Prof Peter Jones

Keynote Speaker

Prof Jones’ research interests have centred on the clinical epidemiology of psychotic disorders including early developmental antecedents, causes and mechanisms; randomised controlled trials (RCTs) of novel and established interventions for mental disorders and of service designs to deliver these treatments; and the implications of permeable diagnostic boundaries across medicine and psychiatry.

Current RCTs include the SINAPPS-2 study of immune therapies in antibody-positive psychosis, Wellcome’s PUMA platform trial (both with Lennox and others), and the TYPPEX programme investigating treatments for common mental disorders including psychotic experiences (with Perez).

Clinically, Prof Jones has been involved in the management of all stages of psychotic disorders and was a co-founder of Cambridgeshire’s award-winning CAMEO early intervention in psychosis service. His management positions have included Chairmanship of the Department of Psychiatry and Deputy Head of the School of Clinical Medicine at the University of Cambridge; he is a past-president of the International Early Intervention and Prevention in Mental Health Association (IEPA), and co-founder of Cambridge Adaptive Testing Ltd.

Abstract

Keynote Address: Psychotic Experiences, Early Intervention and Some Thoughts Against the Stream

Date: 19 November 2024, Tuesday
Time: 9.30 AM

This keynote lecture covers the background and early results of ‘TYPPEX’, a 10-year research programme into the meaning and treatment implications of psychotic experiences (PEs) in people attending primary care services for common mental disorders (CMD). In the context of early intervention, PEs are seen as indicators of a mental state that already is, or may evolve into a first episode psychosis (FEP) syndrome, or as residual features of such a condition following treatment or natural resolution. Outside these specialist services most people with PEs never progress to that full syndrome. PEs can be viewed as a test for psychotic disorder: while most people with a psychotic disorder have a positive test, Bayes’ theorem reminds that is not the same as indicating how likely someone who has PEs will develop a psychotic disorder. This depends on the prior probability of FEP: high in a specialist EI service but very low in the general population or primary care where depression and anxiety are common. But common mental disorders including PEs (CMD-PE) are not included in standard diagnostic criteria, and services for common mental disorders rarely consider, let alone measure PE. This lecture expands the theoretical justification of searching for CMD-PE in high-volume primary care services for more severe depression and anxiety, reports a prevalence study confirming these predictions, and describes clinical phenomenology and outcomes of CMD-PE. Network analysis of phenomenology informed the clinical reformulation of PE and the development of a new CBT-based approach (CBT-ts); this is in the late stages of a multi-centre, stepped-wedge, cluster randomised controlled trial of PE measurement and therapist training. The disruptive implications of this reappraisal of PE as informative in common illnesses will be discussed; they are a new bridge in the mental health ecosystem, not confined to specialist practice.