Dr. M. Moutoussis – Curriculum Vitae – December 2010

Link to the Contents of this CV

Contact details: Michael MOUTOUSSIS

Mobile number: 07963 392 086
Email: fzsemmo [at] gn [dot] apc [dot] org



Contents


  1. Contact details (see above)

  2. Schooling

  3. Undergraduate studies, prizes & elective

  4. Medical Degree

  5. Postgraduate Studies, Degrees and Qualifications

  6. Medical and Surgical experience

  7. Mental health clinical experience, including Core Psychiatric Training, Staff Grade / Clinical Assistant / Associate Specialist experience, Higher Psychiatric Training and Consultant work.

  8. Administrative and Managerial activities

  9. Audit work

  10. Teaching, Presentations, Supervision

  11. Research work, including current studies

  12. Scientific & medical publications

  13. (selected) Conflict resolution & related publications

  14. General interests & entertainment




Education

School :


Undergraduate Education and Qualifications :

1984 - 1987 Imperial College of Science and Technology ( now and Medicine )

B.Sc. Hons (Lond) First Class, ARCS, awarded in Physics, 1987.

[in addition, during the same period: O level Biology ('87, 'A'), A level Chemistry ('87,'B')]
 

1987 - 1993 Charing Cross and Westminster Medical School.
Prizes & Awards:

  1. 1988: 'Burns Prize in Physiology' (shared)

  2. 1989: 'Prize in Psychology ', 'Prize in Sociology ', 'Award of Merit in Biochemistry', 'Award of Merit in Physiology'.

  3. 1991: 'Rudolph Kohnstam Prize in Medicine'; Cash prize for the highest overall marks for Psychiatry student group.

  4. 1992: 'Prize in Immunology'.

  5. 1993: 'The John Adamson Prize in Paediatrics' , 'The H W C Vines Prize in Pathology'.

Elective :

Jan - Feb 1993, University of California, Berkeley, under Prof. W.J. Freeman: Analysis of normal epicortical rabbit EEG from the olfactory system. Contributed to the development of the coupled oscillator neural network approach found to be so fruitful in the mammalian olfactory system. In this work we used methods derived from the field of Complex / Non-linear systems .

Medical Degree :

Bachelor of Medicine and Bachelor of Surgery with
Distinction in Medicine and in Pathology.

Postgraduate Studies, Degrees  & Qualifications :  

· 1989 - 1990 University College London: Master of Science in Physiology, awarded 1990

· 1996 - 1999 Royal Free & University College London Medical School:

Master of Science in Psychiatric Theory and Research Methods, awarded Aug. 1999

Membership of the Royal College of Psychiatrists

[Part II exam passed Spring 1999 at first attempt].

· 2004-2005: Middlesex University: Advanced Diploma in Family-Focused Interventions

awarded 2005


· Currently enrolled to study: Ph.D. in Psychology, University of Manchester:

estimated examination during 2011


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Medicine, Surgery & Psychiatry


Medical & Surgical experience :

  1. Surgical House Officer: Aug. 93, West Middlesex University Hospital. Worked in Urology (Mr. H. S. Rogers) and General Surgery (Mr. K. C. Janardhan and Mr. P. Dawson).

  2. Medical House Officer: Feb. 94, Chelsea & Westminster Hospital. Worked for the Neurology / General Medicine team (Dr F. B. Gibberd), the Dermatology team (Dr. Cream and colleagues) and the Gastroenterology / General Medicine team of Dr. Zeegen.

  3. General Medicine and Elderly Care SHO: Aug. 94 to Aug 95, Bromley Hospitals NHS Trust. Elderly & Orthopaedic, Young Adult and Stroke Rehabilitation (total rehab. 14 weeks); Acute Elderly Care and Acute General Medicine (Worked for consultants with interest in Diabetes as well as some Cardiology and Haematology). I audited the usage of haematinic investigations, which showed a high yield of abnormal B12 & Folate results. This was also true in this combined general medical and psychiatric population when the request was made on the basis of cognitive or mood symptoms. I made special arrangements to attend two services of relevance to psychiatry: I worked in Neurology and Epilepsy Outpatients during my study leave & attended general Psychiatric and Somatoform Disorder clinics (Dr. J. Bird).

