Betsi Cadwaladr University Health Board
01978 726 752
I am a clinical psychiatrist and researcher who was appointed as Consultant Psychiatrist in Wrexham in 2004. I was brought up in Germany where I went to University in Münster (Westphalia). I decided to study medicine after my positive experiences working as an auxiliary nurse as part of my national service (instead of joining the army). I moved to Britain in 1995 and did my postgraduate psychiatric education in and around Liverpool. I have always had an interest in the interface between psychiatry and medicine and obtained accreditation as an adult and a liaison psychiatrist. I received a Masters in Medical Ethics from Liverpool University in 2003 and won several research prizes. I worked as an Associate Medical Director for clinical ethics in North Wales for several years.
My consultant job took me to Wales where I cover a catchment area of about 24,000 adults in Wrexham including some of the most deprived areas in Wales. I lead a clinic for delusional infestation with the School of Tropical Medicine in Liverpool. For some years I co-ran a specialist clinic for adults with ADHD in the Wrexham area. My clinical inspiration is to work with my team to make a positive difference in the lives of those who suffer from severe mental illness.
My job allows me some time for research, and I have developed links with Bangor and Cardiff Universities as well as the Mysore Medical College and Research Institute in India. I have been a member of the European Violence in Psychiatry Research Group (EViPRG) since 2005. EViPRG is a network of international experts who work in the field of coercion and violence with the aim to reduce coercive measures and aggression in medical settings. My research interests include coercion, violence and aggression, clinical ethics, systematic reviews and various other projects. I am an international expert on delusional infestation. I have conducted many international comparison studies between various countries in the field of coercion. More recently I have started to get involved in research projects in India looking at systematic reviews, ethics, human rights and violence prevention.
I am on the steering group of the GMHAT, an international computerised mental health assessment tool developed by Professor Vimal Sharma (Chester University). It allows non-psychiatric clinicians to make working psychiatric diagnoses. The instrument has become particularly popular in countries with few psychiatric staff and is available in many languages.
I have contributed to a number of books and published 160 research articles (update October 2016, h-index: 23; g-index: 38; 1759 citations; 79.95 cites/year; 129 cites each for 2 most cited publications, first publication in 1999). I currently work as a Consultant Psychiatrist in Wrexham and Honoray Professor at Bangor University, North Wales, and Mysore Medical College and Research Institute, India. Since 2009 I have worked closely with Professor Rob Poole and Professor Catherine Robinson in the Centre for Mental Health and Society.
Consultant Psychiatrist, Betsi Cadwaladr University Health Board
Honorary Professor at Bangor University, North Wales and Mysore Medical College and Research Institute, India
Associate Medical Director for Ethics, Capacity and Consent, Betsi Cadwaladr University Health Board
Visiting Professor, Glyndŵr University
Masood B., Lepping P., Romanov D., Poole R., Treatment of alcolhol-indued pyschotic disorder (alcoholic hallucinosis): A systematic review. International Journal of Law and Psychiatry. 2018, Vol 53 No 1 pp 259-267
Huber M., Wolf R.C., Lepping P., Kirchler E., Sambatato F., Karner M., Herrnberger B., Corlett P.R., Freudenmann R.W., Regional gray matter volume and structural network strength in somatic vs non-somatic delusional disorders. Progress in Neuropsychopharmacol Biological Psychiatry. 2018 Mar 2; 82 pp 115-122
