SSC Psychiatry Research: advances, challenges, and controversies Module 1
September – December 2012
Project Title & Summary
Supervisor(s)
Depression and the Environment
Dr Vishal Bhavsar
Academic Clinical Fellow
There is a reported association between depression and characteristics of
Department of Psychosis
the built environment (Weich et al 2002, Galea et al 2005, Mair et al 2008). Studies
However, there is limited evidence on the relationship between built
vishal.2.bhavsar@kcl.ac.uk
environment characteristics and the rates of other mental disorders, such as
psychosis. The mechanism by which the physical environment exerts
effects on mental health is also unclear. The project will involve the
systematic review of literature using Ovid, PsychInfo, and MedLINE:
A) To gather and review literature investigating built environment
characteristics and other mental health outcomes, including psychosis. B)
To gather and review literature investigating the mechanisms of the mental
health effects of the environment.
Machine learning applications in psychiatric research
The diagnosis of psychiatric illnesses suffers from high inter-rated
reliability, complex and heterogeneous clinical presentations, which impair
treatment. In terms of risk factors, a myriad of genetic and environmental
factors and their interactions are thought to be involved. This review aims
to provide a general outlook of the recent application of statistical machine
learning classification methods in risk prediction and characterization of
psychiatric disorders. Being clinically heterogeneous and etiologically
multi-factorial, psychiatric illnesses are likely to profit from statistical
methods which can address multiple putative factors and large, complex
datasets. Specialized in developing such methods, the machine learning
classification approach has started to be used in very recent years and has
successfully revealed biomarkers for schizophrenia, bipolar disorder,
depression, Alzheimer´s disease, among others. The data types that can be
used range from genetic and proteomic through structural and functional
neuroimaging to neuropsychological and environmental. Apart from
contributing to our knowledge of disease etiology and mechanisms, these
biomarkers can most promisingly be used as tools to improve diagnosis,
early disease detection and disease prevention. The high translational
potential of machine learning classification is enhanced by it allowing a
biomarker characterization at the level of the individual rather at grouplevel as in previous techniques.
Diana Prata
NIHR Post-Doc Fellow
Department of Psychosis
Studies
diana.prata@kcl.ac.uk
Exploring the inflammatory cytokines and their role in mood
disorders
Converging evidence suggests that the activation of the inflammatory
cytokine pathway is important in the pathophysiology of mood disorders.
Differences in inflammatory profiles potentially exist between bipolar
disorder patients and unipolar depressed patients with the potential
existence of disorder-specific inflammatory profiles. The presence of these
distinct profiles could aid in clinical diagnoses. Furthermore, research
(including work from our group) has shown that levels of inflammatory
cytokines at both the level of transcription and protein level can predict
responsiveness to particular antidepressants and so may have useful
applications clinically in terms of patient-specific treatment selection. The
aim of the current project is to review existing literature on the role of the
inflammatory cytokines and to explore their role in the pathophysiology
and treatment of mood-disorders. We aim to publish the review as a paper
in its own right or as part of an introduction for a current project underway.
Timothy Powell
PhD Student
SGDP
timothy.powell@kcl.ac.uk
Dr Leo Schalkwyk
Reader
SGDP
leonard.schalkwyk@kcl.ac.u
k
Are there evidences that social class at birth increase risk of psychosis? Dr Simona Stilo MD, PhD
A systematic literature review.
student
Department of Psychosis
In accordance with the social causation hypothesis of psychosis, social Studies
disadvantage may play a role in the development of psychosis. Several simona.stilo@kcl.ac.uk
studies have suggested an association between low social class and
schizophrenia (Eaton 1985; Dohrenwend 1992) whilst other studies did not Prof Robin Murray
find this association (Cannon 1996).
Professor of Psychiatric
Towards a clear conclusion, the student will conduct a systematic literature Research
review on papers that have been written on social class/socio economic Department of Psychosis
status and psychosis.
Studies
To further improve research skills he/she may conduct a data-based project robin.murray@kcl.ac.uk
looking at social class at birth and risk of psychosis in the Genetic and
Psychosis sample (GAP study).
