Studies Completed in 2011: Projects Initiated and Led by Trust Staff and Honorary Appointees
NIHR Portfolio
Social competence in schizophrenia (DISS)
UK CRN ID no. 5825
R&D ref. no. N0707/3
Chief Investigator: Dr Rose McCabe – 02075404210 - r.mccabe@qmul.ac.uk
We propose to investigate social competence in people with a diagnosis of schizophrenia. We will analyse how they interact with others to test the following key hypotheses:
- Schizophrenia is distinguished by specific interactional deficits,
- These can be discriminated through three, logically independent, components of social interaction: (a) Increased superficial reciprocity, (b) Decreased engagement and (c) Decreased anticipatory interactive planning, and
- Each of these components is amplified and, therefore more tractable to analysis in multi-party interaction.
PROMO (Best Practice in Promoting Mental Health in Socially Marginalized People in Europe)
UK CRN ID no. 7532
Chief Investigator: Professor Stefan Priebe – 020 7540 4210 – s.priebe@qmul.ac.uk
Promoting mental health and preventing mental ill health among the increasing groups of socially marginalized people is a major challenge to European societies. There are various policies and services to achieve this in member states, but information on what constitutes best practice is fragmented and consistent guidelines do not exist. PROMO will bring together a multidisciplinary consortium of experts from 14 diverse member states (covering more than 85% of the total EU population) to consolidate the knowledge in the field, and identify best practice. It will consider six different factors of social marginalisation, review legislation and policies, and – focussing on major cities - assess systems of health and social services for the people concerned. PROMO will define guidelines for best practice and disseminate the findings widely among the relevant stakeholder groups in Europe. Finally, it will highlight barriers for the implementation of the guidelines and suggest solutions.
A randomised, controlled trial of adding cognitive behaviour therapy, graded exercise, or adaptive pacing to usual medical care, compared to usual medical care alone for the chronic fatigue syndrome (PACE Trial)
UK CRN ID no. 4502
R&D ref. no. K03042-I
Chief Investigator: Prof. Peter White – 020 3465 5696 – p.d.white@qmul.ac.uk
Chronic fatigue syndrome (CFS) is a chronic disabling condition of unknown cause and no certain treatment. Some 250,000 to 500,000 people suffer from it in the United Kingdom, the difference in prevalence depending on how it is defined. Some differentiate myalgic encephalomyelitis (ME) from CFS, whereas others think it is the same condition. This difficulty in defining it is but one of the controversies that affect CFS, the others being what causes it and how to treat it. The controversy has in the past led to demonstrations to the Department of Health, petitions to government and debates in parliament. Patient organisations complain that the National Health Service does not take CFS seriously, does not provide appropriate health services, and that patients are denied benefits to which they are entitled, leading to poverty and hardship.
One way to resolve controversy is through science, and the PACE trial was designed with the help of a patient charity, Action for ME, to provide some much needed evidence regarding safety and effectiveness of commonly available treatments. The National Institute of Healthcare and Clinical Excellence (NICE) had previously recommended two rehabilitative interventions, cognitive behaviour therapy (CBT) and graded exercise therapy (GET), but this was on the basis of a few small trials. In contrast, patient organisations had reported concerns that CBT and GET were ineffective, or even harmful, with one patient survey finding that 50% of patients reported that GET had harmed them. Patient organisations supported pacing and specialist medical care as alternatives. The PACE trial was therefore designed to test safety and effectiveness of these four interventions.
Own Account Studies
Concepts of Schizophrenia in different professional groups and Mental Health Teams
R&D ref. no. E1004/7
Chief Investigator: Dr. Ronald Bottlender - 020 7540 5076 – Ronald.Bottlender@eastlondon.nhs.uk
Schizophrenia is one of the most biologically perceived mental illness amongst psychiatrists. This is probably not the case amongst other mental health professionals. Recovery orientated approach used in early intervention teams have shaped the understanding of psychosis in varied paradigms in the last decade. Early Intervention teams have shown to produce better outcomes compared to standard care in patients with Schizophrenia. Amongst other reasons, the better outcomes achieved by Early Intervention Teams may be explainable by their multidimensional, optimism-creating, recovery-oriented approach rather than believing schizophrenia is a mainly biologically determined illness with a chronic course and generally poor outcome. On the aforementioned background the present study aims to investigate the attitude/understanding of schizophrenia amongst multidisciplinary team members in early intervention teams as compared to other generic mental health teams and its relationship to the course and outcome of schizophrenia.
