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Hire Dr Tony R.
United Kingdom
USD 50 /hr

Medical doctor with 33 years experience with wide portfolio of experience in content writing on mental and public health

Profile Summary
Subject Matter Expertise
Services
Writing Medical Writing
Work Experience

King's College London

- Present

Consultant

South London and Maudsley NHS Foundation Trust

March 1998 - Present

Education

MBBS (Medical School)

Imperial College London

September 1983 - August 1989

Hills Road Sixth Form College

1981 - 1983

Certifications
  • Certified Health Education Specialist

    University of London

    September 2008 - June 2009

Publications
JOURNAL ARTICLE
Specific depressive symptoms are related with different patterns of alcohol use in community-dwelling older adults @article{a225989a148f4614a921daf1d9a3aaa1, title = "Specific depressive symptoms are related with different patterns of alcohol use in community-dwelling older adults", abstract = "Objectives: To explore how individual depressive symptoms might contribute to different patterns of alcohol consumption in Colombian older adults living in the community. Methods: A Secondary analysis from a nationally representative cross-sectional study of more than 23,000 older adults, with data from 19,004 participants. Drinking frequency, and level (moderate or heavy drinking) were used to assess alcohol use and depressive symptoms explored with the 15 items-GDS., using bivariate and multivariate adjusted regression models. Results: Lower weekly drinking frequency and a higher number of drinks per serving were associated with total GDS score. For individual symptoms, higher drinking frequency was associated with dropping activities and a preference to stay at home. Lower drinking frequency was associated with low mood, unhappiness, feelings of emptiness, worthlessness, hopelessness, and a lack of vigour. Lower number of drinks per serving was associated with withdrawal/apathy related symptoms; these also related to higher frequency of weekly alcohol consumption. Higher number of drinks per serving was associated with feelings of emptiness, worthlessness, boredom, helplessness, worthlessness. not wanting to be alive, thinking that other people are better off in their mood, being afraid that something bad will happen and subjective memory problems. Moderate drinkers had a higher likelihood of reporting lack of vigour. Conclusion: There were diverse patterns of alcohol use according to individual depressive symptoms. This has implications for interventions to reduce alcohol related harm in older people across a range of depressive symptoms with different patterns of alcohol use.", keywords = "Aged, Alcohol drinking, Depression, Depressive disorder, Mental health", author = "Nicol{\'a}s Castellanos-Perilla and Borda, {Miguel Germ{\'a}n} and Sara Cata{\~n}o and Salomon Giraldo and Vik-Mo, {Audun Osland} and Dag Aarsland and Rao, {Rahul Tony}", note = "Funding Information: SABE-Colombia study is supported by a fund (2013, no. 764 ) from Colciencias and the Ministry of Health and Social Protection of Colombia . Publisher Copyright: {\textcopyright} 2022 The Author(s)", year = "2022", month = jul, day = "1", doi = "10.1016/j.archger.2022.104696", language = "English", volume = "101", journal = "ARCHIVES OF GERONTOLOGY AND GERIATRICS", issn = "0167-4943", publisher = "Elsevier Ireland Ltd", } . ARCHIVES OF GERONTOLOGY AND GERIATRICS.
Dual diagnosis in older drinkers during the COVID-19 pandemic @article{5e469e5e547444a7a0d94c0b0a34cb0a, title = "Dual diagnosis in older drinkers during the COVID-19 pandemic", abstract = "Purpose: There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use. Design/methodology/approach: Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders. Findings: In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005). Research limitations/implications: The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers. Originality/value: A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.", author = "Rahul Rao and Christoph Mueller and Matthew Broadbent", note = "Funding Information: The authors are grateful for the support of Professor Robert Stewart and Megan Pritchard in the provision of access to the CRIS database.Conflict of Interest: One of the authors is the editor for the themed issue for which this paper is being submitted. Publisher Copyright: {\textcopyright} 2021, Emerald Publishing Limited. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.", year = "2021", month = may, day = "17", doi = "https://doi.org/10.1108/ADD-12-2020-0028", language = "English", volume = "14", pages = "70--79", journal = "Advances in Dual Diagnosis", issn = "1757-0972", publisher = "Emerald Group Publishing Ltd.", number = "2", } . Advances in Dual Diagnosis.
