Professor Ivana Markova

MBChB., MPhil., MD., FRCPsych.

Professor of Psychiatry / Honorary Consultant in Psychiatry

Role at Hull York Medical School

Professor of psychiatry at the University of Hull and consultant in psychiatry at the department of Psychological Medicine, Humber Teaching NHS Trust.

Biography

Ivana S. Marková is Professor of Psychiatry at Hull York Medical School, University of Hull and Honorary Consultant in Psychiatry at the Department of Psychological Medicine with the Humber Teaching NHS Foundation Trust. She trained in medicine at the University of Glasgow and then in psychiatry at Cambridge. In Cambridge, she also completed her masters in the history and philosophy of science and obtained her higher doctorate in medicine with a thesis on the structure of the concept of insight. She continues to research on the nature of insight in psychiatry as well as on different aspects of descriptive psychopathology and neuropsychiatry. Her other main research focus is on the epistemology of psychiatry and mental symptoms. Her clinical work is in liaison psychiatry with a special interest in neuropsychiatry and Huntington’s disease.

Research

Research interests focus on two main areas. Firstly, this has been around the concept of insight in patients with mental disorders. Questions around whether it is possible for patients with mental disorders to have insight into their conditions, and/or to what extent this might be the case, whether this relates to the specific mental disorder itself or to other psychosocial factors and whether this is associated with prognosis, have concerned clinicians and researchers for many years. Her research in this area, both theoretical and empirical, has helped to highlight the relational structure of insight, the necessarily heterogeneous phenomena of insight that are invoked in relation to various mental disorders, the consequent different contribution of organic and non-organic factors into their constitution and the implications this carries for our understanding of insight and its research. One aspect of this work involved the development of an ‘insight in psychoses’ scale.

Secondly, her research focuses on the epistemology of psychiatry. This research is essential for the understanding of psychiatry as a discipline and for the understanding of the nature of mental symptoms and mental disorders. Epistemology of psychiatry refers to the theory of the grounds of psychiatric knowledge and deals with questions around the nature, origin and stability of psychiatric knowledge. In particular, this work in collaboration with colleagues, has highlighted the deeply hybrid structure of mental symptoms and mental disorders. This means that mental symptoms and mental disorders are constituted not only by neurobiological elements but also by elements of a different order, ones that are unique to the individual. These latter elements are the products of multitudinous factors including the personal (individual experiences, intellect, education, language, personality, etc.), socio-cultural (e.g. family, peers, wider outside influences and contexts) and the interactional (with others and environment). These elements can be called ‘semantic’ in a very broad sense. What is crucial here is that these ‘semantic’ elements together with the neurobiological elements constitute symptoms and disorders. It is this inherently double nature or constitution of mental symptoms and disorders (not to be confused with the biopsychosocial model) that makes for a fundamentally different epistemological position underlying psychiatry from that which underlies medicine. To date, empirical research in psychiatry has tended to follow the empirical methods used in medicine, in turn based on the natural sciences. This research however shows that for empirical research in psychiatry to be valid, it needs to take into account the relative contribution to psychopathology, of the neurobiological and the ‘semantic’ elements, i.e. those complexes of individually and socio-culturally derived meanings. ‘Semantic’ elements are not reducible to the neurobiology of an individual but make up the meaning that is unique to the individual and their socio-cultural environment. As such, they demand a research methodology that draws on a different and wider approach, one that encompasses the exploration and capture of a range of psychological, socio-cultural and interactional factors.

Teaching

Phase 1: Scholarship and Special Interest Programme – on the concept of mental health

Lead tutor for mental health block during clinical placements for Hull York Medical School students at Hull, organising and undertaking group teaching of medical students and participating in their formative and summative assessments.

Supervising postgraduate students: currently supervise 2 PhD students and provide external supervision to several postgraduate students working abroad.

