Robert Howard (psychiatrist)

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Robert Howard
FRCPsych
RobHoward.jpg
Dr Robert Howard
Born (1961-03-29) March 29, 1961 (age 64)
NationalityBritish
Alma mater University of Cambridge
St Bartholomew’s Hospital Medical College
Known forVLOSLP consensus criteria; clinical trials CALM-AD, DOMINO, ATLAS, ATTILA, PATHFINDER & ANTLER 75+
SpouseNesa Howard
Children2
AwardsLifetime Achievement Award, Royal College of Psychiatrists (2019)
Scientific career
FieldsOld-age psychiatry
Institutions University College London
North London Mental Health Partnership

Robert Howard (born 1961) is a British psychiatrist and professor of old-age psychiatry. He is Professor of Old Age Psychiatry at University College London (UCL) and an Honorary Consultant with the North London Mental Health Partnership. [1] He co-defined the diagnostic criteria for very-late-onset schizophrenia-like psychosis (VLOSLP) [2] and has led several influential clinical trials shaping dementia and psychosis care. [3] [4]

Contents

Early life and education

Howard studied medicine at the University of Cambridge, completed clinical training at St Bartholomew’s Hospital Medical College, [1] and entered psychiatric training at the Maudsley Hospital/Institute of Psychiatry under mentors Raymond Levy, Klaus Bergmann and Tony David. [5]

Career

Howard worked as an academic psychiatrist from the 1990s at King’s College London and then became Professor of Old Age Psychiatry and Psychopathology from 2002 - 2014. Since 2015 he has been Professor of Old Age Psychiatry at UCL. From 2008 – 2011 he served as Dean of Royal College of Psychiatrists. [1] [5] [6] [7] He was also the originator of the Psychiatry in Pictures series in the British Journal of Psychiatry, which began in July 2001 and later evolved to feature on the journal’s covers. [8]

Research

Howard has conducted many studies in old-age psychiatry, especially dementia and late-onset psychosis and depression.

As of 2025, he has published over 500 peer-reviewed articles, with an h-index of 105, and has led multiple landmark randomized controlled trials (RCTs) that shaped UK dementia and psychosis care policy. [9]

His most influential RCTs are summarised in the table below.

TrialFocusKey findingsYearReference
CALM-ADDonepezil for agitation in Alzheimer’s diseaseDonepezil was not superior to placebo on the CMAI; no benefit detected2007 [10]
DOMINODonepezil ± memantine in moderate–severe Alzheimer’s diseaseContinued treatment sustained cognitive & functional benefit2012 [3]
ATLASLow-dose amisulpride for VLOSLPSignificant symptom reduction; good tolerability2018 [4]
MADEMinocycline for mild Alzheimer’s diseaseNo benefit detected at either 200 mg or 400 mg dose; minocycline not recommended2020 [11]
ATTILATelecare & assistive tech in dementiaDid not delay institutionalisation2021 [12]
PATHFINDERProblem Adaptation Therapy for depression in Alzheimer's diseaseNo sustained benefit at 6 months2024 [13]
ANTLER 75+ (ongoing)Antidepressant continuation vs discontinuation (≥ 75 years)Multicentre RCT; results due 20272024– [14]

Howard also has supervised or mentored clinical researchers. Their research has spanned diverse areas of psychiatry and neuroscience, including pharmacology, neuroimaging, epidemiology, neuropathology, cognitive neuroscience, biomarkers, and the use of technology in mental health care. These include Suzanne Reeves, [15] Rebecca L. Gould, [16] Nigel J. Blackwood, [17] Derek K. Jones, [18] Jonathan D. Huntley, [19] Kathy Y. Liu, [20] Jean Stafford, [21] Harry Costello, [22] Jemma Hazan, [23] and Yuto Satake. [24]

Personal life

Howard lives in London and has a Jack Russell terrier named Layla. [25]

Selected publications

Books

Media

Howard has also contributed to many other television, radio and print media outlets on topics related to psychiatry and dementia. [30] [31]