Risky alcohol consumption in older people before and during the COVID-19 pandemic in the United Kingdom @article{7c2eebce502f4e898c5ce9f4c4afdcc0, title = "Risky alcohol consumption in older people before and during the COVID-19 pandemic in the United Kingdom", abstract = "Background: There has been little previous research within mental health services exploring changes in drinking behavior among older people during the COVID-19 pandemic. This study compared alcohol use and risky drinking both before and after lockdown in this age group.Methods: The Alcohol Use Disorders Identification Test (AUDIT) was used to identify risky drinking in people aged between 55 and 74, in a sample of 366 people. One hundred and eighty-five people were referred before and one hundred and eighty-one people after lockdown in the UK.Results: Compared with before lockdown, it was more likely for older people referred after lockdown to be female, have less severe cognitive impairment, and to show other features of alcohol-related harm such as morning drinking and feeling guilt or remorse over their drinking.Conclusion: These findings have implications for both access to services and service provision in older people who experience restrictions on their independence during a pandemic.", author = "Rahul Rao and Christoph Mueller and Matthew Broadbent", year = "2021", month = apr, day = "23", doi = "10.1080/14659891.2021.1916851", language = "English", journal = "Journal of Substance Use", issn = "1465-9891", publisher = "Informa Healthcare", } . Journal of Substance Use.
Alcohol use and dementia @article{aabc5deee71c413b815e6b8fd87bc706, title = "Alcohol use and dementia: new research directions", abstract = "PURPOSE OF REVIEW: Alcohol is gaining increased recognition as an important risk factor for dementia. This review summarises recent evidence on the relationship between alcohol use and dementia, focusing on studies published from January 2019 to August 2020. RECENT FINDINGS: Epidemiological data continues to yield results consistent with protective effects of low-to-moderate alcohol consumption for dementia and cognitive function. However, recent literature highlights the methodological limitations of existing observational studies. The effects of chronic, heavy alcohol use are clearer, with excessive consumption causing alcohol-related brain damage. Several pathways to this damage have been suggested, including the neurotoxic effects of thiamine deficiency, ethanol and acetaldehyde. SUMMARY: Future research would benefit from greater implementation of analytical and design-based approaches to robustly model the alcohol use-dementia relationship in the general population, and should make use of large, consortia-level data. Early intervention to prevent dementia is critical: thiamine substitution has shown potential but requires more research, and psychosocial interventions to treat harmful alcohol use have proven effective. Finally, diagnostic criteria for alcohol-related dementia require formal validation to ensure usefulness in clinical practice.", author = "Rachel Visontay and Rao, {Rahul Tony} and Louise Mewton", note = "Publisher Copyright: Copyright {\textcopyright} 2020 Wolters Kluwer Health, Inc. All rights reserved. Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine", year = "2021", month = mar, day = "1", doi = "10.1097/YCO.0000000000000679", language = "English", volume = "34", pages = "165--170", journal = "Current opinion in psychiatry", issn = "1473-6578", publisher = "LIPPINCOTT WILLIAMS & WILKINS", number = "2", } . Current opinion in psychiatry.
Visontay R, Rao RT, Mewton L(2021). Alcohol use and dementia: new research directions . Current opinion in psychiatry.
Rahul Rao(2021). News, guidance and resources related to dual diagnosis in older adults . Advances in Dual Diagnosis. 14. (2). p. 80--82. Emerald Group Publishing Ltd.
Alcohol use disorders and the brain @article{9e3fce59d4f240be8c5c73075b98d028, title = "Alcohol use disorders and the brain", abstract = "A diagnosis of alcohol use disorder is associated with a higher risk of dementia, but a dose–response relationship between alcohol intake consumption and cognitive impairment remains unclear. Alcohol is associated with a range of effects on the central nervous system at different doses and acts on a number of receptors. Acute disorders include Wernicke's encephalopathy (WE), traumatic brain injury, blackouts, seizures, stroke and hepatic encephalopathy. The most common manifestations of chronic alcohol consumption are Korsakoff's syndrome (KS) and alcohol-related dementia (ARD). There is limited evidence for benefit from memantine in the treatment of ARD, but stronger evidence for the use of high-dose parenteral thiamine in the progression of neuropsychiatric symptoms for WE. Accumulating evidence exists for pharmacological treatment in the prevention of hepatic encephalopathy. Rehabilitation of people with ARD may take several years, and requires an approach that addresses physical and psychosocial factors.", keywords = "Alcohol, Korsakoff's syndrome, Wernicke's encephalopathy, dementia: brain, hepatic encephalopathy, thiamine", author = "Rahul Rao", year = "2020", month = aug, day = "1", doi = "https://doi.org/10.1111/add.15023", language = "English", volume = "115", pages = "1580--1589", journal = "Addiction", issn = "0965-2140", publisher = "Wiley-Blackwell Publishing Ltd", number = "8", } . Addiction.
