Carmine Pariante is Professor of Biological Psychiatry at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London and Consultant Perinatal Psychiatrist in the South London and Maudsley NHS Trust. Prof Pariante obtained his Medical Degree in Italy at Università Cattolica del Sacro Cuore of Rome, and specialised in Psychiatry at University of Cagliari. He then undertook a post-doc position at Emory University School of Medicine in Atlanta (USA), before joining the IoPPN in London.
His research investigates the role of stress in the pathogenesis of mental disorders and in the response to psychotropic drugs, both in clinical samples and experimental settings. His work focuses on depression and fatigue, with a particular interest in the perinatal period and in subjects with medical disorders. His dream is that new therapeutic tools targeting the stress system will soon be available to alleviate the suffering of patients with mental health problems.
- Since the beginning of your career, you have never worked in Italy. What made you leave Italy, and what made you stay in London?
I have always been keen in pursuing an academic career in Biological Psychiatry, as I have always been very interested in the interaction between stress, depression and the immune system. In the last year of my Psychiatric training I was awarded an international fellowship from the University of Cagliari which allowed me to spend two years in Atlanta. After that I moved to London for two reasons: the importance of the IoPPN as a world leading research institution; and the wish to find a place where it could be possible to work both as a researcher and as a clinician within the NHS, which has a similar structure to the Italian health care system.
- Based on your experience, which are the main differences between academia in the UK and in Italy? And what about clinical services?
When I left Italy, academia in the UK, compared to that in Italy, emphasised more on merit and was better able to offer me the opportunity to build my career in a serious way. In Italy, both because of limited research funding and for cultural reasons, it was difficult to make long term career plans as there is not a proportional relationship between merit and career progression. Although my experience of Italian academia over the last few years is mostly indirect, I think that some changes are happening, both in the introduction of more precise and stricter criteria for job application and in the lower tolerance of new generations towards unfair dynamics. There is also stronger attention on quality of research in order to have international impact.
The clinical training for psychiatrists and clinical psychologists in the UK seems to be broader and more uniform than it is in Italy, where the training at different schools and universities differs greatly and is more focused towards some disorders or some therapeutic approaches and not others. More generally in the UK there is a highly integrated approach to the patient, which combines adequate treatment decisions involving medication and psychotherapy. The public mental health care system in the UK seems to give better access to mental health services than in Italy where many patients need to seek treatment through private practices, although even the former need to improve and aim to offer better services to an increasing number of people.
- Have you ever thought or tried to go back to Italy? And what would possibly make you do that?
I have never thought and I have never been offered the opportunity to get back to Italy. I have always really enjoyed my life in London and I don’t think there is a place in Italy which is comparable to London.
- What are the three most significant events and achievements in your career?
The first one is surely when I became Professor: I was extremely pleased and it represented the finish line of a journey; and also because I became the first Italian professor at the IoPPN. The second is when I received the Psychopharmacology Award from the British Association for Psychopharmacology, together with the other occasions when I received awards for my work. The third is when my younger collaborators and students, including Valeria Mondelli, also here at the IoPPN, received awards themselves.
- Which are the biggest mistakes you have made and biggest challenges you have encountered in your career?
I don’t think I have made any particular mistake which I could regret, as I have always thought that mistakes can only be an opportunity for learning. I believe that Italians in the UK need to pay great attention to the professional and socio-cultural environment in order to both maintain their Italian culture, whilst avoiding any potential issues. For instance it is important that Italians learn how to modulate their body movements, voice and ways of expressing themselves. In this way our British colleagues can expect some differences in our interactions and ways we express our ideas and feelings, but also appreciate the positive aspects of our origins. Adapting ourselves to different communication dynamics and an understanding that the British people can be somewhat indirect but honest at the same time is key.
- What are the biggest challenges in your research field?
I think that the main problem is that available pharmacotherapies are not satisfactory, as they are not well tolerated and don’t work for a proportion of patients. It’s essential that we find new drugs that are better tolerated by patients and identify those cases where pharmacotherapy is really necessary. It’s a difficult task as unfortunately there is an increasing lack of interest and support by drug companies and more and more organisations against the use of drugs for mental diseases.
- What recommendations would you give to a young psychologist or medic who is starting a career in the UK?
I think that it’s essential to have a deep optimism and sense of ‘mission’. We should always remember that everyday difficulties are nothing compared to the big impact that we can have in people’s lives with our job, and how satisfying this can be. The wonderful thing about research is not only that we create new tools for clinical interventions, but also that we are able to help potential future patients and patients that are not born yet. Both in terms of prevention and intervention aimed at interrupting or correcting individual trajectories and changing the lives of our patients, their families and future generations.
- Many people consider you as a role model. What role models have you had in your career?
First of all my first research supervisor, Andy Miller in Atlanta, who has been and still is a great friend and has taught me how to shift from being a student to being a colleague and a friend. This has been very important not only for myself but also in relation to my collaborators and researchers that have started their career with me and have become more and more independent. I have also had many role models at the IoPPN. Most of all Robin Murray for his enthusiasm and dedication to developing young people’s careers, the energy that he has always shown when working with collaborators and his ability of always being very supportive. Among Italians, Michele Tansella from the University of Verona, who has sadly recently passed away, and has been a fantastic friend and example for his very warm personality and ability to be the lead of a strong research group.
- In your career you have often worked with other Italians. What do you think is the reason for this?
I think it has mostly been due to a word-of-mouth effect. At the beginning of my career in the UK I used to go to conferences in Italy quite often and many young doctors and researchers approached me to work together. I don’t think this has to do with specific characteristics of Italians, apart from strong motivation and willingness to learn maybe.
- We are very interested in your blog on the Huffington Post and your Twitter page. What do you think are the advantages of using these new ways of communication in your job?
I really enjoy the opportunity of writing about something more controversial or in a writing style that is simpler and more journalistic that the one used in scientific writing. Twitter has the great power of keeping you posted in real time on what happens, which I find really addictive! I think that the use of social media is becoming more and more important and I hope I will make the presence of my research group stronger on other social media including Facebook. More generally, I think that using these new technologies may help us to get a broader and long term view of our research, to put things in perspective, and understand what the key messages are that we want to deliver. I believe that as psychiatrists we have the responsibility of being intellectuals, and to contribute to the politic and socio-cultural debate. We need to raise awareness of mental health conditions, and aim to increase the understanding of these issues and fight the social stigma surrounding them.
PsicologiaLondra.com’s team would like to greatly thank Prof Pariante for this interview.