Brain, mind, science+culture. Former Ed of The Lancet Psychiatry. Head of Field Building in Mental Health
@WellcomeTrust
. Early modernist+Modernist. Views mine.
Very sorry to learn of Paul Bebbington's diagnosis of Alzheimer's disease. With characteristic grace and thoughtfulness, he has written a personal account of his experiences in
@TheBJPsych
.
#mentalhealth
#dementia
My father was a little fragile toward the end of his life, but always seemed to magically de-age whenever he went back to Northern Ireland. The last time I was there with him, he made it all the way round the walls of Derry. He saw this mural, and it made him smile.
#DerryGirls
Borderline personality disorder operates “as a closed system... meaning almost any behaviour can be explained within its logic, including refusing to accept the diagnosis”. Great piece by
@Shrink_at_Large
.
@trishgreenhalgh
My mother (who was a teacher, then worked for the local education authority) gave me the best advice I have ever had about being a manager: “People who work for you should never have to worry about what sort of mood you’re in.”
The last
@TheLancetPsych
Editorial published while I’m still in the Ed-in-Chief’s chair. It’s all about the need for public
#mentalhealth
to be effective (in addition to being right).
And yes, the headline is borrowed from
@Manics
.
Second, in
#mentalhealth
research I’d like to see the perception of “lived experience” develop into “lived expertise”. That is, to have first-hand perspectives recognised & respected as sources of knowledge—and of good research questions—in their own right. 3/6
My response to the news from Birkbeck: universities need their arts and humanities departments, *especially* if they are keen on developing STEM subjects. Why? This Brian Eno quote puts it better than I could.
If it's a good research question addressed using an appropriate method, there is no such thing as a "negative result"—just an important answer.
#mentalhealth
#science
Both up-to-the minute and rich with classic
#JamesBond
goodness.
@kimtsherwood
has done some fantastic world-building, and I hope that a heavily highlighted copy is on Barbara Broccoli’s desk.
What could we achieve in
#mentalhealth
science if we all worked together?
We at
@wellcometrust
would like to commission a report on the use of citizen science in mental health.
Expressions of interest: 20 Nov
Full applications: 15 Jan
Full details here:
Concern about depression+anxiety among the young is valid & necessary. But too many adults in public life are leaping to conclusions about causes and solutions based on intuition alone. And the history of
#mentalhealth
has many examples of ideas that were intuitive but wrong. 1/2
If I say it’s hard to summarise
@lfoulkesy
’s book in a tweet, it’s a compliment: this is a carefully argued and nuanced piece of work. It’s also very well written and deeply compassionate.
#mentalhealth
Quick thought:
@JAMAPsych
: shared genetic aetiology between GI disease/
#mentalhealth
problems.
@TheLancetPsych
: polygenic risk scores for schizophrenia assoc w/cardiac problems.
What might we gain—or lose—by reframing some
#mentalhealth
problems as multisystemic conditions?
“Around 2/3 of psychiatrists and other clinicians felt it was their job to predict suicide. Our fantasy that we can do this, and our fear that we can't...distracts us from providing therapeutic care and closes our hearts to those in distress.”
4/6
Third, let’s have deep & precise thinking about how environment and mental illness relate to one another; an ecological approach that can take into account factors within and between individuals, and figure out how exactly this fits into the wider social/economic picture. 4/6
@DrMatthewSweet
Some years ago, Hugh Grant contributed to one of the “Books Beyond Words” series—visual stories for people with learning disabilities. I saw him at the launch, and he was supportive, self-effacing, and completely delightful.
Main impression of
#mentalhealth
research in
#Germany
: there is recognition of the need not just for scientific advances, but to do things differently…
- More collaboration
- Larger projects
- Improved data collection
- Better lived experience engagement & involvement
‘A warning against the use of
#mentalhealth
services to change aspects of human behaviour that are disapproved of on social, political, moral, or religious grounds.’
Sad news about Michael King made me think of this bold & compassionate work from 2004.
I’ve just read one of the best summaries of psychoanalytic psychotherapy in, oddly enough, a neo-noir crime novel. (Jonathan Ames, ‘A Man Named Doll’).
#mentalhealth
First, let’s get clarity. What do we mean by “mental health”/“mental illness”? Are we always talking about the same things when we discuss these subjects? We don’t all need to agree on one diagnostic system—but let’s at least figure out exactly where we disagree. 2/6
We'd like to try something new.
Can you help
@wellcometrust
to run a programme getting bright ideas from *outside* the field that might help move
#mentalhealth
research forward?
If so, please look at our new Request for Proposals.
Deadline Dec 2.
@iaymh
For those attending the morning plenary at
#IAYMH2022
, here are some of the papers/websites to which I just referred.