Child Psychiatry (possible topics)
A literature review of teaching of child psychiatry to medical students
Meeting the health needs of children with developmental disabilities
Inpatient psychiatric services for young people with developmental
disabilities -anticonvulsants as a treatment for behavioural disturbance in
children with developmental disabilities
Dr Sarah Bernard
Consultant Psychiatrist
Mental Health of Child and
Adolescent Learning
Disability Service
The Michael Rutter Centre
Sarah.Bernard@slam.nhs.uk
PSTD
Details to be discussed with supervisor
Factors that Determine Health Care Seeking During a Public Health
Crisis
Large scale public health crisis such as pandemics, industrial accidents or
terrorist attacks present many challenges for the health care system. One of
these is the tendency for large numbers of people to attend hospital in order
to obtain treatment or reassurance, even though they have probably not
have been directly affected by the incident. Such patients used to be called
'the worried well.' However, it is becoming clear that many are not well
and a surprising number are not worried. Understanding why people seek
healthcare during a major incident would allow communicators and
emergency responders to reduce this surge, while making sure that any
genuine health needs are still looked after. In this systematic review, we
will identify the factors that promote healthcare seeking during a crisis.
The project will be jointly supervised by Dr James Rubin (KCL
Department of Psychological Medicine: Senior Lecturer in the Psychology
of Emerging Health Risks) and Dr Richard Amlot (HPA Emergency
Response Department: Team Leader, Behavioural Sciences).
Children’s perceptions of having a father in the military
Dr Laura Goodwin
Postdoctoral Fellow
King’s Centre for Military
Health
laura.goodwin@kcl.ac.uk
Dr James Rubin
Senior Lecturer in the
Psychology of Emerging
Health Risks
Psychological Medicine
gideon.rubin@kcl.ac.uk
Dr Sarah Rowe
Senior Research Coordinator
Children of military families face many unique stressors such as parental
King's Centre for Military
absence, frequent relocations, impact of deployment, influence of media,
Health Research
impact of parental injury, illness or bereavement, and adjustments to family Department of Psychological
life post-deployment. These stressors may subsequently have an adverse
Medicine
effect on areas such as health and wellbeing, development of childhood
sarah.rowe@kcl.ac.uk
behaviour and retention of Service personnel. Much of the literature has
focused on parental perceptions of child outcomes in military families. This
may be problematic as parental perceptions may be biased by their own
mental health and coping levels. We have data from a sample of military
children aged 11-16 years that ask about the positive and negative aspects
of having a father in the military. This project is made up of two parts: For
module 1, the student will conduct a systematic literature review on
children’s perceptions of having a father in military. There is the potential
of this being extended into module 2 where the student will use thematic
analysis to code the free text responses received from military children in
order to identify themes and sub-themes in the responses.
A systematic Review of fatigue (lethargy) in context of psychosis new
onset and chronic patients
The purpose of this review is to examine contributing factors so that a new
model of fatigue may be developed in this context and a rehabilitation
treatment developed and evaluated.
Prof Trudie Chalder
Department of Psychological
Medicine
trudie.chalder@kcl.ac.uk
A systematic review of interventions for distress in Inflammotory
Bowel Disease
A systematic review of fatigue and disability in people who are HIV
positive
The prevalence and risk factors for domestic violence in military
families
What is the optimum method of delivering CBT to employees with
common mental health problems?
Child Psychiatry Teaching
A perennial concern in psychiatry is recruitment into the specialty and
previous studies have shown that undergraduate experience plays a role in
career choice. Within psychiatry, child psychiatry often struggles to attract
trainees to the specialty. Child psychiatry often exists within paediatrics on
the medical syllabus. Many questions arise as to where it is best placed,
how it is relevant to the greater medical curriculum and how it could be
improved. Here we propose a systematic review of the teaching of child
psychiatry on the undergraduate curriculum. The review could include
issues around attitudes to child psychiatry, teaching methods, place on the
syllabus and career choice.
Such a review has never been done and would be highly valuable to
medical educators and child psychiatrists. The Child Psychiatry faculty of
the Royal College of Psychiatrists offers places for undergraduates to
present work and such a review would be potentially publishable.
