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  • Universal Alternative Splicing of Noncoding Exons.

    14 June 2018

    The human transcriptome is so large, diverse, and dynamic that, even after a decade of investigation by RNA sequencing (RNA-seq), we have yet to resolve its true dimensions. RNA-seq suffers from an expression-dependent bias that impedes characterization of low-abundance transcripts. We performed targeted single-molecule and short-read RNA-seq to survey the transcriptional landscape of a single human chromosome (Hsa21) at unprecedented resolution. Our analysis reaches the lower limits of the transcriptome, identifying a fundamental distinction between protein-coding and noncoding gene content: almost every noncoding exon undergoes alternative splicing, producing a seemingly limitless variety of isoforms. Analysis of syntenic regions of the mouse genome shows that few noncoding exons are shared between human and mouse, yet human splicing profiles are recapitulated on Hsa21 in mouse cells, indicative of regulation by a deeply conserved splicing code. We propose that noncoding exons are functionally modular, with alternative splicing generating an enormous repertoire of potential regulatory RNAs and a rich transcriptional reservoir for gene evolution.

  • Antidepressants versus placebo for panic disorder in adults.

    14 June 2018

    BACKGROUND: Panic disorder is characterised by repeated, unexpected panic attacks, which represent a discrete period of fear or anxiety that has a rapid onset, reaches a peak within 10 minutes, and in which at least four of 13 characteristic symptoms are experienced, including racing heart, chest pain, sweating, shaking, dizziness, flushing, stomach churning, faintness and breathlessness. It is common in the general population with a lifetime prevalence of 1% to 4%. The treatment of panic disorder includes psychological and pharmacological interventions. Amongst pharmacological agents, the National Institute for Health and Care Excellence (NICE) and the British Association for Psychopharmacology consider antidepressants, mainly selective serotonin reuptake inhibitors (SSRIs), as the first-line treatment for panic disorder, due to their more favourable adverse effect profile over monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). Several classes of antidepressants have been studied and compared, but it is still unclear which antidepressants have a more or less favourable profile in terms of effectiveness and acceptability in the treatment of this condition. OBJECTIVES: To assess the effects of antidepressants for panic disorder in adults, specifically:1. to determine the efficacy of antidepressants in alleviating symptoms of panic disorder, with or without agoraphobia, in comparison to placebo;2. to review the acceptability of antidepressants in panic disorder, with or without agoraphobia, in comparison with placebo; and3. to investigate the adverse effects of antidepressants in panic disorder, with or without agoraphobia, including the general prevalence of adverse effects, compared to placebo. SEARCH METHODS: We searched the Cochrane Common Mental Disorders' (CCMD) Specialised Register, and CENTRAL, MEDLINE, EMBASE and PsycINFO up to May 2017. We handsearched reference lists of relevant papers and previous systematic reviews. SELECTION CRITERIA: All double-blind, randomised, controlled trials (RCTs) allocating adults with panic disorder to antidepressants or placebo. DATA COLLECTION AND ANALYSIS: Two review authors independently checked eligibility and extracted data using a standard form. We entered data into Review Manager 5 using a double-check procedure. Information extracted included study characteristics, participant characteristics, intervention details and settings. Primary outcomes included failure to respond, measured by a range of response scales, and treatment acceptability, measured by total number of dropouts for any reason. Secondary outcomes included failure to remit, panic symptom scales, frequency of panic attacks, agoraphobia, general anxiety, depression, social functioning, quality of life and patient satisfaction, measured by various scales as defined in individual studies. We used GRADE to assess the quality of the evidence for each outcome MAIN RESULTS: Forty-one unique RCTs including 9377 participants overall, of whom we included 8252 in the 49 placebo-controlled arms of interest (antidepressant as monotherapy and placebo alone) in this review. The majority of studies were of moderate to low quality due to inconsistency, imprecision and unclear risk of selection and performance bias.We found low-quality evidence that revealed a benefit for antidepressants as a group in comparison with placebo in terms of efficacy measured as failure to respond (risk ratio (RR) 0.72, 95% confidence interval (CI) 0.66 to 0.79; participants = 6500; studies = 30). The magnitude of effect corresponds to a number needed to treat for an additional beneficial outcome (NNTB) of 7 (95% CI 6 to 9): that means seven people would need to be treated with antidepressants in order for one to benefit. We observed the same finding when classes of antidepressants were compared with placebo.Moderate-quality evidence suggested a benefit for antidepressants compared to placebo when looking at number of dropouts due to any cause (RR 0.88, 95% CI 0.81 to 0.97; participants = 7850; studies = 30). The magnitude of effect corresponds to a NNTB of 27 (95% CI 17 to 105); treating 27 people will result in one person fewer dropping out. Considering antidepressant classes, TCAs showed a benefit over placebo, while for SSRIs and serotonin-norepinephrine reuptake inhibitor (SNRIs) we observed no difference.When looking at dropouts due to adverse effects, which can be considered as a measure of tolerability, we found moderate-quality evidence showing that antidepressants as a whole are less well tolerated than placebo. In particular, TCAs and SSRIs produced more dropouts due to adverse effects in comparison with placebo, while the confidence interval for SNRI, noradrenergic reuptake inhibitors (NRI) and other antidepressants were wide and included the possibility of no difference. AUTHORS' CONCLUSIONS: The identified studies comprehensively address the objectives of the present review.Based on these results, antidepressants may be more effective than placebo in treating panic disorder. Efficacy can be quantified as a NNTB of 7, implying that seven people need to be treated with antidepressants in order for one to benefit. Antidepressants may also have benefit in comparison with placebo in terms of number of dropouts, but a less favourable profile in terms of dropout due to adverse effects. However, the tolerability profile varied between different classes of antidepressants.The choice of whether antidepressants should be prescribed in clinical practice cannot be made on the basis of this review.Limitations in results include funding of some studies by pharmaceutical companies, and only assessing short-term outcomes.Data from the present review will be included in a network meta-analysis of psychopharmacological treatment in panic disorder, which will hopefully provide further useful information on this issue.