Stone, B., Lepping P., Prolonged Wahnstimmung (delusional mood) without development of a psychotic illness in a 50 year old male: a case report. Indian Journal of Psychiatry. 2018, Vol 59, No 4 pp 496-498
Romanov D.V., Lepping P., Bewley A., Huber M., Freudenmann R.W., Lvov A.N., Squire S.B., Noorthoorn E.O. Longer Duration of untreated psychosis is associated with poorer outcomes for patients with delusional infestation. Acta Derm Venereol. 2018 Jan 24, doi: 10.2340/00015555-2888
Gowda G.S., Kumar C.N, Lepping P., Raveesh B.N., Noorthoorn E.O., Math S.B., Factors influencing the advance directive among psychiatric inpatients from India: A prospective study. International Journal of Law and Psychiatry. 2018 Jan - Feb; Vol 56, pp 17-26
Gowda G.S., Lepping P., Noorthoorn E.O., Kumar S., Raveesh B.N., Math S.B., Restraint prevalence and perceived coercion among psychiatric inpatients from India: A prospective study, Asian J Psych 36 (2018); 10 - 16
Lepping P., Noorthoom, E.O., Kemperman, S., Harth W., Reichenberg J., Bertel Squire S., Shinhmar S., Freudenmann R.W., Bewley A. An international study of the prevalence of substance use in patients with delusional infestation. Journal of the American Academy of Dermatology. 2017, Vol 77, No 4 pp 778-779
Lepping P., Whittington R., Sambhi R.S., Lane S., Poole R., Leucht S., Cuijpers P., McGabe R., Waheed W., Systematic review of the clinical relevance of findings in trials of CBT in depression. European Psychiatry 2017, Vol 45 pp 207-211
Lepping P. Befallswahn : Eine seltene Storung mit hohem Lebensdruck. CliniCum Derma 2017, Vol 3, pp 28-31
Lepping P., Police arrests under Mental Health legislation in England and Wales. World Association for Medical Law Newsletter 2017: pp 5-7
Leucht S., Fennema H., Engel R., Kaspers, M., Lepping P., Szegedi Armin. What does the MADRS mean? Equipercentile linking with the CGI. Journal of Affective Disorders 2017, Vol 210, pp 287-293
Cowman S., Bjorkdahl A., Clarke E., Gethin G., Maguire J., Lepping P., A descriptive survery study of violence management and priorities amon psychiatric staff in mental health services, across seventeen european countries. BMC Health Services Research 2017, Vol 17
Verlinde L., Noorthoorn E., Snelleman W., Snelleman-van-der-Plas, M., Lepping P. Seclusion and enforced medication in dealing with aggression: A prospective dynamic cohort study. European Psychiatry 2017, Vol 39, pp 86-92
Raveesh B.N., Pathare S., Lepping P., Noorthoorn E.O., Gowda G.S., Benders-Aelen J.G.F. Perceived coercion in person with mental discorder in India: A cross sectional study. Indian Journal of Psychiatry 2016. Vol 58, No 6, pp 210-220.
Raveesh B.N., Pathare S., Noorthoorn E.O., Gowda G.S., Lepping P., Bunders-Aelen J.G.F. Staff and caregiver attitude to coercion in India. Indian Journal of Psychiatry 2016. Vol 58, No 6, pp 221 - 229.
Lepping P., Bewley A., Freudenmann R.W. Delusional parasitism. Infectional Diseases: An Encyclopaedia of Causes, Effects and Treatments. Editor, Michael Z David. ABC Clio.
Lepping P., Masood B., Flammer E., Noorthoorn E.O. Comparison of restraint data from four countries. Social Psychiatry and Psychiatric Epidemiology 2016, Vol 51, No 9, pp 1301-1309.
Lepping P, Zwangsmaßnahmen in Großbritannien. [Coercive measures in Great Britain]. Recht und Psychiatrie, in print [in German], Vol 34, No 3, pp 175-179.
Lepping P, Palmstierna T, Raveesh BN. Paternalism versus autonomy – are we barking up the wrong tree? British Journal of Psychiatry 2016, Vol 209, No 2, pp 95-96
Danivas V., Lepping P., Punitharani S., Gowrishree H., Ashwini K., Raveesh B., Palmstierna T. Observation study of aggressive behaviour and coercion on an Indian acute ward. Asian Journal of Psychiatry 2016, Vol 22, pp 150-156.