Dr Deirdre MacManus
Specialist Registrar MRC
Research Training Fellow
Institute of Psychiatry
deirdre.macmanus@kcl.ac.u
k
Dr Ira Madden
Senior lecturer in
occupational medicine,
King’s College London
Chief medical
advisor at Houses of
Parliament
Ira.madan@kcl.ac.uk
Dr Ben Baig
Clinical Lecturer
Department of Child and
Adolescent Psychiatry
Institute of Psychiatry
Benjamin.baig@kcl.ac.uk
Mental Health of Children and Adolescents in Sub-Saharan Africa
Dr Ben Baig
Clinical Lecturer
Department of Child and
Adolescent Psychiatry
Institute of Psychiatry
Benjamin.baig@kcl.ac.uk
Epidemiological studies of psychiatric illness in Africa are few in number
compared to those in high income countries. Problems exist in the
opportunity to gain standardised assessment measures, accurate reporting
and sufficient funding for such research. Epidemiological measures of
child psychiatric illness are even fewer. However, Millennium
Development Goals (MDGs) highlight the importance of child health and
(3 students)
education. Both of these are affected by child psychiatric issues and it
would be important to integrate what research has been done to look at the
epidemiology, aetiology and treatment of these issues. A systematic review
of child and adolescent mental health in sub Saharan Africa would be both
timely and useful. The review could either focus on a specific disorder, a
specific geographical region or a specific treatment or process. The review
would give a wider insight into transcultural psychiatry and whether certain
child psychiatric disorders may be more prevalent in high income
countries.
Such a review could be aimed at the International Psychiatry Journal and
would be of value at a Royal College of Psychiatry Special Interest group
presentation. Furthermore it may be of use for a student interested in
pursuing an elective in Sub-Saharan Africa.
Mental Health and Quality of Life in Paediatric Renal Disease
Liaison psychiatrists have studied the overlap between physical and mental
health issues on a wide range of chronic illnesses. There is good evidence
that depression is very common in physical health conditions and leads to
worse prognosis, longer hospital stay and poorer work and educational
outcome. Such literature does not exist to the same extent in a paediatric
population. Renal disease can cause a wide number of symptoms and
consequences for mental health. Medical admissions, dialysis, transplant
and living with a chronic disease all impact on child development,
schooling and socialising.
The following review will seek to combine available literature on all child
renal disease to assess the nature and extent of mental disorder and quality
of life. The completed review would be of great interest to child
psychiatrists, liaison psychiatrists and nephrologists alike and publication
and presentation of the work could be sought in each of these areas.
Serotonin and gastrointestinal issues in Autism
Autism spectrum disorders (ADS) are pervasive neurodevelopmental
conditions characterised by impairments in social interaction and
communication and presence of repetitive and stereotyped interests and
behaviours. Gastrointestinal disturbances are frequently reported in ASD.
Additionally there is evidence of abnormalities of the neurotransmitter
serotonin in ASD. In addition to its role in the brain, serotonin is also
present in the gut. Therefore we are interested in a review of the literature
pertaining to ASD, serotonin and the gut.
The under-diagnosis of personality disorder amongst Afro-Caribbean
service users in the UK.
Eileen Daly
Lecturer
Department of Forensic and
Neurodevelopmental Science
Eileen.daly@kcl.ac.uk
Dr Piyal Sen
Consultant Forensic
Psychiatrist
Visiting Research Fellow,
Institute of Psychiatry,
King's College, London and
St. Andrew's Academic
Centre, Northampton.
01268 723847
psen@standrew.co.uk
piyal.sen@kcl.ac.uk
(please send any emails to
both addresses)
This review would include an analysis of possible causes for this, leading
to a draft publication. The review would target the Afro-Caribbean group
specifically, as this group has a much higher incidence of schizophrenia,
which is explained by the higher incidence of neurodevelopmental trauma
in this group. The same traumas constitute risk factors for personality
disorder as well, but why do we then see an under-diagnosis, or is it a case
of missed diagnosis? According to the only other systematic review
available, this under-diagnosis is much more of a problem in the UK
compared to the USA, and why that might be the case, is there something
specific to the difficulties within the Afro-Caribbean community? The
prevalence of personality disorder in non-Western countries, and the
possible reasons for the significant under-diagnosis. If they are not
(2 students)
being diagnosed as personality disorder, what labels are being ascribed to
them, or is personality disorder a culture-bound disorder confined to
Western psychiatry? There are currently no systematic reviews available on
this topic.
