Imperial College London

Dr Sofia Pappa MD, Ph.D

Faculty of MedicineDepartment of Brain Sciences

Honorary Senior Lecturer
 
 
 
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s.pappa

 
 
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Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

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62 results found

Pappa S, Barnett J, Mason K, 2023, A 10-Year Observational Study of the Use, Acceptability and Effectiveness of Long-Acting Paliperidone Palmitate: Implications for Clinical Decision Making., CNS Drugs, Vol: 37, Pages: 107-116

BACKGROUND: Long-acting injectable antipsychotics (LAIs) have been shown to improve adherence and prevent relapse in the treatment of schizophrenia and psychotic disorders, though longitudinal data on treatment outcomes are limited. OBJECTIVES: To establish the long-term acceptability and effectiveness of paliperidone palmitate once monthly (PP1M). METHODS: This independent 10-year mirror image study was carried out in a large urban mental health provider. The study evaluated the retention and hospitalization rates 5 years following initiation of PP1M in a naturalistic patient cohort of all adult patients who were newly initiated on PP1M between 2011 and 2015. Electronic records were used to compare the frequency and length of hospital admissions in the 5 years before and after introduction of PP1M. Switching and discontinuation rates and reasons were also recorded with a separate analysis of patients who continued and discontinued PP1M during the study period. RESULTS: A total of 167 patients were included in the study (70% with schizophrenia, 30% with other diagnoses). Discontinuation rates were 24%, 15%, 17%, 5% and 8% in years 1-5, respectively; poor tolerability was the most common cause for stopping PP1M. Demographic and clinical factors such as age, sex, diagnosis and care setting did not discriminate between continuers and discontinuers. The group that completed 5 years on PP1M (46%) showed an overall reduction of 72% in the mean number and 68% in the mean length of admissions compared to the 5-year period before initiation, with more than half of the patients requiring no admission at all during this period of time (median = 0). On the contrary, discontinuers demonstrated worse outcomes in overall bed occupancy than continuers. Findings were overall similar across the total cohort and schizophrenia-only group. CONCLUSIONS: Our study has one of the longest durations of follow up of a naturalistic cohort treated with LAIs confirming sustai

Journal article

Chapman N, Browning M, Baghurst D, Hotopf M, Willis D, Haylock S, Zakaria S, Speechley J, Withey J, Brooks E, Chan F, Pappa S, Geddes J, Insole L, Mohammed Z, Kessler D, Jones PB, Mansoori P, Difficult to Treat Depression Research Priority Setting Groupet al., 2022, Setting national research priorities for difficult-to-treat depression in the UK between 2021-2026., J Glob Health, Vol: 12

BACKGROUND: Difficult-to-treat depression (DTD) presents a substantial health care challenge, with around one-third of people diagnosed with a depressive episode in the UK finding that their symptoms persist following treatment. This study aimed to identify priority research questions (RQs) that could inform the development of new and improved treatments, interventions, and support for people with DTD. METHODS: Using an adapted Child Health and Nutrition Research Initiative (CHNRI) method, this national prioritisation exercise engaged 60 leading researchers and health care professionals in the UK, as well as 25 wider stakeholders with relevant lived experience to produce a ranked list of priority RQs in DTD. The final list of 99 distinct RQs was independently scored by 42 individuals against a list of five criteria: answerability, effectiveness, impact on health, deliverability, and equity. RESULTS: Highly ranked RQs covered a range of novel and existing treatments. The three highest scoring RQs included evaluation of psychological and pharmacological therapies (eg, behavioural activation, and augmentation therapies), as well as social interventions to reduce loneliness or increase support for people with DTD. CONCLUSIONS: This exercise identified and prioritised 99 RQs that could inform future research and funding decisions over the next five years. The results of this research could improve treatment and support for people affected by DTD. It also serves as an example of ways in which the CHNRI method can be adapted in a collaborative manner to provide a more active role for patients, carers, and health care professionals.

