Institute of Psychiatry

We are performing a range of studies through the combined analysis of clinical, imaging, proteomics, transcriptomics and genomic datasets, and have multiple active academic and industrial collaborations.

For a full publication list see either link below (the list provided on this page is incomplete):

http://www.iop.kcl.ac.uk/staff/profile/?go=12524

or

http://www.researcherid.com/rid/C-9269-2011

Activities and Interests

Headache
Guy's & St Thomas's Hospital Charity fund the Neurology & General Practice Unit for Service Delivery and Evaluation of innovation in Headache Services. Six GPs with Special Interest in Headache have been trained. Intermediate Care Clinics have been set up in Southwark and Lambeth and an evaluation published in the BJGP. Patients seen by the GP with Special Interest Service were more satisfied than patients who saw hospital-based general neurologists. The PCT was charged less for the GPwSI service than for hospital care. Further work is in progress to develop a CBT intervention for Migraine.

Prior work funded by the MRC set the stage for this by examining the reasons for referral of patients with headache to specialists. It was found that GPs referred only 2% of consulters for primary headache to neurologists. These patients reported the same level of headache severity and disability as patients managed in primary care. Referred patients expressed more fear and anxiety about their headache symptoms. GPs reported that patient pressure was important in the referral decision, and their wish for a brain scan.

A new study designed to describe the prevalence of PFO and their association with migraine, and trial clopidogrel in the prevention of migraine has begun in collaboration with John Chambers (PI), and funded by the Dunhill Trust.

Fatigue
A Wellcome Trust grant funded the third complex intervention trial by this unit for patients with chronic fatigue in primary care. This three-arm RCT of Graded Exercise, Counselling and Usual Care plus a booklet on CBT has been completed, with results presented at meetings, and papers submitted for publication.

Epilepsy
Prior work has included trial of nurse interventions for people with new and chronic epilepsy. An NIHR SDO grant funds the unit for a study titled: Can nurse-led rehabilitation for epilepsy patients prevent non-planned admissions? A comparison of cost and effectiveness of service models at two centres. This is currently recruiting patients at King's College Hospital and Guy's & St Thomas' Hospitals.
Epilepsy Bereaved is funding an epidemiological study of causes of mortality in epilepsy, using the General Practice Research Database, in collaboration with Martin Gulliford.
In collaboration with Brian Hurwitz, the Unit is hosting Maria Vaccarella, who is funded by a Marie Curie Fellowship, to explore the relationship between epilepsy in the arts and the experience of epilepsy care.

Teaching Activities

Leone Ridsdale is Director of Neurology Undergraduate Clinical Teaching, and Chair of Clinical Teaching in Year 3 for the Neurology-Opthalmology-Psychiatry Rotation. In the past, medical graduates have reported lack of competence and confidence in neurology, amounting to 'neurophobia'. KCL students do 12 a week rotation in clinical neurology, linked with psychiatry teaching. This has been evaluated, and KCL students report as much confidence in their neurology knowledge and skills, as in other Year 3 subjects. Students rated neurology as top, tied with cardiology, for interest and as the subject in which they would like to specialize (Ridsdale L, Massey R, Clark L. (2007) Preventing 'neurophobia' in medical students, and so future doctors. Practical Neurology 7:116-123).

Epidemiology of psychosis
Social factors in the aetiology, course and outcome of psychosis
Culture, ethnicity and mental disorder
Illness behaviour and health service utilisation
Philosophy and sociology of mental illness
Research methodology

Biographical Note: Fotopoulou studied psychology in Athens (Greece); cognitive neuroscience, neuropsychology and theoretical psychoanalysis at University College London (UK); and conducted her PhD in these fields at the University of Durham (UK). She is currently also completing clinical doctorate training in psychotherapy (see below).

Research: Dr Fotopoulou's research focuses on topics and disorders that lie at the borders between neurology and psychiatry, aiming to understand the complex dynamic relation between mind and body. She is particularly interested in understanding how our physical body, our emotions and personal goals, as well as our relations with other people influence the function of our brain and ultimately shape how we understand ourselves and our new experiences. She conducts studies on self-consciousness, pain, emotions and memory in healthy volunteers, in patients that have suffered a stroke or other brain pathologies, as well as in individuals with psychological disorders such as somatisation, functional disorders, chronic pain and depression.

Research Fellowships, Awards and Grants: For these studies, and the many resulting publications in scientific peer-reviewed journals of international standing, Dr Fotopoulou was awarded an ESRC-MRC fellowship in 2005, a Neuropsychoanalysis Fellowship and the Clifford Yorke Prize for Early Career Contributions to Neuropsychoanalysis in 2006, as well as the Papanicolaou Prize from the World Hellenic Biomedical Society (2010). She was also recently awarded the British Neuropsychological Society's Early Career Award: The Elizabeth Warrington Prize (2011).

Finally, having won an earlier European competition of junior investigators (European Platform for Life Sciences, Mind Sciences and the Humanities ; supported by the Volkswagen Foundation), Dr Fotopoulou has more recently (2010) been awarded a further project grant from the Volkswagen Foundation to lead and coordinate an Interdisciplinary European Research Group that considers neuroscientific, psychological and philosophical perspectives in the study of interpersonal body awareness and pain perception. The London-based branch of this group has further won a project grant for the Hope for Depression Research Foundation (2010) to study the neural correlates of these effects in depressed patients.

Clinical Interests, Training and Activities: Dr Fotopoulou is completing a 4-year Doctorate Degree in Counselling and Psychotherapeutic Psychology, accredited by the British Psychological Society. This degree provides formalisation to her long standing interest and extensive volunteer placements in neuropsychological rehabilitation and translational research.

