A Visit to Bristol – By Jonathan Ipser

I visited the University of Bristol (UoB) in 2015 on two separate occasions, as part of the EUSARNAD Fellowship. My first visit was for 4 weeks in February. I was excited to go to Bristol, as I had previously been there for a Cochrane Anxiety, Depression and Neurosis Group (CCDAN) workshop in 2010, and had found the city to be vibrant and full of creative energy. My EUSARNAD host was Prof Marcus Munafo, the director of the Tobacco and Alcohol Research Group (TARG), located within the School of Experimental Psychology at UoB.

On my arrival at TARG, I was welcomed by Prof Munafo, and given a tour of their facilities, as well as introduced to the TARG research and support staff by Dr. Kate Button (now at the University of Bath). Lizzy Dann and Jasmine Khouja were particularly helpful in making sure that I had access to all the facilities I needed whilst there.

My first visit to Bristol was timed to coincide with a 2 day workshop entitled “Introduction to Network Meta-analysis” being held at the UoB, and which I attended with Taryn Amos, another EUSARNAD grant recipient and UCT doctoral candidate whose PhD thesis I am co-supervising. Network meta-analysis (NMA) allows one to make statements about the effectiveness of particular medications in treating anxiety disorders compared to any other medication, regardless whether they have actually been directly compared to these other medications in clinical trials. By drawing evidence from indirect comparisons (via a common comparator, such as placebo), Taryn will be using NMA to determine the relative ranking of medication agents in terms of their efficacy and tolerability in treating social anxiety disorder (SAD).

Taking a break from rowing down the Thames

Taking a break from rowing down the Thames

The two day workshop on NMA provided Taryn and I with a broad overview of this methodology, but more importantly, introduced us to some of the pioneers of this approach, including Dr Deborah Caldwell, who agreed in a subsequent discussion to become a consultant on the SAD NMA. I spent much of the remainder of my time in Bristol assisting with overseeing data entry for the SAD NMA. While in Bristol, I also discussed the possibility of collaborating with Dr Caldwell and Kate Button on developing a novel network cumulative meta-analysis approach, which could be used to track changes to the network of evidence supporting the efficacy of medications over time. This would potentially be useful in supporting decisions regarding when sufficient evidence has accumulated to obviate the need for further trials of that medication in treating anxiety disorders.

Taryn’s ultimate goal is to apply NMA to randomised controlled trials of pharmacotherapy across a range of  anxiety and related disorders (social anxiety disorder, posttraumatic stress disorder and obsessive compulsive disorder), enabling her to compare how the ranking of these agents differs between these disorders. The results of the NMA’s will be compared to standard Cochrane reviews of pharmacotherapy for these disorders. With this in mind, Taryn and I met with Jessica Sharp, the editorial director of CCDAN, to discuss progress on a Cochrane review of pharmacotherapy for SAD. In addition, whilst travelling to Bristol from London, I met with Prof. Andreas Cipriani at Oxford University, one of our collaborators on the PTSD NMA, to obtain further insight into how to apply NMA to the SAD clinical trial pharmacotherapy evidence base.


Clifton Suspension Bridge

My stay in Bristol during February was not all work, however. In addition to seeing Bristol’s famous Clifton suspension bridge, I also took the weekend off to go rowing on the Thames with a friend who stays in London.

I visited Bristol again in September, for two weeks. This time around, I met with Dr Caldwell to discuss progress on the SAD NMA, as well as to formulate a strategy for completing the project within the next year. In addition, I spent the time I was there identifying and extracting data from studies providing norms for neurocognitive tests that had been identified in studies assessing cognitive impairment in PTSD. This work is being conducted as part of a meta-analysis of the clinical impact of cognitive difficulties in individuals diagnosed with PTSD, to be submitted in partial completion of a PhD thesis by Sheri Koopowitz, another PhD study I am co-supervising

Although it rained for most of the two weeks I was in the city, the weekend was fortunately sunny, and so I was able go on a guided tour of the floating harbour in Bristol (see photo).


Bristol’s Floating Harbour

Thanks to the EUSARNAD program, I was able to gain far greater insight into the application of state-of-the-art quantitative data synthesis methodology, as well as form collaborative partnerships with key players in this area. It also helped me to establish ties to Prof Munafo and his team, a relationship that I plan to take full advantage of in future research into anxiety and stress-related disorders. 