Journal article

Taylor D, Chithiramohan R, Grewal J, Gupta A, Hansen L, Reynolds GP, Pappa Set al., 2022, Dopamine partial agonists: a discrete class of antipsychotics., Int J Psychiatry Clin Pract, Pages: 1-13

Worldwide, there are now three marketed dopamine D2 partial agonists: aripiprazole, brexpiprazole and cariprazine. These three drugs share a number of properties other than their action at D2 receptors. Pharmacologically, they are 5HT2 antagonists and D3 and 5HT1A partial agonists but with little or no alpha-adrenergic, anticholinergic or antihistaminic activity. They also share a long duration of action. Clinically, D2 partial agonists are effective antipsychotics and generally have useful antimanic and antidepressant activity. They are usually well tolerated, causing akathisia and insomnia only at the start of treatment, and are non-sedating. These drugs also share a very low risk of increased prolactin and of weight gain and accompanying metabolic effects. They may also have a relatively low risk of tardive dyskinesia. There is some evidence that they are preferred by patients to dopamine antagonists. Individual dopamineD2 partial agonists have much in common and as a group they differ importantly from dopamine D2 antagonists. Dopamine D2 partial agonists should be considered a distinct class of antipsychotics.Key pointsD2 partial agonists share many pharmacological and clinical propertiesD2 partial agonists differ in several important respects from D2 antagonistsD2 partial agonists should be considered a discrete class of antipsychotics.

Journal article

Pappa S, Kalniunas A, Sharma H, Syed A, Kamal M, Larkin Fet al., 2022, Efficacy and safety of cariprazine augmentation in patients treated with clozapine: a pilot study, Therapeutic Advances in Psychopharmacology, Vol: 12, Pages: 1-7, ISSN: 2045-1253

Background: Cariprazine, a novel antipsychotic drug is a partial agonist of dopamine D2/D3 receptors with preferential binding to the D3 receptor. There has been an increasing interest in cariprazine augmentation to clozapine, however the evidence thus far has been only limited to case reports and case series. Aim: To evaluate the efficacy and safety of the augmentation of clozapine with cariprazine in patients with sub-optimal treatment response.Methods: Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline and three months. Tolerability and discontinuation reasons where applicable were also recorded. Results: Ten patients (4 men and 6 women) with a mean age of 36.5 years (range 26-45) were included. Reasons for cariprazine initiation included inadequate treatment response, persistent negative symptoms and/or tolerability issues with clozapine or previous augmentation options. Two patients discontinued cariprazine within the first 6 weeks due to restlessness and poor response, respectively. There was a significant reduction in the median total PANSS score from baseline to 3 months (from 59 to 22.5, p<0.05), median positive PANSS score (11.5 to 5.5, p<0.05) and in the median negative PANSS score (from 15.5 to 3, p<0.05) which correspond to a 48%, 33.8% and 65.8% mean score reduction respectively.Conclusion: This is the first pilot study evaluating the effectiveness of clozapine augmentation. The preliminary evidence suggests that this may be a safe and effective practice in patients failing to adequately respond to or tolerate clozapine and/or previous augmentation strategies.

Journal article

Pappa S, Barnett J, Mason K, 2022, A ten-year observational study of the use, acceptability and effectiveness of Long-Acting Paliperidone Palmitate – implications for clinical decision making, CNS Drugs, ISSN: 1172-7047

Journal article

Thana L, O'Connell L, Carne-Watson A, Shastri A, Budhwani N, Saranamuthu A, Jayacodi S, Leeson V, Munjiza J, Pappa S, Hughes E, Reilly J, Crawford Met al., 2022, Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial, BMC Psychiatry, Vol: 22, ISSN: 1471-244X

Background: More than half of people who use antipsychotic medication for psychosis report having sexual dysfunction. The REMEDY trial aimed to find out if switching antipsychotic medication provides an effective way to reduce sexual dysfunction among people with psychosis. We set out to recruit 216 participants over a two-year period, but recruitment was stopped after an extended 12-month pilot phase, during which we recruited only 10 participants. As part of a nested process evaluation, we conducted qualitative interviews with front-line clinicians to examine barriers to recruitment to the trial.Methods: We developed a semi-structured interview schedule to explore staff views on factors that influenced whether they referred potential participants to the study. We interviewed a purposive sample of 51 staff from four National Health Service (NHS) Trusts in England, ensuring a range of different backgrounds, seniority, and levels of involvement in the trial. Audio recordings of interviews were transcribed for verbatim, and data were analysed using an inductive approach to thematic analysis. Results : Nine interconnected themes were generated. Six themes concerned barriers to recruitment; including; prioritising patients’ mental stability, mutual discomfort and embarrassment about discussing a “taboo” subject, and concerns about unintended consequences of asking people with psychosis about their sexual functioning. Three themes, including the quality of treatment relationships and strategies for opening dialogue suggested ways to improve recognition of these “hidden” side effects. Conclusion: The identification and management of sexual dysfunction among people with psychosis are not priorities for mental health services in England at this time. Many staff working in front-line services feel unprepared and uncomfortable asking people with psychosis about these problems. While greater use of screening tools may improve the identification of

