Glyn Lewis

University College London, Londinium, England, United Kingdom

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Publications (239)1447.12 Total impact

  • Nature Biotechnology 09/2014; 32(9):871-873. · 32.44 Impact Factor
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    ABSTRACT: Being the victim of peer bullying is associated with increased risk of psychopathology, yet it is not known whether similar experiences of bullying increase risk of psychiatric disorder when the perpetrator is a sibling. We tested whether being bullied by a sibling is prospectively associated with depression, anxiety, and self-harm in early adulthood.
    Pediatrics. 09/2014;
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    ABSTRACT: Objective: Alcohol use and internalizing problems are often positively associated during adolescence and adulthood. However, the basis of this relationship remains poorly understood, and longitudinal data collected in population-based samples could improve the development of etiological models. Method: Using a prospective population-based U.K. cohort, the current study examined the relationship between frequency of drinking during adolescence (ages 13-15, N = 7,100) with problems with depression and anxiety at average age 17 years 10 months (n = 4,292). Analyses were conducted separately by sex and adjusted by the inclusion of potential individual- and familial-level confounders. Results: Among boys, drinking frequency was positively associated with later depression but not anxiety. This association was robust to adjustment for covariates/confounders. Among girls, drinking frequency was related to later depression and anxiety in univariable analyses. In multivariable analyses, only the association with depression remained after adjustment for covariates/confounders. Results were comparable across sexes, although the effect size of drinking frequency was higher among boys. Conclusions: Higher adolescent alcohol use, even at sub-clinical levels, is associated with an increased risk of later problems with depression but may not be associated with an aggregate measure of anxiety. Future research should consider the possibility of differential relationships between multiple measures of adolescent alcohol use and distinct internalizing outcomes later in development. (J. Stud. Alcohol Drugs, 75, 758-765, 2014).
    Journal of studies on alcohol and drugs. 09/2014; 75(5):758-765.
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    ABSTRACT: Despite empirical evidence demonstrating the effectiveness of collaborative stepped care program (SCP) in Western countries, such programs have not been evaluated in the east, which has a different services system structure and cultural nuances in seeking help for mental illness. Furthermore, only a few studies have used SCP for depression and anxiety prevention. We conducted a trial to test its effectiveness in preventing major depressive disorder and generalized anxiety disorder among primary care patients with subthreshold depression and/or anxiety in Hong Kong.
    Journal of affective disorders. 08/2014; 169C:212-220.
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    ABSTRACT: Depressive symptoms and alcohol misuse contribute substantially to the global health burden. These phenotypes often manifest, and frequently co-occur, during adolescence. However, few studies have examined whether both baseline levels of depressive symptoms and change in symptoms are associated with alcohol outcomes. In addition, inconsistent findings could be due to sex differences or the use of different alcohol outcomes. Using data from a prospective population-based cohort in the UK, we estimated trajectories of depressive symptoms from 12 years 10 months to 17 years 10 months, separately for male and female participants. We assessed whether baseline and change in depressive symptoms were associated with use and harmful use of alcohol at 18 years 8 months. Among females, increasing depressive symptoms were associated with increased alcohol use; whilst for males, there was little evidence of this. When examining harmful levels of alcohol use, baseline levels of depressive symptoms in males were weakly related to later harmful alcohol use but this association was attenuated substantially through adjustment for confounders. In contrast, both baseline symptoms and increase in symptoms were associated with later harmful alcohol use in females and these associations were not diminished by confounder adjustment. Elevated depressive symptoms during adolescence are positively associated with increases in both use and harmful use of alcohol at 18 years 8 months. These findings differ between the sexes. Further research is needed to examine the mechanisms underlying the link between depressive symptoms and harmful alcohol use to identify potentially modifiable factors for intervention.