EUSARNAD at the British Association for Psychopharmacology Summer Meeting 2014 – 40th Birthday! — By Verity Pinkney

This summer the British Association for Psychopharmacology (or BAP) celebrated its 40th birthday which was recognised by a special return to Cambridge, UK for the annual summer meeting.

The aims of the BAP are two-fold; firstly to support research that investigates “the biological basis of brain and behaviour and its alterations in psychiatric disorders” whilst also encouraging the study of new and existing pharmacological and psychological treatments that can be used to alleviate them. These aims align nicely with those of EUSARNAD where our research attempts to understand both the mechanisms that underlie anxiety disorders through studies of the brain (by for example utilising imaging techniques – Nienke) and behaviour (often by using computerised tasks to examine subtle indices of anxiety such as attention to threat), whilst also examining how current (e.g. pharmacotherapy – myself and Susie, mindfulness – Ben), and novel treatments (e.g. tDCS – Jo and Dan) may provide relief from the symptoms of anxiety.

This year, all attendees enjoyed the hospitality of Robinson College with both professors and students alike staying on-site in their modest dorms and breakfasting together in the canteen, which greatly encouraged some morning networking over a coffee.

Cambridge is a great place for a conference - it manages to be a unique blend of relaxing, yet motivating!

Cambridge is a great place for a conference – it manages to be a unique blend of relaxing, yet motivating!

On both Monday and Tuesday an excellent array of posters were presented over lunch. Our modest department in Southampton put an impressive 9 academic posters on show this year covering a range of topics from the effects of mindfulness on the perception of emotional faces (Ben), to the early effects of the anti-anxiety drug duloxetine on mood and face processing (Dr Susie Bamford and myself). This really gave us an opportunity to “touch base” with one another’s work in our own department as well as share our findings with an attentive audience.

Our very own Dr Ruihua Hou also gave a stimulating talk this year on “a preliminary investigation of associations between attentional control and neuroinflammation” in the short orals session. She summarised some exciting associations that her team have found between anxiety, specific inflammatory markers and problems controlling attention, which, although preliminary, indicates the need for further investigation of drugs that target inflammation in the treatment of anxiety disorders – an important consideration for many EUSARNAD researchers.

BAP Conference Poster Session - Image from official BAP photos - http://bit.ly/1BMT4eT

BAP Conference Poster Session – Image from official BAP photos – http://bit.ly/1BMT4eT

The highlight of this year’s conference for me was the guest lecture entitled “40 years of BAP – a lifetime of psychopharmacology” by well-known Professor David Nutt, past president of the BAP and current Editor-in-Chief of the Journal of Psychopharmacology. David gave us a whistle-stop tour of the past 40 years of the BAP reflecting on both successes, such as the use of imaging techniques to extend our knowledge of neurotransmission (with particular reference to dopamine) and improved safety of antidepressants; and also failures, where he focused heavily on the withdrawal of funding from pharmaceutical companies and our apparent inability to predict which novel compounds will be effective in clinical trials.

He wrapped up his talk by challenging the audience to overcome the current adversities in psychiatry together, perhaps by accepting and adopting new statistical techniques and novel methodologies to perform good science, by building strong multidisciplinary collaborations to share new discoveries and provide different perspectives, and by helping the public/private sector see why it is necessary to invest in neuroscience research. This point really highlights the importance of organisations such as EUSARNAD that encourage researchers to build strong links with like-minded researchers across the world, and this can often be best achieved through the promotion of their work at meetings like BAP.

As a young researcher, I am in an exciting position to be lucky enough to see how the BAP (and mental health research more broadly) will evolve over the next 40 years. Let’s hope the scientific community work together to produce more successes and fewer challenges in the years to come. Thanks to the organising committee for a great conference – we all look forward to travelling to Bristol in 2015!

–          Verity

The Mechanisms of Menace – visiting a Southampton anxiety conference (by Nienke Pannekoek and Ben Ainsworth).