Journal article

Katsarou M-S, Iasonidou E, Osarogue A, Kalafatis E, Stefanatou M, Pappa S, Gatzonis S, Verentzioti A, Gounopoulos P, Demponeras C, Konstantinidou E, Drakoulis N, Asimakos A, Antonoglou A, Mavronasou A, Spetsioti S, Kotanidou A, Katsaounou Pet al., 2022, The Greek Collaborative Long COVID Study: Non-Hospitalized and Hospitalized Patients Share Similar Symptom Patterns, JOURNAL OF PERSONALIZED MEDICINE, Vol: 12

Journal article

Dewa LH, Pappa S, Greene T, Cooke J, Mitchell L, Hadley M, Di Simplicio M, Woodcock T, Aylin Pet al., 2022, The Association Between Sleep Disturbance and Suicidality in Psychiatric Inpatients Transitioning to the Community: Protocol for an Ecological Momentary Assessment Study, JMIR RESEARCH PROTOCOLS, Vol: 11, ISSN: 1929-0748

Journal article

Pappa S, Barmparessou Z, Athanasiou N, Sakka E, Eleftheriou K, Patrinos S, Sakkas N, Pappas A, Kalomenidis I, Katsaounou Pet al., 2022, Depression, Insomnia and Post-Traumatic Stress Disorder in COVID-19 Survivors: Role of Gender and Impact on Quality of Life, JOURNAL OF PERSONALIZED MEDICINE, Vol: 12

Journal article

Pappa S, Sakkas N, Sakka E, 2022, A year in review: sleep dysfunction and psychological distress in healthcare workers during the COVID-19 pandemic, SLEEP MEDICINE, Vol: 91, Pages: 237-245, ISSN: 1389-9457

Journal article

García-Carmona JA, Barnett J, Campos-Navarro MP, Mason K, Valdivia-Muñoz F, Pappa Set al., 2022, Comparative effectiveness of long-acting injectable antipsychotics in a large naturalistic cohort across two European centers: Findings from the long-acting injectable antipsychotics collaborative (LAICO) study., Neuroscience Applied, Vol: 1, Pages: 100111-100111, ISSN: 2772-4085

Journal article

Barnett J, Mason K, Pappa S, 2021, The relationship between level of compliance with aripiprazole long-acting injectable and risk of hospitalisation, 34th European-College-of-Neuropsychopharmacology (ECNP) Congress on Early Career Scientists in Europe, Publisher: ELSEVIER, Pages: S354-S355, ISSN: 0924-977X

Conference paper

Pappa S, Barmparessou Z, Sakka E, Patrinos S, Sakkas N, Athanasiou N, Kalomenidis I, Katsaounou Pet al., 2021, Effects on mental health, sleep and quality of life in hospitalized patients with COVID-19 infection, 34th European-College-of-Neuropsychopharmacology (ECNP) Congress on Early Career Scientists in Europe, Publisher: ELSEVIER, Pages: S581-S582, ISSN: 0924-977X

Conference paper

Kalniunas A, Chakrabarti I, Mandalia R, Munjiza J, Pappa Set al., 2021, The relationship between antipsychotic-induced akathisia and suicidal behaviour: a systematic review, Neuropsychiatric Disease and Treatment, Vol: 2021, Pages: 3489-3497, ISSN: 1176-6328

Objective: We aim to systematically review evidence for an association between antipsychotic-induced akathisia and suicidal behaviour, in order to guide further clinical decision making in this area. Methods: Several electronic databases (Embase, Medline, Cochrane and PsychINFO) were systemically searched for articles published up to February 2021, using search terms related to akathisia, antipsychotics and suicidal behaviour. Two reviewers independently evaluated all the relevant studies using pre-determined criteria and assessed the risk of bias for each included study. The systematic review was conducted in line with PRISMA methodology and reporting.Results: Following de-duplication, screening and application of exclusion criteria, four eligible studies were identified. All of the available studies were in English and included adult patients. Nevertheless, there was significant variability regarding methodology and overall quality was deemed low due to small sample sizes. There was insufficient data to perform statistical analyses of the results. Of the four studies, two found a weak correlation between antipsychotic-related akathisia and suicidal behaviour, a finding that was not supported by the remaining two studies. Conclusion: The search yielded very few studies for inclusion. On the basis of the existing evidence, akathisia cannot be reliably linked to the presence of suicidal behaviour in patients treated with antipsychotic medication. However, proactive screening for emerging suicidal behaviour in this vulnerable patient group is advisable. Our findings highlight the pressing need for further research in this area.

