,” explains Professor Christine Lochner, co-director: South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, a cross-university unit at both Stellenbosch University and the University of Cape Town.

OCD and OCRD can impact life negatively, making it difficult to function satisfactorily. They can take time away from daily life, cause physical, emotional and financial suffering and lead to economic costs to society at large. Lochner notes that OCD is often associated with comorbidities, for example, about 70% of people with OCD have depression.

“OCD is listed as among the 10 most disabling of all medical conditions by the World Health Organisation. While there is growing awareness of the importance of mental health research, not enough time and money is devoted to this area yet,” says Lochner.

In her career as researcher and psychologist, Lochner has made significant contributions in the area of OCD and OCRD. The unit she co-directs researches neuropsychiatric disorders using a multi-disciplinary approach and biopsychosocial focus. This means looking at conditions from multiple angles — biological (such as genetics), clinical (such as using brain imaging with MRIs), psychological, social and environmental.

Since 2001, Lochner has taken the lead in establishing a large database with clinical, genetic, neuropsychological and neuroimaging data from patients with various psychiatric conditions characterised by compulsivity or impulsivity. Currently with just under 1 000 South African patients, the aim is to represent the country’s diverse population across all types of data.

This database facilitates international collaborations with leading scientists worldwide, including international OCD genome-wide association studies. There have been a number of these publications, starting around 2012. Lochner was involved in contributing samples and data and co-writing papers in most of them.

Lochner has a specific research focus on trichotillomania (TTM), a hair-pulling disorder, and excoriation disorder (skin-picking disorder or SPD). Related to this is her work with DSM and ICD Working Groups. “The ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM) and “International Classification of Diseases” (ICD)”    are the go-to publications for classifying mental disorders. Lochner led two international multi-site surveys where the findings resulted in altered diagnostic criteria for TTM and for SPD in DSM, fifth edition. Lochner is now part of an international working group developing clinically useful and structured diagnostic interviews regarding the mental and behavioural disorders in ICD-11.

Another recent accomplishment is being awarded a National Research Foundation grant to conduct a multinational personalised medicine project. It will look at predicting the response to a particular medication based on neuroimaging in OCD patients. The hope is that this will then provide a methodology that can be applied to a range of other neuropsychiatric disorders. — Debbi Schultz

To read the full Mail & Guardian supplement of articles about the work of all the 2020 Award Winners, click here.

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