Schonfeldt-Lecuona C., Lefaucheur J.P., Lepping P., Liepert J., Connemann B.J., Sartorius A., Nowak D.A. Non-Invasive Brain Stimulation in Conversion (Functional) Weakness and Paralysis: A Systematic Review and Future Perspectives. Frontiers in Neuroscience, section Neurodegeneration 2016. Vol 10:140
Lepping P., Tehan B., Benchmarking ist ein wirksames Instrument zur Verbesserung der klinischen Versorgung - Kontra. Psychiatrische Praxis 2016, Vol 43, No 2, pp 72-73
Masood B, Lepping P, Jones E, Morris M, Lewis M, McEwan J, Sussex P, Owen G. National data on coercion in psychiatry from Wales. British Journal of Mental Health Nursing, January/February 2016 Vol 5 No 1 pp18-24
Lepping P, Tehan B: [Benchmarking is an Effective Instrument to Improve Clinical Services - Contra].. Psychiatry Prax. 2016 Mar;43(2):72-3 [in German]
Raveesh BN, Lepping P, Lanka SV, Turner J, Krishna M. Patient and visitor violence towards staff on medical and psychiatric wards in India. Asian Journal of Psychiatry, 2014; doi:10.1016/j.ajp.2014.10.003.
Rishniw M, Lepping P, Freudenmann RW. Delusional infestation by proxy--what should veterinarians do? The Canadian Veterinary Journal. La Revue Veterinaire Canadienne
Lepping P, Schönfeldt-Lecuona C, Sambhi RS, Lanka SV, Lane S, Whittington R, Leucht S, Poole R. A systematic review of the clinical relevance of repetitive transcranial magnetic stimulation. Acta Psychiatrica Scandinavica, 2014,130(5), 326-341.
Sharma VK, Durrani S, Sawa M, Copeland JR, Abou-Saleh MT, Lane S, Lepping P. Arabic version of the Global Mental Health Assessment Tool-Primary Care version (GMHAT/PC): a validity and feasibility study. East Mediterr Health J. 2013 Nov;19(11):905-8.
Honagodu AR, Krishna M, Sundarachar R, Lepping P. Group psychotherapies for depression in persons with HIV: A systematic review. Indian J Psychiatry. 2013 Oct;55(4):323-30.
Wolf RC, Huber M, Depping MS, Thomann PA, Karner M, Lepping P, Freudenmann RW. Abnormal gray and white matter volume in delusional infestation. Prog Neuropsychopharmacol Biol Psychiatry. 2013;46:19-24.
Lepping P, Raveesh BN. Overvaluing autonomous decision making, BrJPsych 2014 Jan; 204:1-2
Lepping P, Lanka SV, Turner J, Stanaway SE, Krishna M. Percentage prevalence of patient and visitor violence against staff in high-risk UK medical wards. Clin Med. 2013 Dec;13(6):543-6.
Wolf C, Huber M, Lepping P, Sambatato F, Karner M, Freudenmann RW. Source-based morphometry reveals distinct patterns of aberrant grey and white matter volume in patients with delusional infestation. Prog Neuropsychopharmacol Biol Psychiatry, 2014 Jan 3; 48:112-116
Sharma BB, Singh V, Sharma VK, Sharma D, Singh S, Lane S, Lepping P, Krishna M, Copeland JR. Psychiatric morbidity in chronic respiratory disorders in a North Indian clinic using the Global Mental Health Assessment Tool. Gen Hosp Psych 2013 Jan;35(1):39-44
Krishna M, Honagodu A, Rajendra R, Sundarachar R, Lane S, Lepping P. A Systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults Int J Geriatr Psychiatry. 2013 Sep;28(9):881-8
Lepping P. The use of emergency medicine: A survey from 21 countries. J Clin Psychopharm, 2013 Apr;33(2):240-2
Leucht S, Fennema H, Engel R, Kaspers M, Lepping P, Szegedi A. What does HAMD mean? J Affect Disord. 2013 Jun; 148(2):243-8
Honagodu AR, Krishna M, Sundarachar R, Lepping P. Group psychotherapies for depression in persons with HIV: A systematic review. Ind J Psych. 2013 Oct; 55(4):323-330
Sharma VK, Durrani S, Sawa M, Copeland JRM, Abou-Saleh MT, Lane S, Lepping P. Arabic version of the Global Mental health Assessment Tool (GMHAT/PC): A validity and feasibility study. Eastern Mediterranean Health Journal, 2013 Dec; 19(11):905-908
Lepping P, Lanka SVN, Turner J, Stanaway SERS, Krishna M. Percentage prevalence of Patient and Visitor Violence against staff in Welsh high-risk medical wards. Clinical Medicine. 2013 Dec; 13(6):543-6
Lepping P, Raveesh BN. The Mysore Declaration, International Psychiatry, Nov 2013; 10(4):98-99
Wolf RC, Huber M, Depping MS, Thomann PA, Karner M, Lepping P, Freudenmann RW. Abnormal gray and white matter volume in delusional infestation. Prog Neuropsychopharmacol Biol Psychiatry, 2013 Oct 1; 46:19-24.