Journal article

Pappa S, Chen J, Barnett J, Chang A, Dong RK, Xu W, Yin A, Chen BZ, Delios AY, Chen RZ, Miller S, Wan X, Zhang SXet al., 2021, A systematic review and meta-analysis of the mental health symptoms during the Covid-19 pandemic in Southeast Asia, PSYCHIATRY AND CLINICAL NEUROSCIENCES, Vol: 76, Pages: 41-50, ISSN: 1323-1316

Journal article

Pataka A, Kotoulas S, Sakka E, Katsaounou P, Pappa Set al., 2021, Sleep Dysfunction in COVID-19 Patients: Prevalence, Risk Factors, Mechanisms, and Management, JOURNAL OF PERSONALIZED MEDICINE, Vol: 11

Journal article

Dewa L, Kalniunas A, Orleans-Foli S, Pappa S, Aylin Pet al., 2021, Detecting signs of deterioration in young patients with serious mental illness: a systematic review, Systematic Reviews, Vol: 10, Pages: 1-8, ISSN: 2046-4053

BackgroundSerious mental illnesses (SMI) such as schizophrenia and bipolar disorder first develop between ages 14-25. Once diagnosed, young peoples’ health can deteriorate, and it is therefore vital to detect this early to prevent severe outcomes including hospitalisations and deaths by suicide. The main study aim is to describe and discuss observational studies that examine signs of deterioration in young patients with SMI. MethodsA systematic review guided by the published protocol was conducted. Cumulative Index to Nursing and allied Health Literature (CINAHL), MEDLINE, Embase, PsycINFO, Health Management Information Consortium (HMIC) and Web of Science were searched against pre-defined criteria until March 1st 2021. Observational studies were extracted according to design, country, participant, indicator, outcome and main finding categories. Quality was assessed independently using the Newcastle Ottawa Scale (NOS). ResultsOf the 15788 publications identified, 5 studies were included and subjected to narrative synthesis. Two indicators of mental health deterioration were identified: cognitive functioning (decline, worsening and poor school/academic performance) and expressed emotion status. Indicators revealed mixed views on predicting deterioration. Worsening cognitive functioning and expressed emotion status significantly predicted medication non-adherence and relapse respectively. However, a decline in cognitive functioning (poor academic performance) was not found to significantly correlate to deaths by suicide. Study quality was mostly poor and associations between indicators and varied outcomes were weak. The heterogeneous nature of the data made comparisons difficult and did not allow for further statistical analysis. ConclusionTo our knowledge, this is the first review of observational studies to identify indicators of deterioration in young patients with SMI. Worsening cognitive functioning and expressed emotion status could indicate non-adherence

Journal article

O'Driscoll C, Shaikh M, Finamore C, Platt B, Pappa S, Saunders Ret al., 2021, Profiles and trajectories of mental health service utilisation during early intervention in psychosis, SCHIZOPHRENIA RESEARCH, Vol: 237, Pages: 47-53, ISSN: 0920-9964