Ketamine
Ketamine, a drug of abuse (and anesthetic medication), has been found to
produce a rapid antidepressant effect. It is an N-methyl-D-aspartate
(NMDA) receptor antagonist that has shown promising therapeutic effects
in treatment-resistant depression. However, it requires intravenous
injections and hospitalization for at least 24 hours post infusion, and can
induce behaviour abnormalities in rodents that simulate those observed in
schizophrenic patients.These apparently contradictory observations (both
antidepressant and psychosis induction properties) have been proposed to
be related to the regulation of the kynurenine pathway. We are interested
in undersatnding the molecular actions of this drug.
Dr Patricia Zunszain
Stress, Psychiatry and
Immunology Laboratory
(SPI-Lab),Centre for the
Cellular Basis of Behaviour
Department of Psychological
Medicine
patricia.zunszain@kcl.ac.uk
Prof CarminePariante
Stress, Psychiatry and
Immunology Laboratory
(SPI-Lab) Department of
Psychological Medicine
carmine.pariante@kcl.ac.uk
Non-coding RNAs and neurodevelopmental disorders
Prof Noel Buckley
Professor of Molecular
Until recently, the human genome was thought to comprise of Neurobiology
around 21,000 protein coding genes occupying less than 2% of the genome, Centre for the Cellular Basis
dispersed as oases across a genomic landscape that was largely seen as a of Behaviour (CCBB)
gene desert, consisting of large regions of non-functional, often repetitive
DNA. However, this view has been completely undermined in the course noel.buckley@kcl.ac.uk
of the past decade as large scale sequencing of the human transcriptome
has revealed widespread and pervasive transcription of the human genome
resulting in production of >10,000 long non-coding RNAs (lncRNAs) in
addition to several hundred short microRNAs. lncRNAs and miRNAs
represent an important and widespread means of gene regulation that is
only beginning to be appreciated. Following rapidly on the heels of this
epiphany has been the realization of the relevance of ncRNAs to disease.
ncRNAs are a recent evolutionary event and seem to be highly developed
in human. The majority of lncRNAs and many miRNAs are expressed in
the brain, many in a cell-type and stage-specific manner further
underwriting the emerging view that ncRNAs may play a pivotal role in
neurodevelopmental and psychiatric disorders.
The ncRNA field has rapidly burgeoned and there is an urgent need
to review the literature to assess the relevance of ncRNAs and their
potential application to the study and treatment of psychiatric disorders.
See John Mattick discuss the recent evolution of non-coding RNAs.
http://vimeo.com/13664571
Impact of mental health difficulties on romantic relationships
Mary Keeling
Researcher
There is a wealth of literature suggesting marriage is beneficial for mental Department of Psychological
health (Marcussen, 2005) and enhances psychological well-being. Medicine
Questions exist in the research literature as to whether this apparent mary.keeling@kcl.ac.uk
protective factor is due to the social rewards such as increased social
support, social integration, financial gains and avoidance of the stigma of Dr Nicola Fear
being unmarried, or due to the characteristics of those who get married; are Reader in Military
those with better psychological health more likely to get married (Horwitz, Epidemiology
Raskin, & Howell-White, 1996). It is probable that the answer is a Department of Psychological
contribution of the two factors. However, what happens when someone in a Medicine
relationship develops a mental health problem? Literature from military Nicola.t.fear@kcl.ac.uk
health suggests that soldiers returning from operations in Iraq and
Afghanistan with Post Traumatic Stress Disorder and/or symptoms of
common mental illness experienced lower relationship satisfaction for both
them and their spouse (Goff, Crow,; Reisbig, &; Hamilton, 2007). Due to
the extra strain and possible burden a spouse with mental health difficulties
places on romantic relationships it is possible that the development of
mental disorders could disrupt relationships however literature
investigating this in the general population is sparse. This project would
aim to investigate, in the general population, current findings regarding the
association between mental health and the impact it plays on romantic
relationships.
