Dr Nicole Needham (BMBS, BSc, MRCPsych, DFSRH)

Clinical Research Fellow

Contact details

Address

Street

Chancellors Building
49 Little France Crescent

City
Edinburgh
Post code
EH16 4SB

Biography

Background

I completed a BMBS at Peninsular College of Medicine and Dentistry in 2015, with an intercalated BSc in Biosciences. Since then I have completed core training in Psychiatry, achieving membership of the Royal College of Psychiatrists, and the first year of higher training in Psychiatry. I am currently out of programme for 4 years, employed as  a Clinical Research Fellow and planning to complete a PhD. I am a diplomate of the Faculty of Sexual and Reproductive Health.

My primary research focus is bipolar disorder, and I am currently working a Wellcome Trust funded project examining the light hypersensitivity hypothesis in bipolar disorder, with a focus on circadian disruption. I have previously coordinated a pilot study looking at use of a ketogenic diet in bipolar disorder, and continue to have an interest in bidirectional relationship of metabolic dysfunction and severe mental illness. I was the PI for a study looking at the acceptability and feasibility of offering sexual health screening to psychiatry inpatients, and have an ongoing interest in improving equity of access to Sexual and reproductive health care in people with mental illness. 

Qualifications

2021       MRCPsych, Member of the Royal College of Psychiatrists, UK

2018       DFSRH, Diplomate of the Faculty of Sexual and Reproductive Health

2015       BMBS, Bachelor of Medicine Bachelor of Surgery, Peninsula College of Medicine and Dentistry

2014       BSc Biosciences, University of Exeter

Research summary

HeliosBD - The light hypersensitivity hypothesis in bipolar disorder

I have a strong interest in bipolar disorder and the light hypersensitivity hypothesis, specifically that people with bipolar disorder may be more sensitive to light than people without bipolar disorder, and that this may be attenuated in people with bipolar disorder taking lithium. I am interested in whether melatonin suppression varies between these three groups following light exposure, and whether there are alterations in retinal structure and function. 

Metabolic psychiatry

I have an interest in the bidirectional nature of metabolic dysfunction in severe mental illness, and previously coordinated a pilot study looking at the use of a ketogenic diet in bipolar disorder. 

Sexual and reproductive health care in psychiatry patients

I have previously been the PI on a study looking at the acceptability and feasibility of sexual health screening in psychiatry inpatients, which demonstrated that this is both acceptable and feasible. Subsequently I have been involved in setting up an onsite clinic at a psychiatric hospital to provide specialist sexual and reproductive healthcare for inpatients. We are aiming to publish the service evaluation of the initial pilot year soon. 

Project activity

HeliosBD

Summary (from www.heliosbd.com)

Lithium has been in use for 70 years and is the most effective treatment for bipolar disorder. It has many actions but the precise mechanism of action in bipolar disorder is uncertain. Recent evidence suggests that lithium may work by stabilizing aberrant circadian rhythms of mood, cognition and rest/activity, possibly via an action at the level of the retina.

Individuals with bipolar disorder who are hypersensitive to the destabilizing effects of excess light in the evening may respond to lithium because it acts on the retina to make light-induced circadian disruption less likely. This is a plausible and exciting hypothesis that, if true, could herald a new era of chronotherapeutic approaches. The project will test whether people with bipolar disorder are hypersensitive to evening light stimuli and whether Lithium may act to counter this. Workstreams 3, 4, and 5 are encompassed in one large study based at the University of Edinburgh.

Part A objectives

  • 1. To assess whether people with bipolar disorder (relative to controls with no history of psychiatric disorder) exhibit greater non-visual responses to light stimuli assessed by the light-induced suppression of melatonin secretion.

  • 2. To assess whether these melatonin responses are less pronounced in those individuals with bipolar disorder who are being treated with lithium therapy (compared to individuals with bipolar disorder not taking lithium).

Part B objectives

  • 1. To characterize the visual, cortical and pupillary responses of people with bipolar disorder (relative to controls with no history of disorder) using a combined electrophysiological and psychophysical study protocol.

  • 2. To assess whether aberrant visual and non-visual responses are less pronounced in those individuals with bipolar disorder who are being treated with lithium therapy (compared to individuals with bipolar disorder not taking lithium).

Part C objectives

  • 1. To assess whether people with bipolar disorder (relative to controls with no history of psychiatric disorder) exhibit microstructural changes in the retina.

  • 2. To assess whether these changes are less pronounced in those individuals with bipolar disorder who are being treated with lithium therapy (compared to individuals with bipolar not taking lithium).

My role

In my role as Clinical Research Fellow working in Edinburgh, I am recruiting participants with bipolar disorder to workstreams 3, 4 and 5 of the project. I am planning to analyse data across the three workstreams to look for differences in melatonin supression following light exposure, and retinal structure and function between the three groups. 

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