  4. Accident and Emergency / primary care: Aug. & Sept. 2001, Hellenic Navy. As a conscript I was briefly re-trained and then posted for 1 month to the health centre covering new recruits in Poros training camp. There I also taught basic resuscitation to new recruits. Then I was posted for 1 month to the A&E department of the Crete Naval Hospital. This hospital provides healthcare to NATO (incl. Greek) forces from the Chania Naval base as well as their relatives.


Mental Health Experience :

As a medical student, I undertook the Cognitive-behavioural treatment of a case of General Anxiety Disorder under the supervision of the Clinical Psychologist & Prof. S. Hirsch at Charing Cross Hospital.


Core Psychiatric Training
From 1996 to 2000 I worked for the North London SHO rotational training scheme for Psychiatry in the following posts :

  1. Psychiatry of the Elderly: 10 Jan 96 to end Aug 96, working for Dr M.W. Orrell. Covered (mainly new) outpatients, functionally ill inpatients, long stay and respite organic illness wards,assessment of liaison referrals, day hospital work and a few GP surgery psychiatry clinics.

  2. Acute Adult Psychiatry:

  3. Liaison Psychiatry: 1 Jul. 97 to 31 Jan. 98, working for Dr. G. Mullen at Whipp's Cross Hospital, Leytonstone. Covered a small inpatient unit dealing with specialist liaison, alcohol detoxification and general psychiatric referrals but mostly provided liaison work for the general hospital.

  4. Psychiatric Research: Feb. 98 - Jul. 98 full time research at Middlesex hospital working for Dr. M.W. Orrell. 'Computer modelling of Executive Control of Attention in Alzheimer's disease' (see below for  about the relevant presentation & publication ).

  5. Community psychiatry: Aug. 98 - Jan. 99, Larkswood Centre, Forest Healthcare trust, working for Drs. Gadhvi & Duignan. Performed assessments in the clinic & at home and carried out short-term follow up as part of a multidisciplinary team. Inpatient work on call. Carried out prison visit & wrote Court Report under the supervision of Dr. Duignan.

  6. Dynamic psychotherapy: Feb. 99 - Jan. 2000, Psychotherapy dept., Forest Healthcare, working for Dr. Garelick (in addition to 2 cases seen during previous training). Carried out individual, couple and (slow open) group therapy under supervision. Continued inpatient work on call.


Staff Grade / Clinical Assistant / Associate Specialist work


Psychiatry of the Elderly: From February to March 2000 (locum staff grade).

Crisis Resolution / Home Treatment:

Military Psychiatry / Therapeutic Community (Sept. 2001- Nov. 2002):

As a conscript I was placed in the Salamina Naval Hospital (SNH) psychiatric dept. & Therapeutic Community (TC). The SNH is placed within a large naval dock. It receives all referrals of seamen and petty officers that appear to need in-depth mental health assessment. My medical work involved -

I was resident 1-in-3 and was the 'first port of call' for psychiatric advice when not resident. The TC part of SNH is based on a modified group-analytic approach. As staff member of the TC I participated in the following groups -

  1. As member: Organising (1 hour weekly), Community-wide (1 hour weekly) and Self-care (20 min. daily) groups.

  2. As one of the conductors: Acquaintance (15 Min daily), Therapeutic Contract (30 Min 4-7 times a week) and Film discussion (2 1/2 h 1-2 times a week) groups.

  3. Having main responsibility for:

    1. Expressive-supportive Art group : (1 1/4 h twice a week). Under close supervision of a psychologist and the Consultant as I had no formal training in this area. The minority of patients with severe mental health problems made good use of this group.

    2. Nursing staff discussion group (1 h weekly) : This was brought together after my initiative at a point when the nursing staff of SNH felt unsupported and alienated from the rest of the TC staff. The group was extremely successful, resulting in better cohesion of the TC as a whole, improvement of nursing staff morale and better relations among the nursing staff themselves. The group contributed to the nursing staff expressing their needs more effectively, particularly in the areas of in-job education and working with challenging patients.

