The Consortium on Vulnerability to Externalizing Disorders and Addictions (cVEDA) is a proposed multi-site, international, collaborative, cohort study based in India. It aims to examine the interactions of environmental exposures, and genomic influences on neurodevelopmental trajectories and downstream vulnerability to psychopathology, with a specific focus on externalizing spectrum disorders.
A biobank has already been established with blood, saliva and urine samples to be used for genetic, epigenetic and toxicological studies. Structural and functional MRI brain scans have already been performed on approximately 15% of the individuals and stored in a databank.
The Indian population aged 10-24 is about a third of the total (>400 million), the largest in the world. This age group has a higher than average rate of mental disturbance, with almost 20% of young people experiencing a mental health condition.
Externalizing disorders are mental conditions characterized by projecting internal self characteristics onto other people and the outside world, and maladaptive behaviors directed toward an individual’s environment, which leads to impairment or interference in life functioning. Alcohol and substance-related disorders can be externalizing disorders.
India has its own unique risk factors in areas such as nutritional stress, environmental neurotoxins and culturally dependent forms of psychosocial stress. Maternal malnutrition, suboptimal breast-feeding, childhood malnutrition, unsafe water, poor sanitation, indoor smoke, and high-risk behaviors are leading causes of death and disability in LMIC, including India.
The international consortium members, the majority of which are based in India with contributions also from UK and France, contend that longitudinal studies over the developmental lifespan are ideally suited to study origins of psychiatric conditions. They intend to achieve this by tracking developmental trajectories, identifying deviations, and studying how deviations, and their interactions with genes and environment, relate to psychopathology.
The cVEDA is valuable as extrapolating findings from high-income settings to low and middle-income countries (LMIC) is problematic. India is a diverse country with ethnic backgrounds and the prevalence of exposures and outcomes pertinent to development and health that vary by income and geography.
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