On the 2nd September, we (that’s Ben and Nien) were lucky enough to join national and international investigators at ‘The Mechanisms of Menace’ conference to discuss recent advances in anxiety research.

Prof. David Baldwin and Dr. Matt Garner, both from the University of Southampton, organised an energetic one-day conference on anxiety that offered students, professors and clinicians from various fields of expertise the opportunity to share their experiences with colleagues, students and interested (/lost) bystanders.

2014-09-05 15.15.40

Professor David Baldwin delivered an interesting and important talk from the academic psychiatrist*s perspective – about the recent changes to BAP guidelines, and how they might affect anxiety treatment/research

Professor Graham Davey from the University of Sussex kicked things off with an insightful assessment of the current state of affairs in anxiety research. While dancing around a self-professed proneness to ranting, a lot of what Professor Davey said was really in tune with the aims of EUSARNAD as a whole: while a lot of people with anxiety might only meet clinical psychologists and psychiatrists, there is a huge amount of research necessary to inform effective treatments – and it’s vital that clinicians and researchers learn from and inform each other effectively in order to develop and improve anxiety interventions.

This point was emphasized when Dr. Julie Hadwin spoke about her research looking at how improvements to basic cognitive processes (like working memory) could help adolescents with anxiety, and the morning session was rounded off by Dr. Lusia Stopa (Uni. Southampton) spoke about her research as a clinical psychologist, looking at how self-imagery could be used to improve social anxiety – exciting evidence of how laboratory experiments can have real world implications.


EUSARNAD member Nienke Pannekoek fielding questions on her work in the fields of comorbid anxiety and depression

Either side of lunch, a number of short, punchy talks explored the mechanisms of anxiety and anxiety interventions. Dr. Kate Button (Bristol University), Maria Ironside (Oxford Uni.), Dr. Ruihua Hou (Uni. Southampton), Michael Breen (Uni. Southampton), Annette Bruhl (Uni. Cambridge) and Nienke Pannekoek (Leiden Uni.) presented some really exciting work that used an amazing range of methodologies: from novel computer tasks to explore maladaptive cognitive processes in anxiety and using electrodes to stimulate specific brain regions [tDCS] to measuring cytokines and genetic predictors of psychopathology.

What was most striking was how all of the different presentations – each requiring a totally different expertise from the researchers! – fit together to help form a coherent understanding of anxiety. Dr. Sam Chamberlain (Uni. Cambridge) kept everyone interested after lunch discussing predictors of OCD.

The day finished with three talks that highlighted the themes of information sharing and  collaboration – Dr. Matt Garner showcased the work that his group have been doing developing a new human-model of anxiety before Professor David Baldwin informed everybody about the changes that the British Association of Psychopharmacology had made to their guidelines for treating anxiety disorders. Lastly, Professor Elaine Fox (Oxford Uni.) gave an entertaining talk on the research she’s been leading investigating cognitive and genetic predictors of anxiety, and whether we can use these predictors to inform anxiety interventions.

Present throughout the day was Amo Kalar from AnxietyUK, a charity that works to support those with anxiety. Amo emphasised that in order to keep helping anxiety, collaboration must be used in conjunction with effective publicity; very much in line with EUSARNAD’s goals. He also had the honour of giving away awards for the two most outstanding posters of the day, by Denise Meuldijk (Leiden University, The Netherlands) and Kiri Granger (Uni. Nottingham).

The conference was a great success and after the day, both of us left feeling extremely motivated. It’s always the sign of a good conference when you leave with new energy, new ideas, new respect for other’s work, and lots of inspiration. It is exciting to see what the future will bring in the joint effort to target the menace of anxiety.

Ben and Nien

Expanding the anxiety umbrella: a collaboration that began with EUSARNAD – by Nienke Pannekoek

It is not uncommon for people to jokingly use the term “hypochondriac” for someone when they are greatly exaggerating some seemingly trivial physical problem. In truth, as a result of my own ridiculous clumsiness, I’ll be the first to admit to probably having said “I’m crippled forever!” after again hitting my knee on a desk drawer/toe on a coffee table/hip on the corner of a shelve/shoulder on a doorpost/… (unfortunately, my list is endless).

