Child and adolescent psychiatry
Mae'r cynnwys hwn ar gael yn Saesneg yn unig.
Our research mission is to generate findings that will improve children and young people’s mental health.
Our research in child and adolescent psychiatry covers four key areas:
Our depression and anxiety research aims to:
Recent discoveries and outputs
- Anxiety and irritability as well as social adversity are important routes into adolescent depression and thus prevention targets
- Social and life-style factors can help promote resilience in young people at increased familial risk for depression
- A digital programme for young people with depression and their families/carers developed in collaboration with young people themselves
- Depression and anxiety symptom trajectories from adolescence to mid-life show important developmental changes; this has future implications for stratification.
Our research in this area explores development, causes and links with anxiety and depression. We aim to:
- examine the natural history, causes and outcomes of ADHD, autism and communication problems from early childhood to adult life
- identify ADHD causes and investigate why there are sex differences using genomics and epidemiological designs
- investigate severe irritability and why those with ADHD and ASD are at elevated risk for anxiety and depression.
Recent discoveries and outputs
- ADHD genetic loading (genetic risk scores) and multi-morbidity (more than one neurodevelopmental problem) predict a persistent ADHD trajectory
- Why neurodevelopmental disorders are more commonly diagnosed in boys than girls
- A co-produced animation on ADHD for children, funded by the Wellcome Trust (to be released October 2019)
- An all-Wales electronic ADHD patient cohort in collaboration with the SAIL Databank at Swansea University
- Contribution to the world's largest international collaborative ADHD genetic study, that identified the first ADHD common genetic loci
Our research aims to:
- examine the development and outcomes of mental health problems across the life course in population-based cohorts
- identify causal environmental exposures using a range of methods and informative designs
- explore how genetic risk factors for disease identified in patient studies affect development and the course of mental health problems in the population more broadly
- examine trends in the population prevalence of child and adolescent mental health problems, and reasons for these.
Recent discoveries and outputs
- Childhood cognitive, social, behavioural, and emotional impairments, implicated as antecedents to schizophrenia in high-risk, developmental studies, might represent early manifestations of genetic liability
- Adolescent mental health problems have become more common over time, that inequalities in mental health have increased and social, educational and health outcomes for children with mental health problems have worsened.
Our research aims to:
- investigate mental health in young people and their life at school. We collaborate with colleagues in the School of Psychology, DECIPHer and Swansea University
- develop new methods of including validated mental health assessments, longitudinal data linkage and secure linkage to electronic health records in school-based research, and testing the feasibility of collecting genetic samples in a classroom setting. We are actively working in this area through the Mental Wellbeing in Adolescence: Genes and Environment Study (MAGES)
- identify ways of promoting good mental health during the transition from primary to secondary school and the importance of children’s age within their school year for mental health.
The Cardiff University Mood and Wellbeing Study
This study, also known as the Early Prediction of Adolescent Depression (EPAD) study, aims to improve understanding of the causes of young people’s mental health.
We also aim to develop evidence-based methods of early intervention and support for people experiencing mental health challenges – with a particular focus on difficulties with low mood and depression.
In General Practice, tools that predict physical health problems are used routinely. We plan to use the results of this study to develop similar tools not currently available for mental health. These sorts of tools will help to ensure that people most in need receive the support and care they need.
The study includes 337 families from across the UK where an individual has been affected by low mood. It is currently the largest study of its type in the world. Since it started in 2007, families have taken part in interviews and a range of other assessments three times when the young people were teenagers.
The study is unique because it has followed families throughout their lives and listened to and documented the ups and downs for over ten years. This type of study enables a thorough understanding of the causes and consequences of low mood and resilience to depression. As well as contributing to the expertise and knowledge of depression nationally and internationally, our research ultimately aims to help those individuals affected by mental health and their families.
The Medical Research Council has funded a fourth phase of research (2017-2020) enabling us to revisit all families and follow the young people into their adult life.
