Overview

Background

Chris trained at the Westminster Hospital Medical School in London, qualifying in 1986. Following qualification he spent a number of years doing clinical medicine in London, Humberside and Manchester, during which he obtained his MRCP qualification. He then switched to psychiatry and completed his basic psychiatric training in Manchester.

With his ongoing interest in clinical medicine, he moved naturally to the interface between medicine and psychiatry. He completed his PhD on the psychiatric problems in people with chronic low back pain whilst simultaneously completing his higher clinical training as a liaison psychiatrist. Since that time he has worked mostly researching the causes, effects and treatments of emotional problems in people with chronic physical illness, across a variety of setting in primary and secondary care.

He moved to the University of Exeter College of Medicine and Health in July 2011 to take up the Chair of Psychological Medicine, where he has continued to focus on the development and evaluation of interventions to improve the management of common mental disorders in people with chronic physical illnesses.

Broad research specialisms include

Assessment of depression and anxiety among people with long term physical health problems in primary and secondary care

Identifying risk factors for depression and anxiety in people with comorbid medical illnesses and multimorbidity, including understanding the role of perseverative negative cognitive processes and negative cognitive biases in contributing to depression and anxiety.

Understanding the impact of such depression and anxiety on physical and psychological outcomes, among people with medical illnesses.

Designing and evaluating complex interventions for depression and anxiety through clinical trials in primary and secondary care

Systematic reviewing and meta analysis.

Qualifications

MB BS, University of London, 1986

MRCP, Royal College of Physicians, UK, 1990

MRCPsych, Royal College of Psychiatrists, 1993

MSc, University of Manchester, 1996

PhD, University of Manchester, 1999

Links

• APEx
• Dementia research within the University
• Mental Health & Dementia Theme Lead

Research group links

• Institute of Health Research

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Research

Research interests

Depression and anxiety are common among people with long term conditions, such as coronary heart disease and diabetes. These problems not only adds to people unhappiness but are associated with adverse health outcomes, such as increased mortality, increased morbidity, worse quality of life, and increased healthcare utilisation. Consequently, getting appropriate and effective treatments for depression and anxiety to people with long term conditions has been prioritized in the NHS and healthcare systems overseas. Adequate treatment of depression and anxiety has proved challenging however due to low rates of detection, reluctance to give / accept appropriate treatments and limited efficacy of available treatments.

The aim of Professor Dickens' research is to improve the mental health of people with long term physical health conditions. He is interested in evaluating existing treatments through trials and systematic reviews, developing and evaluating novel interventions and exploring the barriers to implementing successful treatment strategies.