Publications

Books

Marková, I.S. (2005) Insight in Psychiatry. Cambridge, UK: Cambridge University Press.Boo

Articles

Marková I S (2018) Translational Neuroscience and Psychiatry: a conceptual analysis. Journal of Evaluation in Clinical Practice, special issue, https://doi.org/10.1111/jep.12914

Clare, L., Teale, J.C., Toms, G., Kudlicka, A., Evans, I., Abrahams, S., Goldstein, L.H., Hindle, J.V., Ho, A.K., Jahanshahi, M., Langdon, D., Morris, R., Snowden, J.S., Davies, R., Markova, I., Busse, M. & Thompson-Coon, J. (2018) Cognitive rehabilitation, self-management, psychotherapeutic and caregiver support interventions in progressive neurodegenerative conditions: a scoping review. NeuroRehabilitation. In press

Berrios G E & Marková I S (2018) Historical and conceptual aspects of motor disorders in the psychoses. Schizophrenia Research (special issue) https://doi.org/10.1016/j.schres.2017.09.008

Berrios G E & Marková I S (2016) The Temporalization of Madness in the 19th Century. (La temporalizzazione della follia nel XIX secolo). Rivista Sperimentale di Freniatria 140: 13-27

Marková, I.S. & Berrios, G.E. (2016) Research in Psychiatry: concepts and conceptual analysis. Psychopathology 49, 188-194.

Morris, R.G., Nelis, S.M., Martyr, A., Marková, I.S., Roth, I., Woods, R.T., Whitaker, C.J. & Clare, L. (2016) Awareness of memory task impairment versus everyday memory difficulties in dementia. Journal of Neuropsychology, 10, 130-142.

Aragona, M. & Marková, I.S. (2015) The hermeneutics of mental symptoms in the Cambridge school. Revista Latinoamericana de Psicopatologia Fundamental, 18, 599-618.

Woods RT, Nelis SM, Martyr A, Roberts J, Whitaker CJ, Markova I, Roth I, Morris R, Clare L. (2014), What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study. Health and Quality of Life Outcomes 12:94

Marková, I.S., Clare, L., Whitaker, C.J., Roth, I., Nelis, S.M., Martyr, A., Roberts, J.L., Woods, R.T. & Morris, R.G. (2014) Phenomena of awareness in dementia: heterogeneity and its implications. Consciousness and Cognition, 25, 17-26.

Clare, L., Woods, R.T., Nelis, S.M., Martyr, A., Marková, I.S., Roth, I., Whitaker, C.J. & Morris, R.G. (2014) Trajectories of quality of life in early-stage dementia: individual variation and predictors of change. International Journal of Geriatric Psychiatry. 29 (6) 616-623

Marková, I.S. & Berrios, G.E. (2014) Anosognosia: historical and conceptual analysis. Cortex, special issue: Understanding Babinski’s Anosognosia: 100 years later. 61, 9-17.

Berrios, G. E. & Marková, I. S. (2013) Is the concept of ‘dimension’ applicable to psychiatric objects? World Psychiatry, 12, 76-78.

Clare, L., Whitaker, C.J., Roberts, J.L., Nelis, S.M., Martyr, A., Marková, I.S., Roth, I., Woods, R.T. & Morris, R.G. (2013) Memory awareness profiles for performance monitoring and evaluative judgement differentiate mild cognitive impairment from early-stage dementia. Dementia and Geriatric Cognitive Disorders, 35:266-279.

Clare, L., Nelis, S.M., Martyr, A., Whitaker, C.J., Marková, I.S., Roth, I., Woods, R.T. & Morris, R.G. (2012) Longitudinal trajectories of awareness in early-stage dementia. Alzheimer Disease & Associated Disorders, 26, 140-147.

Clare, L., Nelis, S.M., Whitaker, C.J., Martyr, A, Marková, I.S., Roth, I., Woods, R.T. & Morris, R.G. (2012) Marital relationship quality in early-stage dementia: perspectives from people with dementia and their spouses. Alzheimer Disease & Associated Disorders, 26, 148-158

Clare, L.,Whitaker, C.J., Nelis, S.M, Martyr, A., Markova, I.S., Roth, I., Woods, R.T. & Morris, R.G. (2012) Self-concept in early-stage dementia: profile, course, correlates, predictors, and implications for quality of life. International Journal of Geriatric Psychiatry, 28, 494–503.

Marková, I.S. & Berrios, G.E. (2012) The epistemology of psychiatry. Psychopathology, 45, 220-227.

Clare, L., Nelis, S.M., Martyr, A., Whitaker, C.J., Marková, I.S., Roth, I., Woods, R.T. & Morris, R.G. (2012) ‘She might have what I have got’: the potential utility of vignettes as an indirect measure of awareness in early-stage dementia. Aging & Mental Health, 16, 566-575.

Martyr, A., Clare, L., Nelis, S.M., Marková, I.S., Roth, I., Woods, R.T., Whitaker, C.J. & Morris, R.G. (2012) Verbal fluency and awareness of functional deficits in early-stage dementia. The Clinical Neuropsychologist, 26:3, 501-519.