Our findings so far
Thanks to the families taking part in our study over the last ten years, we are beginning to understand the causes of mental health difficulties as well as positive mental health. We have made many important scientific discoveries and published over 50 reports in scientific journals to date, as well as over 100 papers about depression. You can find these papers on the profiles of our researchers.
A snapshot of some of our most important scientific findings includes identifying factors that promote mental health resilience in young people as well as those that predict the onset of mood problems. Another finding suggests different types of adolescent depression. On a more practical level, several families in our study have contributed to the development of an online package to help young people and their families manage low mood.
The development of this package has been led by Dr Rhys Bevan Jones at Cardiff University. The package is currently being tested in a randomised controlled trial of young people experiencing low mood in a project funded by the National Institute for Health Research.
Take part in our research
Understanding the causes of low mood and depression, and identifying who might be more likely to develop difficulties before problems arise, helps us create better ways to support people and prevent early problems from escalating into something more serious. Taking part in our study is an incredible way to help achieve this and without your help research like this wouldn’t be possible.
Families are usually contacted by the University to organise participation. However if you have taken part in the study previously and would like to arrange taking part in this current phase, please get in touch.
Get in touch
Our team is based at the MRC Centre for Neuropsychiatric Genetics and Genomics, a centre of excellence for mental health research.
Collaborators and advisors
We are working closely with Dr Jon Heron (Bristol University), who is providing expert advice on longitudinal trajectory analysis, and Professor David Osborn (UCL) who will provide expert analysis in individual risk prediction analysis as the study progresses.
Dr Robert Potter, Dr Amani Hassan, Dr Rhys Bevan-Jones and Dr Judith Allardyce are clinical advisors on the study.
Alice Stephens, Bryony Weavers and Jessica Lennon are at the core of our research team, visiting and interviewing families to speak to them and track the changes in their lives over the past few years.
Emma Meilak looks after the administration of our project and is the key point of contact for all our families participating in the study.
National Centre for Mental Health - the NCMH website has a dedicated depression section, including details on research, suggested reading and links to medication information.
Mind - information and support along with downloadable leaflets and real people's stories. Search 'depression' from the homepage.
Samaritans - available 24 hours a day to provide confidential emotional support for people experiencing feelings of distress, despair or suicidal thoughts.
Neurodevelopmental disorders: what happens when children grow up and why?
Neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) affect at least 1 in 10 children.
They are thought to begin in early life and, until recently, most children were thought to grow out of their problems. However, we now know that adults are also affected but not much is known about what these problems look like in adults. To start, we need to know what is “normal” or typical.
For the first time, neurodevelopmental problems will be assessed in a group of around 8,000 adults (26 year olds) who have taken part in repeated assessments since they were in the womb. We will also assess anxiety, depression and irritability using the same measures that were used in childhood and adolescence.
We will describe neurodevelopmental problems at age 26, as well as patterns of comorbidity with anxiety, depression and other mental health problems. We will find out how neurodevelopmental problems are linked to child/adolescent neurodevelopmental profiles and work with population cohorts in other countries to ensure our findings are robust.
We will also test the extent to which early life experiences (in the womb and the early years) make a difference to life-long (at least up to age 26) neurodevelopmental health using a variety of methods to test causal inference, including Mendelian Randomization.
We will also examine the contribution of genes. Working across different populations will internationally strengthen this type of research. This work has been funded as a Wellcome Trust Collaborative Award.
First, we will characterise the natural history of neurodevelopmental disorders from childhood to adult life (aged 4 to 26 years) in a UK population cohort where people have been assessed multiple times at different ages.
We will then investigate the longer-term impacts of early life exposures and risks including links with depression.
Finally, we will apply novel epidemiological methods to infer which early life exposures have causal impacts.