  • Gradually Getting Better: Trajectories of Change in Rumination and Anxious Worry in Mindfulness-Based Cognitive Therapy for Prevention of Relapse to Recurrent Depression

    18 May 2018

    © 2014, Springer Science+Business Media New York. Increased tendencies towards ruminative responses to negative mood and anxious worry are important vulnerability factors for relapse to depression. In this study, we investigated the trajectories of change in rumination and anxious worry over the course of an eight-week programme of mindfulness-based cognitive therapy (MBCT) for relapse prevention in patients with a history of recurrent depression. One hundred and four participants from the MBCT-arm of a randomized-controlled trial provided weekly ratings. Mixed linear models indicated that changes in rumination and worry over the course of the programme followed a general linear trend, with considerable variation around this trend as indicated by significant increases in model fit following inclusion of random slopes. Exploration of individual trajectories showed that, despite considerable fluctuation, there is little evidence to suggest that sudden gains are a common occurrence. The findings are in line with the general notion that, in MBCT, reductions in vulnerability are driven mainly through regular and consistent practice, and that sudden cognitive insights alone are unlikely to lead into lasting effects.

  • Risk perception in individuals with irritable bowel syndrome: Perceived susceptibility to health and non-health threats

    17 May 2018

    This study examined the degree to which individuals with Irritable Bowel Syndrome (IBS) show evidence of increased perceived susceptibility to unrelated health problems (Deep Vein Thrombosis, arthritis, bowel cancer) and non-health physical risks (mugging, traffic accident), both when making estimates for themselves and for an average other person of their own age. Participants with IBS differed from both healthy participants and participants with asthma or eczema, making higher estimates of their own lifetime health risks, with differences between healthy individuals and individuals with IBS remaining after controlling for physical symptoms, illness attitudes, anxiety and depression. No differences were observed between the groups in own lifetime estimates of experiencing non-health physical risks, nor were there differences between groups in estimates of risks for an average person of the participant's own age. A perception of increased susceptibility to illness appears to be present in individuals with IBS, leading to biases in the estimation of health risks. This perception is likely to contribute to IBS-related illness behavior, and may increase vulnerability to the development of other functional disorders.

  • Authorship bias in violence risk assessment? A systematic review and meta-analysis.

    13 June 2018

    Various financial and non-financial conflicts of interests have been shown to influence the reporting of research findings, particularly in clinical medicine. In this study, we examine whether this extends to prognostic instruments designed to assess violence risk. Such instruments have increasingly become a routine part of clinical practice in mental health and criminal justice settings. The present meta-analysis investigated whether an authorship effect exists in the violence risk assessment literature by comparing predictive accuracy outcomes in studies where the individuals who designed these instruments were study authors with independent investigations. A systematic search from 1966 to 2011 was conducted using PsycINFO, EMBASE, MEDLINE, and US National Criminal Justice Reference Service Abstracts to identify predictive validity studies for the nine most commonly used risk assessment tools. Tabular data from 83 studies comprising 104 samples was collected, information on two-thirds of which was received directly from study authors for the review. Random effects subgroup analysis and metaregression were used to explore evidence of an authorship effect. We found a substantial and statistically significant authorship effect. Overall, studies authored by tool designers reported predictive validity findings around two times higher those of investigations reported by independent authors (DOR=6.22 [95% CI=4.68-8.26] in designers' studies vs. DOR=3.08 [95% CI=2.45-3.88] in independent studies). As there was evidence of an authorship effect, we also examined disclosure rates. None of the 25 studies where tool designers or translators were also study authors published a conflict of interest statement to that effect, despite a number of journals requiring that potential conflicts be disclosed. The field of risk assessment would benefit from routine disclosure and registration of research studies. The extent to which similar conflict of interests exists in those developing risk assessment guidelines and providing expert testimony needs clarification.

  • The hospital costs of self-harm

    8 September 2017

    Study reveals the health service costs for hospital care of people who self-harm, emphasising the need for effective clinical services and prevention initiatives.