Alcohol and public mental health for older people: 20 years of UK policy change @article{f00d2c815a8f4395a9f2324ab3640c53, title = "Alcohol and public mental health for older people: 20 years of UK policy change", abstract = "Purpose: The purpose of this paper is to detail developments in UK alcohol policy for older people over the past 20 years, based on evidence for a growing public health problem with alcohol misuse in older people. Design/methodology/approach: A literature search was carried out using health and social care databases, including grey literature. Findings: There has been considerable progress in areas such as screening and brief intervention, low-risk drinking and service provision for integrated care in older people with dual diagnosis. Research limitations/implications: There remains a dearth of research and policy for older people with alcohol misuse and dual diagnosis prior to 2011. Although there remains limited empirical evidence for public health interventions to improve health outcomes from alcohol-related harm, improvements in population health from implementation of recent policy changes and intervention programmes remains to be seen. Practical implications: This review has implications for best practice in the provision of integrated care to reduce harm and improve health and social outcomes in older people with alcohol misuse and dual diagnosis. Originality/value: This review draws together a large area of research and policy on alcohol misuse in older people that has the potential to improve public mental health for older people who are at risk of alcohol-related harm.", keywords = "Alcohol, Alcohol and public health, Dual diagnosis, Integrated care, Older people, Policy", author = "Rahul Rao", year = "2020", month = jul, day = "29", doi = "10.1108/JPMH-05-2020-0055", language = "English", volume = "19", pages = "231--239", journal = "Journal of Public Mental Health", issn = "1746-5729", publisher = "Emerald Group Publishing Ltd.", number = "3", } . Journal of Public Mental Health.
Alcohol consumption of UK members of parliament @article{e3eaec5dc11b4b0288ea2b9b4b747fb3, title = "Alcohol consumption of UK members of parliament: Cross-sectional survey", abstract = "Objectives This study examined the prevalence of risky drinking by members of parliament (MPs), as well as the relationship between risky drinking and age, years spent as an MP, working outside parliament, awareness of the Parliamentary Health and Wellbeing Service, and probable mental ill health. Design A survey questionnaire assessed alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT). Risky drinking was identified by combining categories of increasing (hazardous), higher (harmful) and probable dependent drinking for those with a total score of 8 or more. Comparator groups from the 2014 Adult Psychiatric Morbidity Survey (APMS) were used as controls. Setting UK House of Commons. Participants 650 MPs. Results Compared with all 650 MPs, participants (n=146) were more likely to be female (p<0.05) or have an educational qualification (p<0.05). Weighted proportions on AUDIT items were higher than the APMS comparator group for participants who had a drink four or more times a week, 10 or more drinks on a typical drinking day, six or more drinks in one occasion, or felt guilty because of drinking (p<0.01). Weighted percentages for risky drinking were higher in MPs compared with the whole English population (p<0.05), but similar when compared with socioeconomic comparator groups. The odds of risky drinking were 2.74 times greater for MPs who had an additional work role outside parliament compared with those who did not (95% CI 0.98 to 7.65) and 2.4 times greater for MPs with probable mental ill health compared with those with no evidence of probable mental ill health (95% CI 0.78 to 7.43). Conclusions A low level of awareness of the Parliamentary Health and Wellbeing Service has implications for improving the detection of risky drinking and improving access to this service by MPs. Possible increased likelihood of risky drinking in MPs who also had an additional work role outside Parliament and among those with probable mental ill health requires further exploration.", keywords = "alcohol consumption, Members of Parliament (MPs), policy making, politicians, UK", author = "Rahul Rao and Ioannis Bakolis and Jayati Das-Munshi and Daniel Poulter and Nicole Votruba and Graham Thornicroft", year = "2020", month = mar, day = "3", doi = "10.1136/bmjopen-2019-034929", language = "English", volume = "10", journal = "BMJ Open", issn = "2044-6055", publisher = "BMJ Publishing Group", number = "3", } . BMJ Open.
(2016). 7 day services and psychiatry . The Lancet Psychiatry.
(2016). Managing older people’s alcohol misuse in primary care . British Journal of General Practice.