    3. 'Whole Crew group' (1 1/2 h every 2-3 weeks): Largely as a result of the success of the above, I was asked by the Officer responsible for conscripts of the whole SNH to set up this group. It aimed to discuss conscripts' problems and their relationship with the officers who they came in immediate contact with. The running of this group was informed by Median Group principles, under close supervision.

This Military / Therapeutic Community work was clinically instructive and creative but personally quite difficult (please see below), as well as causing substantial disruption to my career in the UK. The supervising head of department was Lt. K. Papadimitriou H.N.


Higher Psychiatric Training


I worked as Psychiatric Specialist Registrar (in Psychotherapy) in Tolworth Hospital, part of the South-West London and King George's Mental Health Trust, first as a higher trainee and then as a service locum (2005-2009). The department's main orientation was psychodynamic, with an emphasis on group therapy including Foulkesian and Systems-Centred (SCT) approaches. The latter is an integrative approach with both brief and exploratory therapy applications; I received introductory training in both its clinical and organisational aspects. I was the co-therapist in a successful 26-session couple therapy using SCT. Using a Foulkesian approach I was co-therapist to a 'Complex Patient' group aimed at patients who have experienced serious mental illness and / or personality disorder for approximately 6 months. I was also sole group conductor for a 2 ¼ year group-analytic small group. I regularly performed new patient assessments, I completed seeing four year-long weekly individual therapy cases, several short-term (15-20 session) psychodynamic and many 6-12 session CBT therapies. I also saw an intensive individual case (about 350 sessions) under the supervision of Mr. C. Gjetnes. This had a very good outcome. During higher training I first continued having my own individual psychoanalytic psychotherapy; I switched to group analysis in November 2006 and this is ongoing.


During this period I also worked in General Adult psychiatry within the Richmond CMHT (as an 'SpR special interest'). I ran one outpatient clinic for new assessment and follow-up appointments and I regularly participated in multidisciplinary allocation / team discussion meetings. Clinical and educational supervision was provided by Drs. Norman Poole and Mireia Pujol. I was part of the 'senior' (intermediate grade) psychiatric on-call rota and I regularly performed Mental Health Act assessments.

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Consultant work

Locum Consultant Psychiatrist in Psychotherapy (Sept. 2009-Sept.2010):

I worked as Outreach Consultant to a Personality Disorder service, part of the City & Hackney Therapeutic Community and Outreach Team (TCOS). This work included:

During this work I actively participated in Continuing Professional Development (CPD). Two important results of this was to receive training and to apply of Approved Clinician status and to enrol with the “ACP 360 Multi-Source Assessment for Psychiatrists”. Both of these are currently (Oct. 2010) in progress.

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Administrative & managerial activities :

Please also see above under 6.


Audit work :

After the Haematology audit that I carried out as a medical SHO, I -


Teaching, Presentations, Supervision :

- I have delivered many case presentations and journal clubs. Among the best received was my discussion of the journal club paper 'The Popper / Kuhn debate: Truth and two faces of Relativism' on epistemology. I am very interested in epistemological and methodological issues in mental health research.

- During the Psychiatric Research SHO post I occasionally taught medical students. I helped collate and analyse student feedback as part of the Department's evaluation.

- During my time as a conscript I played a major role in ascertaining the educational needs of Nursing Staff and organised seminars to fulfil these needs. I thus lectured on Suicidality and Substance Abuse.

As a Staff Grade / Associate Specialist with the South Islington Crisis Team I -

- played a leading role in developing the team's weekly Case Presentation (established at my initiative), where the team is supervised as to the application of systemic thinking to difficult cases. This survived well my leaving the team.

- shared with the Consultants & SpR the clinical teaching medical students, including appropriate patient selection, demonstration of interview technique and mental state examination & presentation.

- attended a two-day training course on Clinical Supervision

As a Psychotherapy Specialist Registrar, I -

- Provided input to the SHO's 'Case discussion / Balint group' (2005-2006,2009)

- Helped individual SHOs with preparation for clinical exams

- Actively participated in the Psychiatry Academic Program as presenter and as chair.

