Here are a selection of our research projects. If you are
interested in becoming involved please contact the named person on
each project summary. To contact R&D please email research@mhsc.nhs.uk
NIHR Efficacy and Mechanism Evaluation programme - The benefit
on negative symptoms in schizophrenia: extent and mechanisms
Aims and Objectives
To use recently developed PsyGrid
infrastructure for UK-wide clinical and imaging research in first
episode psychosis to:
- determine whether negative symptoms can be lessened or
prevented by minocycline treatment initiated early in the course of
schizophrenia and
- collect biomarker data to test hypotheses about how minocycline
improves negative symptoms.
Primary Efficacy Pediction and Mechanistic
Hypotheses
- Minocycline minimises later negative symptoms when administered
during the acute phase of early psychosis
- Minocycline reduces or prevents the negative symptoms of
schizophrenia by:
- reducing the loss of grey matter associated with early
psychosis.
- interfering with inflammatory cytokine production.
- an action on glutamate systems to improve negative symptoms and
cognitive function.
Design
Multicentre, one year, double-blind randomised
placebo-controlled trial of minocycline versus placebo, added to
standard antipsychotic drug (APD) treatment, for patients in an
early episode of schizophrenia-related psychosis.
Intervention
Minocycline or matching placebo 300mg daily for 12 months.
Outcomes
The primary clinical outcome is negative sydrome subscale score on
the Positive and Negative Syndrome
Scale (PANSS). The mechanistic biomarker variables are:
- change in medial prefrontal grey matter volume over 12
months,
- circulating cytokine concentrations and
- working memory performance and brain activation.
These measures will be related to changes in PANSS negative
symptoms at 2, and 12 months and to quality of life
assessments.
Population and Sample Size
170 patients with early psychosis recruited over 22 months from 6
established PsyGrid centres.
Sites and Researchers
This multicentre UK-wide study will be carried out by a group of
experienced researchers in early psychosis that have worked
together over several years to set up and test a secure UK research
network for people in their first episode of psychosis. It is
called PsyGrid (www.psygrid.org) and was funded
by the Medical Research Council and the Department of Health.
Contact email for further information bill.deakin@manchester.ac.uk
NIHR Programme Grant - Developing effective strategies for
reducing unscheduled care (CHOICE programme)
Background
Reduction in use of unscheduled care in the NHS is a government
priority. Costs can account for over half of the total costs of
care, regardless of the severity of patients' symptoms.
Aims and objectives
The CHOICE research
programme will develop effective strategies to reduce the need for
frequent unscheduled care in patients in four example long term
conditions (diabetes, Asthma, COPD and CHD). Our objectives
are:
- To synthesise current evidence about factors which influence
unscheduled care, and interventions to reduce the frequency.
- To estimate the frequency and pattern of unscheduled care in
patients with the example conditions.
- To develop a 'red flag' system to identify patients with long
term conditions at risk of becoming frequent users of unscheduled
care, and validate it in two NHS Trusts.
- To identify personal reasons for using unscheduled care
including barriers to access for routine care.
- To develop and evaluate an intervention which will
reduce/prevent unscheduled care, whilst maintaining or improving
patient benefit.
- To use modelling to evaluate patient choices concerning
treatment, and estimate the costs and benefits associated.
Project phases
Phase 1 - we will collect information from other research and find
out what is currently known. We will share this information with
our stakeholders and find out what they think.
Phase 2 - we will collect information from approximately 2,000
people, 500 from each group with the example conditions. We will
find out how many use unscheduled care over the next 12 months and
then find out why. This will help us to identify people who need
the most help coping with difficult conditions.
We will interview patients and their families to help us to
understand why they chose to use emergency or out of hours
services. The end result will be a 'red flag' system to
identify those people who may need the most help.
Phase 3 - we will test the new treatment developed from phases 1
and 2. This will help people develop better coping skills and
quality of life. We aim to see whether this helps people to
manage their illness and use unscheduled services less.
For more information visit the CHOICE website: http://choice.mhsc.nhs.uk
Contact email for further information Cara.Afzal@mhsc.nhs.uk
Prevention Of Suicide in Prisons (PROSPeR) Study
The aim of this study is to demonstrate the feasibility of
delivering an existing Cognitive Behavioural Suicide Prevention
(CBSP) intervention in a prison environment. It will also
investigate how best to adapt the delivery for prisoners. To
address these aims, there will be a randomised controlled trial
(RCT) with a group of prisoners at risk of suicidal behaviour
receiving CBSP plus usual treatment. Another group of prisoners,
also at risk, will receive their usual treatment alone. The trial
will inform and subsequently assess the delivery of CBSP to
prisoners. Prisoner interviews and a staff focus group will examine
views on how CBSP should be modified for the prison environment and
there will also be a 6-month follow-up study of the longer-term
impact of the intervention.
