David Baldwin

David Baldwin
University of Southampton · Academic Unit of Clinical and Experimental Sciences

MA DM FRCPsych

About

493
Publications
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Publications

Publications (493)
Article
Full-text available
Threat reversal learning and avoidance habits in generalised anxiety disorder
Article
Background The multimodal antidepressant vortioxetine is effective in reducing somatic symptoms in patients with major depressive disorder (MDD), but little is known about its effects in reducing depressive symptoms in patients with common comorbid physical illnesses. Methods This was a pooled analysis of 13 randomized, placebo-controlled trials w...
Article
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Objectives To find out how medical students think well-being should be measured. Design A mixed-methods study comprising a cross-sectional online survey (November 2020–March 2021) and semi-structured online interviews. Views on the frequency of availability for measurement, the format, type and purpose of measurement, and with whom well-being shou...
Article
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Background Patients who undergo psychological treatment can report both negative and positive effects, but evidence of factors influencing the likelihood of negative effects is limited. Aims To identify aspects of the organisation and delivery of secondary care psychological treatment services that are associated with patient experiences of negati...
Article
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The clinical construct of “anxiety neurosis” was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating...
Preprint
Full-text available
Objectives To find out how, why and when medical students think wellbeing should be measured. Design A mixed methods study comprising a cross-sectional online survey (November 2020-March 2021) and semi-structured on-line interviews. Views on the frequency of availability for measurement, the format, type and purpose of measurement, and with whom we...
Article
Objectives To find out how, why and when medical students think wellbeing should be measured. Design A mixed methods study comprising a cross-sectional online survey (November 2020-March 2021) and semi-structured on-line interviews. Views on the frequency of availability for measurement, the format, type and purpose of measurement, and with whom w...
Article
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Background: There is no international consensus definition of ‘wellbeing’. This has led to wellbeing being captured in many different ways. Aims: To construct an inclusive, global operational definition of wellbeing. Methods: The differences between wellbeing components and determinants and the terms used interchangeably with wellbeing, such as h...
Article
Purpose/background: Despite the availability of a range of efficacious evidence-based treatments for obsessive-compulsive disorder (OCD), not all patients experience sufficient benefit or are able to tolerate them in practice. Monoamine oxidase inhibitors (MAOIs) show efficacy in the treatment of depression and certain anxiety disorders (such as s...
Article
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Aims To achieve a consensus Core Outcome Set for measuring mental wellbeing in doctors. Hypothesis: A minimum set of valid, reliable and practical wellbeing measures is needed for doctors. Background The importance of doctors’ mental wellbeing to everyone using Health Care is highlighted by the levels of burnout reported in doctors around the worl...
Article
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Aims To explore the theory of wellbeing and to propose an operational definition for wellbeing in doctors. Hypothesis: An operational definition for wellbeing in doctors is needed in order for it to be measured and interventions to improve it developed. Background There is no internationally recognised definition for wellbeing and yet wellbeing is...
Article
Monoamine oxidase inhibitors (MAOIs) were among the first licensed pharmacological treatments for patients with depression, but over time have fallen out of mainstream clinical use. This has led to a loss of clinician training opportunities and reduced availability of MAOIs for prescribing. This article provides a concise and practical overview of...
Article
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Objectives To investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020. Design A regression discontinuity in time (RDiT) analysis of daily service-level activity. Setting and participants Mental healthcare data were extracted from 10...
Article
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Background: As the remission rate of panic disorder (PD) achieved with conventional pharmacotherapy ranges between 20% and 50%, alternative psychopharmacological strategies are needed. We aimed to firstly review data regarding use of antipsychotic and non-benzodiazepine anticonvulsant medication in PD patients with or without comorbidities; sec...
Article
Background: Prolonged stress has been associated with elevated levels of circulating proinflammatory cytokines. Cyclo-oxygenase-2 inhibitors such as celecoxib exert anti-inflammatory effects and may enhance the response to antidepressant drug treatment in patients with depressive disorders, but their effect on anxiety symptoms in patients with anx...
Article
To further understand protective mechanisms to prevent post-traumatic stress disorder or assist recovery from psychological trauma, this study investigated whether pharmacological and psychological activation of a secure attachment representation elicits higher felt-security and a related response pattern of reduced physiological arousal and increa...
Article
Background Rumination is an important feature of affective disorders. Relationships between rumination, cognitive function, emotion regulation, and psychological resilience have been examined in unipolar depression; but few studies have determined whether unipolar and bipolar depressive episodes are distinguishable in terms of these variables. This...