- Attended a 5-day course on how the teaching of medical students in a variety of formats - lecture, tutorial, Case-based learning, Problem-based learning.

- Actively participated in the Trust-based MRCPsych teaching program.

- Taught medical students in lecture, tutorial and CBL formats (sometimes under peer observation and feedback).

- Ran a weekly group for SHOs to supervise cases they have in individual therapy.

All these teaching and supervision activities are undertaken under weekly educational supervision by a Consultant. Formal and informal feedback from students of all types is discussed there.

As a Locum Consultant, I -

- Taught medical students on Personality Disorder and Psychotherapy.

- Facilitated the core trainee Case-Based-Discussion group and taught on Personality Disorder, the relevant services and psychodynamic psychotherapy in the the context of this.

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Research work


This has covered several areas, shown below. A theme that sets it apart is the computer modelling of psychopathological processes, which naturally followed from my earlier studies in cardiac and olfactory computer studies (1990-1993). Τhe research project of my second M.Sc. thesis, which received the mark of distinction, was “Simulating deficits in the executive control of attention in Alzheimer's disease(available at http://eireni.gn.apc.org/thesis/thes_a1.htm). The set of simulations of the MSc project led to new ideas, which I implemented, developed, presented and published in the subsequent years (1999-2004; see below).


As a long term project I am interested in the psychological mechanisms in psychosis. I am most interested in the understanding of paranoid ideation. Prof Richard Bentall (Clinical Psychologist at the University of Bangor) and set up set of studies on the role of avoidance & defensive mechanisms in persecutory ideation. This started as an Sp.R. project but then became the focus of my Ph.D. study, which is nearing completion.

This work has included an effort to understand the contribution that the avoidance of negative thoughts about the self (psychological defensiveness) may have in bolstering such ideas. The project has integrated ideas from a wide range of fields, including psychopharmacology and clinical psychology. I have been very fortunate to also receive support and supervision for this project by Prof. Peter Dayan (professor of computational neuroscience at the Gatsby Institute). Two articles and a contribution to a book chapter were accepted for publication and the relevant work was presented with success at two academic meetings. A third original article, entitled “Jumping to conclusions may be due to uncertainty: Bayesian models of paranoid decision-making” has been accepted for publication in “Cognitive Neuropsychiatry”.

This work also formed the basis for my lecturing at the Reinforcement Learning module of the Gulbenkian/Champalimaud Ph.D. Programme in Neurosciences (summer 2008). There I lectured to Ph.D. students on applications of reinforcement learning (especially temporal-difference methods) to the understanding of severe mental illness.

Following the theoretical and computational studies, an empirical human-participant study was approved by the National Research Ethics Committee (2008). It is entitled 'Thinking about aspects of the Self in people who feel under threat' and it aims to explore the contribution of avoidant/defensive thinking in persecutory ideas. Data collection has been completed and data is currently being analysed. This study aims also to operationalise the assessment of the avoidance of private experiences (experiential avoidance) so that it can be used with imaging.

At the same time I have become involved in a number of related research projects and opportunities. These include -



Scientific & medical Publications :

  1. M Moutoussis, IB Gartside and MJ Lab, " Abnormal Segment 'Work' in the Alternating Heart of the Anaesthetised Pig" (Abstract) Journal of Physiology, Charing Cross and Westminster meeting of the Physiological Society, 10-11 January 1991, p 18P.

  2. M Moutoussis, AV Holden and MJ Lab, "Singular Value Decomposition of Mechanical Signals From Anaesthetised Pig Heart" (Abstract) Journal of Physiology, Charing Cross and Westminster meeting of the Physiological Society, 10-11 January 1991, p 66P.

  3. H Zhang, AV Holden, MJ Lab and M Moutoussis, "Estimation of The Persistence of Strain From Experimental Recordings From Cardiac Tissue" Physica D 58 (1992) 489 - 496.

  4. CF Murphy, MJ Lab, FG Harrison, SM Horner, DJ Dick and M Moutoussis, "Characterisation of regional myocardial dynamics during mechanical alternans in heart of anaesthetised pig" Cardiovascular Research 27(9):1639-44, 1993 Sept.