Clare, L., Nelis, S.M., Martyr, A., Roberts, J., Whitaker, C.J., Marková, I.S., Roth, I., Woods, R.T. & Morris, R.G. (2012) The influence of psychological, social and contextual factors on the expression and measurement of awareness in early-stage dementia: testing a biopsychosocial model. International Journal of Geriatric Psychiatry, 27, 167-177.

Marková, I.S. (2011) Insight en demencia: retos para una investigación empírica. (Insight in dementia: challenges for empirical research) Informaciones Psiquiátricas, 204, 85-94.

Clare, L., Marková, I.S., Morris, R. & Roth, I. (2011) Awareness in Alzheimer’s disease and associated dementias: theoretical framework and clinical implications. Aging and Mental Health, 15, 936 - 944.

Nelis, S.M., Clare, L., Martyr, A., Marková, I.S., Roth, I., Woods, R.T., Whitaker, C.J. & Morris, R. G. (2011) Awareness of social and emotional functioning in people with early stage dementia and implications for carers. Aging & Mental Health, 15: 961-969.

Jaafari, N. & Marková, I.S. (2011) Le concept de l’insight en psychiatrie. Annales Médico-Psychologiques, 169, 409-415.

Marková, I.S. & Berrios, G.E. (2011) Awareness and insight in psychopathology: an essential distinction? Theory & Psychology, 21, 421- 437.

Nimmagadda, S.R., Agrawal, N., Worrall-Davies, A., Marková, I. & Rickards, H. (2011) Determinants of irritability in Huntington’s disease. Acta Neuropsychiatrica, 23, 309-314.

Clare, L., Whitaker, C.J., Nelis, S.M., Martyr, A., Marková, I.S., Roth, I., Woods, R.T. & Morris, R. G. (2011) Multi-dimensional assessment of awareness in early-stage dementia: a cluster analytic approach. Dementia & Geriatric Cognitive Disorders, 31, 317- 327.

Martyr, A., Clare, L., Nelis, S.M., Roberts, J.L., Robinson, J.U., Roth, I., Marková, I.S., Woods, R.T., Whitaker, C.J. & Morris, R.G. (2011) Dissociation between implicit and explicit manifestations of awareness in early-stage dementia: evidence from the emotional Stroop effect for dementia-related words. International Journal of Geriatric Psychiatry, 26 (1), 92-99.

Vanelli, I., Chendo, I., Levy, P., Figueira, M.L., Góis, C., Santos, J. & Marková, I. (2010) Adaptação Para Português Da Escala De Insight Marková E Berrios. Acta Medica Portuguesa, 23, 1011-1016.

Marková, I.S., Jaafari, N. & Berrios, G.E. (2009) Insight and obsessive-compulsive disorder: a conceptual analysis. Psychopathology, 42, 277-282.

Marková, I.S. & Berrios, G.E. (2009) The epistemology of mental symptoms. Psychopathology, 42, 343-349.

Craig, K.J., Hietanen, H., Marková, I.S. & Berrios, G.E. (2008) The Irritability Questionnaire: a new scale for the measurement of irritability. Psychiatry Research, 159, 367-375.

Guaiana, G. & Marková, I.S. (2006) Antipsychotic Treatment Improves Outcome in Herpes Simplex Encephalitis: A Case Report. Journal of Neuropsychiatry and Clinical Neurosciences, (letter) 18, 247.

Marková, I.S. & Berrios, G.E. (2006) Approaches to the assessment of awareness: Conceptual issues. Neuropsychological Rehabilitation, 16, 439-455.

Marková, I.S., Clare, L, Wang, M., Romero, B. & Kenny, G. (2005) Awareness in dementia: conceptual issues. Aging and Mental Health, 9, 386-393.

Clare, L., Marková, I.S., Verhey, F. & Kenny, G. (2005) Awareness in dementia: a review of assessment methods and measures. Aging and Mental Health, 9, 394-413.

Marková, I.S., Berrios, G.E. & Hodges, J.R. (2004) Insight into memory function. Neurology, Psychiatry and Brain Research 11, 115-126.

Marková, I.S., Roberts, K.H., Gallagher, C., Boos, H., McKenna, P.J. & Berrios, G.E. (2003) Assessment of insight in psychosis: a re-standardization of a new scale. Psychiatry Research 119 (1-2): 81-88.