We are collaborating on this project with researchers at University of Bristol, including:
- Professor George Davey Smith
- Dr Evie Stergiakouli
- Professor Kate Tilling
- Dr Beate Leppert
All Wales Neurodevelopmental Disorder e-cohort
Children with neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) are at increased risk of developing additional mental health problems in early adulthood and using health services more.
The reasons for this are unknown, with little research on this topic. One major barrier to research in this area is that tracking children with neurodevelopmental disorders into early adulthood is very difficult as they are often poor attenders of outpatient services.
Studies following individuals by looking at patient data from routinely collected GP records offer an attractive solution.
The Wales-based Secure Anonymous Information Linkage (SAIL) databank anonymously collates routinely collected data from the NHS, Government and schools for almost everyone in Wales.
Using this anonymised data, we have identified all cases of ADHD and ASD in Wales. We can now electronically track outcomes using routine data from this population dataset to identify predictors of poor outcomes.
We also previously collected a sample of children with ADHD as part of the Study of ADHD Genes and Environment (SAGE study). We have invited these individuals into the data-linkage study and can electronically track their outcomes. Because we already have so much information about them, they’re an ideal group to see what predicts later outcomes and inform analyses in the larger population dataset.
Having created these unique datasets, we can expand our investigation into the early predictors of poor outcome for those diagnosed with Neurodevelopmental Disorders.
This project is funded by the ISSF3 Population Research Wellcome Trust award.
Co-investigators (Cardiff University)
Co-investigators (Swansea University)
- Professor Ann John
Lles Meddyliol mewn Llencyndod: Genynnau a’r Amgylchedd (MAGES)
I wneud hyn, mae angen samplau DNA arnom gan filoedd o bobl ifanc. Byddwn yn ymweld ag ysgolion yng Nghymru i roi’r cyfle i ddisgyblion blwyddyn 7 ac 8 gymryd rhan yn ein hymchwil drwy roi sampl o boer.
Mae tîm yr Astudiaeth Lles Meddyliol mewn Llencyndod: Genynnau a’r Amgylchedd (MAGES) yn rhan o Ganolfan y Cyngor Ymchwil Feddygol ar gyfer Geneteg Niwroseiciatrig a Genomeg ym Mhrifysgol Caerdydd.
Stephan - Arweinydd y Prosiect
Rwy’n frwd dros iechyd meddwl plant, ac mae gen i fwy nag 20 mlynedd o brofiad ymchwil yn y maes hwn. Mae gen i ddiddordeb arbennig mewn sut i hyrwyddo cadernid iechyd meddwl, y cysylltiadau rhwng iechyd meddwl plant ac oedolion, ac a yw iechyd meddwl pobl ifanc yn gwella neu’n gwaethygu.
Mae’r astudiaeth hon yn bwysig i lywio ein dealltwriaeth o sut mae genynnau a’r amgylchedd yn rhyngweithio i siapio iechyd a lles meddyliol pobl ifanc.
Fran - Uwch Ymchwilydd
Fy mhrif ddiddordeb ymchwil yw nodi’r hyn sy’n achosi iselder mewn llencyndod a pham ei fod yn digwydd dro ar ôl tro. Rwy’n astudio datblygiad gydol oes ac mae gen i ddiddordeb mewn nodi risgiau achosol a ffactorau amddiffynnol y gellir eu targedu fel rhan o ymyriadau seicolegol ac iechyd y cyhoedd.
Naomi - Cynorthwy-ydd Ymchwil
Mae fy rôl yn cynnwys ymweld ag ysgolion i gyflwyno gweithdai gwyddoniaeth hwyl a chasglu samplau poer (DNA) gan ddisgyblion sy’n cymryd rhan yn ein hymchwil.
Mae gen i ddiddordeb mewn ffeindio’r ffactorau sy’n helpu pobl ifanc i gael lles meddyliol da. Mae gen i gefndir mewn ymchwil iechyd meddwl a gweithio gyda phobl ifanc. Ar gyfer fy PhD defnyddiais ddulliau gwahanol i edrych ar y cysylltiad rhwng y cof a hwyliau mewn pobl ifanc. Dwi hefyd wedi bod yn rhan o nifer o brosiectau ymchwil mewn ysgolion a redir gan DECIPHer.