Hypochondriasis pic 1

One generally does not associate ‘hypochondriasis’ with anxiety. Neither did I. But when I was on my EUSARNAD programme in Cape Town to work on the so-called MEGA-SAD project (international, multi-centre MRI database of social anxiety disorder), and professor Dan Stein suggested to write a book chapter about the classification of ‘hypochondriasis’, I took the opportunity to learn. When thinking about “anxiety”, excessive worrying about one’s health and a preoccupation of having a serious illness are probably not the first things that spring to mind. It turned out that whereas the focus lies with physical symptoms in ‘hypochondriasis’, anxiety is actually one of the core issues of this disorder.

But what does it mean to actually suffer from ‘hypochondriasis’? And what exactly is it, anyway?

In short, what typifies ‘hypochondriasis’ is the conviction that one is suffering from a serious physical illness, based on the misinterpretation of bodily symptoms. This leads to repeated consultation with doctors, even after appropriate medical evaluation and reassurance that no illness is present. This belief persists for a period of at least six months, and causes significant impairment in social, occupational, or other important areas of functioning.

Since the archaic origin of the term, first introduced by Hippocrates, the construct has undergone a vast change over the years – first from stemming from abdominal issues, to being viewed as a problem deriving from the nervous system (Freud’s influence), to its final concept as a mental disorder. It has been subjected to tremendous criticism, disagreement between experts, and ongoing debate about its classification. Even with the recent appearance of the DSM-5, in which the controversial and inaccurate use of the term ‘hypochondriasis’ has been abandoned (which is why I write it in quotation marks), the dispute remains unresolved.

Hypochondriasis pic 2

The disorder is, and has been throughout history, surrounded by a haze of issues. The symptoms patients present with are heterogeneous and show overlap with anxiety disorders, somatoform disorders, and obsessive-compulsive disorder. So where should it be classified? Also, the concept ‘hypochondriasis’ is stigmatised in society (“you are only imagining it”) as well as amongst clinicians, whose reassurance is dismissed and whose professional judgement is constantly doubted by their patient. Second opinions are often sought and GPs will be pushed for referral to specialists without the need for it from the clinician’s point of view. Poor patient-doctor relationships are often the result and lead to anger and frustration on both sides. Also, because of the focus on physical symptoms, it is very difficult for clinicians to recognise the mental origin of the disorder. All of the above makes it complicated to correctly diagnose someone as suffering from ‘hypochondriasis’. This has led to the realisation of a guide for clinicians, of which my chapter with professor Dan Stein is part. The book has only very recently been published, which prompted me to write a blog entry for the EUSARNAD website, not in the least because it is a concrete outcome from a collaboration established by EUSARNAD.

I had no idea how complicated and misunderstood ‘hypochondriasis’ is, and I was unaware of the controversy that has been around it for centuries – and still is. Unfortunately, mental health problems still come with a huge stigma, and in that ‘hypochondriasis’ seems to be one of the frontrunners.

Key to EUSARNAD is advancing research in anxiety by uniting researchers from all over the world and thus allowing them to collaborate closely and generate new ideas. EUSARNAD also enables individual researchers to gain wide-ranging, additional insights that go beyond the initial purpose of their exchange schemes; to think slightly out of the anxiety box – this book chapter is a clear example. From this opportunity to write the chapter I have not only learned about ‘hypochondriasis’, but I now also have a better appreciation of the heterogeneity and delicacy of psychiatric disorder in general. Within this niche, however small it may be, I am very grateful to have contributed to a book that can hopefully make the lives of clinicians a little easier in their understanding of the disorder, and most importantly, of their patients.

– Nienke

(For those interested, the book is now available! “Hypochondriasis and Health Anxiety: A Guide for Clinicians” – Editors Vladan Starcevic and Russell Noyes)

Beyond the academic sphere: A European Perspective – by Ben Ainsworth

Earlier this week, I was invited to meet some local politicians to discuss the research that we are doing through EUSARNAD, along with Professor David Baldwin. It’s always interesting to be asked to discuss my research with people who are outside the usual ‘catchment area’ (which normally consists of other researchers in the mental health field, and those unlucky enough to be cornered in the kitchen at parties), and I jumped at the chance to talk to Catherine Bearder and Jackie Porter about our recent efforts in anxiety research.