Article
The COVID-19 pandemic and its restrictions have strained personal psychological resilience, tested family relationships, fragmented local communities, disrupted schools and other educational institutions, exhausted health and social services, and drained national economies. Initial concerns necessarily focused on the ability of primary care service...
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Background Clinical audit is a sustained cyclical quality improvement process seeking to improve patient care and outcomes by evaluating services against explicit standards and implementing necessary changes. National audits aim to improve population-level clinical care by identifying unwarranted variations and making recommendations for clinicians...
Article
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Background: Alcohol-related presentations to acute hospitals in the UK are increasing but relatively little is known of the clinical characteristics or natural history of this patient group. Aims: To describe the clinical characteristics, drinking profile, and trajectory of a cohort of patients with alcohol use disorders attending hospital; and ex...
Article
Background Hair cortisol concentration (HCC) can be used to periodically assess hypothalamic–pituitary–adrenal (HPA) axis function, and appears correlated with prolonged exposure to stress. Methods Serial assessment (at Baseline, Week 6 and Week 12) of participants ( n = 35) with anxiety disorders by psychopathological rating scales, with assays o...
Article
p>Objective: substance use disorders are commonly comorbid with anxiety and depressive disorders and are associated with poor treatment outcomes. The mechanisms underlying this association remain unclear-one possibility is that patients with anxiety/depressive disorders and substance use disorders receive poorer treatment. Concerns have been raised...
Preprint
Abstract Background. Hair cortisol concentration (HCC) can be used to periodically assess hypothalamo-pituitary-adrenal axis function, and appears correlated with prolonged exposure to stress. Methods. Serial assessment (at Baseline, Week 6 and Week 12) of participants (n=35) with anxiety disorders by psychopathological rating scales, with assays...
Article
Full-text available
Background: Questions have been raised regarding differences in the standards of care that patients receive when they are admitted to or discharged from in-patient units at weekends. Aims: To compare the quality of care received by patients with anxiety and depressive disorders who were admitted to or discharged from psychiatric hospital at week...
Chapter
Prescription of a selective serotonin reuptake inhibitor (SSRI) is the usually recommended first‐line pharmacological intervention, based on efficacy, tolerability, and safety in randomized placebo‐controlled trials of short‐term and long‐term treatment. The efficacy of pharmacological treatment in generalized anxiety disorder can only be establish...
Article
BACKGROUND: Questions have been raised regarding differences in the standards of care that patients receive when they are admitted to or discharged from inpatient units at weekends. AIMS: To compare the quality of care received by service users with anxiety and depressive disorders who were admitted to or discharged from psychiatric hospital at w...
Article
This Position Statement provides clinicians with practical advice in relation to the use of monoamine oxidase inhibitors (MAOIs) in treating adult patients with moderate-to-severe depression or anxiety disorders.<br/
Article
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Introduction: Concerns have been raised about the quality of inpatient care received by patients with a diagnosis of personality disorder. Objectives: The aim of this study was to examine the quality of care received by inpatients with an anxiety or depressive disorder, comparing subgroups with or without a co-morbid personality disorder. Metho...
Article
Background: Approximately 40% of women and 30% of men describe sexual dysfunction, although recognition in medical settings is suboptimal, due to problems in reporting and eliciting concerns relating to sexual function and satisfaction. Screening questionnaires may help to support this aspect of clinical practice. The Arizona sexual experiences sca...
Article
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Having responded well to an antidepressant I was determined to continue treatment for six months, to increase the probability of a full and lasting recovery. My productivity at work and confidence in social situations increased and it seemed easier to talk about emotional matters. Side effects became gradually less bothersome, though at times I was...
Article
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In the UK, medical cannabis was approved in November 2018, leading many patients to believe that the medicine would now be available on the NHS. Yet to date, there have been only 12 NHS prescriptions and less than 60 prescriptions in total. In marked contrast a recent patient survey found 1.4 million people are using illicit cannabis for medical pr...
Article
Full-text available
Background Approximately 40% of women and 30% of men describe sexual dysfunction, although recognition in medical settings is suboptimal, due to problems in reporting and eliciting concerns relating to sexual function and satisfaction. Screening questionnaires may help to support this aspect of clinical practice. The Arizona sexual experiences scal...