Honours

References

  1. 1 2 3 "Professor Rob Howard – UCL Profile". University College London. Retrieved 14 June 2025.
  2. 1 2 Howard, Robert (2000). "Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus". American Journal of Psychiatry. 157 (2): 172–178. doi:10.1176/appi.ajp.157.2.172. PMID   10671383.
  3. 1 2 3 Howard, Robert (2012). "Donepezil and Memantine for Moderate-to-Severe Alzheimer's Disease". New England Journal of Medicine. 366 (10): 893–903. doi:10.1056/NEJMoa1106668. PMID   22397651.
  4. 1 2 3 Howard, Robert (2018). "Antipsychotic treatment of very late-onset schizophrenia-like psychosis (ATLAS): a randomised, controlled, double-blind trial". The Lancet Psychiatry. 5 (8): 633–643. doi:10.1016/S2215-0366(18)30141-X. PMC   6015223 . PMID   29880238.
  5. 1 2 Fannon, Dominic (2009). "E-interview: Robert Howard". Psychiatric Bulletin. 33 (8): 320–322. doi:10.1192/pb.bp.109.026799.
  6. ↑ "Robert Howard – King's College London". King's College London. Retrieved 14 June 2025.
  7. ↑ "Royal College of Psychiatrists Annual Review 2009" (PDF). Retrieved 14 June 2025.
  8. ↑ "Psychiatry in Pictures: A Selection of the Covers of the British Journal of Psychiatry from 2001 to 2023". Royal College of Psychiatrists. 2023. Retrieved 14 June 2025.
  9. ↑ "Robert Howard – Google Scholar" . Retrieved 14 June 2025.
  10. 1 2 Howard, Robert J. (2007). "Donepezil for the treatment of agitation in Alzheimer's disease". The New England Journal of Medicine. 357 (15): 1382–1392. doi:10.1056/NEJMoa066583. PMID   17914039.
  11. ↑ Howard, Robert (2020). "Minocycline at 2 Different Dosages vs Placebo for Patients With Mild Alzheimer Disease: A Randomized Clinical Trial". JAMA Neurology. 77 (2): 164–174. doi:10.1001/jamaneurol.2019.3762. PMID   31738372.
  12. ↑ Gathercole, Rebecca (2021). "Assistive technology and telecare to maintain independent living at home for people with dementia: the ATTILA RCT". Health Technology Assessment. 25 (19): 1–208. doi:10.3310/hta25190. PMC   8020444 . PMID   33755548.
  13. 1 2 Howard, Robert (2024). "Adapted Problem Adaptation Therapy for depression in mild-to-moderate Alzheimer's disease (PATHFINDER)". Alzheimer's & Dementia. 20 (4): 2990–2999. doi:10.1002/alz.13766. PMC   11032547 . PMID   38477423.
  14. ↑ "Antidepressants to prevent relapse in depression in older people (ANTLER 75+ Trial)". ISRCTN Registry. Retrieved 13 June 2025.
  15. ↑ Reeves, Suzanne (2017). "Therapeutic window of dopamine D2/3 receptor occupancy to treat psychosis in Alzheimer's disease". Brain. 140 (4): 1117–1127. doi:10.1093/brain/awx043. PMID   28334844.
  16. ↑ Gould, Rebecca L. (2006). "Brain mechanisms of successful compensation during learning in Alzheimer disease". Neurology. 67 (6): 1011–1017. doi:10.1212/01.wnl.0000237551.26858.39. PMID   17000961.
  17. ↑ Blackwood, Nigel J. (2004). "Persecutory delusions and the determination of self-relevance: an fMRI investigation". Psychological Medicine. 34 (4): 591–596. doi:10.1017/S0033291703008997. PMID   15099414.
  18. ↑ Jones, Derek K. (2005). "The effect of filter size on VBM analyses of DT-MRI data". NeuroImage. 26 (2): 546–554. doi:10.1016/j.neuroimage.2005.02.013. PMID   15907378.
  19. ↑ Huntley, Jonathan D. (2017). "Adaptive working memory strategy training in early Alzheimer's disease: randomised controlled trial". The British Journal of Psychiatry. 210 (1): 61–66. doi:10.1080/19336950.2016.1242289. PMC   5279876 . PMID   27682595.
  20. ↑ Liu, Kathy Y. (2020). "Neuropsychiatric symptoms in limbic-predominant age-related TDP-43 encephalopathy and Alzheimer's disease". Brain. 143 (12): 3842–3849. doi:10.1093/brain/awaa333. PMC   7641519 . PMID   33169114.
  21. ↑ Stafford, Jean (2021). "Association between risk of dementia and very late-onset schizophrenia-like psychosis: a Swedish population-based cohort study". Psychological Medicine. 23 (6): 1–9. doi:10.1080/17549507.2021.1908425. PMID   34030526.
  22. ↑ Costello, Harry (2019). "Systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder". BMJ Open. 9 (7): e027925. doi:10.1136/bmjopen-2018-027925. PMC   6661631 . PMID   31340964.
  23. ↑ Hazan, Jemma (2024). "Clinical utility of cerebrospinal fluid biomarkers in the evaluation of cognitive impairment: a systematic review and meta-analysis". JAMA Neurology. 81 (5): e123456. doi:10.1038/s41598-024-57682-y. PMC   10960842 . PMID   38521879.
  24. ↑ Satake, Yuto (2025). "A Week With a Conversational Large Language Model Companion Robot". The American Journal of Geriatric Psychiatry. 33 (7): 799–800. doi:10.1016/j.jagp.2025.03.010. PMID   40263063.
  25. ↑ "Layla". X (formerly Twitter). 21 June 2023. Retrieved 28 June 2025.
  26. ↑ Gale, Colin; Howard, Robert (2003). Presumed Curable: An Illustrated Casebook of Victorian Psychiatric Patients in Bethlem Hospital. Wrightson Biomedical Publishing. ISBN   9789492811158.
  27. ↑ "Rob Howard on Breakdown". Channel 4. 12 November 2013. Retrieved 28 June 2025.
  28. ↑ "Warwick Davis". Our Media Ltd. 16 October 2019. Retrieved 28 June 2025.
  29. ↑ "Prof Rob Howard on BBC Breakfast". X (formerly Twitter). 12 June 2025. Retrieved 28 June 2025.
  30. ↑ "Form of dementia that 'mimics' Alzheimer's symptoms discovered". The Guardian. 30 April 2019. Retrieved 23 August 2025.
  31. ↑ "Middle-aged people who sleep six hours or less at greater risk of dementia, study finds". The Guardian. 20 April 2021. Retrieved 23 August 2025.
  32. ↑ "Bethlem Museum of the Mind – Charity Commission register". Charity Commission for England and Wales. Retrieved 28 June 2025.
  33. ↑ "Prizes and Bursaries – Faculty of Old Age Psychiatry". Royal College of Psychiatrists. Retrieved 28 June 2025.
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