A systemic review (or if possible meta-analysis) about factors affecting
duration of sickness absence due to depression.
Details to be discussed with supervisor
Can robots deliver psychological care?
This will be a scoping review of a) the increasing use of interactive robotic
devices to deliver and support activities of daily living using examples of
current practices eg for the elderly and disabled b) the feasibility of using
these technologies to also deliver interactive psychological support.
Dr Ali Hashtroudi
Consultant in Occupational
Medicine and Honorary
Senior Lecturer Occupational
Health Department
The Education Centre
St Thomas' Hospital
Westminster Bridge Road
London SE1 7EH
Telephone: 020 7188 4152
Fax: 020 7188 4146
Dr Carol Kan
Clinical Researcher
Department of Psychological
Medicine
Carol.kan@kcl.ac.uk
Dr Khalida Ismail
Liasion Psychiatrist,
Consultant Psychiatrist
King’s College Hospital
Department of Psychological
Medicine
khalida.2.ismail@kcl.ac.uk
Possible topics (1 student only)
Neural correlates of BDNF polymorphism: A systematic review of
functional and structural neuroimaging studies of the BDNF
polymorphism.
Definitions of happiness in psychiatry: A systematic review of how
happiness and health is quantified in psychiatric disorders.
Dr Cynthia Fu
Senior Lecturer and
Honorary Consultant
Psychiatrist
MRC Social, Genetic and
Developmental Psychiatry
Centre
cynthia.fu@kcl.ac.uk
Cognitive enhancers in depression: A systematic review of the use of
cognitive adjunctive enhancers in depression.
Epidemiology of atypical vs typical depression: A systematic review of
the features of atypical depression in comparison with melancholic
depression.
(2 students)
Neurological disorders in haematology patients
Neurological disorders in liver patients
Psychosocial aspects of epilepsy in adolescence
Sleep related disorders
Neurological complications of alcohol
Incidence of alcohol and or drug use in patients with non epileptic
seizures: literature review and or prospective study
Obsessive compulsive disorders and patients with epilepsy, literature
review and case series
Dr Chris Clough
Neurology Consultant
Department of Neurology
King’s College London
chris.clough@nhs.net
Dr Nick Moran
Department of Neurology
King’s College London
nicholas.moran@ekht.nhs.ne
t
Dr Tom Britton
Department of Neurology
King’s College London
Thomas.britton@kcl.ac.uk,
or thomasbritton@nhs.net
Dr Franz Brunnhuber
Department of Neurology
King’s College London
Dr Lina Nashef
Department of Neurology
King’s College London
lina.nashef@nhs.net
Neurobiology of Depression: Possibility of co-authoring a book chapter Karim Malki
PhD Student
Major depressive disorder (MDD) is etiologically complex and has a
SGDP
heterogeneous presentation. This heterogeneity limits the ability of
karim.malki@kcl.ac.uk
molecular genetics research to detect small effects conferred by common
genetic variation. Recently, a mega-analysis of genome-wide association
Dr Leo Schalkwyk
studies for major depressive disorder was unable to uncover any single
Reader
nucleotide polymorphism at genome-wide level of significance. Current
SGDP
diagnosis for depression is centred on a quantitative system based on
leonard.schalkwyk@kcl.ac.u
symptom count that is independent of any etiological considerations. It is
k
possible that etiologically different disorders may be homogeneously
diagnosed as MDD. This complicates the selection of patient-groups for
research endeavours. Genetic approaches still hold significant promise to
fundamentally improve our understanding of the pathophysiology and
etiology of depression and may eventually help to inform treatment and
prevention strategies. In this essay we want to present a summary of the
current understanding of the neurobiological substrate underpinning MDD
and explore how these findings will eventually help refine diagnostic
definitions and eventually lead towards individualised prescription of
antidepressants drugs.
We aim to work with the student to develop this essay into a book chapter.
However co-authorship will only be given if the work produced is of
quality.
* If you are interested in this project please contact Karim Malki for
an informal discussion. Given the nature of this project the supervisors
may hold some informal interviews to choose the student they wish to
work with.