Elizabeth Appiah-Kusi

King's College London | KCL · Department of Psychosis Studies

Background Psychiatric morbidity in prisons and police custody is well established, but little is known about individuals attending criminal court. There is international concern that vulnerable defendants are not identified, undermining their right to a fair trial. Aims To explore the prevalence of a wide range of mental disorders in criminal def...

Evidence suggests that people at Clinical High Risk for Psychosis (CHR) have a blunted cortisol response to stress and altered mediotemporal activation during fear processing, which may be neuroendocrine–neuronal signatures of maladaptive threat responses. However, whether these facets are associated with each other and how this relationship is aff...

Emotional dysregulation and anxiety are common in people at clinical high risk for psychosis (CHR) and are associated with altered neural responses to emotional stimuli in the striatum and medial temporal lobe. Using a randomised, double-blind, parallel-group design, 33 CHR patients were randomised to a single oral dose of CBD (600 mg) or placebo....

Background and aims United Kingdom mental healthcare guidelines recommend recovery-focused services for people with psychosis. We evaluated a “Recovery and Enablement Track” (RET) aiming to promote recovery and well-being, reduce distress and maintain independence from secondary care following discharge, for people with established psychosis and lo...

Background There is currently a lack of effective pharmacological treatment for people at Clinical High Risk of Psychosis (CHR), who present with emotional dysregulation and high levels of anxiety. These individuals also show altered neural responses to emotional stimuli in key brain regions implicated in psychosis onset, including the striatum and...

Rationale Stress is a risk factor for psychosis and treatments which mitigate its harmful effects are needed. Cannabidiol (CBD) has antipsychotic and anxiolytic effects. Objectives We investigated whether CBD would normalise the neuroendocrine and anxiety responses to stress in clinical high risk for psychosis (CHR) patients. Methods Thirty-two C...

Objectives: The Imaginator study tested the feasibility of a short mental imagery-based psychological intervention for young people who self-harm and used a stepped-wedge design to investigate effects on self-harm frequency reduction at 3 and 6 months. Method: A total of 38 participants aged 16-25 were recruited via community self-referral and m...

Accumulating evidence points towards the antipsychotic potential of cannabidiol. However, the neurocognitive mechanisms underlying the antipsychotic effect of cannabidiol remain unclear. We investigated this in a double-blind, placebo-controlled, parallel-arm study. We investigated 33 antipsychotic-naïve subjects at clinical high risk for psychosis...

Background Evidence has been accumulating regarding alterations in components of the endocannabinoid system in patients with psychosis. Of all the putative risk factors associated with psychosis, being at clinical high-risk for psychosis (CHR) has the strongest association with the onset of psychosis, and exposure to childhood trauma has been linke...

participants with a dose reduction. Clinician-based assessments indicated ongoing and meaningful TD improvements in participants with schizo-phrenia/schizoaffective disorder who received long-term VBZ treatment (80 or 40 mg) in the current study following up to 48 weeks of treatment in previous VBZ studies. Patient satisfaction rates with VBZ remai...

Background The non-intoxicating cannabinoid compound cannabidiol (CBD) may have the potential to become a new effective, safe and well-tolerated antipsychotic drug. CBD may be particularly feasible as a treatment for people at clinical high risk (CHR) for the development of psychosis due to its lack of serious side effects. Preclinical models sugge...

Importance Cannabidiol (CBD) has antipsychotic effects in humans, but how these are mediated in the brain remains unclear. Objective To investigate the neurocognitive mechanisms that underlie the therapeutic effects of CBD in psychosis. Design, Setting, and Participants In this parallel-group, double-blind, placebo-controlled randomized clinical...

The ability of an individual to participate in courtroom proceedings is assessed by clinicians using legal 'fitness to plead' criteria. Findings of 'unfitness' are so rare that there is considerable professional unease concerning the utility of the current subjective assessment process. As a result, mentally disordered defendants may be subjected u...

Background There has been growing interest in the therapeutic potential of Cannabidiol (CBD) stemming from independent evidence that CBD has antipsychotic and anxiolytic properties in patients with mental health disorders. CBD has been found to be non-inferior to antipsychotic medication in a 4-week clinical trial in acute schizophrenia (Leweke et...

Background Dysfunctional reward processing is associated with a number of psychiatric disorders, such as addiction and schizophrenia. It is thought that reward is regulated mainly by dopamine transmission in the ventral striatum. Contemporary animal models suggest that striatal dopamine concentrations and associated behaviours are related to glutam...

Background: Neuroimaging studies in people with an At-Risk Mental State (ARMS) for psychosis have largely identified reductions in neural activation during various memory and learning related tasks, particularly in the medial temporal lobe, compared to healthy controls. Tetrahydrocannabinol (THC) and cannabidiol (CBD), both components of the cannab...

Exposure to childhood trauma has been associated with psychotic symptoms, being at ultra-high risk for psychosis (UHR), and psychotic disorders such as schizophrenia. Negative self-beliefs have been shown to partially mediate the relationship between childhood trauma and paranoia and have been shown to be characteristic of patients with psychosis....

Background: Impairments of verbal learning and memory are key neuropsychological deficits in those at ultra-high risk of psychosis (UHR). Previous functional magnetic resonance imaging (fMRI) studies have focused on verbal recognition memory, finding functional alterations in the medial temporal lobes. No studies to date have investigated the patte...

The aim of this article is to summarize current evidence regarding alterations in the neuroendocrine stress response system and endocannabinoid system and their relationship in psychotic disorders such as schizophrenia. Exposure to stress is linked to the development of a number of psychiatric disorders including psychosis. However, the precise rol...

This study examined affective and psychological routes from childhood maltreatment to increased paranoia in adulthood. Recent anxiety and negative beliefs about the self partially accounted for the associations between emotional or physical abuse and paranoia. However, as full mediation did not occur, other psychological, social and biological path...