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Research at King's College London (KCL) showed that use of cannabis, especially high potency types such as `Skunk', increases the risk of psychosis. The work has demonstrated that adolescents who start early and carry some genetic vulnerability are at highest risk and that experimental cannabis administration alters brain function and induces transient psychosis. KCL research has led to increased public awareness of the adverse effects of cannabis use on mental health, in the UK and abroad, and sparked a public debate in the UK on the legal status of the drug ending with the Government reclassifying cannabis from Category C to Category B. KCL research on brain function has facilitated a collaboration with industry to develop new psychiatric medication.
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 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.
Psynova Neurotech is a prize-winning spin-out company founded by Professors Sabine Bahn and Chris Lowe from the University of Cambridge. It focuses on the commercialization of novel blood-based biomarker tests for conditions like schizophrenia, depression and bipolar disorder. Psynova and its partner company Rules Based Medicine (now Myriad RBM Inc.) launched the first commercially available Aid for the Diagnosis of Schizophrenia (VeriPsychTM) in 2010. In June 2011, Psynova and Rules Based Medicine were acquired by Myriad Genetics Inc. for £50 million. In February 2011 Psynova Neurotech and Professor Bahn were announced winner of the ACES best European Life Science spin-out award.
Psychosis affects 3-4% of the UK population and is ranked as the third most disabling condition worldwide by the World Health Organisation. Research at the University of Glasgow has changed treatment and services for patients with psychosis by identifying therapies that improve emotional recovery and prevent psychosis relapse and by contributing to the development of early intervention services for individuals with a first episode of psychosis. This work has supported the inclusion of cognitive behaviour therapy (CBT) for psychosis in national clinical guidelines and the implementation of these guidelines via an expanded UK Department of Health programme. University of Glasgow research has also driven the development and expansion of local early intervention services for psychosis, the success of which has directly informed the current Scottish Government Mental Health Strategy.
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.
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.
Schizophrenia affects 1.1% of the adult population. It is one of the most debilitating of the psychiatric disorders, leading to costs of approximately £12Bn/year in the UK. Historically one of the major gaps in service provision has been any approach to prevention, whether primary or secondary. University of Birmingham pioneered the concept and practice of early intervention in psychosis, which is a key feature and indication of schizophrenia. This has gone on to have national and international impact on mental health care. This approach has been recommended in NICE Guidance, the Mental Health Strategy and is a requirement of the NHS Operating Framework for 2011/12. It has resulted in improved outcomes. Evaluation of this approach has found that is preferred by clients, reduces the suicide rate, reduces lost productivity due to illness and over three years the long term benefit of early intervention is between £17,427 and £36,632 per patient compared to standard care. In addition the success of early intervention in schizophrenia has impacted on wider mental health policy and practice, resulting in the development of similar approaches in other areas of mental health.
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.