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Eating disorders (anorexia nervosa, bulimia nervosa and related conditions) are common, often chronic and disabling, and sometimes fatal. Christopher Fairburn and colleagues have engaged in long-term research into the nature and treatment of eating disorders. The impacts are: (1) developing the standard measurement tools for eating disorders; (2) devising the leading and most effective evidence-based therapy for bulimia nervosa (`CBT-BN'); (3) showing that a modified form of the treatment is effective for all eating disorders (`CBT-E'); (4) developing an effective and popular self-help version. These treatments allow, for the first time, a significant chance of complete and sustained recovery from an eating disorder. The treatments are recommended by NICE and international guidelines, and are being disseminated worldwide.
Chronic fatigue syndrome (CFS) is a disorder of unknown cause affecting 1% of people. Studies by Queen Mary researchers between 1993 and 2012 helped to characterise and demystify CFS and, in a series of randomised trials, showed that graded exercise therapy (GET) was effective and cost-effective, especially when costs to the patient and society were included. For impacts, GET was [a] recommended in NICE guidance; [b] offered as standard therapy in most UK centres managing CFS; [c] recommended and used internationally. The lead researchers have worked hard to build a dialogue with patient groups, including working with them to co-design the most recent trial, thereby increasing the chance of acceptance of findings by people affected by CFS.
Congenital myasthenic syndromes (CMS) are diseases leading to muscle weakness. They are caused by various gene mutations. However, for many CMS patients with a `limb girdle' pattern of weakness, the gene was unknown, and they were unresponsive to the usual CMS treatments. Research by David Beeson and colleagues has changed this state of affairs. First, they showed that this form of CMS is caused by a mutation in a gene called DOK7. Second, they identified the mechanism by which the mutation causes the disease. Third, they discovered that patients with DOK7 mutations respond to a different class of drug, 03b22 adrenergic receptor agonists. DOK7 mutations are now routinely tested for in clinical practice, and these drugs are standard therapy.
Two books and review/research articles in Italian have disseminated the findings from the underpinning research on creating false autobiographical memories and the dangers of inadequate interviewing techniques. This work has critically increased awareness in the Italian legal system amongst both barristers and judges, to the point of shaping the practice of interviewing witnesses in that country. It has also informed all verdicts on child sexual abuse by the Supreme Court of Cassation.
The work of Professor Diane Cox has been instrumental in enhancing services and improving outcomes for patients with Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME), and other fatigue related conditions. Primarily, this has been through changing the interventions used by Occupational Therapists and other Allied Health Professionals in healthcare practice to manage such conditions. The research has influenced amendments to professional standards, guidelines and training for use of activity and lifestyle management approaches to treating CFS and related conditions, and has had further impact through influencing the set-up of specific CFS services using these techniques. The research has demonstrated that Occupational Therapy can improve engagement and participation in occupations through activity, and led to its widespread uptake into practice throughout the UK. The research has underpinned the National Institute for Health and Clinical Excellence (NICE) guidelines for CFS/ME and directly influenced the form and implementation of NHS and private service provision for these conditions in the UK.
Chronic fatigue syndrome (CFS) is characterised by prolonged and profound fatigue. The prevalence of CFS is between 0.2% and 2.6% worldwide. Researchers from King's College London (KCL) have shown that Cognitive Behaviour Therapy and Graded Exercise Therapy can improve the symptoms and disability of CFS. This evidence led to both therapies being recommended by the National Institute for Health and Care Excellence and the British Association for Chronic Fatigue Syndrome/ME and becoming standard practice in the UK. These treatments, backed by the KCL studies, are also recommended worldwide including in the United States, Australia and Norway.
Around 28% of people worldwide will experience a sleep disorder at some point in their lives. Cognitive behavioural therapy (CBT) is an optimal treatment of choice for sleep disorders, but access to treatment is limited by the low number of expert CBT practitioners, resulting in long waiting times for CBT. University of Glasgow Sleep Centre research led to the development of an online CBT course (`Sleepio'), which has been sold online since 2010, and since September 2012 has been sold online by The Boots Company Plc. (Boots). Sleepio has been included in the NHS Health Apps Library and selected for integration with two of the best-selling fitness monitors. University of Glasgow expertise also underpinned `Sleep Matters', a year-long campaign by the UK Mental Health Foundation (MHF) which generated 300 media articles with a combined circulation of 145 million, raising awareness of and widening access to treatment for sleep disorders.
While in Oxford, David M. Clark and colleagues developed psychological models of panic disorder and social anxiety disorder, tested the models in experiments, and devised novel psychological treatments (forms of cognitive therapy [CT]) that target the processes in the models. Randomised controlled trials (RCTs) showed that CT was more effective than existing psychological and drug treatments, with 70-80% of people recovering. The therapies are recommended first-line interventions in current NICE guidelines, and are widely available in the NHS through the Improving Access to Psychological Therapies (IAPT) programme, which Clark helped establish and is now evaluating. The treatments are also being used and recommended in many other countries.
Depression and anxiety are common, cause significant disability and are costly to the individual, the NHS and wider society. UK management of depression and anxiety has been revolutionised as a result of our research at the University of Manchester (UoM) on low intensity psychological interventions (cognitive behaviour therapy (CBT) based Guided Self-Help (GSH)) which is the primary form of care for hundreds of thousands of people with depression and anxiety disorders (including generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder) through the "Improving Access to Psychological Therapies" (IAPT) scheme. Between 2009 and 2012 more than one million people used the new services, recovery rates are in excess of 45% and consequently 45,000 people have moved off benefits.
Research by Anke Ehlers' group at Oxford University has had major impacts on the treatment and outcome of post-traumatic stress disorder (PTSD). The group developed and validated a psychological model of the key factors that lead to PTSD. A novel form of cognitive therapy (CT) that specifically targets these psychological processes was then developed. Randomised controlled trials showed that CT is highly acceptable and highly effective in recent-onset and chronic PTSD, in adults and children. It is one of the recommended first-line interventions in the NICE PTSD guideline. It has been made widely available in the NHS through Improving Access to Psychological Therapies (IAPT), and is being disseminated in other countries. Separate research by Ehlers showed that a previously leading treatment, debriefing, was ineffective, leading to it not being recommended by NICE.