Chris Griffiths, Alex O'Neill-Kerr (2019) Patients, carers and the public’s perspectives on electroconvulsive therapy: Frontiers in Psychiatry, section Mood and Anxiety Disorders, Manuscript ID: 434097

Griffiths, C., O’Neill-Kerr, A, Millward T, da Silva, K. (2019) Repetitive transcranial magnetic stimulation (rTMS) for depression: outcomes in a United Kingdom (UK) clinical practice 30th March 2019

Response and remission rates, respectively, were 40.4% and 25.5% for the HAM-D; 35.6% and 20.8% for the BDI; and 51.1% and 52.1% for the CGI. Effect sizes were medium (0.54, 0.52 and 0.56, respectively).

Griffiths, C., O’Neill-Kerr, A, De Vai, R., da Silva, K. (2019). Impact of repetitive transcranial magnetic stimulation on generalised anxiety disorder in treatment resistant depression. Annals of Clinical Psychiatry. Conclusion: The results show that right DLPFC inhibitory rTMS immediately prior to delivery of FDA left dorsolateral prefrontal cortex depression rTMS treatment in a clinical service can be effective in treating depression and anxiety symptoms of treatment resistant depression patients. There are discrepancies between clinician and patient rated change in depression symptoms, highlighting the subjective nature of depression and the value in gaining both a clinician and patient view. Over a quarter demonstrated generalised anxiety disorder remission.

Griffiths, C., da Silva K, De Vai, R., O’Neill-Kerr, A. Repetitive Transcranial Magnetic Stimulation (rTMS) in treatment resistant depression: retrospective data analysis from clinical practice Open Journal of Depression 2019, 8. Outcomes: in 144 patients between 2015 and 2017 Response and remission rates were 34.6% and 20.6% for the HAM-D and 31.8% remission on the CGI, comparable to published international data.

O’Neill-Kerr A, 3rd International Brain Stimulation Conference, 2018 (poster) The Clinical use of rTMS in an NHS Setting. Outcome data from United Kingdom (UK) NHS clinical rTMS service provider: treatment resistant depression and anxiety. Conclusion: We have demonstrated that rTMS can be delivered cost effectively in an NHS clinical setting whilst still maintaining patient outcomes.

Patient Reported Experience of Electroconvulsive Therapy (ECT) Chris Griffiths, Alexander O'Neill-Kerr and Rose Thompson, jneuropsychiatry Review Article - (2018) Volume 8, Issue 5. A key finding from this study is that the caring attitude of staff has a significant impact on the experience and outcomes of patients undergoing ECT. In comparison to studies in the early 2000’s and predominantly American and Australian data on patient satisfaction surveys relating to ECT treatment which find a consistently negative attitude by patients towards ECT, this paper demonstrates that this attitude has been changing in 2013/15 in the UK. This has been attributed to a greater emphasis on patient and carers experience as well as improved information sharing and consent processes and confirms the trend identified in the ECTAS and SEAN annual reports (2016).

O’Neill-Kerr A, The Clinical TMS Society International conference 2017 New York, (poster) UK rTMS data, this was the first new data on rTMS outcomes from the UK to be presented to the international community. Objective was to present the outcomes data from the leading United Kingdom (UK) NHS clinical rTMS service provider. Conclusions were: The results show that a UK based clinical service can achieve similar results to that seen in the international literature and that clinical rTMS is deliverable in the NHS and has significant impact on patients with TRD in the UK. This is important as there are no recent large scale data on remission/response rates for rTMS focused on the effectiveness of clinical rTMS in the NHS. In a financially challenged healthcare system such as the NHS investment in new Neuromodulation techniques such as rTMS which could reduce the direct costs of TRD to the NHS are important.

Switching From Age-Based Stimulus Dosing to Dose Titration Protocols in Electroconvulsive Therapy: Empirical Evidence for Better Patient Outcomes With Lower Peak and Cumulative Energy Doses. A O'Neill-Kerr et al. J ECT 33 (3), 181-184. 9, 2017.

Switching From Age-Based Stimulus Dosing to Dose Titration Protocols in Electroconvulsive Therapy: Empirical Evidence for Better Patient Outcomes With Lower Peak and Cumulative Energy Doses. A O'Neill-Kerr et al. J ECT 33 (3), 181-184. 9, 2017.

Hardy et al, BJPsych Advances co-author, Transcranial magnetic stimulation in clinical practice November 2016 - Volume - 22 - issue 6 - p 273 – 279 as this is a Royal College publication.

Hardy et al, Journal of ECT co author, Should Nurses Administer Electroconvulsive Therapy? December 2015 – Volume 31 – issue 4 – p 207 – 208.

Journal of ECT, WHO Checklist for ECT co-author 2014 Woodcock et al, The Development and Use of a Modified WHO Checklist for Use in Electroconvulsive Therapy. Journal of ECT; Volume 00, Number 00, 2014.

Asked by the cqc to write a commentary on rTMS for their website. 2015

Asked the Royal College of Psychiatry (2012) to allow the evaluation of Nurse administered ECT (2012). The first pilot evaluation of nurse administered ECT in the world. Published in the Journal of ECT 2015. This has resulted in changes to the ECTAS standards (the National College standards) to allow nurses to administer ECT. This innovation is the most significant advance in ECT in more than 60 years and has attracted attention from American ECT clinics.

Co-authored the Royal College of Psychiatrists ECT committee position statement on rTMS 2017 which sets out quality and safety aspects of rTMS delivery. This is an important aspect of ensuring safe and effective use of TMS in the UK.

Co-wrote the chapter on standards for rTMS and standards for ECT suites for the RCPsych ECT Handbook IV Edition 2019, Developed an rTMS training course which meets the RCPsych standards. The ECT handbook is considered to be the standard textbook for ECT and related treatments in the UK.

A qualitative study of patients' experience of ketamine treatment for depression: The ‘Ketamine and me’ project January 2021. DOI: 10.1016/j.jadr.2021.100079

There has been a lack of in-depth interviews investigating patient experience of ketamine treatment for depression. We examined participants’ pathways to receiving ketamine infusion to treat their depression, and their responses to, lived experiences of, and attitudes towards ketamine treatment.

Results For the majority of participants ketamine infusion causes a reported initial ‘high’, enhanced perception, and dissociative experience; followed by a lifting of mood and a reduction in or removal of suicidal ideation and depression symptoms lasting around 3 to 6 days. This leads to a reported increase in motivation, socialisation, and activity. All participants valued the therapeutic alliance with clinicians which enhanced the treatment experience and all advocated treatment access for those with depression who have not responded to other treatments. Limitations Small numbers, and single site recruitment limit generalisability. Conclusions Ketamine for depression can have many beneficial effects, and it is potentially life-transforming for some. Ketamine may be a source of hope for patients for whom other treatments have not been effective. For some, ketamine is not tolerated or does not have anti-depressive effects.