Dr Fotopoulou has been a member of the Neuropsychoanalysis Society's executive and organizational committee since 2003 and has run a monthly Neuropsychoanalysis and Psychodynamic Neuroscience group in London since September 2009. In 2007 she and Professor Martin Conway were awarded a grant from the British Economic and Social Sciences Council to host a two-year long seminar series in London. Bringing together distinguished scholars and researchers from the fields of psychology, neuroscience and psychoanalysis, the resulting publication (Eds. A. Fotopoulou, D. Pfaff & M.A. Conway), entitled 'From the Couch to the Lab: Trends in Psychodynamic Neuroscience' is due to be published by Oxford University Press in March 2012.

• The attitude-behaviour relationship
• Behavioural interventions
• Motivation, cognition, and emotion
• Dual-process models of cognition
• Cognitive dissonance, self-affirmation, and information processing
• Emotional intelligence
• Mindfulness meditation and its cognitive and emotional benefits
• Meta-cognition and self-knowledge
• Persuasion and social influence

(ii) Understanding adjustment to chronic illness from both the patient and family perspectives.

(iii) Developing self-management and CBT based interventions for people with chronic illnesses such as multiple sclerosis, IBS and CFS including telecare and web interventions.

(iv) RCT's of psychological interventions.

(v) Exploring the role of people's perceptions and responses to their symptoms, illness and treatments in affecting outcome. Recent projects include developing measures of perceptions of multi-morbidity and children's perceptions of parental illness.

Behaviour change, including the use of financial incentives.

Emotional and behavioural responses to biomarker feedback.

I am also interested in identifying biomarkers that can be used as predictors of treatment response within clinical trials.

Dr MacCabe has been honorary consultant psychiatrist at the National Psychosis Unit since 2005, where he is responsible for treating inpatients with severe psychosis and conducting clinical trials.  Dr MacCabe is special advisor on psychosis to the mental health charity, SANE.

Dr MacCabe conducts research into the causes and consequences of psychoses using the tools of lifecourse epidemiology. Much of his research is conducted in collaboration with international partners in Sweden and elsewhere.  His research interests include cognitive function in schizophrenia and bipolar, and trajectories of cognitive function prior to illness onset, differences in cognitive function between schizophrenia and bipolar disorder, associations between high cognitive function, creativity and mental disorders, and fertility of patients with psychosis.  He also has a clinical interest in treatment refractory schizophrenia and conducts research in improving the safety, tolerability and effectiveness of antipsychotic drugs, particularly clozapine.  

Mental illnesses are a major cause of ill health and premature death. They account for four of the six leading causes of adult disability in the world and one in every ten hospital beds in the UK is for the treatment of psychotic disorders such as schizophrenia.

Current work in his Group focuses on:

* Understanding the brain changes that lead to the development of psychotic disorders, using multi-modal imaging with PET and fMRI to understand the receptor and other functional brain changes underlying these disorders

* Examining the effects of cannabis and other drugs on the brain, and the influence of common genetic polymorphisms on brain function to understand why some people are vulnerable to psychosis

* Determining why some patients respond to treatments and others don't

* Using novel approaches to diagnosing mental illnesses

* Developing preclinical models for future drug development

She worked at St Thomas' Hospital in London as a House Officer and then trained in Psychiatry as a Senior House Officer on the St George's rotation, before moving to the Institute of Psychiatry, KCL and the Maudsley Hospital as a Clinical Researcher and Honorary SpR in 2005 after attaining the MRCPsych in 2004.

In 2007 she was awarded an MRC Training Fellowship under the supervision of Professors Robin Murray and Matthew Hotopf. In the same year she received the British Medical Association (BMA) Margaret Temple Research Award.

In 2008 she obtained an MSc with distinction in Epidemiology at the London School of Hygiene and Tropical Medicine. Her PhD thesis was on the subject of Suicide and Premature Death following First Episode Psychosis. In 2011 Rina was named the Royal Society of Medicine's Young Researcher of the Year, she was also awarded a second grant from the BMA which funds her PhD student's research concerning Insight in Psychosis and Risk of Suicide.

After obtaining her CCT in General Psychiatry with sub-specialisation in Liaison Psychiatry, she has worked as an Honorary Consultant Psychiatrist for the National Affective Disorders Unit, providing second opinions in a tertiary referral service. Her clinical special interest is in bipolar affective disorder and the mental health of health care professionals.

Dr. Frangou graduated from the medical school of the University of Athens, Greece. She then obtained a master's in Neuroscience followed by a doctoral degree in endophenotypes for psychosis from the University of London in the UK. Dr. Frangou did her postgraduate psychiatry training at the Maudsley Hospital in London.

Dr. Frangou is Editor of "European Psychiatry", the official Journal of the European Psychiatric Association. She is a Fellow of the Royal College of Psychiatrists and of the European Psychiatric Association. She has served on the Council of the British Association for Psychopharmacology (BAP) and co-authored the BAP guidelines for the treatment of Bipolar Disorder and is currently Expert Reviewer for the Working Group on the Classification of Mood and Anxiety Disorders for the Revision of ICD-10 Mental and Behavioural Disorders. She is vice-president for the International Society for Bipolar Disorders, Secretary and founding member of the EPA Section of NeuroImaging and heads the Brain Imaging Network of the European College of Neuropsychopharmacology.

My research focus is the development and application of statistical methods in human genetics, to identify and characterise genes contributing to common, complex disorders. Current research includes genome-wide association studies and disease risk prediction using genetic and environmental factors.

Mood, psychosis and addiction biology and genetics; the genetics of complex psychiatric disorders and co-morbid disorders; genetic technologies and bioinformatics.