Project Details

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Professor Steven Marwaha

Project area or title

Pharmacological treatment of affective instability: Network Meta-analysis of treatment of a transdiagnostic symptom


Affective instability can be defined as rapid oscillations of intense affect, with a difficulty in regulating these oscillations or their behavioural consequences. It is often referred to as emotional dysregulation, mood instability, mood swings etc in the scientific literature, and the construct fulfils many of the Research Domain Criteria of NIMH. It is transdiagnostic, and is associated with the onset of depression, bipolar disorder, borderline personality disorder and psychosis, as well as functioning, detention under the mental health act and longer-term outcomes. Around 70% of referrals to mental health services mention affective instability (or terms akin to this) as one of the difficulties that are being experienced. Despite this need, effective treatments are lacking. Whilst psychological treatment is often offered first line, patients routinely find it difficult to engage with and requests for medication are frequent. We currently do now know what medication may be effective. The student will develop a protocol, complete a scoping review, and then conduct a systematic review and network meta-analysis on the effectiveness of a range of pharmacological treatments for affective instability. This will be a means to identify the most promising medications that can be investigated in larger RCTs post PhD.


Common Mental Health (covering anxiety, depression)


University of Birmingham

Specific Project Eligibility