Lepping P, Malik M. Community treatment orders: current practice and a framework to aid clinicians, The Psychiatrist, Febr 2013
Bell C, Lepping P, Clifford JM, Garner-Thorpe C. A Case of Todd's Palsy following Unilateral ECT. Ind J Psych. 2012 April-June; 54(2):192-193
Freudenmann RW, Lepping P, Huber M, Dieckmann S, Bauer-Dubau K, Ignatius R, Misery L, Schollhammer M, Harth W, Taylor RE, Bewley AP. Delusional infestation and the specimen sign: a European multicentre study in 148 consecutive cases.Br J Dermatol. 2012 Aug;167(2):247-251
Sharma BB, Singh V, Sharma VK, Sharma D, Singh S, Lane S, Lepping P, Krishna M, Copeland JR. Psychiatric morbidity in chronic respiratory disorders in a North Indian clinic using the Global Mental Health Assessment Tool. Hosp Psychiatry. 2012 Oct 30. doi:pii: S0163-8343(12)00281-2. 10.1016
Krishna M, Honagodu A, Rajendra R, Sundarachar R, Lane S, Lepping P. A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults.Int J Geriatr Psychiatry. 2012 Nov 12. doi: 10.1002/gps.3905
Gahr M, Kölle MA, Schönfeldt-Lecuona C, Lepping P, Freudenmann, RW. Paliperidone Extended Release: Does it have a place antipsychotic therapy? Drug Des Devel Ther. 2011 Mar 11;5:125-46
Krishna M, Jauhari A, Lepping P, Turner J, Crossley D, Krishnamoorthy A. Is group psychotherapy effective in older adults with depression? A systematic review. Int J Geriatr Psychiatry. 2011 Apr;26(4):331-40
Lepping P, Sambhi RS, Whittington R, Lane S, Poole R. The clinical relevance of findings in trials of antipsychotics: A systematic review. British Journal of Psychiatry, 2011 May;198:341-5
Huber M, Lepping P, Pycha R, Karner M, Schwitzer J, Freudenmann RW. 2011, Delusional infestation: Treatment outcome with antipsychotics in 17 consecutive patients (using standardized reporting criteria), Gen Hosp Psychiatry. 2011 Nov-Dec;33(6):604-11
Krishna M, Lepping P. Ethics of xenotransplantation. British Journal of Medical Practicioners, 2011;4(3):a425
Lepping P. Overestimating patients’ capacity. British Journal of Psychiatry, 2011, 199: 355-356
Lepping P, Delieu J, Mellor R, Williams JHH, Hudson PR, Hunter-Lavin C. Antipsychotic medication and oxidative cell stress – a systematic review. Journal of Clinical Psychiatry. 2011 Mar;72(3):273-85.
Steinert T, Lepping P, Bernhardsgrütter R, Conca A, Hatling T, Janssen W, Keski-Valkama A, Mayoral F, Whittington R. Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends. Soc Psychiatry Psychiatr Epidemiol. 2010 Sep;45(9):889-97
Cole-King A, Lepping P. Suicide mitigation: time for a more realistic approach. British Journal of General Practice. 2010 Jan;60(570):1-3
Lepping P, Baker C, Freudenmann RW. Delusional infestation in dermatology in the UK: Prevalence, treatment strategies, and feasibility of a RCT. Clinical and Experimental Dermatology. 2010 Dec;35(8):841-4
Lepping P, Sambhi RS, Williams-Jones K. Deprivation of liberty safeguards – How prepared are we? Journal of Medical Ethics. 2010 Mar;36(3):170-3
Sharma VK, Krishna M, Lepping P, Palanisamy V, Kallumpuram SV, Mottram P, Lane S, Wilson K, Copeland JRM. Validation and feasibility of Global Mental Health Assessment Tool – Primary care version (GMHAT/PC) in the older adults. Age and Ageing. 2010 Jul;39(4):496-9
Kölle M, Lepping P, Kassubek J, Schönfeldt-Lecuona C, Freudenmann RW. Delusional Infestation induced by Piribedil Add-On in Parkinson’s Disease. Pharmacopsychiatry. 2010 Jul 7.