Yn fy amser sbâr, dwi’n mwynhau treulio amser gyda fy nghath, chwarae badminton a gwneud gwaith celf.
Sarah - Cynorthwy-ydd Ymchwil
Dwi’n ymweld ag ysgolion i helpu i redeg gweithdai gwyddoniaeth a chasglu DNA (poer!) gan bobl ifanc sy’n cymryd rhan yn ein hastudiaeth.
Mae gen i ddiddordeb mewn helpu pobl i wella eu lles meddyliol. Yn flaenorol dwi wedi gweithio ar brosiect ymchwil mawr yn edrych ar y defnydd o Therapi Gwybyddol Ymddygiadol (ThGY) gyda phobl ifanc mewn ysgolion. Dwi hefyd wedi gweithio mewn rôl glinigol gyda phobl ifanc mewn gwasanaeth poen cronig.
Pan dwi ddim yn y gwaith dwi’n mwynhau mynd am dro hir gyda fy nghi, treulio amser gyda fy nheulu a theithio.
Lesley - Rheolwr Labordy
Dwi’n cydlynu tîm o wyddonwyr a fydd yn cynnal y gwaith labordy, gan gynnwys echdynnu’r DNA o’r samplau poer a rhedeg y peiriannau sy’n dadansoddi’r DNA.
Fel rheolwr labordy, dwi’n gweithio gyda nifer o dimau ymchwil gwahanol yng Nghanolfan y Cyngor Ymchwil Feddygol ar gyfer Geneteg Niwroseiciatrig a Genomeg i gefnogi eu hymchwil. Dwi hefyd yn gyfrifol am redeg y labordy o ddydd i ddydd.
Yn fy amser sbâr dwi’n mwynhau mynd i’r theatr, nofio ac ymweld â ffrindiau a theulu.
Lucinda - Rheolwr Samplau a Llywodraethu
Dwi’n rheoli’r samplau DNA sy’n cael eu casglu ar gyfer MAGES. Mae hyn yn cynnwys cadw cofnodion o union leoliad yr holl samplau yn y labordy ac unrhyw waith labordy sy’n cael ei wneud arnynt.
Fel rheolwr samplau a llywodraethu ar gyfer Canolfan y Cyngor Ymchwil Feddygol ar gyfer Geneteg Niwroseiciatrig a Genomeg, dwi’n rheoli dros 10,000 o samplau ymchwil. Dwi hefyd yn sicrhau bod ein storfa a’n defnydd o samplau yn cydymffurfio â rheoliadau moeseg ymchwil.
Y tu allan i’r gwaith dwi’n dwlu treulio amser gyda fy nheulu a ffrindiau ac yn mwynhau dawnsio neuadd, teithio a mynd i weld sioeau cerdd a chyngherddau.
MoodHwb: mood and wellbeing in young people
Each year as many as 1 in 20 young people will be diagnosed with depression. Both boys and girls can be affected, although girls are twice as likely to experience it as boys.
UK guidelines stress the need for good information and psychological/talking and social therapies, backed by strong evidence.
Developing a resource
As part of a National Institute for Health Research (NIHRI) / Health and Care Research Wales doctoral fellowship, we developed a web programme called MoodHwb to help with low mood and depression in young people and their parents/carers.
MoodHwb has been co-designed with young people and parents/carers and aims to engage young people, promote self-help and help-seeking where appropriate. It uses developmentally appropriate language, illustrations, animations and interactive components (e.g. profile-building, mood monitoring, goal-setting).
There are several ways to personalise the programme and there is a section for families/carers, friends and professionals – in part to promote social support. It also includes resources for other issues commonly experienced alongside depression (e.g. anxiety).