Recent advances in treatment for older people with substance use problems @article{4f83b588b4ef45baab000f50db294dd6, title = "Recent advances in treatment for older people with substance use problems: An updated systematic and narrative review", abstract = "Substance use disorders among the elderly are a growing public health concern but there is a limited evidence base on interventions designed specifically for this population group. This review aims to update the review by Moy et al., 2011, by examining recent advances in the treatment of substance use disorders in the elderly. Medline, Embase, PsycInfo, and Cochrane Library databases were searched. Appropriate inclusion and exclusion criteria were applied and eligible papers were selected through a sequential screening process. Data were extracted using a standard data extraction form, and synthesised. Thirteen papers were eligible for inclusion in the review. All the studies were conducted in developed countries. The interventions included pharmacological and psychological treatments for alcohol consumption, cigarette smoking, and prescription medication use, all delivered in a range of healthcare settings. The evidence for treatments of alcohol use related problems supports psychological interventions for reducing alcohol consumption. Studies on the treatments for tobacco use point towards the strength of cognitive behavioural therapy and combined treatments for smoking cessation. For prescription medications, counselling interventions were found to be effective. Older people were reported to have responded to interventions such as brief interventions, multicomponent interventions, educational interventions, counselling, amongst others. There remain limitations in this field of research, as the studies were undertaken only in developed countries, using psychological interventions with varying characteristics, and short follow-up periods.", keywords = "Older adults, Substance use disorders, Systematic review, Treatment", author = "U. Bhatia and A. Nadkarni and P. Murthy and R. Rao and I. Crome", year = "2015", month = jan, day = "1", doi = "10.1016/j.eurger.2015.07.001", language = "English", volume = "6", pages = "580--586", journal = "European Geriatric Medicine", issn = "1878-7649", publisher = "Elsevier Masson", number = "6", } . European Geriatric Medicine.
Rao, R., Schofield, P., Ashworth, M.(2015). Alcohol use, socioeconomic deprivation and ethnicity in older people . BMJ Open. 5. (8).
Rao, R., Draper, B.(2015). Alcohol-related brain damage in older people . The Lancet Psychiatry. 2. (8). p. 674-675.
Bhatia, U., Nadkarni, A., Murthy, P., Rao, R., Crome, I.(2015). Recent advances in treatment for older people with substance use problems: An updated systematic and narrative review . European Geriatric Medicine.
Crome, I.B., Rao, R., Crome, P.(2015). Substance misuse and older people: Better information, better care . Age and Ageing. 44. (5). p. 729-731.
Rao, R.(2014). Improving the coaching and mentoring of IMGs . BMJ (Online). 348.
Nadkarni, A., Murthy, P., Crome, I.B., Rao, R.(2013). Alcohol use and alcohol-use disorders among older adults in India: A literature review . Aging and Mental Health. 17. (8). p. 979-991.
Rao, R.(2013). Outcomes from liaison psychiatry referrals for older people with alcohol use disorders in the UK . Mental Health and Substance Use: Dual Diagnosis. 6. (4). p. 362-368.
Crome, I., Li, T.-K., Rao, R., Wu, L.-T.(2012). Alcohol limits in older people . Addiction. 107. (9). p. 1541-1543.
Crome, I.B., Crome, P., Rao, R.(2011). Addiction and ageing-awareness, assessment and action . Age and Ageing. 40. (6). p. 657-658.
Crome, I., Rao, R.(2011). Substance misuse and older people - Our Invisible Addicts . Mental Health and Substance Use: Dual Diagnosis. 4. (4). p. 267-269.
Rao, R., Wolff, K., Marshall, E.J.(2008). Alcohol use and misuse in older people: A local prevalence study comparing English and Irish inner-city residents living in the UK . Journal of Substance Use. 13. (1). p. 17-26.
Whelan, P., Meerten, M., Rao, R., Jarrett, P., Muthukumaraswamy, A., Bhugra, D.(2008). Stress, lies and red tape: The views, success rates and stress levels of the MTAS cohort . Journal of the Royal Society of Medicine. 101. (6). p. 313-318.
Rao, R.(2006). Alcohol misuse and ethnicity . British Medical Journal. 332. (7543).
Rao, R.(2006). Alcohol use disorders identification test has bias [10] . British Medical Journal. 332. (7542). p. 667-668.
Rao, R.(2006). Protecting the heart may not protect the public health [5] . British Medical Journal. 332. (7554).
Rao, R.(2003). Does personality disorder influence the likelihood of in-patient admissionin late-life depression? . International Journal of Geriatric Psychiatry. 18. (10). p. 960-961.
Rao, R.(2002). The role of carotid stenosis in vascular cognitive impairment . Journal of the Neurological Sciences. 203-204. p. 103-107.
(2000). Cerebrovascular disease and late life depression: an age old association revisited. International Journal of Geriatric Psychiatry.
(1999). Primitive reflexes in cerebrovascular disease: a community study of older people with stroke and carotid stenosis. International Journal of Geriatric Psychiatry.
(1998). Vascular dementia: dead or alive?. International Journal of Geriatric Psychiatry.
(1997). SUICIDAL THINKING IN COMMUNITY RESIDENTS OVER EIGHTY. International Journal of Geriatric Psychiatry.
OTHER
BOOK
Rao, R.T., Crome, I.B., Crome, P., Martin, F.C.(2014). Current Healthcare Models and Clinical Practices . Substance Use and Older People. p. 265-270.
Rao, R.T.(2014). Integrated Treatment Models for Co-Morbid Disorders . Substance Use and Older People. p. 340-350.
Crome, I.B., Crome, P., Rao, R.T., Wu, L.-T.(2014). Recommendations . Substance Use and Older People. p. 383-387.
Wilson, D., Jackson, S., Crome, I.B., Rao, R.T., Crome, P.(2014). Comprehensive Geriatric Assessment and the Special Needs of Older People . Substance Use and Older People. p. 171-191.