Contact email for further information daniel.pratt@manchester.ac.uk
NIHR Programme Development Grant - Enhancing the quality and
purpose of care planning in mental health services.
The investigators intend to evaluate and implement best evidence
on user and carer involvement in care planning through the
development of a training package and assess the feasibility of
implementation. The programme development grant work plan has three
stages. Firstly, to engage with and develop strong service user
collaboration and increase their capacity to engage fully in the
programme grant in two mental health trusts. We will provide a
training course for users and carers in research methods. Secondly,
to undertake a scoping review of the literature to explore the
current evidence on effective care planning and to identify
suitable outcome measures for use in the programme grant. The third
stage will enable the project team to form a consensual strong
working group in order to deliver on a future programme of
work.
Contact email for further information John.A.Baker@manchester.ac.uk
NIHR Programme Grant - Psychological approaches to
understanding and promoting recovery from psychosis
The Recovery Programme is a five-year programme of research into
understanding and promoting recovery from psychosis, in a manner
that is acceptable to and empowering of service users. This
programme is hosted by Greater
Manchester West NHS Trust and Manchester Mental Health and
Social Care Trust is a collaborating site. The programme is funded
by the National Institute of Health Research (NIHR) with ongoing
support from the Mental Health Research Network (MHRN). Academics
involved in the Programme are based at the Universities of
Manchester, Lancaster and Bangor.
The Recovery Programme aims to produce:
- User-defined measures of psychotic experiences.
- Several service user informed therapy manuals suitable for
dissemination to multidisciplinary teams.
- New evidence-based therapies that are acceptable to service
users.
- Guides for promoting recovery and models of collaborative
provision of services to people with psychosis.
- Information regarding service user preferences.
The programme consists of 5 streams of research, with
each project being led by professors of Clinical Psychology,
with the involvement of Service User Researchers. The projects
are:
- A study to develop a service user defined measure of psychotic
symptoms
- An investigation of the role of psychological processes in
determining judgements of recovery in patients with psychosis
- A pilot study of a recovery-focused self help package of
treatment for people with psychosis
- Prevention of suicide risk in psychotic patients through the
development of a focused and conceptually driven intervention
- Understanding and evaluating recovery in individuals with
experience of bipolar disorder
Contact email for further information Heather.law@gmw.nhs.uk
(Recovery Programme Co-ordinator)
NIHR Doctoral Fellowship - Therapeutic Interventions for Carers
in Crisis Study (TICCS)
Title: The development of a family focused
intervention with families and carers of individuals who are
admitted to Crisis Resolution Home Treatment teams as a result of
an acute psychotic illness.
Summary: Crisis Resolution Home Treatment
(CRHT) teams offer interventions to over 75,000 individuals across
the UK each year. As a result, patients are supported in their own
homes by family and/or friends as their main carers, many of whom
have little experience of mental health distress. Although
collaboration with service users and carers is a key priority in
mental health services, the evidence base for meaningful and
evidence based interventions for carers who are in contact with
CRHT teams does not exist. The focus of this study is to develop a
family focused intervention which is based upon a review existing
studies of family interventions in mental health settings. This is
supplemented by the opinions and views of families, carers and
patients who have experienced CRHT care. These findings will
contribute to the development of a family focused intervention to
be implemented by CRHT clinicians. The anticipated outcome of this
study will be the development of a feasible and acceptable
intervention and training schedule. If viable and acceptable this
intervention could be used within a multi-sited randomised
controlled trial to determine its effectiveness in mainstream CRHT
teams.
Research Question - Can family focused intervention for families
and carers supporting individuals admitted to crisis resolution
home treatment teams reduce the stress levels in families, prevent
in-patient admission and maintain social and occupational
functioning of individuals in an acute psychosis?
Contact email for further information L.A.Rigby@postgrad.manchester.ac.uk
NIHR programme grant - National Trends and Local Delivery in
Old Age Mental Health Services: Towards an evidence-base
This programme of research based, at the Personal Social
Services Research Unit in Manchester, is run in partnership
with Manchester Mental Health and Social Care Trust.
NIHR programme grant - Reducing relapse and suicide in bipolar
disorder: Practical clinical approaches to identifying risk,
reducing harm and engaging service users in planning and delivery
of care (PARADES programme)
For further information visit PARADES
NIHR Programme Grant - A multi-centre programme of clinical and
public health research in support of the National Suicide
Prevention Strategy for England.
For further information contact the lead
NIHR Programme grant - Early phase treatment for the prevention
of relapse in first episode schizophrenia.
For further information contact the lead
NIHR RfPB grant - Recognition of and consultation for memory
problems among South Asian elders: a literature review and face to
face interviews to study explanatory models
For further information contact the lead