Adolescent Depression: National Trends, Risk Factors, and Healthcare Disparities: Adolescent Depression:
It's time to approach the
#mentalhealth
literature in a new way—one that helps us to shape and design projects that will make a real difference. Wellcome is delighted to support
@GALENOS_Global
.
Read all about it:
Welcome to a new world of literature-based
#mentalhealth
research & publishing.
The first
@GALENOS_Global
review is up!
Are TAAR1 agonists viable as antipsychotic drugs?
All evidence gathered & analysed here,
#openaccess
, w/plain language summary.
Today’s new word: “erschöpfungsdepression” (exhaustion-depression). Coined many decades ago by Swiss psychiatrist Paul Kielholz; now—says Marie Åsberg—a concept that is again gaining popularity.
#ECNP2022
Would you like to shape the future of
#mentalhealth
?
@GALENOS_Global
, a Wellcome-funded project, is producing an open, comprehensive, constantly updating catalogue of the best scientific literature & setting the research questions that matter. 1/2
Young people deserve better than for their problems to be used as a screen on which adults project their concerns about adolescent lifestyles and/or the world in general. A sense of urgency is good; but so is suspending preconceptions and actually listening to young people. 2/2
Particularly interested in this
#ECNP2023
talk. Migraine is an example of a non-psych specialty condition with no biomarkers, diagnosis relying on subjective report, and unclear mechanism. How were new therapeutics developed, and what can
#mentalhealth
learn from this?
'21st-century mental health science has incredible potential to transform lives for the better. Our job is to build and nurture the systems and resources that will allow it to fulfil this potential.'
Field building in
#mentalhealth
at
@wellcometrust
.
A new contract opportunity from the
@wellcometrust
Mental Health team!
It’s one for the medical historians and science writers.
Yes, we’re going back to the future…
#twitterstorians
#mentalhealth
🧵1/4
Robin Murray: “Once we treat psychosis with D2 blockers, our job is only beginning. We need to treat the multiple causes of the psychosis.”
#mentalhealth
#WCP23
Fourth, let’s not rush to judgement on every innovation in
#mentalhealth
based on personal likes/dislikes; but neither should we let novel therapies hang around in the “promising” category for too long. Rigorous & transparent testing ASAP, please. 5/6
Should we be testing for autoimmune encephalitis in psychotic disorders?
Tom Pollak says “yes”:
⁃Early stage AE can look just like idiopathic psychosis
⁃Early detection and treatment saves brain
⁃Should test for it in all acute psychoses with red flag signs
#ECNP2023
Long time since I was a junior dr (we used the 4 humours in those days, &c). But I hope this is relevant to new FY1s:
The most anyone can ask at this stage is that you’re a safe dr. Stay organised, know when patients are getting in danger, & look after each other. And that’s it.
Brenda Penninx: distinguishing between “typical” and “immuno-metabolic” depression.
“Immune function dysregulation will not be present in all patients. We need to take this into account in order to stratify.”
#ECNP2023
The RADAR trial of antipsychotic reduction/discontinuation has been a big talking point for the past week.
All I have to say on the subject is that I respect anyone who tests their opinions against the evidence.
2/6
@Dr2NisreenAlwan
“If you’re someone’s boss, they should never have to worry about what sort of mood you’re in.” A very valuable piece of advice from my mother.
Formulating a good research question in
#mentalhealth
means drawing on many different sources of knowledge.
How can people's subjective experiences inform new understanding?
Can you help us find out?
Full details of our new
@wellcometrust
contract call:
.
@TheLancet
: ‘We have not developed effective means to select, organise, and present new research in a way that optimises understanding and application.’
We’re onto this at Wellcome. More news soon on the
#mentalhealth
evidence synthesis and research prioritisation programme.
We are looking for a Research Manager and a Senior Research Manager for our
#mentalhealth
Field Building team at
@wellcometrust
. Why not join the crew?
It’s Thursday, so it’s
#weeklypapers
day:
#mentalhealth
publications that have caught my eye this week. Bio/psycho/social/whatever. I dig everything.
This week’s pick… 1/6
It’s Thursday, so time for another weekly papers round-up. For newcomers, this is just a selection of
#mentalhealth
publications that have caught my eye this week. 1/5
Robin Murray points out the many, many pathways to psychosis. If you just take a group of people with “psychosis” and do 500 scans, “you’re muddling up all these aetiological groups”.
#WCP23
#mentalhealth
New blog: Deep thought and simple questions.
What is the single most important research question to move
#mentalhealth
science forward?
Please tell me what you think.
A selection of
#mentalhealth
publications I’ve been reading this week. No endorsement implied—just things that have caught my eye. If people find this thread useful, I might do it again. 1/6
I have been in Berlin for just over 24h, and learned more than an album trilogy’s-worth about big things happening in
#mentalhealth
research here. Munich tomorrow!