Research projects

• SCENE -  a research programme that aims to develop and evaluate a new intervention to help patients with psychosis to overcome social isolation and improve their quality of life.  SCENE will last from June 2017 to November 2022 and is funded by the National Institute for Health Research   http://scene.elft.nhs.uk/
• HOME Study - How can we best address prolonged acute hospital stays in older inpatients with medical-psychiatric multimorbidity?: A pragmatic multicentre,randomised controlled trial to compare the effectiveness and cost-effectiveness of Proactive Liaison Psychiatry with usual care 
• CCUK Award - Prospective cohort study to identify causes of depression and how depression leads to relapse in people with Ulcerative Colitis 
• CADENCE trial
  Depression is common in people with coronary heart disease and is linked to adverse health outcomes such as increased mortality, increased morbidity, worse health related quality of life and increased healthcare utilisation. The aims of this project are to develop, test feasibility and acceptability, and to conduct a pilot trial of enhanced psychological care for people undergoing cardiac rehabilitation
• Reducing urgent hospital admissions for residents of care homes
  The number of urgent ambulance calls and urgent hospital admissions is increasing annually. The aim of this project is to understand processes that drive use of urgent ambulance services by care homes and their residents, with a view to developing an intervention to reduce the number of urgent ambulance calls to care homes.
• Mapping Service for People with Dementia in the South West
  There are multiple sources of healthcare and support for people suffering from dementia and their carers, provided by the NHS, private organisations and the voluntary sector. For individuals with dementia and their families, these services are sometimes difficult to identify and to access. From the perspective of NHS commissioners and providers of services development and provision of services which integrate optimally with existing services is challenging, as it often is not clear what services are being provided and by whom. his project aims to map current services available for people with dementia and their families. We intend to develop a geographic map of services, including a description of each service (where it is based, who it is for, what services are provided, throughput of service users, and outcomes where these are available).
• COINCIDE trial
  As part of his work in the Greater Manchester CLAHRC, he is involved in a programme of work to develop and evaluate a collaborative care intervention for anxiety and depression for people with CHD and / or diabetes in primary care. Since moving to Exeter he has remained involved in the programme despite moving to Exeter. Currently they are conducting a large scale RCT in primary care to evaluate the cost-effectiveness of collaborative care for depression, as delivered by IAPT (Improving Access to Psychological Therapy) low intensity psychological therapists. Data collection for this trial will be completed by October 2013.
• CHOICE Programme
  This NIHR research programme led by Professor Else Guthrie in Manchester aims to investigate psychosocial contributor to the use of urgent and unscheduled care among people with long term physical health conditions and to develop and evaluate feasibility of interventions to reduce use of such care. This programme has included systematic reviews to explore the association of depression with use of unscheduled care and to investigate the characteristics of interventions which reduce use of urgent and unscheduled care in people with long term physical health conditions. In addition, they have conducted qualitative work with health service users to gain understanding of the factors which lead to use of urgent and unscheduled care. Finally they will develop and evaluate feasibility of an intervention aimed to reduce the use of urgent and unscheduled care. This programme is due for completion in Jan 2014.
• MIR Trial
  This HTA funded trial, led by David Kessler in Bristol, aims to evaluate the benefits of adding mirtazapine to among people who have failed to respond to first line antidepressants. This trial will run across centres in Bristol, Exeter, York and Keele.
• STEPWISE trial
  This recently funded HTA trial, led by Richard Holt in Southampton, aims to adapt the DESMOND lifestyle intervention for people with diabetes, to make it suitable for people with schizophrenia. The programme of work will commence in October 2013 with time spent adapting the interventions and developing the training programme. Recruitement to the trial will commence in 2014 and will run over 10 sites across the UK, including Devon, Cornwall and Somerset.
• Developing Mindfulness Based Cognitive therapy (MBCT) for people with vascular disorders.
  This NIHR PenCLAHRC funded project aims to develop and evaluate feasibility of MBCT to better meet the needs of people with vascular disorders, including coronary heart disease. This project, with Professor Willem Kuyken at Exeter's Mood Disorders Centre, relies on existing expertise within the MDC, expertise in the management of anxiety and depression among people with coronary heart disease and input from people with lived experience of vascular disorders to manualise and evaluate MBCT.
• Adapting low intensity psychological interventions for people with long term physical health conditions.
  With Dr Paul Farrand of Exeter's Mood Disorders Centre and Sarah Harris (PhD student) he is exploring the possibility of adapting low intensity psychological interventions to make them better meet the needs of people with long term physical health conditions.
• Investigating the role of perseverative negative cognitive process in predicting depression in people with long term physical health conditions.
  Working with Professor Ed Watkins and Leanne trick (PenCLAHRC funded PhD student) he is investigating the extent to which worry and rumination predict depression in people with long term physical health conditions.

