Before medicine: In ’76 I began studying for a BSc in Electrical & Electronic Engineering then switched to the last 3 years of Mathematical Physics at Strathclyde University.  After this I did a PhD in Physics at Glasgow University, using electron microscopy to study animal & human pathology samples of aluminium poisoning, for quantitative spectroscopic chemical analyses.  The work was supported by a CASE studentship with sponsorship from Riker Laboratories Ltd, Loughborough, a pharmaceutical company.  I spent significant time developing software which was later used by Glasgow University in part-payment for a new electron microscope.

After PhD studies I worked for three years as NHS Medical Physicist in Glasgow, in Radiotherapy Treatment Planning and Nuclear Medicine, then one year as Software R&D Engineer for General Electric Ltd, Hertfordshire, developing a new Radiotherapy Treatment Planning system, an earlier version of which I had used as an NHS Medical Physicist at Belvidere Hospital in Glasgow.

Medicine: I began studying Medicine at Edinburgh University in ’89 and became interested in psychiatric neuroimaging during an undergraduate medical student placement at the MRC Brain Metabolism Unit, Royal Edinburgh Hospital.  After graduating MB ChB, I trained in psychiatry based at the Royal Edinburgh Hospital, obtained Royal College of Psychiatrists Membership (MRCPsych), then worked for Edinburgh University as a Clinical Lecturer & Honorary Specialist Registrar in Psychiatry, with a year spent working in ward 2 which specialised in the treatment of schizophrenia.

This is when I first became interested in Severe Psychiatric Illnesses (SPI), which are a small fraction of General Psychiatry (‘mental health’) referrals, but occur in a significant percentage (~3%) of the UK's population.  These illnesses are associated with quantitative brain abnormalities, cognitive and motivational impairments, ‘soft’ neurological signs, a substantial reduction in average life expectancy, now recognised as mostly due to treatable cardiometabolic causes, and can be objectively diagnosed in individual patients using neuroimaging with machine learning.

On obtaining a CCST in General Psychiatry and an MD in Psychiatry & Neuroimaging, I moved in ‘04 to Aberdeen University as Clinical Senior Lecturer & Honorary Consultant Psychiatrist.  During this period I was effectively a full-time NHS Consultant Psychiatrist, focusing on inpatient work but also dealing with community MHA detentions.  As such, I was one of the last academic psychiatrists in the UK running an NHS General Psychiatry inpatient service.  After 5 years I moved to Dundee University and was later elected Fellow of the Royal College of Psychiatrists (FRCPsych).

Lack of progress in the clinical practice of psychiatry since the 1970s is caused by a flawed dualistic framework, not by the complexity of the brain. This approach, by creating a false distinction between "mental" and "physical" illnesses, obscures the causes of illnesses.  The solution is a non-dualistic (and non-monistic) approach that recognizes only illnesses. This avoids biological reductionism by treating symptoms (subjective experience) as equally important as signs (objective observations).  Progress doesn't depend on solving the "hard problem" of consciousness. Since there are no examples of disembodied minds, the burden of proof rests on those who claim a solution is necessary.  Historically, psychiatrists used the term "psychic" and this is still used by contemporary psychodynamic psychiatrists, but in mainstream psychiatry "psychic" was replaced by "mental" which is very commonly used now.  However, in psychiatry "mental" and "symptom" mean the same things, so the commonly used "mental symptom" is a taudology.

Syndromes, which are recognizable recurring groups of symptoms and signs, are considered illnesses when they lead to negative outcomes, usually ranked in order of importance: premature death, disability, distress. This is a standard concept across medicine which includes psychiatry. The problem with DSM (Diagnostic and Statistical Manual of Mental Disorders) and ICD is that they describe syndromes without considering outcomes: all cause mortality and long term disability.  This consideration is essential for prioritising resource allocation in healthcare systems such as the NHS, and prioritising research funding such as by UKRI, when resources are finite, which is always the case.  Severe illnesses are severe because of the severity of the outcomes.  Unfortunately, psychiatry conflates confusion about what illnesses are with dualism, resulting in confused terminology, e.g., "mental illness" means "symptom illness" where just "illness" would be better.