Professor Baldwin, Catherine Bearder and I were able to have a good discussion about the contributions the EU has made to funding psychiatric research

Professor Baldwin, Catherine Bearder and I were able to have a good discussion about the contributions the EU has made to funding psychiatric research

Catherine is a Member of the European Parliament for the South East England, and Jackie is a prospective MP for Winchester and Chandler’s Ford – for those of you who aren’t entirely familiar with British geography, both represent people between London and Southampton, and were genuinely interested in the ways that EUSARNAD researchers are trying to improve and inform mental health care.

After telling Catherine and Jackie about my personal experience of spending time at the Cape Universities Brain Imaging Unit in South Africa, we discussed the importance of the scheme in terms of both ‘tooling up’ researchers who want to expand their horizons into new research methodologies and encouraging the collaboration and networking between young researchers that’s very likely to form foundations for the important research of the future. Being involved in the European Parliament, Catherine was understandably pleased when we spoke about the subsequent collaborative research I completed at the Leiden University Medical Centre (which came about off some informal discussions I had on the very first day of my EUSARNAD programme trip to Cape Town!).


Jackie Porter, Alarcos Cieza, David Baldwin and Catherine Bearder are clearly all much more adept at smiling for the camera than me!

We were also joined in the meeting by Professor Alarcos Cieza, who spoke about the MARATONE project (that’s “Mental Health Training Through Research Network in Europe”). MARATONE is an exciting research project that builds on the idea of ‘horizontal epidemiology’ – basically, the idea that we can study symptoms that are common to more than one mental health disorder as important psycho-social factors in themselves, rather than studying them individually under the label of a specific mental disorder. MARATONE also provides opportunities for junior researchers, and similar to EUSARNAD recognises the need for high-level training and collaborative efforts across multiple institutions. It’s an important and worthy cause, and is clearly something that Professor Cieza is very passionate about.

In psychiatric science, you can sometimes forget that the research we are doing is for the benefit of patients  (in my case, patients with anxiety) and will eventually help them to access better psychiatric treatment. In order to do that, the research has to go beyond the academic sphere, and it’s certainly very encouraging to know that Jackie Porter and Catherine Bearder are taking an interest.

– Ben

Würzburg to Cape Town, part two – by Maximilian Geiger

Six weeks have passed very quickly – and I am writing this from back in Würzburg. Browsing my notes, reports and photos, the amount and variety of experiences feels simply amazing.

My secondment started with a meeting with Dan Stein and the local MRI experts, Jonathan Ipser and JP Fouche plus Henk van Steenbergen another visitor from Leiden University. During this meeting I got a first impression of the work that is currently done in their workgroup at the Groote Schuur Hospital in Cape Town. Being still a little paralyzed and overwhelmed by South Africa, Cape Town and my new working environment, I was asked about my expectations and interests. I am more than happy that my reply was answered with the opportunity to work on some ‘real’ data in the field of social anxiety disorder.

During the first days Jonathan offered a lot of his time in setting up my workstation and helping me to get into the data. We discussed what research question and what approach would be most interesting. In retrospect I am very happy that we found a good balance between my previous skills and the opportunity to extend these skills. Here it was very helpful that Jonathan worked on a similar project and we could share experience.


During my secondment I also got in touch with the field of biology: Cape Penguin (Spheniscus demersus)

The comparison between functional connectivity in certain resting-state networks between patients with social anxiety disorder and healthy controls led to some interesting primary results. Unfortunately the time was too short to completely finish the analysis, and to answer some open questions, but I hope to continue working on this now I am back in Würzburg. I had worked on topics related to social anxiety disorder during my Bachelor’s thesis and Master’s thesis before. It is an interesting and multifaceted disorder but also debilitating. It was great that my secondment in Cape Town gave me the space and the opportunity to get back into the recent literature and relate this to my analysis. I also became aware of a lot of methodological and technical issues. In studying functional connectivity it is often not very clear and sometimes even controversial which approach in analyzing data one should follow, and it is a challenge to find the technique that is most valid in answering your research question. I think I picked up some very useful skills which will be very helpful in my future work.