    European Child & Adolescent Psychiatry 08/2014; · 3.70 Impact Factor
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    ABSTRACT: Longitudinal studies have linked the systemic inflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP) with the risk of developing heart disease and diabetes mellitus, which are common comorbidities for depression and psychosis. Recent meta-analyses of cross-sectional studies have reported increased serum levels of these inflammatory markers in depression, first-episode psychosis, and acute psychotic relapse; however, the direction of the association has been unclear.
    JAMA Psychiatry 08/2014; · 12.01 Impact Factor
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    ABSTRACT: Several studies suggest a link between early-life infection and adult schizophrenia. Cross-sectional studies have reported: (1) increased prevalence of Epstein-Barr Virus (EBV), a member of the Herpesviridae family in schizophrenia; (2) a possible role of Herpes simplex virus in cognitive dysfunction in schizophrenia and healthy controls. We report a longitudinal serological study of early-life EBV infection, childhood IQ, and subsequent risk of psychotic experiences (PE) in adolescence.
    Schizophrenia Research 07/2014; · 4.59 Impact Factor
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    ABSTRACT: Objective: Prior studies of the relationship between socioeconomic status (SES) and alcohol consumption and problems in adolescence have been inconclusive. Few studies have examined all three major SES indicators and a broad range of alcohol-related outcomes at different ages. Method: In the Avon Longitudinal Study of Parents and Children cohort, we examined (by logistic regression, with differential weighting to control for attrition) the relationship between family income and parental education and occupational status, and five alcohol outcomes assessed at ages 16 and 18 years. Results: At age 16, high SES-as indexed by income and education-significantly predicted frequent alcohol consumption. Low SES-as measured by education and occupational status-predicted alcohol-related problems. At age 18, high SES-particularly income and education-significantly predicted frequent alcohol consumption and heavy episodic drinking and, more weakly, symptoms of alcohol dependence. All three measures of SES were inversely related to high-quantity consumption and alcohol behavioral problems. Conclusions: In adolescents in the United Kingdom, the relationship between SES and alcohol-related behaviors is complex and varies as a function of age, SES measure, and specific outcome. High SES tends to predict increased consumption and, in later adolescence, heavy episodic drinking and perhaps symptoms of alcohol dependence. Low SES predicts alcohol-related behavioral problems and, in later adolescence, high-quantity alcohol consumption. (J. Stud. Alcohol Drugs, 75, 541-545, 2014).
    Journal of studies on alcohol and drugs. 07/2014; 75(4):541-5.
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    ABSTRACT: To investigate which parental mental illnesses are associated with eating disorders in their offspring.
    International Journal of Eating Disorders 06/2014; · 3.03 Impact Factor
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    ABSTRACT: The co-occurrence of alcohol use and antisocial behavior is well established, but different hypotheses exist regarding the direction of effects between the 2 behaviors. We used longitudinal data to examine the directional relationship between the 2 behaviors across adolescence.
    Alcoholism Clinical and Experimental Research 06/2014; · 3.42 Impact Factor
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    ABSTRACT: The relationship between childhood internalizing problems and early adolescent alcohol use has been infrequently explored and remains unclear.
    Alcoholism Clinical and Experimental Research 05/2014; · 3.42 Impact Factor
  • Proceedings of the International Society for Magnetic Resonance in Medicine, Milan, Italy; 05/2014
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    ABSTRACT: BackgroundA substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT programme in school classrooms. The cost-effectiveness of the programme for preventing low mood and depression for all participants from a health and social care sector perspective needs to be determined.MethodsA trial-based cost-effectiveness analysis based on a cluster-randomized controlled trial (trial registration – ISRCTN 19083628) comparing classroom-based CBT with usual school provision of Personal Social and Health Education. Per-student cost of intervention was estimated from programme records. The study was undertaken in eight mixed-sex UK secondary schools, and included 3,357 school children aged 12 to 16 years (in the two trial arms evaluated in the cost-effectiveness analysis). The main outcome measures were individual self-reported data on care costs, Quality-Adjusted Life-Years (QALYs, based on the EQ-5D health-related quality-of-life instrument) and symptoms of depression (Short Mood and Feelings Questionnaire) at baseline, 6 and 12 months.ResultsAlthough there was lower quality-adjusted life-years over 12 months (−.05 QALYs per person, 95% confidence interval −.09 to −.005, p = .03) with CBT, this is a ‘clinically’ negligible difference, which was not found in the complete case analyses. There was little evidence of any between-arm differences in SMFQ scores (0.19, 95% CI −0.57 to 0.95, p = .62), or costs (£142, 95% CI −£132 to £415, p = .31) per person for CBT versus usual school provision.Conclusions Our analysis suggests that the universal provision of classroom-based CBT is unlikely to be either more effective or less costly than usual school provision.