Grants/Funding

• 2018 – 2020, £45,636 Pharmacosmos – “Iron deficiency and quality of life in IBD: Prospective cohort study of iron (III) isomaltoside 1000 (Monofer) on quality of life and work productivity in patients with inflammatory bowel disease
• 2017- 2020 £119,721 CCUK Prospective cohort study to identify causes of depression and how depression leads to relapse in people with Ulcerative Colitis (Chief Investigator)
• 2017 – 2020 £1,992,654.32 NIHR HS&DR How can we best address prolonged acute hospital stays in older inpatients with medical-psychiatric multimorbidity?: A pragmatic multicentre,randomised controlled trial to compare the effectiveness and cost-effectiveness of Proactive Liaison Psychiatry with usual care (co-applicant).
• 2016-2017 - £284,067 NIHR HTA 14/157/06 , Improving the mental health of children with long-term conditions (co-applicant)
• 2014 - 2016 - £484,288  NIHR HTA - A feasibility study and pilot RCT to establish methods for assessing the acceptability, and clinical and cost-effectiveness of enhanced psychological care (EPC) in cardiac rehabilitation services for patients with new onset depressive symptoms compared with treatment as usual. CADENCE study.  (Co-Investigator)
• 2013-2017 £1.8 millions, HTA. STEPWISE: Structured lifestyle Education for People With Schizophrenia (lead applicant Richard Holt).
• 2013-2018 £250,000 Mary Kinross Trust. Vascular Aspects of Cognitive Impairment and Dementia (lead applicant David Llewellyn)
• 2013-2016 £1.9 millions, HTA. Mirtazapine added to SSRIs for Treatment - Resistant Depression in Primary Care: a placebo controlled randomised controlled trial (co-applicant; lead applicant - Kessler)
• 2012–2013 £14,412 - NIHR PenCLAHRC Determining the Feasibility and Acceptability of Mindfulness-Based Interventions in Depressed People with Chronic Physical Health Problems: A Pilot Study
• 2008-2013 £2.8 millions Practitioner theme of the Greater Manchester Collaboration for Leadership in Applied Health Research and Care (NIHR) (Programme Director). The programme forms part of the Greater Manchester CLAHRC funded for £20 millions.
• 2009-2014, £1, 995,000 NIHR Programme Grant (lead applicant - Guthrie) "Developing effective strategies to reduce unscheduled care in chronic disease" (co-applicant). In this programme they aim to develop strategies to reduce use of urgent and unscheduled care by people with chronic physical illness. He leads the systematic reviews that investigate which psychosocial factors predict unscheduled care and what are the characteristics of psychosocial interventions that reduce unscheduled care.
• 2011-2012 £28, 860 NIHR CLAHRC Flexibility and Sustainability Funding (co-applicant) Developing a mindfulness type intervention for people with long term conditions.
• 2011-2012, £29,172 NIHR CLAHRC Flexibility and Sustainability Funding (Principal Investigator) Risk factors for non-response to conventional depression treatment among people with CHD and diabetes: a systematic review.
• 2010-2012, £25,000, Manchester academic Health Science Centre funded pilot project (co-applicant). "NorthWest 10,000 Mood Clues project" to investigate the feasibility of collecting a minimum data set of information (genetic, demographic, medical, psychological and social) relevant to the prevention and treatment of depression on 10,000 people in the North West of England.
• 2009-2010, £46,318 NIHR CLAHRC Flexibility and Sustainability Funding (Principal Investigator), "Psychological processes common to people with different long term conditions that are associated with moderate to severe depression" Funding for an RA to conduct a mixed methods study investigating the extent to which worry /rumination, thought intrusion and meta–cognitive belief are related to depression in people with coronary heart disease, diabetes, rheumatoid arthritis and COPD.
• 2009- 2010 BUPA Foundation £56,580 (Co-applicant). Acute Intervention for ST-Elevation Myocardial Infarction: Patient Experiences and Patient Related Outcomes Study. Funding to support Research Assistant and Research Nurse to complete data collection on a study to investigate the predictors of outcome in people with recent Acute Coronary Syndrome.

Links

• IAPT
• Dementia Mapping Project
• CADENCE
• MIR Trial
• HeLM Project
• STEPWISE Trial
• HOME Study

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Publications

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Teaching

Teaches on the MRCPsych courses in Plymouth and Torbay on Research Methods and Critical Appraisal

Delivers training to low intensity psychological wellbeing practitioners on working with people with long term conditions

Organises and delivers content on the annual Advanced Liaison Psychiatry Course

Involved in the training of various clinical and professional groups on the assessment and management of common mental disorders among people in the acute hospital.

Modules

2023/24

Information not currently available

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Supervision / Group

Research Fellows

Postgraduate researchers

Alumni

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