Keith Matthews

Biography

Professor Matthews trained in medicine and psychiatry in Aberdeen and in behavioural neuroscience and experimental psychology in San Diego and Cambridge, respectively. He obtained his MBChB (1984) and MD (1997) degrees at the University of Aberdeen and his PhD (1998) from the University of Cambridge.  His research interests include the influences of early experience on behavioural and neural development and the neurobiology and treatment of developmental psychiatric disorders, drug addiction, mood and anxiety disorders.

Research Interest

Psychiatric disorders represent the great remaining “undiscovered country” of biomedical sciences. Despite the high prevalence rates of psychiatric disorders and the associated global health burden, research into aetiological mechanisms and the neurobiology underpinning treatment effects (and ‘treatment resistance’) remains in its infancy.  There are many highly effective treatments for psychiatric disorders; indeed much of general psychiatric practice is supported by an extensive, high quality evidence base. For example, despite repeated and consistent media misrepresentation of the research evidence, antidepressant drug therapies are highly effective and safe treatments for most patients with Major Depression and Obsessive Compulsive Disorder.  However, it is imperative that we develop novel and improved treatments, most notably for the many patients who do not experience satisfactory treatment responses to ‘first line’ therapies such as antidepressant medication and cognitive behavioural therapy.  It order to achieve this goal, we must first improve our understanding of relevant aetiological factors and of underlying mechanisms of illness and mechanisms of action of existing effective therapies. Professor Matthews’ main research interests fall within the domains of behavioural neuroscience, experimental psychology and clinical studies of the pathogenesis and treatment of Major Depression, Obsessive Compulsive Disorder (OCD), substance use disorders and addiction, and developmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD).   Recent research projects have applied structural and functional neuroimaging approaches to the study of the pathophysiology of Major Depression (in collaboration with Professor Douglas Steele, Dr Reiner Sprengelmeyer -University of St Andrews, and Dr David Christmas), opiate addiction (in collaboration with Professor Douglas Steele and Dr Alex Baldacchino) and ADHD (in collaboration with Professor Douglas Steele and Dr David Coghill). Other active areas of research include: the efficacy and mechanisms of ventral striatum and subthalamic nucleus deep brain stimulation for refractory OCD (MRC-funded study with Professor Eileen Joyce, Institute of Neurology, London as Principal Investigator). the use of health informatics to evaluate treatment outcomes for treatment seeking substance misuse populations (with Dr Brian Kidd and Dr Alex Baldacchino) the use of neuropsychological testing to refine the behavioural phenotyping of developmental psychiatric disorders – ADHD and Conduct Disorder (with Dr David Coghill, Dr Sarah Seth and Dr Helen Smith). the evaluation of psychological therapies for chronic Major Depression (with John Swan, Bob MacVicar and Dr David Christmas) Neurosurgery for Mental Disorder Targeted lesions in brain structures are used to treat to a small number of individuals each year with severe, chronic, and treatment-refractory depressive illness and obsessive-compulsive disorder. Dundee hosts the only UK centre performing such procedures within a national specialist service funded by the National Service Division of NHS Scotland. There has been a neurosurgical treatment programme for psychiatric disorders in Dundee since 1992. This was established by George Fenton (my predecessor as Professor of Psychiatry) and local neurosurgeon T.K. Varma. International studies confirm that a significant proportion of patients accrue long-term benefits from surgery, with surprisingly modest rates of adverse effects (Shields et al., Biol Psychiatry 2008, 64, 449-454), including a key study from Dundee (Steele et al., Biol Psychiatry 2008, 63, 670-677). The mechanism(s) of action remain unknown, although we have recently reported a striking relationship between lesion placement and clinical outcome (as above), confirming that the structural and functional impact of such lesions is critically dependent upon which groups of neurons and/or fibres of connection are affected. With the context of delivering a national specialist service for NHS Scotland, the Advanced Interventions Service is committed to the rigorous evaluation of a range of treatment approaches for patients with chronic, refractory mood disorders and OCD. These approaches include psychological therapies (e.g. CBASP, ERP and CBT), neurostimulation (vagus nerve stimulation – VNS and deep brain stimulation – DBS)  and lesion surgery (anterior capsulotomy and anterior cingulotomy). Professor Matthews is executive adviser to the World Society for Stereotactic & Functional Neurosurgery Psychiatric Neurosurgery Committee. Professor Matthews is Clinical Lead for Tayside and a member of the Management Board of the Scottish Mental Health Research Network  Professor Matthews is a Member of the Clinical Advisory Group for the charity OCD action