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Bulimic eating disorders are disabling conditions affecting approximately 5% of the population. Effective specialist treatment exists in the form of cognitive behavioural therapy (CBT), but only a minority of patients access this. Researchers at King's College London developed book-, CD-ROM-and web-based CBT self-care interventions for bulimic disorders that provide early effective treatment with outcomes comparable to costly specialist CBT. Locally, at the South London and Maudsley NHS Foundation Trust Eating Disorders Service, this has significantly reduced waiting lists. The research has had national and international impact with UK, German and US guidelines endorsing guided self-care as a first treatment step for bulimic disorders and the KCL manual and website are internationally recommended.
Psychosis is a serious mental illness for which treatment can be aided by psychological therapies. Researchers at King's College London (KCL) demonstrated that family environment is key to recovery and developed and validated a family intervention for psychosis. Family intervention for psychosis is a recommended treatment in NICE guidelines (2009), as well as by the Patient Outcomes Research Team in the USA. The NICE guideline committee was chaired and advised by KCL researchers. Family intervention for psychosis is part of training programs for clinical staff and has changed NHS practice. The KCL-led website mentalhealthcare.org.uk disseminates this research to families of those with psychosis.
King's College London (KCL) researchers discovered that heroin overdose is a common and accidental occurrence which is usually witnessed. Risk of fatal overdose on prison release is exceptionally high with 1 in 200 dying of an overdose within four weeks. KCL researchers proposed and tested the acceptability of prior provision of take-home emergency supplies of the heroin antidote naloxone. KCL research created the stimulus for a national training project for families and carers to administer naloxone and as a result, lives are now being saved. KCL research had a substantial impact on national and international policy and service delivery with take-home naloxone programs introduced around the world. KCL researchers lead the first trial to assess the effectiveness of naloxone for prisoners on release.
King's College London researchers have had a major widespread impact on medical care for people with dementia. They have demonstrated the limited benefit and considerable harm done by the use of antipsychotics in dementia patients. Their follow-on campaigning and policy work brought this major health issue to the forefront of the political agenda and led them to work with the Department of Health to create a best practice guide, now widely used nationally and internationally. In addition, they have worked with the BMJ to develop an e- learning package for General Practitioners. The combined impact of this work has made a major contribution to a 60% reduction in the use of antipsychotic drugs in people with dementia in the UK and major changes in practice internationally, preventing 1000's of unnecessary deaths.
King's College London (KCL) researchers developed cognitive behaviour therapy for psychosis (CBTp), which is now a National Institute for Health and Care Excellence-recommended psychological intervention. CBTp is now part of routine NHS treatment and an estimated 25,000 patients in England and Wales receive it annually. Implementation of CBTp has been steered by KCL researchers' involvement with the Government's Increasing Access to Psychological Therapies — Severe Mental Illness initiative. The KCL model for CBTp has been used to develop clinics in Australia and the US and information on this therapy is disseminated via a KCL-led website.
The use of a formulary to influence prescribing practice is common, with almost all hospitals possessing one that attempts to provide advice on the safe, effective and economic use of medicines. The Maudsley Prescribing Guidelines to Psychiatry steps beyond the function of a mere formulary and provides evidence-based guidance on the use of psychotropic medicines that influences prescribing on both a national and international basis. Now in its 11th Edition and translated into nine languages, much of the evidence in The Guidelines is generated by King's College London research. Additionally, this research is used in other guidelines, in clinical handbooks and in prescribing practices around the world.
Research led by Professor Sue Yeandle at Leeds on working age carers has focused policymakers' attention on carers' contributions to society, their role in the health and social care system, and the issues they confront in reconciling paid work with unpaid care. The research findings have: (a) provided a vital evidence base, shaping policy work of the national charity, Carers UK, (b) influenced Government policy formation and evaluation, including playing a direct role in shaping the Government's National Care Strategy in 2008, and (c) informed wider policy and parliamentary debate supporting carers of working age.
King's College London (KCL) researchers contributed to the discovery that increased C fibre nerve activity in the bladder is a major cause of overactive bladder (OAB) syndrome. Based on this insight, KCL researcher Professor Dasgupta, a surgical urologist at Guy's Hospital, and his team pioneered a new surgical technique for micro-injecting Botulinum Toxin-A (BTX-A) directly into the bladder to suppress C fibres and improve bladder control. The KCL team then conducted the world's first successful clinical trials into the minimally invasive injection of BTX-A n OAB patients. These trials received significant international media coverage. This cost-effective OAB therapy is now licensed by the EU and FDA, is recommended in national and international guidelines, and has significantly improved the treatment of a common health problem.
Some 480,000 UK children show persistent antisocial behaviour (Conduct Disorder), a major mental health problem in childhood with strong continuity to adult substance misuse, violence and criminality. Research at King's College London (KCL) showed that these children cost the public ten times more than individuals without Conduct Disorder by age 28. To tackle the problem, KCL researchers were the first to demonstrate that a rigorous parenting programme is a highly effective treatment, even for severe cases. KCL leads the National Academy for Parenting Research which has trained 3,192 practitioners in these approaches, who are estimated to have treated 192,000 troubled children. This success has contributed to the programmes being recommended in NICE guidance and incorporated in a new nation-wide Department of Health-funded rollout reaching 54% of 0-19 year olds in England. The training has also been disseminated internationally.
King's College London (KCL) research has transformed how people's preferences are respected, supported and achieved at the end of their lives. It has driven policy for end-of-life care in the UK, Europe and Australia, with a cascading impact on clinical practice and training. Our research has helped to reduce institutionalisation at the time of death despite an ageing population. These tremendous economic, sociological and psychological impacts were based on an integrated KCL research programme that identified dying at home as an important and often unmet preference, highlighted barriers that must be overcome, and aids that could help people at the end of life to achieve their preferred place of care and death.