The programme is multi-platform, and there is an accompanying ‘app’, which includes the interactive components and a mobile-friendly version of the main site. It is available in English and Welsh ('hwb' is the Welsh translation for 'hub', and also means a 'lift' or 'boost').
There is more information on its design and development in the paper: A Web-Based Psychoeducational Intervention for Adolescent Depression: Design and Development of MoodHwb
Future of the programme
During an early evaluation, young people, parents/carers and professionals reported that MoodHwb was engaging, clear, easy to use and helpful. The feedback contributed to the refinement of the programme.
We aim to test this new version in schools and primary mental health services in Wales and Scotland, as part of an NIHR/Health and Care Research Wales Post-Doctoral Fellowship.
This work will help ensure that it is closer to being rolled-out as an early intervention programme in health, education, youth and social services/charities.
Despite being present in 3-5% of children, ADHD remains misunderstood and there is a great deal of stigma associated with having ADHD.
Children and their families often face challenges when they are first diagnosed with ADHD. One challenge is accessing information and resources about ADHD, particularly those that can explain ADHD to children affected by the condition. The few resources that are currently available are not fit for purpose and are not targeted at children aged 7-11 years (the age group when ADHD is most likely to be diagnosed in the UK).
Let's talk about ADHD
We worked together with local ADHD parent support groups to develop an animation video for children aged 7-11 years about what it means to have ADHD. This video is based on our research as well as ideas and opinions from people with lived experienced of ADHD.
This project was funded by the ISSF3 Public Engagement Proof-of-Concept Wellcome Trust award.
We conducted a series of focus groups to develop and revise a storyboard for a three-minute animation. Professionals from clinical services were asked for their opinions to ensure that the animation provides information in an accurate and accessible way.
The project culminated with a launch event to celebrate the work of those involved, get feedback on the animation and promote the animation to ADHD support groups across South Wales, clinicians and relevant academics.
The animation will be a valuable resource to support children diagnosed with ADHD and in line with NICE UK guideline emphasis on provision of psychoeducation to those diagnosed with ADHD.
This animation will be readily available for families via support groups and clinical services. This will be a starting point for the development of a more comprehensive support package for individuals diagnosed with ADHD and their families/carers.
It is hoped that this process also helped cement collaborations between our child and adolescent psychiatry team, local ADHD support groups and professionals from clinical services.
We also collaborated with Sarah Jane Bailey, founder of ADHD Cardiff.
Training and knowledge mobilisation
Our aim is to support and develop talented people, enabling them to become tomorrow's scientists who investigate young people's mental health.
We are embedded within the NHS with strong research, training and clinical links to health boards across Wales. We provide training in youth mental health to undergraduate medical students, specialist doctors in child and adolescent psychiatry and other practitioners.
Our activities in this area include:
- helping teaching staff and other relevant professionals understand more about children’s difficulties and the types of support these children may need through our links with the Neurodevelopment Assessment Unit
- shaping the way clinical services are configured, for instance in the creation of cross-diagnosis and cross-discipline child neurodevelopmental clinics and the successfully piloting of age 15 – 25 year clinical transition service
- contributions via an expert reference group to a national government review on Child and Adolescent Mental Health Service provision and presentation to a sub-committee of MPs at Westminster as part of the Youth Parliament UK campaign on mental health services
- Professor Thapar is joint-lead editor of the leading textbook used by practitioners training to specialise in child and adolescent psychiatrists; Rutter's Child and Adolescent Psychiatry
- Professor Gordon Harold (University of Sussex)
- Dr Ruth Sellers (University of Sussex)
- Professor Ann John (Swansea University)
- Professor Rudolph Uher (Dalhousie University)
- Professor George Davey Smith (University of Bristol)
- Dr Evie Stergiakouli (University of Bristol)
- Dr Beate Leppert (University of Bristol)
- Professor Kate Tilling (University of Bristol)
- Dr Gemma Hammerton (University of Bristol)
- Dr Jon Heron (University of Bristol)