  • Adam Al-Diwani wins the Margaret Temple Award

    8 November 2017

    Wellcome DPhil Training Fellowship researcher is awarded BMA grant given to assist research into schizophrenia.

  • Trust Me I'm a Doctor: Mental Health Special

    1 November 2017

    On 1 November, BBC Two's flagship medical show focuses on two areas of research at the Department of Psychiatry. Find out more about the research here.

  • Oxford Dementia Research Day

    30 May 2017

    NIHR Oxford Health Biomedical Research Centre and ARUK Oxford Local Network are jointly hosting the annual Oxford Dementia Research Day.

  • A tribute: Elisa Favaron

    5 February 2018

    Valeria Frighi honours friend and colleague, Elisa Favaron, who tragically passed away on 19th January 2018 from breast cancer.

  • Major award to develop VR treatment in the NHS for mental health disorders

    5 February 2018

    The National Institute of Health Research (NIHR) awarded £4 million to enable state-of-the-art psychological therapy to be delivered via virtual reality (VR) in the NHS.

  • 5th Course on Network Meta-Analysis

    5 February 2018

    Andrea Cipriani leads this 3-day interactive course with lectures, group work, hands-on tutorials and supervised statistical sessions for clinicians, researchers and policy makers.

  • Even moderate drinking linked to a decline in brain health, finds study

    7 June 2017

    Moderate alcohol consumption is associated with increased risk of adverse brain outcomes and steeper decline in cognitive skills, finds a study led by Dr Anya Topiwala at the Department of Psychiatry, and published by The BMJ.

  • Department of Psychiatry researchers join the Curiosity Carnival

    26 September 2017

    Curiosity Carnival is part of European Researchers’ Night. This is the first time that the University has taken part, and activities will be taking place across the city on 29 September.

  • Time to vote!

    20 May 2014

    Contested Elections: 12 June 2014 One member of Congregation elected by Congregation from members of the faculties in the Divisions of Mathematical, Physical and Life Sciences and of Medical Sciences

  • OxCaMS

    5 September 2017

    Have you been experiencing mood swings? Have you recently engaged in risky behaviour, been so hyper that you got into trouble, had much more energy than usual and/or been so irritable that you started fights?

  • Can brief daily mental exercises change the way the human brain processes certain kinds of information?

    20 June 2017

    The aim of this study is to investigate the effects of certain brief mental exercises on the way in which the brain processes specific kinds of information. We are looking for healthy participants (both male and female), aged 18 to 65 years. In order to participate, you must be in good health, not be regularly engaged in any kind of formal mental exercises (e.g. yoga, meditation, mindfulness practices, positive psychology exercises, psychotherapy etc.) and you must not have a history of any mental disorder (such as depression, anxiety disorder, or eating disorder). You would be invited to the Department of Psychiatry (Warneford Hospital) for two study sessions. Both sessions would take approximately 60 to 90 minutes. Between the sessions you would be assigned a brief mental exercise (taking approximately 10 minutes per day) and you would be asked to carry out this exercise each evening for 7 days. After practising for 7 days, your performance on a range of computerized psychological tasks would be assessed. If you are interested and would like more information, please contact Dr Alexander Kaltenboeck (alexander.kaltenboeck@psych.ox.ac.uk) at the Department of Psychiatry. Ethics Approval Reference: R49254/RE003

  • Friends of Oxford Dementia and Ageing Research (OxDARE)

    27 March 2018

    Anyone who is interested in finding out more about dementia and ageing research in Oxford is invited to become a Friend of OxDARE. Friends can choose to register an interest in taking part in future studies and/or receive quarterly newsletters. When new studies get underway, OxDARE researchers will invite interested Friends to take part by email. If you are contacted by one of our researchers, it is your choice whether you would like to participate in their study or not.

  • Volunteers needed for a Virtual Reality Study!

    27 March 2018

    One 45 minute session

  • Lamotrigine and Brain Imaging Study: Healthy Volunteers Needed

    5 May 2017

    This project is about studying the effects of a single dose of oral lamotrigine, a commonly prescribed medication for epilepsy and bipolar depression, on brain activity using brain imaging technology. The study would involve 2 visits lasting approximately 1 and 5 hours, respectively. Ethics Approval Reference: R49749/RE001

  • Are spiders a problem for you?

    28 November 2017

    We are looking for healthy volunteers aged 18-60 years and fluent in English to take part in a study investigating how a single dose of the medication hydrocortisone affects attention for spiders, using simple computer tasks. Hydrocortisone is a stress hormone also naturally occurring in the body. However, we think that it may also enhance the effectiveness of psychological therapies such as Cognitive-Behaviour Therapy. The study involves four appointments of about 5 hours in total.

  • Neural mechanisms underlying decision making

    6 March 2018

    Who are we looking for? Healthy fluent English-speaking people aged 18-85 who are not pregnant. You will be asked questions about your medical history to check your suitability for an MRI scan. MRI is a method to measure brain activity that allows us to see how the brain is organised, processes information and performs skills like speech or memory. This scan is safe and does not involve any needles or injections.