    Journal of Child Psychology and Psychiatry 05/2014; · 5.42 Impact Factor
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    ABSTRACT: Only one-third of patients with depression respond fully to treatment with antidepressant medication. However, there is little robust evidence to guide the management of those whose symptoms are 'treatment resistant'. The CoBalT trial examined the clinical effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy) for primary care patients with treatment-resistant depression (TRD) compared with usual care alone. Pragmatic, multicentre individually randomised controlled trial with follow-up at 3, 6, 9 and 12 months. A subset took part in a qualitative study investigating views and experiences of CBT, reasons for completing/not completing therapy, and usual care for TRD. General practices in Bristol, Exeter and Glasgow, and surrounding areas. Patients aged 18-75 years who had TRD [on antidepressants for ≥ 6 weeks, had adhered to medication, Beck Depression Inventory, 2nd version (BDI-II) score of ≥ 14 and fulfilled the International Classification of Diseases and Related Health Problems, Tenth edition criteria for depression]. Individuals were excluded who (1) had bipolar disorder/psychosis or major alcohol/substance abuse problems; (2) were unable to complete the questionnaires; or (3) were pregnant, as were those currently receiving CBT/other psychotherapy/secondary care for depression, or who had received CBT in the past 3 years. Participants were randomised, using a computer-generated code, to usual care or CBT (12-18 sessions) in addition to usual care. The primary outcome was 'response', defined as ≥ 50% reduction in depressive symptoms (BDI-II score) at 6 months compared with baseline. Secondary outcomes included BDI-II score as a continuous variable, remission of symptoms (BDI-II score of < 10), quality of life, anxiety and antidepressant use at 6 and 12 months. Data on health and social care use, personal costs, and time off work were collected at 6 and 12 months. Costs from these three perspectives were reported using a cost-consequence analysis. A cost-utility analysis compared health and social care costs with quality adjusted life-years. A total of 469 patients were randomised (intervention: n = 234; usual care: n = 235), with 422 participants (90%) and 396 (84%) followed up at 6 and 12 months. Ninety-five participants (46.1%) in the intervention group met criteria for 'response' at 6 months compared with 46 (21.6%) in the usual-care group {odds ratio [OR] 3.26 [95% confidence interval (CI) 2.10 to 5.06], p < 0.001}. In repeated measures analyses using data from 6 and 12 months, the OR for 'response' was 2.89 (95% CI 2.03 to 4.10, p < 0.001) and for a secondary 'remission' outcome (BDI-II score of < 10) 2.74 (95% CI 1.82 to 4.13, p < 0.001). The mean cost of CBT per participant was £910, the incremental health and social care cost £850, the incremental QALY gain 0.057 and incremental cost-effectiveness ratio £14,911. Forty participants were interviewed. Patients described CBT as challenging but helping them to manage their depression; listed social, emotional and practical reasons for not completing treatment; and described usual care as mainly taking medication. Among patients who have not responded to antidepressants, augmenting usual care with CBT is effective in reducing depressive symptoms, and these effects, including outcomes reflecting remission, are maintained over 12 months. The intervention was cost-effective based on the National Institute for Health and Care Excellence threshold. Patients may experience CBT as difficult but effective. Further research should evaluate long-term effectiveness, as this would have major implications for the recommended treatment of depression. Current Controlled Trials ISRCTN38231611. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 31. See the NIHR Journals Library website for further project information.
