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Chronic Fatigue Syndrome or CFS (also known as CFS/ME) affects two percent of the population. Michael Sharpe and colleagues in Oxford developed a cognitive behavioural treatment (CBT) for CFS. In 1996 they published the first randomised controlled trial finding that CBT was substantially more effective than standard care, with patients three times more likely to improve. This was the first treatment ever to be shown to be effective for CFS in a clinical trial. The finding was subsequently confirmed in other trials. Sharpe's research has benefitted people with CFS by: [a] challenging the prevailing view of the illness as untreatable, [b] informing current NICE treatment guidance, [c] providing the leading evidence-based treatment. In England alone, the treatment is implemented in 46 NHS specialist CFS centres, to over 7000 patients per year.
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.
This case study describes how Prof Cecilia Essau's research into emotional and behavioural problems in children and adolescents has been of benefit to children and has helped parents and schools to provide them with better support. Essau has worked with a children's charity to use her externally funded research to contribute to public understanding through providing presentations and skills training and to underpin the development and implementation of an anxiety prevention programme, Super Skills for Life (SSL), which has had a demonstrable benefit on children's wellbeing. In addition, Essau's research has been of value in informing the development of DSM-5, in introducing a specifier to the diagnosis of conduct disorder using callous-unemotional traits, and in refining the diagnosis of somatic symptom disorder. It has also contributed to policies and interventions internationally.
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.
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.
The benefits of office-based psychotherapies such as cognitive-behaviour therapy (CBT) are well-established in the treatment of common psychiatric disorders but their effectiveness with more severe conditions and when administered in circumstances beyond the reach of conventional services have not been known. Researchers at the University of Liverpool (UoL) have developed, adapted and evaluated CBT as a treatment for patients with schizophrenia, bipolar disorder and eating disorders and are now pioneering the delivery of CBT in rural areas in the developing world. This work has led to changes in treatment guidelines and improved treatment in the UK and in other countries.
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 pain, defined as pain lasting for more than 6 months, affects more than 25% of adults in developed nations. Drugs are costly, carry risks of side effects and dependence, and are of limited effectiveness in many cases. Morley, at the University of Leeds (UoL), collaborated on a series of definitive reviews and meta-analyses proving that active psychological treatments based on cognitive behavioural therapy (CBT) are effective in treating chronic pain. This led to changes in UK government and world health organization (WHO) guidelines and the adoption of CBT at specialist pain clinics, reducing patient suffering, increasing social role functioning and ensuring more cost-effective treatment.
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.
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.