Berrios, G.E. & Marková, I.S. (2002) The concept of neuropsychiatry. A historical overview. Journal of Psychosomatic Research 53 (2): 629-638.

Berrios, G.E. & Marková, I.S. (2002) Assessment and Measurement in Neuropsychiatry: A Conceptual History. Seminars in Clinical Neuropsychiatry 7: 3-10.

Berrios, G.E., Wagle, A.C., Marková, I.S., Wagle, S.A., Rosser, A. & Hodges, J.R. (2002) Psychiatric symptoms in neurologically asymptomatic Huntington’s disease gene carriers: a comparison with gene negative at risk subjects. Acta Psychiatrica Scandinavica 105: 224-230.

Marková, I.S. & Berrios, G.E. (2001) The ‘Object’ of Insight Assessment: Relationship to Insight ‘Structure’. Psychopathology 34: 245-252.

Berrios, G.E., Wagle, A.C., Marková, I.S., Wagle, S.A., Ho, L.W., Rubinsztein, D.C., Whittaker, J., ffrench-Constant, C., Kershaw, A., Rosser, A., Bak, T. & Hodges, J.R. (2001) Psychiatric symptoms & CAG repeats in neurologically asymptomatic Huntington’s disease gene carriers. Psychiatry Research 102: 217-225.

Wagle, A.C., Wagle, S.A., Marková, I.S. & Berrios, G.E. (2000) Psychiatric morbidity in Huntington’s Disease: the current view. Neurology, Psychiatry and Brain Research 8: 5-16.

Berrios, G.E., Marková, I.S. & Gimbrett, R. (1995) The role of psychiatry in genetic prediction programmes for Huntington's disease. Psychiatric Bulletin 19:203-206.

Marková, I.S. & Berrios, G.E. (1995) Mental symptoms: Are They Similar Phenomena? The Problem of Symptom Heterogeneity. Psychopathology 28:147-157.

Marková, I.S. & Berrios, G.E. (1995) Insight in clinical psychiatry revisited. Comprehensive Psychiatry 36:367-376.

Marková, I.S. & Berrios, G.E. (1995) Insight in clinical psychiatry: A new model. Journal of Nervous and Mental Disease 183:743-751.

Berrios, G.E., Marková, I.S. & Olivares, J.M. (1995) Retorno a los síntomas mentales: hacia una nueva metateoría. Psiquiatría Biológica 2:13-24.

Marková, I.S. & Berrios, G.E. (1994) Delusional Misidentifications: Facts and Fancies. Psychopathology 27:136-143.

Marková, I.S. & Berrios, G.E. (1992) The Meaning of Insight in Clinical Psychiatry. British Journal of Psychiatry 160:850-860.

Marková, I.S. & Berrios, G.E. (1992) The assessment of insight in clinical psychiatry: a new scale. Acta Psychiatrica Scandinavica 86:159-164.

Book Chapters

Marková, I.S. & Berrios, G.E. (2018/2019) Nature of Interactional Field: psychopathological configurators. In (eds. Gianni Francesetti/Tonino Griffero) Neither Inside Nor Outside. Psychopathology and Atmospheres. Cambridge Scholars Publishing – in press.

Berrios, G.E. & Marková, I.S. (2018) History of developments in understanding abnormal behavior. In J.N. Butcher & J. M. Hooley (eds.) APA – Handbook of Psychopathology. Washington DC: American Psychological Association, pp 13-39.

Berrios, G.E. & Marková, I.S. (2017) Cultural history of depression. In C. Foster & J. Herring (Eds.), Depression: Law and ethics. Oxford: Oxford University Press, pp 45-57.

Berrios, G.E. & Marková, I.S. (2017) The epistemology and classification of ‘madness’ since the 18th century. In G.Eghegian (ed) The Routledge History of Madness and Mental Health. Oxford: Routledge, pp 115-134.

Berrios, G.E. & Marková, I.S. (2017) The Epistemology of Psychiatry and of Mental Symptoms: the Cambridge view. In A. Mishara, P. Corlett, P. Fletcher & M. Schwartz (eds) Phenomenological Neuropsychiatry: How Patient Experience Bridges Clinic with Clinical Neuroscience. Springer. In press

Marková, I.S. & Berrios, G.E. (2015) Neuroimaging in psychiatry: epistemological considerations. In P. Zachar, D.S. Stoyanov, M. Aragona & A. Jablensky (eds.) Alternative Perspectives on Psychiatric Validation. Oxford, UK: Oxford University Press. pp 112-127.