    Health technology assessment (Winchester, England). 05/2014; 18(31):1-168.
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    ABSTRACT: Pathways from early-life conduct problems to young adult depression remain poorly understood. To test developmental pathways from early-life conduct problems to depression at age 18. Data (n = 3542) came from the Avon Longitudinal Study of Parents and Children (ALSPAC). Previously derived conduct problem trajectories (ages 4-13 years) were used to examine associations with depression from ages 10 to 18 years, and the role of early childhood factors as potential confounders. Over 43% of young adults with depression in the ALSPAC cohort had a history of child or adolescent conduct problems, yielding a population attributable fraction of 0.15 (95% CI 0.08-0.22). The association between conduct problems and depression at age 18 was considerable even after adjusting for prior depression (odds ratio 1.55, 95% CI 1.24-1.94). Early-onset persistent conduct problems carried the highest risk for later depression. Irritability characterised depression for those with a history of conduct problems. Early-life conduct problems are robustly associated with later depressive disorder and may be useful targets for early intervention.
    The British journal of psychiatry: the journal of mental science 04/2014; · 6.62 Impact Factor
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    ABSTRACT: Studies examining the validity of the Short Mood and Feelings Questionnaire (SMFQ; Angold, Costello, & Messer, 1995) have largely focused on selected or clinical samples in childhood (6-11 years) or early to midadolescence (12-16 years) and have not investigated misclassifications or how the SMFQ relates to adult depression measures. Using data from the Avon Longitudinal Study of Parents and Children (2012), we assessed the validity of the SMFQ in relation to an adult depression measure administered in late adolescence (age 17-18 years). We also investigated sociodemographic and clinical variables previously shown to affect misclassification on short self-administered questionnaires compared with more detailed assessments of depression. We assessed construct validity using factor and item response theory analysis. To investigate content validity, we tabulated SMFQ items against the International Classification of Diseases (ICD-10; World Health Organization, 1992) and Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) depressive symptoms. Criterion validity was examined using receiver operating characteristic (ROC) analysis. Potential misclassifications were investigated using logistic regression and multiple-indicator multiple-cause modeling. Factor analysis produced high loadings, low residual variances, and appropriate model fit indices. Seven of the 10 ICD-10 depressive symptoms were covered by at least 1 SMFQ item. The discriminatory ability of the SMFQ for meeting ICD-10 diagnostic criteria for depression was very high (area under ROC curve = 0.90). Individuals with anxiety symptoms, females, and less well-educated individuals overreported depressive symptoms on the SMFQ in relation to ICD-10 depression. We conclude the SMFQ is a valid instrument capturing a latent trait of depression in a community-based sample in late adolescence. Further work should be carried out to increase understanding of variables associated with misclassification. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychological Assessment 04/2014; · 2.99 Impact Factor
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    ABSTRACT: Background Peer victimization is ubiquitous across schools and cultures, and has been suggested as one developmental pathway to anxiety disorders. However, there is a dearth of prospective studies examining this relationship. The purpose of this cohort study was to examine the association between peer victimization during adolescence and subsequent anxiety diagnoses in adulthood. A secondary aim was to investigate whether victimization increases risk for severe anxiety presentations involving diagnostic comorbidity.Methods The sample comprised 6,208 adolescents from the Avon Longitudinal Study of Parents and Children who were interviewed about experiences of peer victimization at age 13. Maternal report of her child's victimization was also assessed. Anxiety disorders at age 18 were assessed with the Clinical Interview Schedule–Revised. Multivariable logistic regression was used to examine the association between victimization and anxiety diagnoses adjusted for potentially confounding individual and family factors. Sensitivity analyses explored whether the association was independent of diagnostic comorbidity with depression.ResultsFrequently victimized adolescents were two to three times more likely to develop an anxiety disorder than nonvictimized adolescents (OR = 2.49, 95% CI: 1.62–3.85). The association remained after adjustment for potentially confounding individual and family factors, and was not attributable to diagnostic overlap with depression. Frequently victimized adolescents were also more likely to develop multiple internalizing diagnoses in adulthood.Conclusions Victimized adolescents are at increased risk of anxiety disorders in later life. Interventions to reduce peer victimization and provide support for victims may be an effective strategy for reducing the burden associated with these disorders.