Freudenmann RW, Kölle M, Huwe A, Luster M, Reske SN, Huber M, Lepping P, Schönfeldt-Lecuona C. Delusional Infestation: Neural correlates and antipsychotic therapy investigated by multimodal neuroimaging. . 2010 Prog Neuropsychopharmacol Biol Psychiatryct 1;34(7):1215-22
Bewley A, Lepping P, Freudenmann RW, Taylor R Delusional Parasitosis: Time to call it delusional infestation. Br J Dermatol. 2010 Jul;163(1):1-2
Cole-King A, Lepping P. Will the new UK government change our approach to risk? BMJ.2010 Jul 21;341:c3890
Freudenmann RW, Kölle M, Schönfeldt-Lecuona C, Dieckmann S, Harth W, Lepping, P. Delusional parasitosis and the matchbox sign revisited: the international perspective. Acta Derm Venereol. 2010 Sep;90(5):517-9.
Lepping P, Huber M. Role of zinc in the pathogenesis of ADHD: implications for research and treatment. CNS Drugs. 2010 Sep 1;24(9):721-8
Sambhi RS, Lepping P. Psychiatric treatments in dermatology: an update.Clinical and Experimental Dermatology. 2010 Mar;35(2):120-5
Sharma VK, Jagawat S, Midha A, Jain A, Tambi A, Mangwani LK, Sharma B, Dubey P, Satija V, Copeland JRM, Lepping P, Lane S, Krishna M, Pangaria A. The Global mental Health Assessment Tool- Validation of GMHAT/PC in Hindi. A Validity and Feasibility Study. Ind J Psych,2010 Oct;52(4):316-9.
Lepping P, Paravastu CV, Turner J, Billings P, Minshom P. Copying GP letters to patients: A comprehensive study across four different departments in a district general hospital Health Informatics Journal. 2010; 16(1), 58-62
Freudenmann RW, Kühnlein P, Lepping P, Schönfeldt-Lecuona C. Secondary delusional parasitosis treated with paliperidone. Clinical and Experimental Dermatology. 2009; 34(3):375-7.
Steinert T, Lepping P. Legal provisions and practice in the management of violent patients. A case vignette study in 16 European countries. European Psychiatry, 2009; 24(2):135-41
Crossley D, Lepping P. Role confusion, values-based practice and the demise of the generalist. Psychiatric Bulletin. 2009; 33: 7 - 9.
Carson AM, Lepping P. Ethical psychiatry in an uncertain world: conversations and parallel truths.Philosophy Ethics Humanity in Medicine. 2009 Jun; 25;4:7.
Lepping P. Consent and capacity for dermatologists: an ethical review and update.Clinical and Experimental Dermatology. 2009 Aug;34(6):655-7
Lepping P, Steinert T, Needham I, Abderhalden C, Flammer E, Schmid P. Ward safety perceived by ward managers in Britain, Germany and Switzerland: identifying factors that improve ability to deal with violence.Journal of Psychiatric Mental Health Nursing. 2009 Sep;16(7):629-35.
Freudenmann RW, Lepping P. Delusional infestation. Clinical Microbiology Reviews. 2009 Oct;22(4):690-732.
Sambhi RS, Lepping P. Adult ADHD and psychosis: A review of the literature and two cases. Clinical Neuropsychiatry. 2009; 6,4, 174-8,
Lepping P, Freudenmann RW. Delusional parasitosis: a new pathway for diagnosis and treatment. Clinical and Experimental Dermatology, 2008; 33(2):113-117.
Gorton AJ, Jayanthi NV, Lepping P, Scriven MW. Patients' attitudes towards "do not attempt resuscitation" status. Journal of Medical Ethics, 2008 Aug;34(8):624-6.
Sharma VK, Lepping P, Krishna M, Durrani S, Copeland JR, Mottram P, Parhee R, Quinn B, Lane S, Cummins A. Mental health diagnosis by nurses using the Global Mental Health Assessment Tool: a validity and feasibility study. British Journal of General Practice, 2008 Jun;58(551):411-6.