#Germany
#Deutchland
Kings College London on the side of The Strand building is an homage to my brilliant dad. Photo sent to all of my siblings by my sister who lives and works in the city. In memoriam xx
@KingsCollegeLon
Over the past week, I’ve been asking researchers “If you were to travel 10 years into the future, how would you know that current
#mentalhealth
research efforts have succeeded?” A few of the answers:
(1/2)
Allan Young: “Bipolar disorder is the only disorder in medicine in which individuals can present with symptoms that are diametrically opposite… Everything about it is complicated.”
#mentalhealth
#WCP23
Allowing for healthy scepticism re: some of the social psychology cited, I’d recommend this fine book by
@mrianleslie
to everyone in the
#mentalhealth
world. We need ‘the integration: the alchemic reaction that occurs when opposing views collide and transform into something new.’
As Keith Hawton retires, a look back on the considerable progress in suicide prevention in the past decade.
Keith is far too modest to trumpet his part in this. But he has saved more lives than most other doctors you’ll meet.
Feeling overwhelmed by the sheer number of
#mentalhealth
publications?
Not to worry. Here are the
#weeklypapers
: my small, personal selection of the most interesting research, comment, and more.
My take on lessons for
#mentalhealth
science from migraine: listen to lived experience. Phenomenology can provide important mechanistic clues. Question assumptions re: cause & effect. Learn from failures. When targets are identified, rapid progress is possible.
#ECNP2023
I’ve been to a lot of conferences, and judging by attendance and mood in the room, this certainly counts as a buzz.
All the more reason to seek out and rigorously analyse the evidence!
#ECNP2023
#mentalhealth
Prevalence of psychotic disorders in the general population: 0.4%.
In people experiencing homelessness: 14%.
Something is badly wrong with health and social care.
Young person on the train extolling the virtues of wired headphones: “They take up no space! They never need recharging! Best purchase ever!”
As I always say: don’t try to be cool, just stick with it long enough and cool eventually comes back round to you.
Janet Cunningham discussing experiences in implementing immunopsychiatry in real life. “It was a lot harder than we thought. Healthcare is not built for this sort of interaction between disciplines”.
#ECNP2023
#mentalhealth
I asked: ‘What is the single most important research question to move
#mentalhealth
science forward?’
Thanks for all your responses!
In some ways, the most intriguing questions were the ones that *weren’t* raised...
At this year’s Kraepelin Symposium in Munich. The theme is “Precision Psychiatry”—or to put it another way, can
#mentalhealth
research and practice finally go beyond Kraepelin?
Eyes on the prize.
Can you help
@wellcometrust
scope and design a new major prize in
#mentalhealth
science?
💷£50k budget incl VAT
⏳EOI/Q&A deadline: 13 May
⏰Final deadline: 5 June
What do
#psychedelics
actually do? Friederike Holze gives
#ECNP2023
the facts.
“The results indicate that any differences in the pharmacological profiles of mescaline, LSD, & psilocybin do not translate into relevant diffs in the subjective experience.”
Robin Murray on cannabis and psychosis risk: “The most important thing not the legal status. The most important thing is education.” And public education on this subject is generally poor.
#WCP23
#mentalhealth
“When someone asks me what works for me, I answer: accepting my illness, being patient with myself, taking the right medication, and having things to help me distract myself… All this takes time.” A wise and insightful personal account of psychosis. 5/6
@StuartJRitchie
Interesting. I recently did something like this (re-evaluated some of the evidence that people in pre-industrial England experienced segmented "first" and "second" sleeps).
@wendyburn
Reminds me of a time a colleague wrote ‘Your last email ended rather abruptly”, and I replied “Sorry, my cat sent it before I was finished.”
I made my TV acting debut in a ‘Fist of Fun’ sketch in the 1990s. A major role playing ‘Student in a big crowd of students’ in the University of Life sketch. Was paid £5 cash, Hollywood did not come calling.
@Herring1967
If you like my
#weeklypapers
thread, why not subscribe to the weekly newsletter?
You'll receive *free* notes on my selection of top
#mentalhealth
research, comment, and more.
A tremendous discovery (the benefits of browsing in a bricks-&-mortar bookshop). It's a thriller, a political polemic, a philosophical treatise, and an act of historical witness.
Best line: 'You can't talk French to a cow, and you can't talk sense to a Nazi.'
When I was a
#mentalhealth
journal editor, I found there were all kinds of problems with literature reviews:
- They didn't keep up w/the science
- They didn't triangulate animal+human data
- They weren't
#openaccess
- They weren't transparent—leading to problems with trust
John Cryan: What next for the microbiome and
#mentalhealth
? We are stuck at correlations. Need to parse causality and mechanisms. Large-scale longitudinal and translational studies are necessary.
#ECNP2023
Picture yourself in a boat on a river, with tangerine trees and marmalade skies. Alternatively, picture yourself in Hall F2 at the Austria Center, Vienna, where the session on psychedelics is about to begin.
#WCP23