My clinical academic interests are neuropsychiatric and general medical Illnesses.  Psychiatric illnesses comprise: melancholia, mania, psychosis, addictions, schizophrenia, dementia; neurological and general medical illnesses include: movement disorders, chronic pain, epilepsy, glioblastoma, metabolic syndrome.  Regarding NHS work, over the past 20 years as a Consultant I have worked in a range of secondary and tertiary care settings, with a particular interest in affective disorders: General Psychiatry inpatients; treatment-resistant depression at the Advanced Interventions Service, a nationally commissioned NHS specialist service; Addictions Service outpatients; and Neurology outpatients, mostly patients with Parkinson's disease but also epilepsy.

Two research themes:

a) Medical Practice and Policy

b) Translational Neuroscience

• Machine Learning for individual patient diagnostic and prognostic predictions.  Initial work were proof of concept studies using research data now focused on application to routinely acquired NHS data.  Success in obtaining MRC Programme Grant and follow-on funding ('PICTURES' and 'ScanDan')
• Mechanisms Research which includes computational modelling of decision making and brain function, causal therapeutic interventions for brain disorders and back translation for drug discovery.  Success in obtaining two major MRC grants ('CAPE' and 'PAINSTORM')

Selected Publications

Semple, D., Suveges, S., Steele, J.D. (2024) "Electroconvulsive treatment response and remission for moderate to severe depressive illness: a decade of national Scottish data", British Journal of Psychiatry (in press)

Gilmour, W., Mackenzie, G., Feile, M., Tayler-Grint, T., Suveges, S., Macfarlane, J.A., Macleod, A., Marshall, V., Grunwald, I.Q., Steele, J.D., Gilbertson, T. (2024) "Impaired value-based decision-making in Parkinson's disease apathy", Brain (in press)

de A. Marcelino, A. L., Gray, O., Al-Fatly, B., Gilmour, W., Steele, J.D., Kühn, A. A., & Gilbertson, T. (2023). "Pallidal neuromodulation of the explore/exploit trade-off in decision-making", eLife, 12, Article e79642. https://doi.org/10.7554/eLife.79642

Tolomeo, S., Baldacchino, A., Volkow, N., Steele, J.D. (2022) "Protracted Abstinence in Males with an Opioid Use Disorder: Partial Recovery of Nuceus Accumbens Function", Translational Psychiatry, (in press)

Backhouse, E., Shenkin, S., McIntosh, A., Bastin, M.,  Whalley, H., Hernandez, M., Munoz-Maniega, M., Harris, M., Stolicyn, A., Campbell, A., Steele, JD, Waiter, G., Sandu, A., Waymont, J., Murray, A., Cox, S., de Rooij, S., Roseboom, T., Wardlaw, J (2021) "Early life predictors of late life cerebral small vessel disease in four prospective cohort studies." Brain (in press)

Tolomeo, S., Macfarlane, J., Baldacchino A., Koob, G., Steele, J.D. (2020) “Alcohol Binge Drinking: Negative and Positive Valence System Abnormalities” Biological Psychiatry: Cognitive Neuroscience and Neuroimaging 6(1): 126-134

Rupprechter, S., Romaniuk, L., Series, P., Hirose, Y., Hawkins, E., Sandu-Giuraniuc, A., Waiter, G., McNeil, C., Shen, X., Harris, M., Campbell, A., Porteous, D., McFarlane, J., Lawrie, S., Murray, A., Delgado, M., McIntosh, A., Whalley H., Steele, J.D. (2020) “Blunted Medial Prefrontal Reward-Related Effective Connectivity and Depression" Brain 143(6): 1946-1956

Steele, J.D., Paulus, M. (2019) “Pragmatic Neuroscience for Clinical Psychiatry”, British Journal of Psychiatry 215(1), 404-408

Geugies, H., Mocking, R., Figueroa, C., Groot, P., Marsman, J., Servaas, M., Steele, J.D., Schene, A., Rhue, H (2019) “‘Impaired Reward-Related Learning Signals in Remitted Unmedicated Patients with Recurrent Depression” Brain 142(8): 2510-2522

Queirazza, F., Fouragnan, E., Steele, J.D., Cavanagh, J., Philiastides, M. (2019) “Neural correlates of weighted reward prediction error during reinforcement learning classify response to Cognitive Behavioural Therapy in depression” Science Advances 5(7) doi: 10.1126/sciadv.aav4926

