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Epidemiology and cultural

Environmental and Cultural Psychiatry involves studies of environmental risk factors such as transport noise and air pollution and their effects on health (Stansfeld & Clark), social and cultural risk factors for common mental disorders (Bhui), for example, cultural identity and discrimination and the relation between work and mental health (Stansfeld, Bhui).

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There is a strong emphasis in our research on clinical relevance and applying epidemiological insights to our diverse local population. We study a wide range of physical and socio-cultural risk factors in relation to the aetiology of well-being, common mental disorders, affective disorders and psychosis, including schizophrenia. Our expertise is especially in the investigation of social and psychological risk factors for common mental disorders using a wide range of different methods: epidemiological studies of large population samples, qualitative interview and focus group studies, ecological analyses, cluster randomised trials, systematic reviews and meta-analyses. Environmental and Cultural Psychiatry involves studies of environmental risk factors such as transport noise and air pollution (Stansfeld & Clark) and social and cultural risk factors for common mental disorders (Bhui), for example, cultural identity and discrimination, social capital and housing.

We are involved in a number of longitudinal studies of risks for mental ill-health. These studies help to disentangle the contribution of genetic and early environmental factors on health and how these influences continue across the lifecourse into adulthood. Longitudinal associations of work and mental health, lifelong consequences of childhood mental health on adult social position and health have been studied in the 1958 Birth Cohort (NCDS) and the Whitehall II Study informing cross sectional analyses of work and non-work stressors in national studies such as the 2007 Adult Psychiatric Morbidity Survey (Stansfeld, Clark). Studies of work and health include quantitative analyses of large population studies such as the 1958 Birth Cohort (Clark & Stansfeld) and qualitative studies on work stress in a range of different types of employment (Bhui). These studies form the basis of a current pilot study developing testable interventions to improve employees’ health (Guided e-learning for managers: GEM Study) (Stansfeld, Bhui, Clark).

Studies of complex interventions include the development of and testing a new complex intervention to improve patient outcomes when there are conflicting and competing narratives about what causes illness and what the treatment is (Bhui). A programme of work continues to pilot and test the efficacy of the Cultural Consultation Service with clinicians. Recent collaborations with UCL include funding from the MRC/ESRC on the extending working lives programme (Stansfeld, Clark). We are also collaborating with Centres in Gothenburg and Rome on studies of work and mental health.

Studies of Chronic Fatigue Syndrome are a consistent theme within the Centre, overlapping strongly with Liaison Psychiatry including analyses of early life predictors of Chronic Fatigue Syndrome in the 1958 Birth Cohort and ALSPAC (Clark, Stansfeld, White), and Chronic Fatigue Syndrome in ethnic minorities (Bhui). We are interested in adolescent mental health, investigating resilience as well as risk factors, and the consequences for adult mental health and occupational functioning. In the ORiEL Study, on the impact of the regeneration surrounding the Olympics on childhood wellbeing and physical activity in the East London Boroughs we collaborate with the London School of Hygiene and Tropical Medicine (Stansfeld, Clark). We are also working with UCL on an e-portal intervention for adolescents with emotional and conduct problems and comorbid physical illnesses under the umbrella of the joint CLARHC initiative. Collaborations with colleagues in other medical disciplines include work on hepatitis C transmission and prevention (NIHR Programme grant), studies of diabetes interventions in South Asian, studies of assessing dementia in South Asians who may not recognise the symptom patterns as a disorder (Bhui).

Our research has strong international collaborations, particularly in Europe on studies of environmental noise: The European Network on Noise and Health (Stansfeld, Clark) ENNAH, was a European 7th Framework coordination and support network set up decide on future priorities for environmental noise and health research in Europe. It involved 33 centres from 16 European countries. Workshops were carried out on a review of the literature, noise exposure measurement, moderating factors, measurement of health outcomes, and new strategies for noise and health. Workshop reports are available to download from the website in addition to the final report and network newsletters.

We also work closely with other members of the International Commission on the Biological Effects of Noise on studies of noise and health.

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