MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Advances in Psychiatric Treatment' source. Tue, 07 Feb 2012 09:35:39 +0100 http://www.medworm.com/index.php?rid=5570539&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F79-a%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570539 Tue, 03 Jan 2012 05:00:00 +0100 5570539 http://www.medworm.com/index.php?rid=5570538&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F79%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570538 Tue, 03 Jan 2012 05:00:00 +0100 5570538 http://www.medworm.com/index.php?rid=5570537&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F78-b%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570537 Tue, 03 Jan 2012 05:00:00 +0100 5570537 http://www.medworm.com/index.php?rid=5570536&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F78-a%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570536 Tue, 03 Jan 2012 05:00:00 +0100 5570536 http://www.medworm.com/index.php?rid=5570535&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F78%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570535 Tue, 03 Jan 2012 05:00:00 +0100 5570535 http://www.medworm.com/index.php?rid=5570534&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F67%3Frss%3D1 In the second of two articles on rare causes of dementia, the authors describe toxic, iatrogenic, nutritional, traumatic, metabolic, neoplastic and autoimmune causes of dementia. Disorders are graded according to their prevalence, to give an idea of the likelihood of their presentation. Guidance is given on the investigation of uncommon cognitive impairment and dementia, especially in early-onset illness. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570534 Tue, 03 Jan 2012 05:00:00 +0100 5570534 http://www.medworm.com/index.php?rid=5570533&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F59%3Frss%3D1 This article describes some of the practical implementation challenges that may arise when using schemes such as the HCR-20 in multi-disciplinary team meetings. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570533 Tue, 03 Jan 2012 05:00:00 +0100 5570533 http://www.medworm.com/index.php?rid=5570532&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F56%3Frss%3D1 This article examines John Clare’s prose account of his escape from High Beach Asylum in 1841. Clare has attracted attention for his nature poems as much as for his humble, peasant background and his well-described mental illness, including his asylum committals. Recollections of journey from Essex is unique as a piece of writing describing escape from an asylum and illustrating to some degree the mental state and experiences of a psychiatrically ill person in England in the mid-1800s. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570532 Tue, 03 Jan 2012 05:00:00 +0100 5570532 http://www.medworm.com/index.php?rid=5570531&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F44%3Frss%3D1 Over the past decade attention to the provision of healthcare for individuals with personality disorder, particularly those who pose a risk to others, has substantially increased. Keeping pace with such developments with a suitably trained, consistent and motivated workforce, interfacing health and criminal justice systems where necessary, presents an enormous challenge. Staff must be experts in managing conflict at every level, while sustaining an optimistic and therapeutic orientation. Boundaried relationships provide the context for recovery for patients. Key principles and practices likely to promote resilience in personality disorder services, with a focus on the role of supervision, are outlined in order to support staff in keeping themselves afloat, their patients safe, and their se... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570531 Tue, 03 Jan 2012 05:00:00 +0100 5570531 http://www.medworm.com/index.php?rid=5570530&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F34%3Frss%3D1 Although most patients with severe eating disorders are treated in specialist eating disorder services, general psychiatrists are often responsible for the care of many with mild to moderate disorder. Treating and supporting these patients in a non-specialist setting can sometimes be challenging but this need not be the case. Having a clear understanding of the clinical features of these conditions forms the foundation on which a comprehensive assessment and management plan can be made. We summarise the clinical features of eating disorders and explore the unique role of the general psychiatrist in identifying people with these conditions, supporting them and directing them into evidence-based treatments. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570530 Tue, 03 Jan 2012 05:00:00 +0100 5570530 http://www.medworm.com/index.php?rid=5570529&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F32%3Frss%3D1 This article provides a brief overview of the history of the concept, and suggests a parsimonious approach for clinicians. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570529 Tue, 03 Jan 2012 05:00:00 +0100 5570529 http://www.medworm.com/index.php?rid=5570528&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F25%3Frss%3D1 This article focuses on Fanon’s work and contributions to psychiatry, as well as his philosophy, advocacy for social inclusion and pioneering work in culturally relevant rehabilitation. It also examines what lessons could be learnt from his life’s work as a psychiatrist and traces his influence on a generation of psychiatric researchers, suggesting how his contribution may have influenced critical thought and current views. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570528 Tue, 03 Jan 2012 05:00:00 +0100 5570528 http://www.medworm.com/index.php?rid=5570527&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F17%3Frss%3D1 This article describes a special adaptation of group psychotherapy as a psychological treatment for people with a variety of gender identity disorders. It can be used as an alternative to or concurrently with hormonal and/or surgical interventions for transgender people. It is also suitable for individuals whose gender identity disorder remains after physical interventions. The article draws from a UK specialist pilot for such a treatment service and describes the explicit aims of the psychotherapy, the specialist adaptation of therapeutic technique required and observed thematic features relevant to working in this specific field. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570527 Tue, 03 Jan 2012 05:00:00 +0100 5570527 http://www.medworm.com/index.php?rid=5570526&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F12%3Frss%3D1 This article reviews the treatment of gender dysphoria, including psychotherapy, and how eligibility and readiness for surgery are assessed. It considers issues facing transgender individuals detained in prison or psychiatric hospital, the factors that affect patients’ satisfaction with gender reassignment surgery and how the specialist can ensure a satisfactory outcome. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570526 Tue, 03 Jan 2012 05:00:00 +0100 5570526 http://www.medworm.com/index.php?rid=5570525&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F2%3Frss%3D1 The role of the mental health professional, and of the psychiatrist in particular, is evolving and changing. As the recognition of transsexualism and gender identity disorder expands across the transgender spectrum, it has been recommended that gender dysphoria should replace existing diagnostic terminology. Patient-focused care is evolving and this article considers the limitations of current healthcare settings and how the mental health professional can support patients undergoing the real-life experience. Differentiation from other mental health conditions that may present as gender dysphoria is outlined, as well as specific clinical situations. