ORCID Profile
0000-0001-8996-2000
Current Organisations
Royal College of Psychiatrists
,
UMDS, now Kings College London
,
University College London
,
King's College London, formerly UMDS
,
London School of Hygiene and Tropical Medicine
,
Queen Mary University of London
,
University of Oxford
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Publications
The Concise Guide to PHARMACOLOGY 2015/16: Overview
Publisher: Wiley
Date: 12-2015
DOI: 10.1111/BPH.13347
Functional analysis of missense variants in the TRESK (KCNK18) K+ channel
Publisher: Springer Science and Business Media LLC
Date: 27-01-2012
DOI: 10.1038/SREP00237
ICD-11 and bipolar II disorder: so much ado and yet nothing new
Publisher: Royal College of Psychiatrists
Date: 08-2023
DOI: 10.1192/BJP.2023.66
Abstract: The long-awaited 11th revision of the International Classification of Diseases (ICD-11) makes important advances but simultaneously compromises on some aspects, which may have a negative impact on clinical practice. This editorial illustrates the double-edged nature of some of the changes in ICD-11, focusing on mood disorders and specifically the subtyping of bipolar disorder.
Ethnic inequalities in clozapine use among people with treatment-resistant schizophrenia: a retrospective cohort study using data from electronic clinical records
Publisher: Springer Science and Business Media LLC
Date: 04-03-2022
DOI: 10.1007/S00127-022-02257-3
Abstract: Clozapine is the most effective intervention for treatment-resistant schizophrenia (TRS). Several studies report ethnic disparities in clozapine treatment. However, few studies restrict analyses to TRS cohorts alone or address confounding by benign ethnic neutropenia. This study investigates ethnic equity in access to clozapine treatment for people with treatment-resistant schizophrenia spectrum disorder. A retrospective cohort study, using information from 11 years of clinical records (2007–2017) from the South London and Maudsley NHS Trust. We identified a cohort of service-users with TRS using a validated algorithm. We investigated associations between ethnicity and clozapine treatment, adjusting for sociodemographic factors, psychiatric multi-morbidity, substance misuse, neutropenia, and service-use. Among 2239 cases of TRS, Black service-users were less likely to be receive clozapine compared with White British service-users after adjusting for confounders (Black African aOR = 0.49, 95% CI [0.33, 0.74], p = 0.001 Black Caribbean aOR = 0.64, 95% CI [0.43, 0.93], p = 0.019 Black British aOR = 0.61, 95% CI [0.41, 0.91], p = 0.016). It was additionally observed that neutropenia was not related to treatment with clozapine. Also, a detention under the Mental Health Act was negatively associated clozapine receipt, suggesting people with TRS who were detained are less likely to be treated with clozapine. Black service-users with TRS were less likely to receive clozapine than White British service-users. Considering the protective effect of treatment with clozapine, these inequities may place Black service-users at higher risk for hospital admissions and mortality.
Ethnic inequities in multimorbidity among people with psychosis: a retrospective cohort study
Publisher: Cambridge University Press (CUP)
Date: 2022
DOI: 10.1017/S2045796022000385
Abstract: Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have an increased risk of multiple long-term conditions (MLTC multimorbidity). However, there is limited research regarding ethnic inequities in multimorbidity in people with psychosis. This study investigates ethnic inequities in physical health multimorbidity in a cohort of people with psychosis. In this retrospective cohort study, using the Clinical Records Interactive Search (CRIS) system, we identified service-users of the South London and Maudsley NHS Trust with a schizophrenia spectrum disorder, and then additional diagnoses of diabetes, hypertension, low blood pressure, overweight or obesity and rheumatoid arthritis. Logistic and multinomial logistic regressions were used to investigate ethnic inequities in odds of multimorbidity (psychosis plus one physical health condition), and multimorbidity severity (having one or two physical health conditions, or three or more conditions), compared with no additional health conditions (no multimorbidity), respectively. The regression models adjusted for age and duration of care and investigated the influence of gender and area-level deprivation. On a s le of 20 800 service-users with psychosis, aged 13–65, ethnic differences were observed in the odds for multimorbidity. Controlling for sociodemographic factors and duration of care, compared to White British people, higher odds of multimorbidity were found for people of Black African [adjusted Odds Ratio = 1.41, 95% Confidence Intervals (1.23–1.56)], Black Caribbean [aOR = 1.79, 95% CI (1.58–2.03)] and Black British [aOR = 1.64, 95% CI (1.49–1.81)] ethnicity. Reduced odds were observed among people of Chinese [aOR = 0.61, 95% CI (0.43–0.88)] and Other ethnic [aOR = 0.67, 95% CI (0.59–0.76)] backgrounds. Increased odds of severe multimorbidity (three or more physical health conditions) were also observed for people of any Black background. Ethnic inequities are observed for multimorbidity among people with psychosis. Further research is needed to understand the aetiology and impact of these inequities. These findings support the provision of integrated health care interventions and public health preventive policies and actions.