Lepping, P. Is psychiatry torn in different ethical directions? Psychiatric Bulletin, 2008;32:325-6.
Kandarp J, Slegg G, Lepping P. The psychopathology of AIDS within the Surat region of India: A cohort study. The Psychologist in Wales, 2008, 21:17-24
Huber M, Karner M, Kirchler E, Lepping P, Freudenmann RW. Striatal lesions in delusional parasitosis revealed by magnetic resonance imaging. Progress in Neuropsychopharmacology and Biological Psychiatry. 2008 Dec 12;32(8):1967-71
Lepping P, Mukandan J, Poole R. Neuroleptic Malignant Syndrome and Catatonia. Progress in Neurology and Psychiatry, 2007;11(1):9-14.
Lepping P. Ethical analysis of the new proposed mental health legislation in England and Wales. Philosophy, Ethics and Humanity in Medicine, 2007;2:5.
Lepping P, Menkes D. Abuse of dosulepin to induce mania. Addiction, 2007; 102(7):1166-7.
Freudenmann RW, Schönfeldt-Lecuona C, Lepping P. Primary delusional parasitosis treated with olanzapine. Journal of International Psychogeriatrics, 2007;19(6):1161-1168.
Paravastu S, Billings P, Lepping P. Copying clinic letters to surgical patients. Annals of the Royal College of Surgeons England (Suppl), 2007;89:288–90.
Lepping P, Russell I, Freudenmann RW. Antipsychotic treatment of delusional parasitosis – a systematic review. British Journal of Psychiatry, 2007;191:198-205.
Lepping P, The practice of physical restraint in the UK. BMC Psychiatry, 2007;7(Suppl 1):S61
Lepping P, Woodworth B, Roberts L, Turner J. Increasing psychosocial assessments by introducing a self-harm pathway. Psychiatric Bulletin, 2006;30:169-72.
Lepping P. The Organisation of Emergency Psychiatry in Great Britain. Krakenhauspsychiatrie (Hospital Psychiatry), 2005;16:75-78, published in German.
Steinert T, Lepping P, Baranyai R, Hoffmann M, Leherr H. Compulsory admission and treatment in schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 2005;40 (8):635-641.
Lepping P, Gil-Candon R, Freudenmann R. Delusional Parasitosis Treated with Amisulpride. Progress in Neurology and Psychiatry, 2005;9 (7):12-16.
Salize HJ, Lepping P, Dreßing HJ. How harmonised are we? Forensic Mental Health Legislation and Service Provision in the European Union. Criminal Behaviour and Mental Health, 2005;15 (3):143-147.
Lepping P, Steinert T, Gebhardt RP. A comparison of ethical attitudes of English and German health professionals and lay people towards formal admission - Implications for the new Mental Health Act, Journal of Philosophy, Science and law (web-based) 2004; 3.
Lepping P, Swinton M. Borderline Personality Disorder associated with psychotic symptoms and parietal abnormalities. Psychiatrische Praxis, 2004;31:96-99, published in German.
Lepping P. Treatment of parasuicide in Great Britain – psychosocial assessment instead of hospitalisation. Krankenhauspsychiatrie (Hospital Psychiatry), 2004;15:9-11, published in German.
Sharma VK, Lepping P, Cummins A, Copeland J, Parhee R, Mottram P. The Global Mental Health Assessment Tool Primary Care Version (GMHAT/PC): Development, Reliability and Validity. World Psychiatry,2004;3 (2):115-119.
Lepping P. An ethical review of consent in medicine. Psychiatric Bulletin, August 2003;27(8):285-290.
Lepping P. Psychiatric Training in Great Britain. Krankenhauspsychiatrie (Hospital Psychiatry), 2003;14:167-9, published in German.
Röttgers HR, Lepping P. Sectioning and treatment of the psychiatrically ill in the UK and Germany. Psychiatrische Praxis. 1999;26(99):139-42, published in German.
Röttgers HR, Lepping P. Treatment of the mentally ill in the Federal Republic of Germany. Psychiatric Bulletin, 1999;23(10):601-603.