Project ID NS-MH2026_36

ThemeNS-MH

Co Supervisor 1A Dr Hubertus Himmerich Institute of Psychiatry, Psychology & Neuroscience, School of Academic Psychiatry, Department of Psychological MedicineEmail

Co Supervisor 1B Prof Janet Treasure Institute of Psychiatry, Psychology & Neuroscience, School of Academic Psychiatry, Department of Psychological MedicineEmail

Third Supervisor Dr Johanna Keeler

Partner Neurocentrx

Cognition, fatigue and sleep in people with anorexia nervosa and during treatment with ketamine

(a) Scientific basis
Anorexia nervosa (AN) is a serious psychiatric condition with the highest mortality rate of any psychiatric illness. Depression has been identified as a main factor leading to the chronicity of AN. Recent research has highlighted the importance of sleep, fatigue and problems with memory and attentional capacity in both conditions.
The project involves a systematic literature search and meta-analysis, focus groups to learn about sleep and fatigue in people with lived experience of AN and help with the conduct and data evaluation of a feasibility RCT (EDEN) in 60 patients with anorexia nervosa and depression. The potential PhD student will evaluate data on fatigue and sleep during the treatment with ketamine and at follow-up time points at 3 months and 6 months. They will also design and conduct a longitudinal study examining cognitive performance (memory, attention, visuospatial abilities) and sleep and fatigue in people with AN.

(b) Techniques and skills the student will develop
– Skills in reviewing scientific literature (e.g., database searches, systematic literature review, quality assessment, literature synthesis).
– Recruitment of participants for qualitative and quantitative studies.
– Qualitative research skills (e.g., the facilitation of focus groups, coding, different strategies of qualitative analysis).
– Quantitative data analysis.
– Research and trial design.

(c) Overarching aims of the project
– To explore the experiences of people with AN and depression about the importance of behavioural activation, cognition, sleep and fatigue.
– To evaluate data from a feasibility RCT on cognitive performance, sleep and fatigue.
– To design and implement a longitudinal study exploring cognition, sleep and fatigue in people with AN.

(d) Measurable objectives for each year
– Year 1: Systematic review/meta-analysis of sleep- and fatigue-related parameters in AN; obtaining ethical approval. Help with recruitment, screening and conduct of the feasibility RCT.
– Year 2: Facilitation of the focus groups, coding, qualitative evaluation of the focus groups and data collection for the new longitudinal study.
– Year 3: Continuation of data collection for the new cross-sectional study. Data analysis of feasibility RCT outcomes.
– Year 4: Data analysis of the cross-sectional study outcomes; publication of manuscripts; thesis write-up.

For a 3-year programme, the project can be modified by changing the longitudinal to cross-sectional study design. In general, this project can be adapted according to the successful candidate’s preferences.

(e) 3-month rotation project
The PhD candidate will be offered rotate into SlaM’s clinical service for people with AN and perform an audit or quality improvement project related to sleep (e.g., on sleep hygiene or sleep medication).

Representative Publications

1) Said O, Stringer D, Sengun Filiz E, Mutwalli H, Bektas S, Akkese MN, Kellermann V, Ireland K, Tyrrell-Bunge E, Beishon-Murley D, Khor JWT, Allman L, Barker J, Kotze N, Carter B, Simic M, Sually DS, Bentley J, Young AH, Madden S, Byford S, Landau S, Lawrence V, Treasure J, Schmidt U, Nicholls D, Himmerich H. Olanzapine for young PEople with aNorexia nervosa (OPEN): results of a feasibility study. BMC Psychiatry. 2024;24:779. doi: 10.1186/s12888-024-06215-y. 2) Himmerich H, Keeler JL, Davies HL, Tessema SA, Treasure J. The evolving profile of eating disorders and their treatment in a changing and globalised world. Lancet. 2024;403:2671-2675. doi: 10.1016/S0140-6736(24)00874-2. 3) Himmerich H, Lewis YD, Conti C, Mutwalli H, Karwautz A, Sjögren JM, Uribe Isaza MM, Tyszkiewicz-Nwafor M, Aigner M, McElroy SL, Treasure J, Kasper S; WFSBP Task Force on Eating Disorders. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines update 2023 on the pharmacological treatment of eating disorders. World J Biol Psychiatry. 2023;8:643-706. doi: 10.1080/15622975.2023.2179663.

“1) Cardi V, Rowlands K, Ambwani S, Macdonald P, Arcelus J, Schmidt U, Treasure J. Patient and carer feedback and engagement with ECHOMANTRA, a digital guided intervention for anorexia nervosa. Eur Eat Disord Rev. 2025;33:210-220. doi: 10.1002/erv.3140. 2) Cardi V, Rowlands K, Ambwani S, Lord J, Clark-Bryan D, McDaid D, Schmidt U, Macdonald P, Arcelus J, Landau S, Treasure J. Efficacy and cost-effectiveness of a digital guided self-management intervention to support transition from intensive care to community care in anorexia nervosa (TRIANGLE): pragmatic multicentre randomised controlled trial and economic evaluation. EClinicalMedicine. 2024;73:102645. doi: 10.1016/j.eclinm.2024.102645. 3) Treasure J, Duarte TA, Schmidt U. Eating disorders. Lancet. 2020;395:899-911. doi: 10.1016/S0140-6736(20)30059-3.”