Berrios, G.E. & Marková, I.S. (2015) Shared pathologies. In (eds. D. Bhugra & G. Malhi) Troublesome Disguises, Wiley-Blackwell. Pp 3-15.

Berrios, G.E. & Marková, I.S. (2015) Visual Hallucinations: history and context of current research. In D. Collerton, U.P. Mosimann & E. Perry (eds) The Neuroscience of Visual Hallucinations. Wiley – Blackwell. Pp 3-22.

Berrios, G.E. & Marková, I.S. (2015) Towards a New Epistemology of Psychiatry. In L.J. Kirmayer, R. Lemelson & C. Cummings (eds) Revisioning Psychiatry. Cultural phenomenology, Critical Neuroscience and Global Mental Health. New York: Cambridge University Press. Pp 41-64

Berrios, G.E. & Marková, I.S. (2012) The Construction of Hallucination: History and Epistemology. In Jan Dirk Blom & Iris Sommer (eds) Hallucinations. Research and Practice. New York: Springer. Pp 55 – 71.

Clare, L., Marková, I.S., Romero, B., Verhey, F., Wang, M., Woods, R.T. & Keady, J. (2006) Awareness and people with early-stage dementia. In Bère M.L. Miesen & Gemma M.M. Jones (Eds.) Care-giving in Dementia, London: Routledge, Vol.4, pp. 133-151.

Berrios, G. E. & Marková, I.S. (2006) Symptoms – Historical Perspective and Effect on Diagnosis. In Psychosomatic Medicine (eds. M. Blumenfield & J.J. Strain), Philadelphia,USA: Lippincott Williams & Wilkins, pp. 27-38.

Berrios, G.E. & Marková, I.S. (2004) Insight in the psychoses: a conceptual history. In Insight and Psychosis, 2nd edition (eds. X. Amador & A. David). Oxford:OxfordUniversity Press, pp 31-50.

Berrios, G.E. & Marková, I.S. (2003) The self and psychiatry: a conceptual history. In The Self in Neuroscience and Psychiatry (eds. T. Kircher & A. David), Cambridge, UK: Cambridge University Press, pp 9-39.

Berrios, G.E. & Marková, I.S. (2002) Conceptual Issues. In Biological Psychiatry (eds. H. D’haenen, J.A. den Boer & P. Willner), Chichester,UK: John Wiley & Sons, Ltd. pp 3-24.

Berrios, G.E. & Marková, I.S. (2001) Psychiatric disorders mimicking dementia. In Early-Onset Dementia. A Multidisciplinary Approach (ed. J.R. Hodges) Oxford, UK: OxfordUniversity Press, pp 104-123.

Marková, I.S. & Berrios, G.E. (2000) Insight into memory deficits. In Memory disorders in psychiatric practice (eds. G.E. Berrios & J.R. Hodges) Cambridge, UK: Cambridge University Press, pp 204-233.

Marková, I.S. & Berrios, G.E. (2000) Paramnesias and delusions of memory. In Memory disorders in psychiatric practice (eds. G.E. Berrios & J.R. Hodges) Cambridge, UK: Cambridge University Press, pp 313-337.

Berrios, G.E., Marková, I.S. & Girala, N. (2000) Functional memory complaints: hypochondria and disorganization. In Memory disorders in psychiatric practice (eds. G.E. Berrios & J.R. Hodges) Cambridge, UK: Cambridge University Press, pp 384-399.

Collaborations

Collaboration with colleagues in Bangor, Wales/Exeter and Kings College London in programmes of research on awareness/insight in people with dementia.

Collaboration with Cambridge University, UK – school of psychopathology – on research into epistemology of psychiatry. This is extending to colleagues in Europe, Hong-Kong and South America with the aim of developing this field.

Collaboration with University of Poitiers, France in long term multi-disciplinary projects – initially focusing on studies on insight in OCD but extending now into other areas of psychopathology.

Collaboration with colleagues in the Enroll-HD clinic. This is a nationally and internationally linked research clinic held monthly where patients and families with Huntington’s disease attend annually, participating in research data collection. This multidisciplinary clinic also enables patients with HD and families to take part in relevant national and international intervention trials.

External roles

External examiner of the psychiatric curriculum of the MBBS degree course at the University of Hong Kong – 2017-2020, assessing and reporting on quality of psychiatric curriculum and teaching as well as participating in final examinations and in the pass/fail and distinction vivas of candidates.