Tolomeo, S., Christmas, D., Jentzsch, I., Johnston, B., Sprenglemeyer, R., Matthews, K., Steele, J.D. (2016) “A Causal Role for the Anterior Mid-Cingulate Cortex in Negative Affect and Cognitive Control”  Brain 139(Pt 6) 1844-54

Johnston, B.A.., Tolomeo, S, Gradin, V., Christmas, D., Matthews, K., Steele J.D. (2015) “Failure of Hippocampal Deactivation during Loss Events in Treatment-Resistant Depression” Brain 138(9) 2766-76

Gradin V., Baldacchino A., Balfour D., Matthews K, Steele J.D. (2014) “Abnormal Brain Activity during a Reward and Loss Task in Opiate Dependent Patients receiving Methadone Maintenance Therapy" Neuropsychopharmacology 39(4): 885-94

Mwangi, B., Ebmeier K.P., Matthews, K.M., Steele, J.D. (2012) "Multicentre Diagnostic Classification of Individual Structural Neuroimaging Scans from Patients with Major Depressive Disorder", Brain 135(1) 1508-21

Perrin, J., Merz, S., Bennett, D.., Currie, J., Steele J.D., Reid I., Schwarzbauer C. (2012) "Electroconvulsive Therapy Reduces Frontal Connectivity in Severe Depression", Proc Natl Acad Sci USA 109(14) 5464-8

Gradin, V., Kumar, P., Waiter, G., Ahearn, T., Stickle, C., Milders, M., Reid, I., Hall, J., Steele, J.D. (2011) "Expected Value and Prediction Error Abnormalities in Depression and Schizophrenia", Brain 134(6) 1751-1764

Kumar P, Waiter G, Ahearn T, Milders M, Reid I, Steele J.D. (2008) “Abnormal temporal difference reward-learning signals in major depression” Brain 131(8) 2084-2093

Rück C, Karlsson A, Steele J.D., Edman G, Meyerson B.A., Ericson K, Nyman H, Åsberg M, Svanborg P (2008) "Capsulotomy for Obsessive-Compulsive Disorder – long-term follow-up of 25 patients" JAMA Psychiatry, 65(8), 914-921

Steele J.D., Christmas D., Eljamel M.S., Matthews K. (2008) “Anterior cingulotomy for major depression: Clinical outcome and relationship to lesion characteristics” Biological Psychiatry, 63(7), 670-677

Steele J.D., Kumar P., Ebmeier, K.P. (2007) “Blunted response to feedback information in depressive illness”, Brain 130 (9), 2367-74

Ebmeier K., Donaghey C., Steele J.D. (2006) “Recent Developments and Current Controversies in Depression”, Lancet, 367, 153-167

Completed PhD students (*primary supervisor): Poornima Kumar*, Victoria Gradin*, Benson Mwangi*, Blair Johnston*, James Currie*, Alex Stolicyn, Filippo Queira, Serenella Tolomeo*, Sam Rupprechter, Georgia Antoniou*, Abeer Alhussaini*

I teach computational neuroimaging and machine learning on School of Science and Engineering Biomedical Engineering MSc module ME51012 "Medical Image Processing and Analysis", am supervisor for Biomedical Engineering ME52002 MSc projects, and School of Medicine MSc module GM51075 "Translational Neuroscience" projects.

I was Module Manager for School of Life Sciences and Medical School, BSc and BMSc, BS42017 and BM40019 “Psychiatric Disorders”, involving course design, teaching and examination of translational neuroscience, and still teach and examine on these courses.

I am PhD Lead for the Division responsible for organising Thesis Monitoring Committees, represent the Division on the Medical School Research Postgraduate Committee, and Chair one of the TMCs.

I have supervised many completed PhD students, some MD and MSc students, and am regular external PhD examiner to several Universities including Edinburgh, Aberdeen and Kings College London.  I was external examiner for Edinburgh University MSc in “Neuroimaging”, Edinburgh University MSc “Neuroimaging for Research”, and St Andrews University MSc in “Digital Health”.

I teach and examine psychiatry for undergraduate medical students at Ninewells, was for a number of years external examiner for Edinburgh University MB ChB undergraduate psychiatry, and was NHS Consultant supervisor for many SpRs and SHOs in General Psychiatry training.