High Dependency, high containment, difficult to manage psychiatric patients: finding solutions (HICON)
R&D ref. no. S0911/2
Chief Investigator: Professor Len Bowers – 02070405824 - l.bowers@city.ac.uk
To identify and describe:
- The nature of patient problem behaviours that result in high levels of containment.
- The observed and self-reported motivations of patients for their behaviours.
- The motivation and reasoning of staff in containment strategy selection.
- The patients who exhibit these behaviour patterns, including past psychiatric histories.
- Their numbers and location in the psychiatric system
- Different ways of managing the same problem behaviour patterns, with their outcomes.
To compare high dependency, high containment, difficult to manage psychiatric inpatients demographic features and diagnoses to other patients in the same units.
Processes of clinical improvement and personally-defined recovery from borderline personality disorder (BPD) and self-harming
R&D ref. no. K0901/4
Chief Investigator: Dr Christina Katsakou – 02075406755 - christina.katsakou@eastlondon.nhs.uk
The purpose of this research is to define:
- How clinical improvement from borderline personality disorder (BPD) and self-harming occurs through the use of either routine or specialised mental health services, and what factors facilitate or hinder this process,
- Whether there is a discrepancy between clinical improvement and personally-defined recovery for service users, and
- How is personal recovery achieved and what are the factors that could accelerate or delay this process.
Psychiatry Trainees' attitudes towards personality disorder
R&D ref. no. E1004/4
Chief Investigator: Dr. Tennyson Lee - Tennyson.Lee@eastlondon.nhs.uk - 020 7791 7600
The proposed study is a case vignette based survey of attitudes amongst psychiatry trainees toward patients with a previous diagnosis of borderline personality disorder or depression. In addition, the vignettes will give the opportunity to explore any differences related to the ethnicity of the patient. The trainees will be asked to read one of four randomly assigned vignettes then indicate their likely management and attitudes on a number of semantic differential scales. They will also be asked to complete an Attitudes to Personality Disorder Questionnaire (APDQ) and supply some basic demographic data about their stage in training. The aim of the study is to describe attitudes of trainees toward patients against the variables of previous diagnosis and ethnicity, and the current level of training and perceived training needs of these trainees.
Educational Projects
Perceived Stress, Coping Processes, Nurses, Medium Secure Hospital
R&D ref. no. K0809/2
Chief Investigator: Dr. Karen Brown -- 020 8588 4573 -- Karen.Brown@swlstg-tr.nhs.uk
Principal Investigator: Dr.Oluwasseun Adebambo -- 020 8510 2005 x2020 – Oluwaseun.Adebambo@eastlondon.nhs.uk
This research seeks to test if the Cognitive Appraisal Framework is applicable to nurses in a medium secure hospital. Do nurses with more experience show differences in and or greater number of coping processes in dealing with stressful situations or do medium secure hospital nurses employ a universal (ward culture) response, irrespective of the type, extent or severity of the stressor?
The answer to this question will be relevant in providing guidance for ward managers to deal with and address the stress ward staff face at work, and provide the necessary support systems to mitigate the effect of these stressors. Essentially what I am looking at is how ward staff perceive work situations as stressful and what coping processes they mount to overcome or manage the stress.
Holding the service users as parents in mind
R&D ref. no. K0809/2
Chief Investigator: Ms Karen V Daniel – 02032225600 - karen.daniel@eastlondon.nhs.uk
Does the multi media training resource: “Being Seen and Heard: The Needs of Children of Parents with Mental Illness” The Royal College of Psychiatrists (2004) have an impact on a sample of community adult mental health professionals’ clinical practice?