As a young piano student, Brian J. Miller confessed to a deep dislike for the complex tunes of Johann Sebastian Bach, music which he later came to love. It is a similar attention to detail that is helping to establish him as a young researcher at Medical College of Georgia.
Miller, the chief resident of general psychiatry at MCG, was named Resident of the Year this year and was also one of 10 nationwide to receive a Laughlin Fellowship from the American College of Psychiatrists.
While still at Ohio State University, where he was earning both a medical degree and a master's degree in public health, he studied the health problems of patients in Ohio's psychiatric hospitals.
The study later led the Ohio Department of Mental Health to implement guidelines from the American Heart Association on preventing heart disease. The link between mental illness and other diseases is often overlooked, Miller said.
"That's really what captivated me about psychiatry, even as a third-year medical student, that my patients had their psychiatric illness and the severe impairments associated with that but that they also had a number of other very significant medical conditions," he said. "And there was a strong interplay between those."
In fact, people with severe mental illness on average die 20 years earlier than the general population, Miller said.
"While suicide is a leading cause of death among these patients, the No. 1 cause of death is cardiovascular disease," he said.
That can be a problem for the patients Miller sees now.
"One of the issues that is a constant challenge for our patients is ensuring that they get the adequate primary health care that they need to monitor problems related to diabetes, hypertension, high cholesterol that are all risk factors for heart disease," he said.
As if the challenges here were not enough, Miller is looking across the Atlantic to Finland, where he is completing a doctorate of medical science at the University of Oulu.
This grew out of an earlier quest to try to study the relationship between the age of the father and the risk of premature death in the offspring.
After Miller sent e-mails worldwide looking for data, researchers at the Finnish university responded with an ideal model: the Northern Finland 1966 Birth Cohort.
"Their register includes everyone born in the northern half of Finland in 1966," Miller said. "And they've followed these people for 44 years now on a fairly regular basis. So they have a tremendous amount of data. And in their system, they have more data than (they have) people, time, resources to analyze them. So they are always looking for collaborators."
In some studies pending publication, Miller and colleagues found that the risk of mortality increases linearly over time with the increasing age of the father after the 25-29-year-old age period.
Other studies have noted an increased risk of death in offspring up to age 18 with advanced paternal age.
"Our work in Finland is unique in that we extended that finding and showed that association exists both in the general population and within schizophrenia into adulthood," Miller said. "So there appears to be an association between paternal age and mortality that extends into middle age."
The investigators are hoping to better characterize the known link between advanced paternal age and increased risk of the offspring developing schizophrenia. Being able to do large population studies -- with as many as 10,000 people at times -- has given him the chance to revel in numbers and statistics.
"That's been one of the fun parts of our work with Finland," Miller said. "It's been kind of mathematical psychiatry, if you will. A lot of math, a lot of statistics. I certainly enjoy that mode of thinking."