Cape Town University attracts renowned researchers and I benefited a lot from exchanging thoughts and listening to interesting talks while I was here. Even though time was short I am very happy that I also got the opportunity to visit other mental health departments in Cape Town, to see the scanner facilities and learn a little about other imaging modalities such as DTI.

Six weeks South Africa is more than another filled page in your passport. Cape Town offers a beautiful nature and landscape and you get the possibility to get so close to all kinds of animals you would never believe. But on the other hand you never have to miss the vibrancy and cultural offers of urban life because it´s all there. My visit to Cape Town provided me with varied cultural and academic experience. I really enjoyed the possibility in exchanging thoughts and the freedom in following and focusing my interests in the project. It feels like I will benefit a lot from the techniques and skills I learnt during my stay and I am looking forward to working together with the researchers from Cape Town in the future.


Definitely the place to be in 2014: Cape Town

ECNP Workshop on Neuropsychopharmacology for Young Researchers, Nice, France – by Verity Pinkney

An audible sigh of relief announces take-off with the expectation of leaving the seemingly endless rain in Southampton behind to land in Southern France drenched in glorious sunshine. The European College of Neuropsychopharmacology (ECNP) invite to attend their annual Workshop for Young Researchers was met with excitement in our office when we realised that three of us (Ben Ainsworth, Joanna Miler and I) were lucky enough to have been awarded a place to attend. The three-day conference in Nice aims to give early-career researchers like myself a chance to present and discuss their research in interactive sessions and provides ample opportunity to network with likeminded students, postdocs and psychiatrists from all over Europe.


The Nice vista, captured from our hotel balcony

Within minutes of our arrival we began our networking experience and met Mathieu, a Frenchman from Montpellier who has traded France for Leicester to study for his PhD at De Montfort University. After a not-so-brief detour around central Nice and a visit to the wrong hotel we soon found ourselves in the Boscolo Plaza hotel lobby which buzzed with energetic researchers at the welcome reception.


Day 1 kicked off with a good selection of impressive talks covering a wide range of topics, from the use of proteomics in CNS disorders to animal models of fragile X syndrome. One talk in particular that caught my attention presented interesting fMRI data showing that threat-related brain function could be moderated by daily bright-light intervention; an area that offers exciting possibilities in how treatments of this type may work in Seasonal Affective Disorder. After a brief interlude for lunch, the quality of the talks continued throughout the afternoon and was followed by an evening of poster presentations, networking, French wine and the local cuisine.


The first couple of talks in each session were presented by distinguished scientists in their field of research. These were a great way to illustrate the positive impact a lifetime of research in Psychology and Psychiatry can have to an audience of fresh-faced scientists keen to consider this challenging career path. Saturday began with an inspiring talk by psychiatrist Thomas Schlaepfer who presented some exciting results on the use of deep brain stimulation to alleviate symptoms of severe, treatment-resistant depression. We then enjoyed a few hours of sea and sunshine, before going to two well-attended optional talks covering “how to write good papers” and two personal accounts of careers in industry and academia.


This was again followed by another enjoyable evening of poster sessions where we quickly got chatting with other PhD students who talked enthusiastically and knowledgeably about their work.

After a third morning jam-packed with a wide range of talks, very quickly it seemed that our time in Nice was over. This ECNP workshop gave me the chance to meet some lovely people from a variety of different research areas and also gave me a first-hand account of the vast amount of top quality research that is being undertaken across Europe every day. I now look forward to attending the ECNP Congress in October in Berlin and hope to see some familiar faces there.

For further information about ECNP visit http://www.ecnp.eu/.

(Ed’s note: Based on the quality of her research and her poster presentation in Nice, Verity was selected by senior ECNP scientists to present her research at the ECNP conference 2014 in Berlin – congratulations Verity!) 

Würzburg to Cape Town, part one – by Maximilian Geiger

Sunshine, twenty six degrees, a little windy and no clouds – when I arrived in Cape Town on Wednesday morning I seriously doubted that during my visit I would ever be able to spend only one hour in a dark office room working behind a flickering computer screen. About six months ago I was offered the great opportunity to take part in the exchange program of the European and South African Research Network for Anxiety Disorders (EUSARNAD). It did not take too much contemplating and weighting up before I knew that I definitely wanted to go.