A dominant-negative mutation in the TRESK potassium channel is linked to familial migraine with aura
Publisher: Springer Science and Business Media LLC
Date: 26-09-2010
DOI: 10.1038/NM.2216
Abstract: Migraine with aura is a common, debilitating, recurrent headache disorder associated with transient and reversible focal neurological symptoms. A role has been suggested for the two-pore domain (K2P) potassium channel, TWIK-related spinal cord potassium channel (TRESK, encoded by KCNK18), in pain pathways and general anaesthesia. We therefore examined whether TRESK is involved in migraine by screening the KCNK18 gene in subjects diagnosed with migraine. Here we report a frameshift mutation, F139WfsX24, which segregates perfectly with typical migraine with aura in a large pedigree. We also identified prominent TRESK expression in migraine-salient areas such as the trigeminal ganglion. Functional characterization of this mutation demonstrates that it causes a complete loss of TRESK function and that the mutant subunit suppresses wild-type channel function through a dominant-negative effect, thus explaining the dominant penetrance of this allele. These results therefore support a role for TRESK in the pathogenesis of typical migraine with aura and further support the role of this channel as a potential therapeutic target.
Using patient experience data to support improvements in inpatient mental health care: the EURIPIDES multimethod study
Publisher: National Institute for Health and Care Research
Date: 04-2020
DOI: 10.3310/HSDR08210
Abstract: All NHS providers collect data on patient experience, although there is limited evidence about what to measure or how to collect and use data to improve services. We studied inpatient mental health services, as these are important, costly and often unpopular services within which serious incidents occur. To identify which approaches to collecting and using patient experience data are most useful for supporting improvements in inpatient mental health care. The study comprised five work packages: a systematic review to identify evidence-based patient experience themes relevant to inpatient mental health care (work package 1) a survey of patient experience leads in NHS mental health trusts in England to describe current approaches to collecting and using patient experience data in inpatient mental health services, and to populate the s ling frame for work package 3 (work package 2) in-depth case studies at sites selected using the work package 2 findings, analysed using a realist approach (work package 3) a consensus conference to agree on recommendations about best practice (work package 4) and health economic modelling to estimate resource requirements and potential benefits arising from the adoption of best practice (work package 5). Using a realist methodology, we analysed and presented our findings using a framework based on four stages of the patient experience data pathway, for which we coined the term CRAICh (collecting and giving, receiving and listening, analysing, and quality improvement and change). The project was supported by a patient and public involvement team that contributed to work package 1 and the development of programme theories (work package 3). Two employed survivor researchers worked on work packages 2, 3 and 4. The study was conducted in 57 NHS providers of inpatient mental health care in England. In work package 2, 47 NHS patient experience leads took part and, in work package 3, 62 service users, 19 carers and 101 NHS staff participated, across six trusts. Forty-four in iduals attended the work package 4 consensus conference. The patient experience feedback cycle was rarely completed and, even when improvements were implemented, these tended to be environmental rather than cultural. There were few ex les of triangulation with patient safety or outcomes data. We identified 18 rules for best practice in collecting and using inpatient mental health experience data, and 154 realist context–mechanism–outcome configurations that underpin and explain these. The study was cross-sectional in design and we relied on ex les of historical service improvement. Our health economic models (in work package 5) were therefore limited in the estimation and modelling of prospective benefits associated with the collection and use of patient experience data. Patient experience work is insufficiently embedded in most mental health trusts. More attention to analysis and interpretation of patient experience data is needed, particularly to ways of triangulating these with outcomes and safety data. Further evaluative research is needed to develop and evaluate a locally adapted intervention based on the 18 rules for best practice. The systematic review (work package 1) is registered as PROSPERO CRD42016033556. This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research Vol. 8, No. 21. See the NIHR Journals Library website for further project information.