  5. M Moutoussis & MW Orrell, "Baclofen Therapy for rigidity associated with Lewy body dementia", The British Journal of Psychiatry, Vol.169, 795 (1996) [letter]

  6. M Moutoussis, F Gilmour, MW Orrell & D Baker, "Quality of Care in a Psychiatric Outpatient Department", Journal of Mental Health 9:4, 409-420, 2000.

  7. M Moutoussis, MW Orrell & R Morris,"Modelling Discoordination of Cortical Neuroactivity: Relevance for the Executive Control of Attention in Alzheimer's Disease", Journal of Integrative Neuroscience 3:1, 85-104, 2004.

  8. M. Moutoussis, J.O.H. Williams, P. Dayan & R. P. Bentall, “Persecutory delusions and the conditioned avoidance paradigm: Towards an integration of the psychology and biology of paranoia”, Cognitive Neuropsychiatry 12(6):495-510, 2007.

  9. M. Moutoussis, R.P. Bentall, J.O.H. Williams & P. Dayan, “A temporal Difference Account of Avoidance Learning”, Network: Computation in Neural Systems 19(2):137 – 160, 2008.

  10. R.P. Bentall, P. Kinderman & M. Moutoussis “The role of self-esteem in paranoid delusions: the psychology, neurophysiology and development of persecutory beliefs” in D. Freeman, R.P. Bentall & P. Garety (Eds.) Persecutory Delusions: Assessment, Theory and Treatment. Oxford University Press, Oxford, 2008.

  11. M. Moutoussis, P.P. Bentall, W. El-Deredy & P. Dayan, (2010) “Bayesian modelling of Jumping-to-Conclusions in delusional patients”. (Cognitive Neuropsychiatry – in press).

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Other publications & Interests

Essays and opinion pieces :

  1. M Moutoussis, "On the Barbaric Nature of Boxing: Thoughts Following the Panorama Debate on Banning Boxing after Yet Another Death", Medicine, Conflict & Survival, Vol.12, 62-64 (1996)

  2. M Moutoussis, "The Tragic Roads to Suicide" in the special supplement of the Greek newspaper Eleftherotypia 90:4-7, 2000 Dec. [Review][Greek]

  3. M Moutoussis, "A Psychiatric Approach Concerning the Victims and Perpetrators of Torture" in the special supplement of the Greek newspaper 'Eleftherotypia' 138:10-11, 2001 Nov. [Review][Greek]

  4. M Williams, JOH & Moutoussis M, "Computational Modelling of Psychopathology", Newsletter of the Computers in Psychiatry Special Interest Group of the Royal College of Psychiatrists, November 2004.

Conflict resolution & related publications (selected examples) :

  1. M Moutoussis, "The Background to the New Balkan Wars" Medicine and War, Vol. 9, 317 - 325 (1993)

  2. M Moutoussis, "The United Nations and its Teeth", Medicine, Conflict & Survival, Vol.12, 126-130 (1996)

  3. K Geling, PJ Klasse, M Moutoussis, JJ Patterson, J Piachaud & R Stott "Preventing War through Non-Violent Direct Involvement in Conflict - I. Principles and Background" Medicine, Conflict and Survival 17(4):309-22, 2001 Oct-Dec.

  4. K Geling, PJ Klasse, M Moutoussis, JJ Patterson, J Piachaud & R Stott "Preventing War through Non-Violent Direct Involvement in Conflict - II. Proposal for the Role of IPPNW" Medicine, Conflict and Survival 17(4):323-36, 2001 Oct-Dec.


General Interests :

Peace / Conflict-Resolution issues -

I regard these as quite important. I feel that nowadays non-violent solutions are little researched, under-promoted and wrongly stereotyped as 'doing little or nothing'. Thus they are funded and implemented very inadequately. I have therefore devoted some effort to the pursuit of justice and peace through non-violent means. Examples include :

Entertainment - hobbies :

DIY / woodwork (I have built a 10 ft sailing dinghy); Sailing and windsurfing, particularly with my children.





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