"J Block" - where I will be spending time working with Professor Dan Stein

“J Block” – where I will be spending time working with Professor Dan Stein

After departing Frankfurt, I was very excited but also a little nervous about what life in Cape Town would be like. Not visible to me as a passenger sitting in the middle row, but as announced by the copilot we passed the Table Mountain and the Table Bay on our approach to Cape Town. I had to wait until I had solid ground under my feet before I got the first impression of South Africa. When I left Cape Town International Airport, which was extensively renovated before the FIFA World Cup in 2010, the first thing I saw was palm trees, rough beautiful mountains but from the highway in my rental car I also caught sight of parts of the housings of the Cape Flats. Cape Town is an amazing city integrated in the natural topography and built around the Table Mountain at the eastern shore of the Atlantic Ocean.

After passing fall and winter in Europe, it is hard to even think about working when you surrounded by this beautiful scenery. This of course changed dramatically when I met the resident researchers, who managed to be extraordinary productive and apparently overcome all the obstacles imposed by living in this beautiful city. I was very interested in meeting these people. Dan Stein, Jonathan Ipser and JP Fouche gave me a warm welcome on my first day. Even though I will be here only for four weeks they offered a lot of their time to introduce me to the clinic and my project. The idea is to compare the functional connectivity of fMRI resting-state networks of participants with an anxiety disorders and healthy controls. Considering that I will be here for such a short time I immediately started working. It is an exciting but also demanding task which will hopefully lead to some preliminary results or at least to some learning experience.

mx_cape point

Not in the dark back office at this particular moment!

Brain imaging data analysis is done far too often in the dark back office. At least from my office in the Department of Psychiatry and Mental Health at the Groote Schuur Hospital I can see the foothills of the Table Mountain massif which will hopefully be motivating and inspiring. I am looking forward to the upcoming next weeks in this unique city with lots of cultural and academic experiences with the EUSARNAD program.

EUSARNAD exchange in Southampton – reminiscing from the sleep lab, by Gosia Lipinska

I can’t believe it’s a whole week since I’ve been back in Cape Town. And I’m back in the sleep lab, watching the EEG of my sleeping participant as I reminisce about my exchange at the University of Southampton. Since I’ve been back I’ve been able to apply many things I’ve learnt already – especially related to the sleep lab. The exchange was a fantastic experience in acquiring international experience in the field of sleep research.

In terms of applying my newly acquired sleep research knowledge, I spent today adjusting my entire montage to represent a configuration that is more commonly accepted world-wide. A polysomnographic montage is the unique configuration of electrodes that makes up the EEG reading that you see on the screen. Because the technicians who set up our configuration were not sleep researchers and our team was too green in the field to know any better, our set-up was not optimal for our purposes.


Working at my computer!

I’m also in the processes of applying for an equipment grant so that we can update the kind of electrodes we use, as well as the method of attaching the electrodes. Currently we use a potent glue called collodian, which is pretty much amazing at keeping the electrodes stuck to the head. However it has some pitfalls – it’s very strong smelling, hard to apply and time consuming to remove. There are better products on the market, as I now know, and I’ve located a supplier in Cape Town.

I’ve also come back with lots of clinical knowledge, which will be immensely helpful when I start seeing patients again. I’m also really excited about working on the collaborations I built up during my time – I’m busy selecting articles from a large data base to be included in a Cochrane review of anti-depressant treatment for insomnia. I’m also writing a conceptual short article for the Journal of Human Psychopharmacology examining the treatment of sleep difficulties in posttraumatic stress disorder, collaborating with Cathy Hill on a sleep and high-altitude study and working out the details of future studies with a genetics researcher with an interest in psychiatric disorders. In summary, many papers and future projects to look forward to!


In front of College Keep, where I spent a good deal of time.

Many many thanks to Professor David Baldwin for facilitating this exchange and having me sit in on his outpatients clinic; to the administrative staff, especially Magda Nowak who worked out all the details; to Dr Cathy Hill, Michael Breen and Dr Topher Woelk and Dr Hazel Everitt for including me in their interesting projects; to Dr Jonathan Dakin and Dr Lars Hansen for including me in their clinics and to Sue Johnstone for hosting me!