Reducing excess mortality due to chronic disease in people with severe mental illness: Meta-review of health interventions
Publisher: Royal College of Psychiatrists
Date: 04-2016
DOI: 10.1192/BJP.BP.115.163170
Abstract: People with severe mental illness (SMI) have high rates of chronic disease and premature death. To explore the strength of evidence for interventions to reduce risk of mortality in people with SMI. In a meta-review of 16 systematic reviews of controlled studies, mortality was the primary outcome (8 reviews). Physiological health measures (body mass index, weight, glucose levels, lipid profiles and blood pressure) were secondary outcomes (14 reviews). Antipsychotic and antidepressant medications had some protective effect on mortality, subject to treatment adherence. Integrative community care programmes may reduce physical morbidity and excess deaths, but the effective ingredients are unknown. Interventions to improve unhealthy lifestyles and risky behaviours can improve risk factor profiles, but longer follow-up is needed. Preventive interventions and improved medical care for comorbid chronic disease may reduce excess mortality, but data are lacking. Improved adherence to pharmacological and physical health management guidelines is indicated.
Realist Evaluation of the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care (EURIPIDES) in England: study protocol
Publisher: BMJ
Date: 06-2018
From Allostatic Load to Allostatic State-An Endogenous Sympathetic Strategy to Deal With Chronic Anxiety and Stress?
Publisher: Frontiers Media SA
Date: 21-03-2019
The social underpinnings of mental distress in the time of COVID-19 – time for urgent action
Publisher: F1000 Research Ltd
Date: 13-07-2020
DOI: 10.12688/WELLCOMEOPENRES.16123.1
Abstract: We argue that predictions of a ‘tsunami’ of mental health problems as a consequence of the pandemic of coronavirus disease 2019 (COVID-19) and the lockdown are overstated feelings of anxiety and sadness are entirely normal reactions to difficult circumstances, not symptoms of poor mental health. Some people will need specialised mental health support, especially those already leading tough lives we need immediate reversal of years of underfunding of community mental health services. However, the disproportionate effects of COVID-19 on the most disadvantaged, especially BAME people placed at risk by their social and economic conditions, were entirely predictable. Mental health is best ensured by urgently rebuilding the social and economic supports stripped away over the last decade. Governments must pump funds into local authorities to rebuild community services, peer support, mutual aid and local community and voluntary sector organisations. Health care organisations must tackle racism and discrimination to ensure genuine equal access to universal health care. Government must replace highly conditional benefit systems by something like a universal basic income. All economic and social policies must be subjected to a legally binding mental health audit. This may sound unfeasibly expensive, but the social and economic costs, not to mention the costs in personal and community suffering, though often invisible, are far greater.
CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: A 2017 Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts
Publisher: American College of Physicians
Date: 20-06-2017
DOI: 10.7326/M17-0046
Differences in mental health, substance use, and other problems among dual diagnosis patients attending psychiatric or substance misuse treatment services
Publisher: Informa UK Limited
Date: 02-2008
Heteromeric channel formation and Ca2+‐free media reduce the toxic effect of the weaver Kir 3.2 allele
Publisher: Wiley
Date: 29-07-1996
DOI: 10.1016/0014-5793(96)00635-7
Abstract: Weaver mice have a severe hypoplasia of the cerebellum with an almost complete loss of the midline granule cells. Recent genetic studies of weaver mice have identified a mutation resulting in an amino acid substitution (G156S) in the pore of the inwardly rectifying potassium channel subunit Kir 3.2. When expressed in Xenopus oocytes the weaver mutation alters channel selectivity from a potassium-selective to a nonspecific cation-selective pore. In this study we confirm by cell-attached patch-cl recording that the mutation produces a non-selective cation channel. We also demonstrate that the cell death induced by weaver expression may be prevented by elimination of calcium from the extracellular solution as well as by coexpression with the wild-type Kir 3.2 allele, or other members of the Kir 3.0 subfamily. These results suggest that the weaver defect in Kir 3.2 may cause cerebellar cell death by cell swelling and calcium overload. Cells which express the weaver subunit, but which normally survive, may do so because of heteromeric subunit assembly with wild-type subunits of the Kir 3.0 subfamily.
De novopoint mutations in patients diagnosed with ataxic cerebral palsy
Publisher: Oxford University Press (OUP)
Date: 16-05-2015
DOI: 10.1093/BRAIN/AWV117
Ethnic inequities in multimorbidity among people with psychosis: A retrospective cohort study
Publisher: Cold Spring Harbor Laboratory
Date: 17-02-2022
DOI: 10.1101/2022.02.16.22271050
Abstract: Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have a higher risk of multiple long-term conditions (MLTC multimorbidity). However, there is limited research regarding ethnic inequalities in multimorbidity in people with a schizophrenia spectrum disorder. This study investigates ethnic disparities in physical health multimorbidity in a cohort of people with psychosis. In this retrospective cohort study, using the Clinical Records Interactive Search (CRIS) system, we identified service-users of the South London and Maudsley NHS Trust with a schizophrenia spectrum disorder, and then additional diagnoses of diabetes, hypertension, low blood pressure, overweight or obesity, and rheumatoid arthritis. Multinomial logistic regression was then used to investigate ethnic inequities in odds of multimorbidity (psychosis plus one physical health condition), as well as multimorbidity severity (having one or two physical health conditions, or three or more conditions), compared with no additional health conditions (no multimorbidity). The regression models adjusted for age and duration of care and investigated the influence of gender and area-level deprivation. On a s le of 20,800 service-users with psychosis, aged 13-65, ethnic differences were observed in the odds for multimorbidity. Compared to White British people, higher odds of multimorbidity were found for people of Black African [aOR=1.41, 95%CI (1.23 - 1.56)], Black Caribbean [aOR=1.79, 95%CI (1.58 – 2.03)], and Black British [aOR=1.64, 95%CI (1.49 - 1.81)] ethnicity. Reduced odds were observed among people of Chinese [aOR=0.61, 95%CI (0.43 – 0.88)] and Other ethnicities [aOR=0.67, 95%CI (0.59 – 0.76)]. Increased odds for severe multimorbidity (three or more physical health conditions) were also observed for people of any Black background. Ethnic inequities are observed for multimorbidity among people with psychosis. Further research is needed to understand the aetiology and impact of these inequities. These findings support the provision of integrated health care interventions and public health preventive policies and actions.
THE CONCISE GUIDE TO PHARMACOLOGY 2017/18: Overview
Publisher: Wiley
Date: 21-10-2017
DOI: 10.1111/BPH.13882
Social Scaffolding
Publisher: Cambridge University Press
Date: 14-06-2019
Related Organisations
Royal College Of Psychiatrists
Location: United Kingdom of Great Britain and Northern Ireland
UMDS, Now Kings College London
Location: United Kingdom of Great Britain and Northern Ireland
United Medical And Dental Schools Of Guy's And St Thomas, Now King's College London
Location: United Kingdom of Great Britain and Northern Ireland
University College London
Location: United Kingdom of Great Britain and Northern Ireland
King's College London, Formerly UMDS
Location: United Kingdom of Great Britain and Northern Ireland
London School Of Hygiene And Tropical Medicine
Location: United Kingdom of Great Britain and Northern Ireland
Queen Mary University Of London
Location: United Kingdom of Great Britain and Northern Ireland
University Of Oxford
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
No related grants have been discovered for Stephen Tucker.