    Depression and Anxiety 04/2014; · 4.61 Impact Factor
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    ABSTRACT: Overgeneral autobiographical memory has repeatedly been identified as a risk factor for adolescent and adult psychopathology but the factors that cause such over-generality remain unclear. This study examined the association between childhood exposure to traumatic events and early adolescent overgeneral autobiographical memory in a large population sample. Thirteen-year-olds, n = 5,792, participating in an ongoing longitudinal cohort study (ALSPAC) completed a written version of the Autobiographical Memory Test. Performance on this task was examined in relation to experience of traumatic events, using data recorded by caregivers close to the time of exposure. Results indicated that experiencing a severe event in middle childhood increased the likelihood of an adolescent falling into the lowest quartile for autobiographical memory specificity (retrieving 0 or 1 specific memory) at age 13 by approximately 60%. The association persisted after controlling for a range of potential socio-demographic confounders. Data on the traumatic event exposures was limited by the relatively restricted range of traumas examined, and the lack of contextual details surrounding both the traumatic event exposures themselves and the severity of children's post-traumatic stress reactions. This is the largest study to date of the association between childhood trauma exposure and overgeneral autobiographical memory in adolescence. Findings suggest a modest association between exposure to traumatic events and later overgeneral autobiographical memory, a psychological variable that has been linked to vulnerability to clinical depression.
    Journal of Behavior Therapy and Experimental Psychiatry 03/2014; 45(3):330-338. · 2.23 Impact Factor
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    ABSTRACT: Premature discontinuation of antidepressant drugs is a frequent clinical problem. Adverse effects are common, occur early on in treatment and are reported to be one of the main reasons for discontinuation of antidepressant treatment. To investigate the association between adverse effects occurring in the first 2 weeks of antidepressant treatment and discontinuation by 6 weeks as the outcome. To investigate the time profile of adverse effects induced by the selective serotonin reuptake inhibitor citalopram and the noradrenaline reuptake inhibitor reboxetine over 12 weeks of treatment. Six hundred and one depressed individuals were randomly allocated to either citalopram (20 mg daily) or reboxetine (4 mg twice daily). A modified version of the Toronto Side Effects Scale was used to measure 14 physical symptoms at baseline (medication free) and at 2, 6 and 12 weeks after randomisation. Individuals randomised to reboxetine reported a greater number of adverse effects and were more likely to stop treatment than individuals receiving citalopram. Dizziness (OR 1.83; 95% CI 1.09, 3.09; p = 0.02) and the total number of adverse effects (OR 1.12; 95% CI 1.00, 1.25; p = 0.06) reported at 2 weeks were associated with discontinuation from overall antidepressant treatment by 6 weeks. Reports of adverse effects tended to reduce throughout the 12 weeks for both antidepressants. The majority of adverse effects were not individually associated with discontinuation from antidepressant treatment. Reports of physical symptoms tended to reduce over time. The physical symptoms that did not reduce over time may represent symptoms of depression rather than antidepressant-induced adverse effects.