Article
Valproate-containing medicines have long been used in psychiatric practice, principally in the treatment of acute manic episodes, as augmentation agents in the treatment of bipolar and unipolar depressive episodes, and in the prophylaxis of bipolar affective disorder. Many babies are still being born with the adverse consequences of valproate expos...
Conference Paper
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Epidemiological studies indicate that approximately 40% of women and 30% of men report sexual difficulties but recognition in medical settings is sub-optimal, possibly due to problems in describing and eliciting concerns relating to sexual function (Baldwin et al 2015). Screening questionnaires may help to support this aspect of clinical practice (...
Article
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Depression crept quietly over me as a shadow lengthens towards dusk. Probable contributory factors include familial predisposition, multiple bereavement, physical illness and being abused on-line. The first few days of antidepressant drug treatment were unsettling, but I responded steadily, the medication side effects proved tolerable, and my depre...
Article
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Background: specialist inpatient dementia units (SIDU) have been developed to address adverse outcomes often experienced by people living with dementia admitted to acute hospitals. However, the evidence base of their effectiveness remains limited. Aim: to review the current literature to establish the comparative effectiveness of acute hospital SI...
Article
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Controversy continues in regard to antidepressants and withdrawal. Recent debates have focused on the prevalence and length of withdrawal, and some continue to state that withdrawal from these compounds constitutes “addiction”. In this editorial we examine the evidence underlying these recent debates. We acknowledge gaps in knowledge, and make sugg...
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Aim: This study aims to evaluate the feasibility and effects of instruction in yogic breathing techniques (Pranayama) in patients with treatment-resistant generalized anxiety disorder (GAD) in UK secondary mental health services settings. Materials and Methods: Participants were adult primary or secondary care patients with a primary diagnosis of...
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Introduction: Electroencephalography (EEG) has been proposed as a neurophysiological biomarker to delineate psychotic disorders. It is known that increased delta and decreased alpha, which are apparent in psychosis, are indicative of inappropriate arousal state, which leads to reduced ability to attend to relevant information. On this premise we in...
Article
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New regulatory requirements relating to valproate-containing medicines necessarily have a significant impact on the overall care and management of many pregnant women, and girls and women of childbearing potential, who suffer from bipolar disorder or other psychiatric disorders.The Psychopharmacology Committee of the Royal College of Psychiatrists...
Poster
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Baclofen and anxiety symptoms in patients with alcohol use disorders: structured review Amaro HJ, Sinclair JMA, Baldwin DS. Clinical and Experimental Sciences Academic Unit, Faculty of Medicine, University of Southampton, United Kingdom Background. Baclofen is a GABAB receptor agonist (with some α2δ subunit-containing voltage-gated calcium channe...
Article
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Established treatments for obsessive compulsive disorder (OCD) include cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication. Combined treatment may outperform monotherapy, but few studies have investigated this. A total of 49 community-based adults with OCD were randomly assigned to CBT, SSRI, or SSRI+CBT....
Article
Background Established treatments for Obsessive Compulsive Disorder (OCD) include cognitive behavioural psychotherapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication. Combining CBT with SSRI may be superior to either monotherapy, but few studies have addressed this question in adults with OCD. Aim Optimal Treatment for OCD (OTO)...
Article
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Objectives: referral to tertiary services is recommended when patients with mood and anxiety disorders have not responded to multiple treatments in primary or secondary care. Within specialist services some patients undergo treatment with licensed psychotropic medications outside the narrow terms of their market authorisation (‘unlicensed applicati...
Article
Background: The aim of this study was to assess the potential effectiveness of secure attachment priming in outpatients with depressive disorders. Methods: Forty-eight participants engaged in secure attachment priming or neutral priming in the laboratory (Time 1), after which they received three daily consecutive primes via text message (Times 2...
Article
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Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment-related sexual adverse events tend to persist over time, and are unfortunately under-recognized by clinicians and scarcely...
Article
Pharmacological treatment is an important component of much of psychiatric practice. Many psychotropic medications and psychological interventions are available for patients with mental health problems, but patients often remain troubled by distressing symptoms despite undergoing a series of pharmacological and psychological treatments. In this sit...
Article
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In his early novels, the Icelandic Nobel laureate Halldór Laxness portrayed troubled individuals beset by familial, societal and economic challenges within an unpredictable and often unforgiving landscape; his later work addressed humanistic concerns regarding a well-lived life and the harmony of individual and environment. His 1957 novel The Fish...
Article
Objective: Between 30% and 62% of patients with schizophrenia present with co-morbid anxiety disorders that are associated with increased overall burden. Our aim was to summarize current and potential interventions for anxiety in schizophrenia. Design: Structured review, summarizing pharmacological and psychosocial interventions used to reduce a...