With Sue, just before I left in a rare moment of sunshine

With Sue, just before I left in a rare moment of sunshine

And lastly may the sun shine in England again!

Cape Town: the best city in the world – by Nienke Pannekoek

One month in Cape Town is not enough. It just does not cut it. It is not enough to enjoy the city and all it has to offer, but also not to really get started on a big, international collaboration. Just when you start to find your feet and get into the topic of your project, it is already time to go. It should not be much of a surprise that I jumped at the chance to return for another, extended period of 6 months to continue working on the social anxiety disorder mega-analysis at the Groote Schuur Hospital!

Together with Jean-Paul (JP) Fouché I was coordinating a big international project on which we had already been working since JP’s visit to Leiden, The Netherlands, in early 2012. At this stage, the social anxiety mega-analysis (or, as we like to call it, the mega-SAD) involves MRI data of subjects with social anxiety disorder and control subjects from 11 research centres in five countries. This does not just mean trying to get the data from all these sites in one place, but it also means dealing with the ethics committees of each centre, which takes time and patience. During JP’s visit to Leiden and my first visit to Cape Town last year, we had been doing some necessary preparatory work. It took us a while, but once we were in possession of all the data, we could really dive in and my six months were spent doing quality checks, troubleshooting, preprocessing, troubleshooting, creating the analysis designs, and more troubleshooting. Did I already mention that there was a lot of troubleshooting? All this resulted in a final dataset of a whopping total of 458 subjects! Each step forward got us more and more excited about the project, and the initial preliminary results look extremely promising.


JP Fouche and I have spent a lot of time working together since early 2012

Unfortunately I am no longer in Cape Town, but some final analyses are now running, and we are looking forward to start writing up the results very soon. Apart from working on the mega-analysis, I have had the pleasure of attending meetings, seminars and lectures, and some new and exciting collaborations have been established with my colleagues at the Psychiatry Department of the Groote Schuur Hospital.


The stunning backdrop of Table Mountain

Of course, living in the most beautiful city in the world (it didn’t get voted ‘best city in the world 2013’ by the Telegraph for nothing…) means that there is more to do than just work. My free time was spent hiking and running on and around the Mountain, wine tasting (and even a combination of both, in costume!) failed attempts to win quiz night, making many great friends, spending time on the beach in front of my house, and enjoying fantastic food in the Mother City. It has been a journey with many ‘firsts’. When you come from a cold and rainy country like The Netherlands, spending Christmas in the sun is such a strange experience! And to celebrate New Year’s Eve ON TOP of Table Mountain is something you only do once in a lifetime.


Working (slash-running-slash-wine tasting) with colleagues

One thing I will never forget is being in South Africa when the beloved Nelson Mandela passed away. Knowing beforehand that this was a possibility during my stay, I was not sure what to expect in the unfortunate event of his death. However, the unity that I witnessed in Cape Town was astonishing. I went to several events remembering Madiba, including an interreligious service that featured speakers each of a different faith, where all people had gathered as one to remember him. Apart from expressing profound sadness of his passing, South Africa paid respect and gratitude to the Father they loved. But there was also joy, and Mandela’s life was energetically celebrated. Several memorial concerts were organised nationwide, and I attended the one at the Cape Town Stadium. The speeches by politicians were moving and heartfelt, the artists were visibly proud to pay a musical tribute to Madiba, and the crowd was celebrating his life. The message of all speakers and performers was clear: South Africa must never forget this great man and build upon the foundations he laid for a better future.


The mega-SAD analysis is still in full swing and there are countless opportunities to continue this project. I am looking forward to presenting the results in the near future, and this is only going to be the first of many publications that can be based on the international database resulting from this exciting collaboration.

For me, this opportunity has meant more to me than I could have ever imagined. The project has been challenging and educational, and I have learned a lot. As for living in the Mother City, Cape Town has fully embraced me and I have fully embraced Cape Town. After my previous visit last year, I knew within 24 hours after arriving in Leiden that I would be back in South Africa a couple of months later. This time I do not know exactly when I will be back, but I can guarantee that it will not be long. Once one has experienced life in Cape Town, once simply cannot stay away!

– Nienke