Imperial College London


Faculty of MedicineSchool of Public Health

Research Associate







Reynolds BuildingCharing Cross Campus





Publication Type

9 results found

Reyes BD, Hargreaves DS, Creese H, 2021, Early-life maternal attachment and risky health behaviours in adolescence: Findings from the United Kingdom Millennium Cohort Study, BMC Public Health, Vol: 21, Pages: 1-11, ISSN: 1471-2458

BackgroundEarly uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study.MethodsTotal maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years.ResultsChildren of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting fo

Journal article

Creese H, Lai E, Mason K, Schlueter DK, Saglani S, Taylor-Robinson D, Saxena Set al., 2021, Disadvantage in early-life and persistent asthma in adolescents: a UK cohort study, THORAX, ISSN: 0040-6376

Journal article

Blackwell J, Saxena S, Petersen I, Hotopf M, Creese H, Bottle A, Alexakis C, Pollok RCet al., 2021, Depression in individuals who subsequently develop inflammatory bowel disease: a population-based nested case-control study, GUT, Vol: 70, Pages: 1642-1648, ISSN: 0017-5749

Journal article

Blackwell J, Alexakis C, Saxena S, Creese H, Bottle R, Petersen I, Matthew H, Pollok Ret al., 2021, The association between antidepressant medication use and steroid dependency in patients with ulcerative colitis: a population-based study, BMJ Open Gastroenterology, Vol: 8, ISSN: 2054-4774

Background: Animal studies indicate a potential protective role of antidepressant medication (ADM) in models of colitis but the effect of their use in humans with ulcerative colitis (UC) remains unclear. Objective: To study the relationship between ADM use and corticosteroid dependency in UC. Design: Using the Clinical Practice Research Datalink we identified patients diagnosed with UC between 2005-2016. We grouped patients according to serotonin selective reuptake inhibitor (SSRI) and tricyclic antidepressant (TCA) exposure in the 3 years following diagnosis: 'continuous users', 'intermittent users' and 'non users'. We used logistic regression to estimate the adjusted risk of corticosteroid dependency between ADM exposure groups. Results: We identified 6373 patients with UC. 5,230 (82%) use no ADMs, 627 (10%) were intermittent SSRI users and 282 (4%) were continuous SSRI users, 246 (4%) were intermittent TCA users and 63 (1%) were continuous TCA users. Corticosteroid dependency was more frequent in continuous SSRI and TCA users compared with non-users (19% vs. 24% vs. 14%, respectively, χ2 p=0.002). Intermittent SSRI and TCA users had similar risks of developing corticosteroid dependency to non-users (SSRI: OR 1.19, 95%CI 0.95-1.50, TCA: OR 1.14, CI 0.78-1.66). Continuous users of both SSRIs and TCAs had significantly higher risks of corticosteroid dependency compared to non-users (SSRI: OR 1.62, CI 1.15-2.27, TCA: OR 2.02, CI 1.07-3.81). Conclusions: Continuous ADM exposure has no protective effect in routine clinical practice in UC and identifies a population of patients requiring more intensive medical therapy. ADM use is a flag for potentially worse clinical outcomes in UC.

Journal article

Jayasooriya N, Saxena S, Blackwell J, Petersen I, Bottle A, Creese H, Pollok Ret al., 2021, Impact of consultation frequency and time to diagnosis on subsequent Inflammatory Bowel Disease outcomes, Publisher: OXFORD UNIV PRESS, Pages: S242-S243, ISSN: 1873-9946

Conference paper

Creese H-M, Hope S, Christie D, Goddings A-L, Viner Ret al., 2021, Is earlier obesity associated with poorer executive functioning later in childhood? Findings from the Millennium Cohort Study, PEDIATRIC OBESITY, Vol: 16, ISSN: 2047-6310

Journal article

Blackwell J, Saxena S, Jayasooriya N, Petersen I, Hotopf M, Creese H, Bottle A, Pollok RCG, POP-IBD Study Groupet al., 2020, Stoma Formation in Crohn's Disease and the Likelihood of Antidepressant Use: A Population-Based Cohort Study., Clin Gastroenterol Hepatol

BACKGROUND & AIMS: The impact of a temporary or permanent stoma on mental health in Crohn's Disease (CD) is unknown. The aim was to examine the association between intestinal surgery and stoma formation and subsequent antidepressant medication (ADM) use. METHODS: Using the Clinical Practice Research Datalink, we identified individuals with CD who underwent intestinal surgery between 1998-2018. We excluded individuals with a prescription for an ADM in the 6 months before surgery. Individuals were stratified into three groups: no stoma, temporary stoma, and permanent stoma. We used Kaplan-Meier curves to examine initiation of ADM after intestinal surgery and Cox regression to identify risk factors for ADM use after intestinal surgery. RESULTS: We identified 1,272 cases of CD undergoing their first intestinal surgery. Of these, 871 (68.5%) had no stoma, 191 (15.0%) had a temporary stoma and 210 (16.5%) had a permanent stoma. The 10-year cumulative incidence of ADM use was 26.4%, 33.4% and 37.3% respectively. Individuals with a permanent stoma were 71% more likely to receive an ADM than those with no stoma (HR 1.71, 95% CI 1.20-2.44). Individuals with a temporary stoma reversed within 12 months had a similar likelihood of ADM use to those without stoma formation (HR 0.99, 95% CI 0.64-1.53) whereas temporary stoma formation with late reversal after 12 months was associated with significantly greater likelihood of ADM use (HR 1.85, 95% CI 1.15-2.96). CONCLUSIONS: Permanent stomas and temporary stomas with late reversal surgery are associated with increased ADM use after intestinal surgery, likely associated with increased anxiety and depression.

Journal article

Creese H-M, Taylor-Robinson D, Saglani S, Saxena Set al., 2020, Primary care of children and young people with asthma during the Covid-19 era, British Journal of General Practice, Vol: 70, Pages: 528-529, ISSN: 0960-1643

Around 1.1 million children and young people (CYP)currently receive treatment for asthma in the United Kingdom (UK)(1). The UK performs poorly compared with other European countries in children's outcomes of asthma management and has had amongst the highest number of reported asthma deaths in Europesince 1998 (2). We evaluate evidenceofthe impact of Covid-19 on CYP with asthma and consider what actionsgeneral practitioners can take to protect these children from serious harm.

Journal article

Creese H, Mason K, Schluter DK, Taylor-Robinson D, Saxena Set al., 2020, Early years pathways to inequalities in childhood asthma? A causal mediation analysis, EUPHA, Publisher: OXFORD UNIV PRESS, Pages: V434-V434, ISSN: 1101-1262

Conference paper

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