    Psychopharmacology 02/2014; · 4.06 Impact Factor
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    ABSTRACT: Background:The unwanted side effects associated with antidepressants are key determinants of treatment adherence in depression; propensity to experience these adverse drug reactions (ADRs) may be influenced by genetic variation. However, previous work attempting to ascertain the genetic variants involved has had limited success, in part due to the range of ADRs reported with antidepressants.Method:ADRs reported with antidepressant treatment were categorised using their likely pharmacological basis; adrenergic, cholinergic, serotonergic and histaminergic. To identify genetic predictors of susceptibility to each group of ADRs, a candidate gene analysis was performed with data from 431 depressed patients (from a total sample size of 811 patients) enrolled in the Genome-Based Therapeutic Drugs for Depression (GENDEP) project, who were randomly allocated to receive treatment with escitalopram or nortriptyline. Data from 474 patients treated with citalopram or reboxetine in the GenPod project (total sample of 601 patients) were used for replication of significant findings.Results:We found no significant predictors of presumed adrenergic, cholinergic and histaminergic ADRs. Putative serotonergic ADRs were significantly associated with variation in the gene encoding the serotonin 2C receptor (HTR2C, rs6644093, odds ratio (OR)=1.72, 95% confidence interval (CI)=1.31-2.25, p=7.43×10(-5)) in GENDEP. However, this finding was not replicated in GenPod.Conclusions:The association between serotonergic side effects and variation in the HTR2C gene in the GENDEP sample supports the hypothesis that serotonin receptor-mediated mechanisms underlie these adverse reactions, however this finding was not replicated in GenPod.
    Journal of Psychopharmacology 01/2014; · 3.37 Impact Factor

Publication Stats

5k Citations
1,447.12 Total Impact Points


  • 2003–2014
    • University College London
      • Mental Health Sciences Unit
      Londinium, England, United Kingdom
  • 2013
    • The University of Hong Kong
      Hong Kong, Hong Kong
    • University of Queensland 
      • School of Population Health
      Brisbane, Queensland, Australia
    • Virginia Commonwealth University
      • Virginia Institute for Psychiatric and Behavioral Genetics
      Richmond, VA, United States
    • London School of Hygiene and Tropical Medicine
      • Centre for Global Mental Health
      London, ENG, United Kingdom
    • University of Chicago
      • Department of Psychiatry and Behavioral Neuroscience
      Chicago, IL, United States
  • 2012–2013
    • University of Cambridge
      • Department of Psychiatry
      Cambridge, England, United Kingdom
  • 2010–2013
    • University Hospital of Ioannina
      Yannina, Epirus, Greece
  • 2006–2013
    • The University of Warwick
      • • Department of Psychology
      • • Warwick Medical School (WMS)
      Coventry, England, United Kingdom
  • 2005–2013
    • King's College London
      • • Department of Psychological Medicine
      • • MRC Social, Genetic and Developmental Psychiatry Centre
      • • Institute of Psychiatry
      Londinium, England, United Kingdom
    • The Kings College
      Brooklyn, New York, United States
    • University of Santiago, Chile
      CiudadSantiago, Santiago, Chile
  • 2002–2013
    • University of Bristol
      • School of Social and Community Medicine
      Bristol, ENG, United Kingdom
  • 2002–2012
    • Cardiff University
      • Department of Psychological Medicine and Neurology
      Cardiff, WLS, United Kingdom
  • 2004–2011
    • University of Ioannina
      • School of Medicine
      Ioánnina, Ipeiros, Greece
  • 2003–2011
    • Federal University of Pernambuco
      • • Hospital das Clinicas
      • • Departamento de Medicina Social
      Recife, Estado de Pernambuco, Brazil
  • 2007
    • University of Chile
      • Facultad de Medicina
      Santiago, Region Metropolitana de Santiago, Chile
    • São Paulo State University
      • Faculdade de Medicina de Botucatu
      São Paulo, Estado de Sao Paulo, Brazil
  • 2003–2007
    • Queen Mary, University of London
      • Barts and The London School of Medicine and Dentistry
      Londinium, England, United Kingdom
  • 2004–2005
    • University of Leicester
      • Department of Health Sciences
      Leicester, ENG, United Kingdom
  • 2002–2005
    • University of Wales
      • College of Medicine
      Cardiff, Wales, United Kingdom