Journal article

Barmparessou Z, Pappa S, Pappas A, Eleftheriou K, Patrinos S, Polydora E, Athanasiou N, Kalomenidis I, Katsaounou Pet al., 2021, Sex differences in mental health of hospitalized patients with COVID-19, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Athanasiou N, Pappa S, Pataka A, Tsikrika S, Mpousiou D, Patrinos S, Gida S, Sigala I, Barmparessou Z, Adraktas A, Migdalis I, Vlahakos V, Manos E, Aggelonidou E, Giannou A, Abdelrasoul M, Tsagaraki L, Chatziantoniou A, Agorogianni A, Vagiakis E, Katsaounou Pet al., 2021, Sleep disorders in healthcare workers(HCWs) working in the frontline during the first wave of the COVID-19 pandemic, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Athanasiou N, Pappa S, Mpousiou D, Tsikrika S, Barmparessou Z, Pataka A, Gida S, Patrinos S, Sigala I, Manos E, Migdalis I, Vlahakos V, Andraktas A, Savvidi EC, Giannou A, Aqeel I, Chasouraki A, Aggelonidou E, Katsaounou Pet al., 2021, Smoking of healthcare workers(HCWs) working in reference hospitals during the first wave of the COVID-19 pandemic, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Barmparessou Z, Korkontzelou A, Ioannou M, Vichos N, Gkotsina M, Mprinia K, Saltagianni V, Giannakas T, Giannakoulis V, Athanasiou N, Antonoglou A, Gida S, Kakavas S, Boulbasakos G, Pappa S, Zervas E, Katsaounou Pet al., 2021, High prevalence of mild asthma among asthmatics visiting emergency department (ED), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Mason K, Barnett J, Pappa S, 2021, Effectiveness of 2-year treatment with aripiprazole long-acting injectable and comparison with paliperidone palmitate, THERAPEUTIC ADVANCES IN PSYCHOPHARMACOLOGY, Vol: 11, ISSN: 2045-1253

Journal article

Pappa S, Barnett J, Berges I, Sakkas Net al., 2021, Tired, Worried and Burned Out, but Still Resilient: A Cross-Sectional Study of Mental Health Workers in the UK during the COVID-19 Pandemic, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 18

Journal article

Dewa L, Lawrence-Jones A, Kalorkoti C, Jaques J, Pickles K, Lavelle M, Pappa S, Aylin Pet al., 2021, Reflections, impact and recommendations of a co-produced qualitative study with young people who have experience of mental health difficulties, Health Expectations, Vol: 24, Pages: 134-146, ISSN: 1369-6513

BackgroundThere is limited evidence of genuine equal partnership where power is shared with young people with mental health difficulties throughout all research stages, particularly in data collection and analysis.ObjectiveTo describe how our qualitative study, exploring young peoples’ perceptions on the feasibility of using technology to detect mental health deterioration, was co-produced using principles of co-production, whilst reflecting on impact, challenges and recommendations.MethodsYoung people with experience of mental health difficulties were appointed and then worked with researchers throughout all research stages. The study was evaluated against the five principles of co-production. Reflections from researchers and young people were collected throughout.ResultsSeven young people formed an initial Young People's Advisory Group (YPAG); three became co-researchers. Reflection was key throughout the process. Sharing power became easier and more evident as trust, confidence and mutual respect grew over time, particularly after a safe space was established. The safe space was crucial for open discussions, and our WhatsApp group enabled continual communication, support and shared decision-making. The resulting co-produced topic guide, coding framework, thematic map, papers and presentations demonstrated significant impact.ConclusionsTo our knowledge, this is the first qualitative mental health study to be co-produced using the principles of co-production. Our rigorous assessment can be utilized as an informative document to help others to produce meaningful co-produced future research. Although co-production takes time, it makes significant impact to the research, researchers and co-researchers. Flexible funding for spontaneous suggestions from co-researchers and more time for interview training is recommended.

Journal article

Pappa S, Athanasiou N, Sakkas N, Patrinos S, Sakka E, Barmparessou Z, Tsikrika S, Adraktas A, Pataka A, Migdalis I, Gida S, Katsaounou Pet al., 2021, From Recession to Depression? Prevalence and Correlates of Depression, Anxiety, Traumatic Stress and Burnout in Healthcare Workers during the COVID-19 Pandemic in Greece: A Multi-Center, Cross-Sectional Study, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 18

Journal article

Pappa S, Giannakoulis VG, Papoutsi E, Katsaounou Pet al., 2021, Author reply - Letter to the editor "The challenges of quantifying the psychological burden of COVID-19 on heathcare workers", BRAIN BEHAVIOR AND IMMUNITY, Vol: 92, Pages: 209-210, ISSN: 0889-1591

Journal article

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou Pet al., 2021, Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis (vol 88, pg 901, 2020), BRAIN BEHAVIOR AND IMMUNITY, Vol: 92, Pages: 245-245, ISSN: 0889-1591

Journal article

Pappa S, Barnett J, Gomme S, Iliopoulou A, Moore I, Whitaker M, McGrath J, Sie Met al., 2021, Shared and Supported Decision Making in Medication in a Mental Health Setting: How Far Have We Come?, COMMUNITY MENTAL HEALTH JOURNAL, Vol: 57, Pages: 1566-1578, ISSN: 0010-3853

Journal article

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