Washington University School of Medicine

About Our Center

The Washington Early Recognition Center (WERC) was formed with the goal of preventing at-risk adolescents and young adults (aged 13-30 yrs) from developing mental disorders, such as schizophrenia and bipolar disorder. These disorders can cause significant suffering for both affected youth and their families, and are major causes of disability worldwide. Research at WERC aims to accurately identify those at risk, monitor brain and behavior changes over time, and develop effective interventions against illness progression.

Adolescence and young adulthood are particularly formative periods in life when several major changes occur. During this time, the brain undergoes a rearrangement of critical neural circuits and it is also when many potentially severe mental disorders first manifest clinically. Studies have shown that intervening early in the course of a disorder can improve long-term outcomes compared to intervening years after disorder onset. Therefore, it is important to accurately identify those who are at risk. Major areas of focus at WERC include:

  • Early identification and assessment of at-risk youth:
    We plan to conduct behavioral and brain MRI assessments in individuals who do not have schizophrenia or bipolar disorder, but have specific psychological symptoms or a recent deterioration in mental state. These individuals would be assessed periodically for a year or longer.
  • Intervention for at-risk youth:
    Following initial assessments at WERC, youth are provided with individualized information on area resources (if indicated) for clinical care and/or support with psychosocial issues. Some participants may also be enrolled in a research study involving computerized training of cognitive function (e.g. working memory, attention or abstraction). In the future, we hope to study the effectiveness of additional individualized interventions.
  • Neuroimaging in schizophrenia or bipolar disorder:
    Some of the research at WERC uses state-of-the-art computational methods to analyze brain MRI images of young people (aged 30 yrs or less) with schizophrenia or bipolar disorder. These methods are able to provide a rich detail of the connections between different brain regions, the functional relationship between regions, and their three-dimensional structure. Characterizing these brain abnormalities can make it possible to more accurately identify those at risk or at the very early stage of a disorder.
  • Population and cross-cultural studies:
    Other projects include epidemiologic studies to characterize psychiatric symptoms in the population and identify risk traits for developing mental illness. Our previous epidemiologic studies have included community, school or youth center populations in the United States, Kenya and Rwanda. WERC has also developed screening tools to assess schizophrenia and bipolar disorder risk, psychological stress and substance use problems. These can be downloaded for free here.

Advances in technology have led to major discoveries in neuroscience, allowing us to get a clearer understanding about the structure and workings of the brain. Research at WERC hopes to achieve further innovations in psychiatry and brain neuroimaging methods. For example, we are evaluating the possibility of using brain structural and functional connectivity data to refine the diagnosis of psychiatric conditions. This could be an improvement over the current diagnostic system, which relies exclusively on behavioral symptoms. In collaboration with Washington University faculty in the departments of radiology and physics, we are also working to develop newer imaging acquisition methods for measuring brain tissue abnormalities.

Research conducted at WERC has been primarily funded by the National Institute of Mental Health (NIMH). Other sources of financial support have come from NARSAD, a private non-profit organization, and from individual contributions or endowments. (Information on supporting Washington University research can be found here).

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