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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.
An estimated one in four people in the UK will experience depression or anxiety at some point in their lives. Cognitive behavioural therapy (CBT) is the most widely recommended non-medication- based treatment for common mental health problems, although access to this treatment is limited because of low numbers of expert practitioners. Self-help CBT resources developed by researchers at the University of Glasgow have been integrated into routine clinical practice delivered by health services and the voluntary sector in the UK, Ireland and Canada. Since 2008, these practical user-friendly resources have provided support to over 200,000 users online and an estimated 250,000 people on a one-to-one basis or within a class.
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.
Depression is a major public health problem producing substantial decrements in health and well-being, with 15% lifetime prevalence, affecting 350 million people worldwide. The Mood Disorders Centre (MDC) has improved treatment for depression by (i) understanding psychological mechanisms underpinning depression; (ii) translating this into innovative treatments and prevention interventions, evaluated in clinical trials; (iii) improving dissemination, delivery, and access to treatments. This research has improved patient care and quality of life, influenced national policy (NICE Depression Guidelines), informed national service and training provision (Improving Access to Psychological Therapies IAPT programme, with 680,000 people completing treatment 2008-2011) and achieved international impact on clinical practice.
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.
A decade of research at the University of Southampton has given thousands of people around the world suffering from dizziness and balance disorders access to a self-management resource that can alleviate their symptoms. Professor Lucy Yardley has pioneered the use of a Balance Retraining (BR) booklet to transform the means of delivering cost-effective, life-changing treatment previously offered to less than one in ten UK patients. The booklet, translated into several languages, has been distributed to patients and practitioners as far afield as China and Japan. Yardley's findings have contributed the bulk of good quality evidence to the Cochrane Review on vestibular rehabilitation.
Eating disorders affect 5-10% of young people and in many cases persist into adulthood. At their most severe they can evoke intense emotional responses from those closest to the person. King's College London (KCL) research established that the response from others, combined with personal factors and beliefs, were key maintaining factors in the disorder. As a result, KCL researchers developed self-help materials that reduced distress and improved carers' ability to manage the person they were helping. This intervention programme has been adapted into a workshop, a self- help book, a DVD and a clinical handbook. The programme has been adopted by two of the largest UK eating disorder charities (BEAT and SUCCEED) and is recommended by the USA-based international charity FEAST and forms the basis of local NHS and international services including in the USA and Australia.
Impact: By showing the benefits of accurate identification and targeted treatment of chronic fatigue syndrome, UoE research has influenced worldwide medical practice and stimulated public and governmental debate.
Significance: Guidelines and policy debate have resulted in improved patient treatment, with associated economic benefit.
Beneficiaries: Patients with medically unexplained symptoms, policy-makers, clinicians.
Attribution: Work conducted at UoE in a team led by Carson and Sharpe.
Reach: The research affects the more than 25% of all GP presentations who have unexplained symptoms / chronic fatigue syndrome (40% in gastroenterology and neurology). Guidelines have been changed internationally including UK, USA, Australasia.
Research into primary care insomnia by the Community and Health Research Unit (CaHRU) has led to broad improvements in healthcare provision for insomnia, improved patient quality of life, informed national/international policy and practice in insomnia care and impacted directly on health professional practice and insomnia sufferers, initially in Lincolnshire spreading across the UK and internationally from 2008 to 2011. Direct effects on practice include changes in sleep management and reduced hypnotic prescribing through seminars, workshops, conferences and e-learning developed by the team; inclusion in UK policy, practitioner information, training materials and guidance on hypnotics has led to greater professional and public awareness of sleep management internationally.