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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.
Cardiff University research quantifying the association between cannabis use and increased risk of psychosis has transformed the global debate on cannabis use and continues to shape governmental policies, guidelines and public attitude internationally. Cardiff's findings regarding the effects of cannabis use on mental health are both widely cited in the media and commonly used worldwide as information sources when delivering public health educational material. Cardiff research demonstrated that cannabis use is the only individual-specific, modifiable risk factor known for schizophrenia. Results were used to calculate that, in the UK alone, approximately 15% of cases of schizophrenia are preventable if cannabis were to be eliminated from the population.
Studies conducted at Imperial College, over the last 20 years, have improved the rational, evidence-based treatment of schizophrenia. Our research has covered symptomatology, neurocognitive function, medication side effects, and comorbid substance use, and involved clinical trials of pharmacological and psychosocial treatments. We lead national quality improvement programmes supporting the implementation of psychopharmacological practice standards. Our work has impacted upon the understanding, clinical assessment and treatment of this condition in both first-episode patients and established schizophrenia, and has improved prescribing practice and the identification and assessment of side-effects.
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.
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.
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.
People who develop psychosis (1% of population) typically experience lengthy delays (months to years) before treatment. Researchers at the University of Manchester (UoM) established a concrete and significant association between delay in treatment of the first episode of psychosis and outcome. We demonstrated that outcome of psychosis could be improved considerably if these lengthy delays were reduced. This research influenced policy and practice in the UK and abroad. Policy changes included the establishment of early psychosis teams dedicated to early detection and treatment (50 in England alone). Practice changes included amendments to clinical guidelines in the UK and abroad that now require clinicians to respond urgently to a first episode of psychosis. These changes to clinical practice have increased the proportion of patients with a short DUP from 55.6 to 77.4%.
Psychosis devastates quality of life. Since 1995, work led by Professor David Fowler at The University of East Anglia (UEA) has made significant contributions to a series of UK and international trials which show that Cognitive Behaviour Therapy (CBT) is effective in reducing distress, emotional dysfunction and social disability in patients with chronic schizophrenia, and as part of early intervention services for first episode and at-risk patients. This work has had a major impact on mental health services as reflected in national and international mental health policy guidance, service development guidance, policy implementation guidance and training programmes for mental health workers.
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.
Epilepsy, a condition that affects ca. 1% of the world's population, has severe clinical consequences; people with epilepsy (PWE) and poorly controlled seizures exhibit nearly an order of magnitude increase in premature death relative to the general population. About one-third of PWE do not benefit from treatment with currently approved medicines. Although historical evidence has suggested that cannabis might be useful in the control of epilepsy, work initiated by Drs Ben Whalley and Gary Stephens at University of Reading revealed that non-psychoactive components of cannabis can control epileptic seizures in animal models. This finding has led to a funded collaboration of ca £1.4M with GW Pharmaceuticals (UK) and Otsuka Pharmaceuticals (Japan) to establish a case for translation of two such components, cannabidiol (CBD) and cannabidavarin (CBDV), to human clinical drug trials. In particular, Reading research has resulted in GW trialling CBD (Phase 2, 50 participants, design stage) for a new indication of epilepsy treatment. A Phase 1 trial for CBDV (20 participants) began in July 2013, with a Phase 2 trial to begin immediately after successful completion of Phase 1. Results from the use of CBD on an open-label basis have shown major quality-of-life improvements for the patients concerned.