Article
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Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, owing to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. Th...
Article
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Development of payment systems for mental health services has been hindered by limited evidence for the utility of diagnosis or symptoms in predicting costs of care. We investigated the utility of functioning information in predicting costs for patients with mood and anxiety disorders. This was a prospective cohort study involving 102 adult patient...
Article
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Background: The negative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation and socialization that tend to be persistent despite standard antipsychotic treatment. Two sub-domains of expressive deficits (affective flattening and poverty of speech) and avolition-amotivation for daily-life and social activities (a...
Article
Introduction: Previous investigations have demonstrated that major depression is associated with particular patterns of cytokine signalling. The primary aim of this study was to examine peripheral pro-inflammatory and anti-inflammatory cytokines and immune balance in generalised anxiety disorder (GAD). Methods: A case-controlled cross-sectional...
Chapter
Problems abound when assessing the comparative acceptability and safety of antidepressant drugs. The findings of double-blind randomised placebo- and comparator-controlled trials provide a reasonable impression of the relative tolerability of antidepressants in short-term treatment, but less is confidently known about their relative acceptability a...
Article
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Background Few countries have made much progress in implementing transparent and efficient systems for the allocation of mental health care resources. In England there are ongoing efforts by the National Health Service (NHS) to develop mental health ‘payment by results’ (PbR). The system depends on the ability of patient ‘clusters’ derived from the...
Data
Associations of individual HoNOS items and the Total HoNOS score with inpatient admission and ‘regular’ vs ‘high’ community mental health service costs. (DOCX)
Article
Introduction Greater understanding of the role of cytokines in interactions between the nervous and immune systems has led to integrative and explanatory models for neuropsychiatric disorders. Our study aimed to examine peripheral inflammatory cytokines and immune balance in generalised anxiety disorder (GAD). Methods A case-controlled cross-sectio...
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The novels of the Icelandic Nobel laureate Halldór Laxness depict individuals who are confronted by personal, familial and societal challenges in an isolated, sparsely populated and unpredictable but sublime and almost magical land. Novels which are currently available in English translation carefully illustrate the potentially damaging consequence...
Article
IntroductionThe utility of blood for genome-wide gene expression profiling and biomarker discovery has received much attention in patients diagnosed with major neuropsychiatric disorders. While numerous studies have been conducted, statistical rigor and clarity in terms of blood-based biomarker discovery, validation, and testing are needed. Methods...
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Objective: Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). Methods: Findings in biomarker...
Article
Objectives: Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Methods: Findings in bioma...
Article
Anxiety disorders are common, comorbid, and disabling conditions, often underdiagnosed and under-treated, typically with an early onset, chronic course, and prolonged duration of untreated illness. The present study aimed to explore the influence of sociodemographic and clinical factors in relation to onset and latency to treatment in patients with...
Article
Erectile dysfunction (ED) has been well recognized as a marker of increased cardiovascular risk for more than 15 years, especially in younger men. Early detection of ED represents an opportunity to intervene to decrease the risk of future cardiovascular events and limit the progression of ED severity. Evidence suggests there is a window of opportun...
Article
Electroconvulsive therapy (ECT) is known to be one of the most effective treatments for managing depression and other severe mental illnesses. Nevertheless, the exact mechanisms underlying response to ECT remain uncertain. This mini-review presents clinical findings regarding the role of genetic factors in the aetiology of the ECT response. Studies...
Article
Introduction: The diagnosis, treatment, and survivorship of cancer have a profound effect on the quality of life and psychological well-being of men and women. Indeed, the perturbation of sexual function because of neoplasm has far-reaching implications. Aims: To explore the prevalence, pathophysiology, and treatment of sexual issues in persons...
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Background: Negative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation, socialisation, speech and movement. When persistent, they are held to account for much of the poor functional outcomes associated with schizophrenia. There are currently no approved pharmacological treatments. While the available evidence...
Article
Symptoms of sleep disturbance, particularly nightmares and insomnia, are a central feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that specific treatment of PTSD-related sleep disturbance improves other symptoms of the disorder, which in turn suggests that such disturbance may be fundamental to development and maintena...
Article
Leuchter et al 's[1][1] findings extend the current understanding of the placebo response and raise important questions regarding the design of antidepressant trials. An important finding was that expectation of medication effectiveness predicted treatment response in the placebo group only, which