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570525 Tue, 03 Jan 2012 05:00:00 +0100 5570525 http://www.medworm.com/index.php?rid=5570524&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F1%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5570524 Tue, 03 Jan 2012 05:00:00 +0100 5570524 http://www.medworm.com/index.php?rid=5378495&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F476-a%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378495 Mon, 31 Oct 2011 04:00:00 +0100 5378495 http://www.medworm.com/index.php?rid=5378494&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F476%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378494 Mon, 31 Oct 2011 04:00:00 +0100 5378494 http://www.medworm.com/index.php?rid=5378493&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F470%3Frss%3D1 This article outlines the concept of PbR in learning disability services and describes the progress of the pilot work being undertaken in this area. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378493 Mon, 31 Oct 2011 04:00:00 +0100 5378493 http://www.medworm.com/index.php?rid=5378492&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F461%3Frss%3D1 The article discusses the issues and challenges for mental health services in providing care for adults with attention-deficit hyperactivity disorder (ADHD). Based on work developed in Sheffield (UK), it describes the contribution that services integrated into community mental health teams may be able to provide. Given the likely increase in numbers of referrals of adults with ADHD (both ‘graduates’ from children’s services and adults seeking diagnosis) and the pressures on resources, it is unlikely that current specialist services will be able to address the growing demand. A local service that can link with other mental health services and that has close links to primary care is most likely to provide a sustainable service model, but there are still considerable trainin... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378492 Mon, 31 Oct 2011 04:00:00 +0100 5378492 http://www.medworm.com/index.php?rid=5378491&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F454%3Frss%3D1 This article reviews the recent changes in the law in England and Wales relating to consent to treatment for young people, in particular the Mental Capacity Act 2005 and the 2007 amendments to the Mental Health Act 1983. Using a fictitious case study, it offers a structured approach to the application of these new items of legislation that could be useful to trainers and their trainees. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378491 Mon, 31 Oct 2011 04:00:00 +0100 5378491 http://www.medworm.com/index.php?rid=5378490&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F451%3Frss%3D1 This article is about the novel Coming Through Slaughter by Michael Ondaatje, which is based on Bolden’s life. I discuss how the form of the text – including its refusal to comment on where sense is lost – conveys to readers the bewilderment and conviction of Bolden’s experience and allows them to share something of this. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378490 Mon, 31 Oct 2011 04:00:00 +0100 5378490 http://www.medworm.com/index.php?rid=5378489&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F447%3Frss%3D1 In this article it is suggested that empathy is a core component of musical appreciation and particularly of the relationship between the singer and the audience. The brain pathways activated in musical appreciation are outlined and the nature of the empathic process considered with reference to Robert Schumann’s songs and his experience of severe mental disorder. The article suggests that listening to Schumann’s song cycle Dichterliebe (Poet’s Love), or to other great music, is a useful component of continuing professional development and that such experience enhances therapeutic effectiveness and empathy, as well as increasing the understanding of the relationship between creativity and mental health. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378489 Mon, 31 Oct 2011 04:00:00 +0100 5378489 http://www.medworm.com/index.php?rid=5378488&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F435%3Frss%3D1 This article promotes a pragmatic approach to assessing the risk of self-harm clinically to arrive at hierarchical risk judgements. It further suggests an algorithmic approach to managing these risks and provides testable strategies that can be adapted for use in various secure institutions. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378488 Mon, 31 Oct 2011 04:00:00 +0100 5378488 http://www.medworm.com/index.php?rid=5378487&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F419%3Frss%3D1 We present a narrative review of evidence-based treatment for obsessive–compulsive disorder (OCD), covering first-line pharmacological treatment, augmentation strategies, approaches for treatment-refractory OCD and the management of OCD in special populations (children and adolescents, pregnant and breast-feeding women, and elderly people). (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378487 Mon, 31 Oct 2011 04:00:00 +0100 5378487 http://www.medworm.com/index.php?rid=5378486&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F417%3Frss%3D1 Transference reveals the mental state of the other to us through our countertransference. Our emotional responses to the transference relationship are different depending on the degree of disturbance evoked in us. Reflecting on our countertransference can convey emotional insight into the nature and meaning of the transference as a way of understanding the emotional experiences of the other. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378486 Mon, 31 Oct 2011 04:00:00 +0100 5378486 http://www.medworm.com/index.php?rid=5378485&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F408%3Frss%3D1 Engaging patients in first-episode psychosis services is critical in maximising the effect of early intervention and establishing a framework for longer-term treatment. Biopsychosocial assessments determine a working diagnosis and inform evidence-based treatment. Atypical antipsychotics should be used at doses that maximise therapeutic benefit and adherence while minimising side-effects. Patients are helped to construct a narrative of their illness, including a shared understanding of the contribution of biological and environmental risks, and early warning signs. Common comorbid conditions, including depression, suicidal ideation, substance misuse and anxiety, should be addressed. Management of comorbid borderline and antisocial personality disorders is difficult; their nexus with psychos... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378485 Mon, 31 Oct 2011 04:00:00 +0100 5378485 http://www.medworm.com/index.php?rid=5378484&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F401%3Frss%3D1 Early intervention services were established on the basis of a number of fundamental principles, including the notions that intervening in the early stages of psychosis alters illness trajectory and prognosis, that multicomponent interventions promote psychosocial recovery and reduce iatrogenic damage, and that early targeting of non-responders reduces treatment resistance. There is growing evidence of the benefits of specialised early intervention services. These include improved clinical, social and vocational outcomes, reduced in-patient stays and better engagement. Early intervention services can also significantly reduce the risk of a second episode and are highly valued by service users and carers. Duration of treatment appears to determine long-term outcome and there remains uncerta... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378484 Mon, 31 Oct 2011 04:00:00 +0100 5378484 http://www.medworm.com/index.php?rid=5378483&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F398%3Frss%3D1 This issue of Advances carries two articles from Melbourne, Australia, outlining the rationale for, and implementation of, early psychosis services. Their publication provides an opportunity to address some of the more contentious issues relating to the early psychosis intervention movement. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378483 Mon, 31 Oct 2011 04:00:00 +0100 5378483 http://www.medworm.com/index.php?rid=5378482&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F397%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5378482 Mon, 31 Oct 2011 04:00:00 +0100 5378482 http://www.medworm.com/index.php?rid=5181281&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F389%3Frss%3D1 This article outlines the key elements of evidence-based psychiatry in an attempt to address these needs. Initially, an evidence-based approach is about asking an answerable question, searching for the evidence and then critically appraising the available information for its validity and relevance. The fourth step involves integrating the evidence with clinical expertise and the patient’s values. The whole idea is to improve real-life patient care. This article outlines a number of the tools needed to overcome some of the common problems that psychiatrists face when trying to find and use published research results to help solve patients’ problems. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181281 Tue, 30 Aug 2011 23:00:00 +0100 5181281 http://www.medworm.com/index.php?rid=5181280&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F381%3Frss%3D1 Gender identity disorders are not common. The most frequent is dual-role transvestism, but it rarely needs medical attention. The least frequent is transsexualism. Transsexualism is not usually indicative of serious psychopathology. Diagnoses should be made by a gender identity clinic and never by the patient, and a clear change of gender role should precede any hormone treatment. Patients must have lived and thrived entirely in their new gender role for at least 2 years before any genital surgery is undertaken. However, bilateral mastectomy might be considered for females after a year of life in a male role. With these selection criteria, the outcomes of surgery are generally good. In the UK, individuals may legally change their recorded sex, usually after gender reassignment treatment. (... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181280 Tue, 30 Aug 2011 23:00:00 +0100 5181280 http://www.medworm.com/index.php?rid=5181279&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F372%3Frss%3D1 A recommendation of the UK’s National Dementia Strategy is to develop the skills of the care workers who provide day-to-day care for people with dementia. On the basis of a systematic review of the literature, we suggest evidence-based areas in which the skills of care workers can be developed to reduce the incidence of difficult behaviour and the use of antipsychotic medication in dementia. We discuss core features of carer training, education and practice. Psychiatrists involved in the training of carers can teach new skills to carers. Psychiatrists in community mental health teams can, through leadership and clinical liaison, reinforce and enable these skills in care homes, domiciliary services and in-patient settings serving people with dementia. (Source: Advances in Psychiatric ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181279 Tue, 30 Aug 2011 23:00:00 +0100 5181279 http://www.medworm.com/index.php?rid=5181278&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F365%3Frss%3D1 Despite the guidance published in revised Codes of Practice and by the Royal College of Psychiatrists, implementation of Section 136 of the Mental Health Act 1983 is still variable. Government funding in England to establish places of safety in psychiatric facilities has been effective but custody suites are still used excessively, especially for those who are brought in intoxicated. Patients feel criminalised by this use of custody suites and by the use of police vehicles rather than ambulance transport for conveyance to the place of safety. There is often a delay in commencing the assessment and the first doctor does not always have Section 12 approval as recommended in the Codes of Practice. The importance of the local Section 136 group tasked with developing and overseeing the implemen... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181278 Tue, 30 Aug 2011 23:00:00 +0100 5181278 http://www.medworm.com/index.php?rid=5181277&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F357%3Frss%3D1 This article reviews mania and hypomania in late life and concentrates on diagnosis, assessment and treatment, as well as on the management considerations associated with this important age group. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181277 Tue, 30 Aug 2011 23:00:00 +0100 5181277 http://www.medworm.com/index.php?rid=5181276&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F350%3Frss%3D1 This article outlines the structure and function of the DMHS and its approach to risk management. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181276 Tue, 30 Aug 2011 23:00:00 +0100 5181276 http://www.medworm.com/index.php?rid=5181275&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F340%3Frss%3D1 This article explores psychiatrists’ involvement in advocating for treatment inclusion, assessing patients’ capacity to make treatment-related decisions and supporting the medical team in managing the complex journey a patient undertakes from being at high risk to receiving treatment for neuropsychiatric symptoms. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181275 Tue, 30 Aug 2011 23:00:00 +0100 5181275 http://www.medworm.com/index.php?rid=5181274&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F332%3Frss%3D1 Delusions are a key symptom of psychosis and they are frequently distressing and disabling. Existing treatments, both pharmacological and psychological, are only partially effective. It is important to develop new treatment approaches based on theoretically derived and empirically tested processes. Delusions are associated with a reasoning bias: the jumping to conclusions (JTC) bias involves gathering limited information to reach decisions. It is proposed that this bias influences appraisals of psychotic experiences leading to the formation and persistence of delusions. Existing treatments do not influence JTC. A new intensive treatment approach – ‘reasoning training’ – is described. It aims to encourage participants to gather information, consider alternative expla... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181274 Tue, 30 Aug 2011 23:00:00 +0100 5181274 http://www.medworm.com/index.php?rid=5181273&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F323%3Frss%3D1 Patients detained at high and medium security reveal significant gender differences in the presentation of psychopathology, mental disorder and social and offending profiles. However, secure mental health services in England, like prisons, generally fail to recognise the core importance of the differing biopsychosocial development in women and the impact of life experiences on women’s subsequent biopsychosocial functioning. As a consequence, women are often inadequately provided for in services dictated by the identified needs, risks and responsiveness of men. The lack of clinically appropriate facilities for women may account for the increased frequency with which women are readmitted to medium security and for their longer admissions to both high and medium secure care. New tertiar... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181273 Tue, 30 Aug 2011 23:00:00 +0100 5181273 http://www.medworm.com/index.php?rid=5181272&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F322%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181272 Tue, 30 Aug 2011 23:00:00 +0100 5181272 http://www.medworm.com/index.php?rid=5181271&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F318%3Frss%3D1 Despite Britain’s high prevalence of problem gambling, its liberal gambling legislation, a rapidly expanding online gambling industry and the impending opening of casinos across the country, treatment provision is grossly inadequate. We discuss some of the present gaps and future opportunities in treating Britain’s problem gamblers, and urge Britain’s healthcare policy makers, gambling regulators, service commissioners and service providers to do more to help them. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181271 Tue, 30 Aug 2011 23:00:00 +0100 5181271 http://www.medworm.com/index.php?rid=5181270&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F317%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=5181270 Tue, 30 Aug 2011 23:00:00 +0100 5181270 http://www.medworm.com/index.php?rid=4992351&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F309%3Frss%3D1 Acceptance and commitment therapy (ACT) is a descendant of cognitive–behavioural therapy (CBT). The model draws techniques from a wide variety of sources and unites them within a philosophical and scientific framework to create a principle-driven therapy. Psychopathology is understood as a narrowing behavioural repertoire that develops over time through maladaptive strategies to cope with unwanted private events. The six core components of the therapy remain consistent across a wide range of clinical conditions. The approach combines processes of acceptance and mindfulness with those of commitment and behavioural change to produce increased psychological flexibility and an expanded behavioural repertoire. Since its introduction in 1999 an increasing number of trials show promising re... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992351 Wed, 29 Jun 2011 23:00:00 +0100 4992351 http://www.medworm.com/index.php?rid=4992350&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F301%3Frss%3D1 Psychiatry has had a significant influence on both Hollywood and world cinema. In turn, psychiatrists’ fascination with psychiatric themes in films has inspired scores of books and bibliographies about films and psychiatry. Advances in medical education have led to the development of core-competency-based curricula for both undergraduate and postgraduate students. Learning objectives underpin such competencies. However, teaching competencies in the workplace is hampered by practical and ethical issues, especially in the case of psychiatric patients. Medical educationalists have found films to be a useful teaching tool with their larger-than-life vivid portrayals. In this article we demonstrate, with examples, the use of films and discrete film clips to achieve specific learning objec... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992350 Wed, 29 Jun 2011 23:00:00 +0100 4992350 http://www.medworm.com/index.php?rid=4992349&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F292%3Frss%3D1 Various UK reports have identified issues of poor health and social care for people with an intellectual disability. Such reports emphasise the vital importance of addressing human rights issues in the future to improve and address shortcomings in such care. Article 8 of the European Convention on Human Rights affords protection for private and family life, and applies irrespective of whether someone has the capacity to make such decisions affecting their life. This in particular is important for people with an intellectual disability. Compared with the rest of the Convention, there has been relatively more case law pertaining to Article 8. This review considers Article 8 case law involving people with an intellectual disability in the areas of community care, accommodation, day centres, l... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992349 Wed, 29 Jun 2011 23:00:00 +0100 4992349 http://www.medworm.com/index.php?rid=4992348&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F283%3Frss%3D1 This article reviews the literature on the early detection of bipolar disorder and on the effectiveness of pharmacological, psychological and psychosocial interventions in the early phase of the disorder. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992348 Wed, 29 Jun 2011 23:00:00 +0100 4992348 http://www.medworm.com/index.php?rid=4992347&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F275%3Frss%3D1 This article explores these topics, with a particular emphasis on assessment and management in everyday practice. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992347 Wed, 29 Jun 2011 23:00:00 +0100 4992347 http://www.medworm.com/index.php?rid=4992346&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F266%3Frss%3D1 This article describes the concept of quality of life (QoL) as applied to mental health. It also outlines relevant tools for measuring QoL, both generic and health-specific, and explains their approaches and purposes. These tools are intended to enable researchers to ask questions that are more patient-centred and psychosocial than traditional clinical measures for evaluating outcomes of treatment. However, a number of studies have criticised existing QoL tools in terms of their sensitivity to change and their relevance to mental health patients’ concerns. Studies have shown that patients can give accurate self-reports even when ill. Given that government and professional policies favour effective service user involvement and routine outcome monitoring, more effort should be made to ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992346 Wed, 29 Jun 2011 23:00:00 +0100 4992346 http://www.medworm.com/index.php?rid=4992345&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F265%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992345 Wed, 29 Jun 2011 23:00:00 +0100 4992345 http://www.medworm.com/index.php?rid=4992344&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F256%3Frss%3D1 Clozapine remains underutilised as the only antipsychotic for treatment-resistant schizophrenia, despite liberal National Institute for Health and Clinical Excellence guidelines for its consideration. Bearing in mind its monitoring requirements and poor tolerability, suggestions are made for patients who fail to improve on other antipsychotic drugs. Clozapine may be offered to apparently unsuitable patients, although this is fraught with difficulty. A realistic appraisal of the alternatives is essential in this situation. Optimising plasma clozapine levels, alongside the use of rehabilitative interventions and adjuncts as necessary, will maximise efficacy, and there are numerous options to minimise side-effects. Clozapine requires a lengthier trial than other antipsychotics and discontinua... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992344 Wed, 29 Jun 2011 23:00:00 +0100 4992344 http://www.medworm.com/index.php?rid=4992343&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F250%3Frss%3D1 Up to a third of patients with schizophrenia develop treatment resistance. Clozapine has been established as the most effective antipsychotic medication for treatment-resistant schizophrenia. However, it is significantly underutilised in this population. Possible reasons include clinicians’ lack of experience with the drug and negative attitudes towards it. African–Caribbean patients are less likely to be treated with clozapine compared with their White counterparts and more likely to have treatment discontinued due to perceived risk of agranulocytosis. This paper discusses the current evidence relating to the underuse of clozapine and factors responsible for this. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992343 Wed, 29 Jun 2011 23:00:00 +0100 4992343 http://www.medworm.com/index.php?rid=4992342&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F243%3Frss%3D1 This article makes a case for training and developing psychotherapeutically competent consultant general psychiatrists. It describes what such psychiatrists should know and suggests that they should be able to prescribe psychotherapy rationally and assess its outcome. They should be able to deliver some psychological treatments themselves but, more importantly, they should be competent to apply psychotherapeutic knowledge and emotional literacy skills to their routine clinical practice. Possible CPD experiences are suggested to increase the competencies of existing consultant general psychiatrists. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992342 Wed, 29 Jun 2011 23:00:00 +0100 4992342 http://www.medworm.com/index.php?rid=4992341&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F240%3Frss%3D1 The recent expansion of neuroscientific knowledge is changing the nature of psychotherapeutically competent psychiatric practice. For example, components of medical psychotherapy that optimise neuroplasticity and restructure and reinforce synaptic connections can bring about enduring therapeutic changes in patients’ personal functioning, experience and behaviour. By renewing their connection to the advancements of neuroscience, psychiatrists in all specialties can build their identities as professionals and their skills as practitioners, making psychotherapeutic interventions more effective for their patients. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992341 Wed, 29 Jun 2011 23:00:00 +0100 4992341 http://www.medworm.com/index.php?rid=4992340&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F239%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4992340 Wed, 29 Jun 2011 23:00:00 +0100 4992340 http://www.medworm.com/index.php?rid=4770921&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F236-c%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770921 Fri, 29 Apr 2011 23:00:00 +0100 4770921 http://www.medworm.com/index.php?rid=4770920&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F236-b%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770920 Fri, 29 Apr 2011 23:00:00 +0100 4770920 http://www.medworm.com/index.php?rid=4770919&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F236-a%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770919 Fri, 29 Apr 2011 23:00:00 +0100 4770919 http://www.medworm.com/index.php?rid=4770918&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F236%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770918 Fri, 29 Apr 2011 23:00:00 +0100 4770918 http://www.medworm.com/index.php?rid=4770917&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F227%3Frss%3D1 This article illuminates the topic of hope from four different perspectives relevant to psychiatric research and practice. The four authors discuss hope from the viewpoint of their specific area of expertise, providing an overview of philosophical, conceptual, research and recovery-related reflections concerning hope in psychiatry. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770917 Fri, 29 Apr 2011 23:00:00 +0100 4770917 http://www.medworm.com/index.php?rid=4770916&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F220%3Frss%3D1 This article considers the derivation from case law of this novel concept and in particular its relationship with the European Convention on Human Rights. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770916 Fri, 29 Apr 2011 23:00:00 +0100 4770916 http://www.medworm.com/index.php?rid=4770915&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F214%3Frss%3D1 This article begins with a brief history of attitudes in the UK and Europe towards those who attempt suicide. It describes the main philosophical positions regarding suicide, including the principle of respect for life, the utilitarian position, the theological principle, and the principles of autonomy and duty to others. It concludes that short-term interventions are justified in most cases, for example when the suicide attempt is a ‘cry for help’ and/or the individual is ambivalent in their attempt or likely to have a mental illness. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770915 Fri, 29 Apr 2011 23:00:00 +0100 4770915 http://www.medworm.com/index.php?rid=4770914&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F206%3Frss%3D1 This article will review skills-based treatments (as opposed to insight-based treatments). Two approaches are outlined: cognitive–behavioural therapy and dialectical behaviour therapy. The article details the underpinning theory and the model of personality disorder utilised by the two approaches, and describes how the therapy is applied. Evidence of therapeutic efficacy is presented along with information about accessing training and therapy materials. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770914 Fri, 29 Apr 2011 23:00:00 +0100 4770914 http://www.medworm.com/index.php?rid=4770913&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F201%3Frss%3D1 This article focuses on service user involvement in supporting and undertaking mental health research. It is written from the author’s perspective as a service user with bipolar disorder who has built on previous experience as an academic researcher in business and management studies by active involvement in a number of mental health research projects in a service user capacity. The article highlights contrasting approaches taken by different projects in how they involve service users and provides learning points based on the author’s and other service users’ experiences. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770913 Fri, 29 Apr 2011 23:00:00 +0100 4770913 http://www.medworm.com/index.php?rid=4770912&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F191%3Frss%3D1 ICD-1O and DSM-IV-TR diagnostic guidelines do not list psychopathy as a distinct psychiatric entity. However, there are significant overlaps between psychopathy and DSM-IV-TR Cluster B personality disorders. Neuroimaging studies implicate deficits in structure and function of frontal and limbic regions in this group of personality disorders, while highlighting both distinctions and overlaps between syndromes. Here, these data are reviewed and implications for diagnosis and clinical practice are discussed. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770912 Fri, 29 Apr 2011 23:00:00 +0100 4770912 http://www.medworm.com/index.php?rid=4770911&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F188%3Frss%3D1 It has been suggested that a recovery-focused approach and treatment under the Mental Health Act are mutually exclusive, hence the limited applicability of ‘recovery’ in forensic psychiatry. This is heightened if recovery is seen as a ‘model’ that does or does not fit, and lessened if seen as ‘values-in-action’ that need reinterpretation in context. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770911 Fri, 29 Apr 2011 23:00:00 +0100 4770911 http://www.medworm.com/index.php?rid=4770910&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F187%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770910 Fri, 29 Apr 2011 23:00:00 +0100 4770910 http://www.medworm.com/index.php?rid=4770909&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F178%3Frss%3D1 Recovery approaches are now being developed in forensic as well as general mental health services. These are welcome developments that offer new ways of working with a socially excluded group of patients. However, the theoretical basis of recovery, with its individual humanistic ethos, may struggle to articulate the unique problems of forensic service users. In this article, we describe those problems and propose a ‘third way’ of thinking that bridges the recovery agenda (which looks for the best in people) and the forensic agenda (which must consider the worst in people). We propose using a ‘narrative approach’, which sees the forensic service user’s offence and cruelty as part of their human story. We link this explicitly with the work of Dan McAdams and his... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770909 Fri, 29 Apr 2011 23:00:00 +0100 4770909 http://www.medworm.com/index.php?rid=4770908&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F171%3Frss%3D1 Research has consistently demonstrated a connection between affect dysregulation and experiences of early childhood neglect, trauma and attachment failure. Without adequate regulation of the infant’s distress states, the nervous system and affect-regulating brain structures fail to develop optimally. Affect dysregulation is a component of all mood, anxiety and borderline personality disorders as well as a contributor to addictive and suicidal behaviour. Methods to increase self-regulation are crucial to the effectiveness of any treatment for these problems. Traditional therapeutic modalities that address distorted cognitions or focus on emotional expression attempt to address affect regulation but fail to modify its underlying basis in the nervous system. Sensorimotor psychotherapy, ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770908 Fri, 29 Apr 2011 23:00:00 +0100 4770908 http://www.medworm.com/index.php?rid=4770907&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F162%3Frss%3D1 This article is of particular relevance to educational supervisors, as it describes how they can support junior doctors in achieving the leadership and management competencies outlined in the 2009 core and specialty psychiatry curriculum. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770907 Fri, 29 Apr 2011 23:00:00 +0100 4770907 http://www.medworm.com/index.php?rid=4770906&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F160%3Frss%3D1 Medical leadership is important and must be a part of training. It requires qualities at three levels: the personal, the interpersonal (working with and through others) and the organisational (in political and cultural contexts). Some of the traits of good leadership can be taught and learnt, whereas others are inherent. The roles of individual leaders depend on the organisations in which they are involved. Different contexts require different leadership styles. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770906 Fri, 29 Apr 2011 23:00:00 +0100 4770906 http://www.medworm.com/index.php?rid=4770905&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F159%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4770905 Fri, 29 Apr 2011 23:00:00 +0100 4770905 http://www.medworm.com/index.php?rid=4531994&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F158-b%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531994 Mon, 28 Feb 2011 00:00:00 +0100 4531994 http://www.medworm.com/index.php?rid=4531993&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F158-a%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531993 Mon, 28 Feb 2011 00:00:00 +0100 4531993 http://www.medworm.com/index.php?rid=4531992&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F158%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531992 Mon, 28 Feb 2011 00:00:00 +0100 4531992 http://www.medworm.com/index.php?rid=4531991&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F150%3Frss%3D1 This article answers fundamental questions related to peer reviewing and includes practical tips to writing reviews. It will be helpful for those keen on improving their knowledge about the peer-review process. It will not only benefit those who are reviewers or thinking about becoming reviewers, but also authors, who can use the information to improve their chances of publication. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531991 Mon, 28 Feb 2011 00:00:00 +0100 4531991 http://www.medworm.com/index.php?rid=4531990&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F142%3Frss%3D1 This article reviews the diagnostic criteria for the disorder, its validity and its relationship to other disorders such as obsessive–compulsive disorder, anorexia nervosa, social phobia and somatisation disorders. The course of the illness, its aetiology and treatment approaches are discussed. As research is growing alongside an increase in patient presentations, body dysmorphic disorder requires a coherent response from healthcare services. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531990 Mon, 28 Feb 2011 00:00:00 +0100 4531990 http://www.medworm.com/index.php?rid=4531989&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F139%3Frss%3D1 This case illustrates a clinical management problem in which a terminally ill psychiatric patient racially abuses the Black staff caring for him. The clinical team has to tread a fine line between supporting staff victimised by the patient and ensuring his quality of life and care. It is important that patients’ (and staff’s) sensitivities relating to race and ethnicity are openly discussed at an early stage, so that appropriate clinical management can be negotiated. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531989 Mon, 28 Feb 2011 00:00:00 +0100 4531989 http://www.medworm.com/index.php?rid=4531988&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F131%3Frss%3D1 This article gives advice and strategies for working with struggling teams. It recommends combining objective-, data- and procedure-driven approaches to technical challenges with ‘softer’ person-centred and relational strategies matched to the learning needs of the team. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531988 Mon, 28 Feb 2011 00:00:00 +0100 4531988 http://www.medworm.com/index.php?rid=4531987&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F122%3Frss%3D1 This article explores complaints primarily in the context of the UK National Health Service complaints system. However, much of the content will apply to other settings, such as the independent sector. The infrequent but serious ramifications of complaints are also considered, including retraining and suspension. The article is written from a medical perspective but considers the roles of other professionals, the organisation and the complainant. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531987 Mon, 28 Feb 2011 00:00:00 +0100 4531987 http://www.medworm.com/index.php?rid=4531986&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F114%3Frss%3D1 We describe specific EEG changes associated with major psychiatric disorders. We conclude by offering pragmatic considerations when referring a patient for EEG, emphasising the fact that the information provided to the neurophysiologist plays a crucial role in interpreting the EEG recording in a diagnostically meaningful way. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531986 Mon, 28 Feb 2011 00:00:00 +0100 4531986 http://www.medworm.com/index.php?rid=4531985&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F110%3Frss%3D1 This commentary discusses the key issues facing undergraduate psychiatry teaching and the factors inhibiting psychiatrists’ roles as medical educators. Potential solutions to allow psychiatrists to fully embrace their teaching role are presented. A particular focus is on enhancing teaching skills, challenging student perceptions of psychiatry and ensuring that teaching is protected, valued and appropriately rewarded. This requires a concerted approach on individual, organisational and policy levels. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531985 Mon, 28 Feb 2011 00:00:00 +0100 4531985 http://www.medworm.com/index.php?rid=4531984&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F104%3Frss%3D1 This article is a brief review of the teaching role of psychiatrists and is directed at psychiatrists in the UK National Health Service who teach medical undergraduates. It reviews the responsibility of delivering teaching, the delineation of teaching duties, and the teaching roles of the psychiatrist in the changing environment of medical education. Application of good principles of clinical teaching and delivery of tomorrow’s doctors in line with the General Medical Council’s recommendations are discussed. The article also describes a recommended core curriculum in psychiatry for undergraduates, which lays out what should be taught. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531984 Mon, 28 Feb 2011 00:00:00 +0100 4531984 http://www.medworm.com/index.php?rid=4531983&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F103%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531983 Mon, 28 Feb 2011 00:00:00 +0100 4531983 http://www.medworm.com/index.php?rid=4531982&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F101%3Frss%3D1 Treatment of psychotic agitation is an area that is very poorly evidenced, principally because research evidence from patients with moderate agitation may not generalise to the more severely agitated patients. There is a significant gap between current treatment recommendations and what is seen in clinical practice. There are also big differences in clinical practice between different units treating seemingly similar patient groups. This commentary considers possible reasons for these findings and also discusses non-pharmacological interventions, which probably contribute more to the management of psychotic agitation than does the choice of one antipsychotic drug over another. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531982 Mon, 28 Feb 2011 00:00:00 +0100 4531982 http://www.medworm.com/index.php?rid=4531981&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F91%3Frss%3D1 Agitation in psychiatric settings, particularly in psychosis, presents a staggering challenge for clinicians, who must both manage the patient’s acute symptoms and simultaneously make an accurate diagnosis. Too often, the management of the former confounds the latter. Patients are very often sedated medically, which masks their underlying condition, rendering accurate diagnosis delayed and inherently difficult. Significant data are available regarding both pharmacological and non-pharmacological interventions for agitation that maximise symptom control while minimising confounding side-effects. In this article, a review of the historical evolution of agitation management in psychotic illness is presented, followed by an evidence-based clinical guideline for managing agitation in psyc... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531981 Mon, 28 Feb 2011 00:00:00 +0100 4531981 http://www.medworm.com/index.php?rid=4531980&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F85%3Frss%3D1 This article discusses the origins of the instrument in Canada and the USA before describing its use in the UK. Case-based discussion is placed within the context of contemporary postgraduate medical education and the curricula of the College, offering practical guidance on how best to use this method for the assessment of reasoning and judgement. Finally, some questions are posed regarding the potential use of case-based discussion in the proposals for revalidation. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531980 Mon, 28 Feb 2011 00:00:00 +0100 4531980 http://www.medworm.com/index.php?rid=4531979&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F82%3Frss%3D1 Psychiatry receives less media coverage than general medicine, and the coverage it does receive is four times as likely to be negatively framed. In addition, coverage of mental health problems is often negative in tone and mental health research tends to be underrepresented in the media. As the media is likely to be a key source of information for the general public about mental health and psychiatry, this is worrying. There are opportunities, however, to change this landscape; the UK national news media are keen to cover more stories about mental health problems and to feature more psychiatrists’ comments in their coverage. By engaging with the media, psychiatrists have the chance to create better-informed media narrative. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531979 Mon, 28 Feb 2011 00:00:00 +0100 4531979 http://www.medworm.com/index.php?rid=4531978&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F81%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4531978 Mon, 28 Feb 2011 00:00:00 +0100 4531978 http://www.medworm.com/index.php?rid=4309380&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F72%3Frss%3D1 This article outlines how MRCPsych courses have developed historically and gives an account of the factors that are currently driving changes in postgraduate psychiatric education. A brief description of educational theory that is applicable to the teaching of these courses is given, followed by a description of the teaching methods used. We also describe the different elements of an MRCPsych course, from the resource requirements to the way the course is structured and delivered. The principles described and examples given may be of interest to experienced course organisers and may be helpful to those taking on the role of course organiser for the first time. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309380 Mon, 03 Jan 2011 00:00:00 +0100 4309380 http://www.medworm.com/index.php?rid=4309379&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F63%3Frss%3D1 The evaluation of treatment effects is important to both the clinician and the patient. However, outcomes in randomised trials are often difficult to apply to the clinic. The number needed to treat (NNT) is one method that facilitates the interpretation of clinical trials in a meaningful way. When combined with the number needed to harm (NNH), the balance between the risks and benefits of a particular treatment can be appreciated. We illustrate the use of these concepts by focusing on recent large pragmatic studies of antipsychotics, including CATIE, EUFEST and CUtLASS. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309379 Mon, 03 Jan 2011 00:00:00 +0100 4309379 http://www.medworm.com/index.php?rid=4309378&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F54%3Frss%3D1 This article focuses on the mechanisms by which early language deprivation mediates emotional/behavioural difficulties and consequent emotional dysregulation, and may produce behaviours and symptoms that can be misdiagnosed as neurodevelopmental disorders in deaf children and adolescents (from infancy to 18 years of age). (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309378 Mon, 03 Jan 2011 00:00:00 +0100 4309378 http://www.medworm.com/index.php?rid=4309377&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F44%3Frss%3D1 Epilepsy is a common neurological condition with wide-ranging neuropsychiatric manifestations. The relationship between epilepsy and psychiatry has been recognised for centuries. However, the wide range of neuropsychiatric comorbidities and their extent is only now beginning to be appreciated. The impact of these comorbidities on patients’ help-seeking behaviour, seizure control and quality of life suggests that early detection and treatment are of paramount importance. Clinical issues in relation to accurate recognition and appropriate management of neuropsychiatric conditions in epilepsy are discussed. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309377 Mon, 03 Jan 2011 00:00:00 +0100 4309377 http://www.medworm.com/index.php?rid=4309376&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F41%3Frss%3D1 Ingmar Bergman was a Swedish director, writer and producer for film, stage and television. He directed 62 films, most of which he also wrote. Many of his films were set in the landscape of Sweden and he explored the themes of death, illness, cruelty, betrayal, mental illness, religion, and relationships between partners, children and their parents. Known as an auteur, he frequently used his film-making to examine issues from his own childhood. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309376 Mon, 03 Jan 2011 00:00:00 +0100 4309376 http://www.medworm.com/index.php?rid=4309375&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F32%3Frss%3D1 Children and adolescents with intellectual disability have high rates of psychiatric morbidity, the most common presentation being behavioural difficulties, especially in the context of autism. This clinical review describes the applicability of the full range of current psychopharmacological agents to the mental health difficulties commonly encountered in clinical practice in this field, with an emphasis on informing the choice of an initial ‘best fit’ single agent for the various clusters of symptoms and signs presented by individual patients. It is emphasised that the evidence base for most practice parameters in this area is extremely modest and that a high level of caution is recommended when applying this information in everyday practice. The article also discusses some o... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309375 Mon, 03 Jan 2011 00:00:00 +0100 4309375 http://www.medworm.com/index.php?rid=4309374&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F23%3Frss%3D1 This article outlines the background to interpersonal psychotherapy, the process of therapy and the expansion of the evidence base. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309374 Mon, 03 Jan 2011 00:00:00 +0100 4309374 http://www.medworm.com/index.php?rid=4309373&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F15%3Frss%3D1 This article is intended as a reminder of these studies and illustrates how the original theories have evolved. This evolution has been brought about largely by modern brain imaging techniques in human studies and in patients treated with ECT. These new findings will be set in the context of contemporary ideas about the neuroanatomy of mood disorders and the cellular mechanisms of the long-term effects of antidepressant treatments. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309373 Mon, 03 Jan 2011 00:00:00 +0100 4309373 http://www.medworm.com/index.php?rid=4309372&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F12%3Frss%3D1 The US Supreme Court’s complaint in 2005 about inconsistencies in research into adolescents’ decision-making capacity did not take into account the different demands placed on adolescents by controlled situations and unstructured situations. Apparent inconsistencies in research into adolescents’ capacity in treatment situations and in trial situations may simply be due to methodological differences between the two bodies of research. Apparent inconsistencies in the law regarding presumptions about adolescents’ capacity are related to differences in societal objectives across decision-making contexts. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309372 Mon, 03 Jan 2011 00:00:00 +0100 4309372 http://www.medworm.com/index.php?rid=4309371&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F11%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309371 Mon, 03 Jan 2011 00:00:00 +0100 4309371 http://www.medworm.com/index.php?rid=4309370&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F5%3Frss%3D1 This article focuses on the theoretical foundations of capacity or competence and provides guidance on how to negotiate common clinical pitfalls when assessing capacity in an adolescent. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309370 Mon, 03 Jan 2011 00:00:00 +0100 4309370 http://www.medworm.com/index.php?rid=4309369&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F2%3Frss%3D1 Mental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges. (Source: Adva... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309369 Mon, 03 Jan 2011 00:00:00 +0100 4309369 http://www.medworm.com/index.php?rid=4309368&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F1%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4309368 Mon, 03 Jan 2011 00:00:00 +0100 4309368 http://www.medworm.com/index.php?rid=4118363&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F476-a%3Frss%3D1 (No abstract is available for this citation) (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118363 Thu, 28 Oct 2010 23:00:00 +0100 4118363 http://www.medworm.com/index.php?rid=4118362&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F476%3Frss%3D1 (No abstract is available for this citation) (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118362 Thu, 28 Oct 2010 23:00:00 +0100 4118362 http://www.medworm.com/index.php?rid=4118361&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F474%3Frss%3D1 This commentary focuses principally on the semantics of using the term ‘mental health’ rather than ‘mental illness’ and the effect this has in creating a paradigm shift in psychiatry in relation to other medical specialties. The consequences, intended or unintended, are demonstrated and the relationship between ethics and economics in mental health is discussed. The view that economic evaluation is methodologically unsound in ‘mental health’, that it is a special case because of its complexity, does not acknowledge the significant paradigm shift that has occurred. Casual acceptance of the term ‘mental health’ in a serious economic debate about resources for people with mental illnesses is worrying and further diminishes the medical specialty ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118361 Thu, 28 Oct 2010 23:00:00 +0100 4118361 http://www.medworm.com/index.php?rid=4118360&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F468%3Frss%3D1 In making treatment decisions, psychiatrists, like other medical professionals, must adhere to rules of ethical medical conduct. They may also need to negotiate the legalities associated with detention and treatment against a patient’s wishes. The growth in guidance produced by organisations such as the National Institute for Health and Clinical Excellence has added further complexity. Practitioners are increasingly required to consider cost-effectiveness in their treatment decisions and this can appear to conflict with the principles of medical ethics. With particular reference to mental healthcare, this article attempts to answer two questions: Is economic evaluation unethical? And are the methods of economic evaluation unsound for the purpose of achieving an ethical distribution o... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118360 Thu, 28 Oct 2010 23:00:00 +0100 4118360 http://www.medworm.com/index.php?rid=4118359&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F459%3Frss%3D1 Mental health services are increasingly expected to engage in a process of cultural change to fulfil guiding values and hopes for choice, personalisation, self-determination, social inclusion and personal recovery. It is unclear how this will be achieved. This transformational agenda also engages with an ambition for progressive change in practice across mental health professions to support people in self-care and self-management, based on a new relationship between practitioners and users of mental health services. There is little consistent guidance on the content of recovery-oriented and socially inclusive practice and what may be the new competencies and skills that would most effectively support recovery outcomes. Life coaching to support recovery for people with mental health needs i... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118359 Thu, 28 Oct 2010 23:00:00 +0100 4118359 http://www.medworm.com/index.php?rid=4118358&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F456%3Frss%3D1 Advance statements in Scotland have a specific legal meaning and come into effect when someone is subject to the Mental Health (Care and Treatment) (Scotland) Act 2003. This Act requires a person being compulsorily treated to have significantly impaired decision-making ability in respect of medical decisions. The advance statement is intended to cover treatment wishes – both refusal and acceptance of treatment. In addition, a personal statement can be made which covers wider issues. There is evidence that in many statements these are being combined, raising questions about what is meant by treatment. Issues of revoking advance statements are also considered. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118358 Thu, 28 Oct 2010 23:00:00 +0100 4118358 http://www.medworm.com/index.php?rid=4118357&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F448%3Frss%3D1 This article reviews the literature on advance statements, including current mental health law and guidance in England and Wales, ethical and practical advantages, disadvantages and barriers to implementation. The idea of planning psychiatric treatment for a time when mental capacity may be impaired is not new. Yet there has been a renewed interest following the introduction of the Mental Capacity Act’s 2005 provision of legally binding advance decisions to refuse treatment. In addition to information on treatment refusals, advance statements provide information on treatment preferences and personal care instructions which, although not legally binding, should inform treatment decisions. Advance statements are not yet widely used, but existing limited evidence suggests that they coul... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118357 Thu, 28 Oct 2010 23:00:00 +0100 4118357 http://www.medworm.com/index.php?rid=4118356&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F440%3Frss%3D1 We describe in detail the assessment of capacity to consent to treatment in this case and good practice in making best interests decisions in everyday clinical practice. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118356 Thu, 28 Oct 2010 23:00:00 +0100 4118356 http://www.medworm.com/index.php?rid=4118355&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F438%3Frss%3D1 The deprivation of liberty safeguards apply to England and Wales. In Scotland, trends and uncertainties in the use of welfare guardianship (the equivalent action under Scottish law) provide a useful comparison. In both jurisdictions, there are risks to the rights of individuals. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118355 Thu, 28 Oct 2010 23:00:00 +0100 4118355 http://www.medworm.com/index.php?rid=4118354&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F430%3Frss%3D1 The deprivation of liberty safeguards were introduced into the Mental Capacity Act in 2008 to enhance the protection of adults in residential homes or hospitals who lack capacity in relation to their care arrangements and who are or may be deprived of their liberty. Deprivation of liberty itself is an imprecise concept and there may be difficulty in applying the appropriate authority where there is a choice between the Mental Capacity Act 2005 and the Mental Health Act 1983. Therefore, this article explains the evolution of mental capacity legislation and the concept of deprivation of liberty, how it may be recognised, prevented and authorised by deprivation of liberty safeguards, along with some of the interface issues with the Mental Health Act 1983. (Source: Advances in Psychiatric Trea... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118354 Thu, 28 Oct 2010 23:00:00 +0100 4118354 http://www.medworm.com/index.php?rid=4118353&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F421%3Frss%3D1 This article looks at the prevalence of substance misuse in the people over the age of 60. The reasons for difficulty in diagnosing substance misuse are explored and ways to improve diagnostic ability are discussed. Substance misuse leads to severe physical and psychiatric morbidity that is being managed by meagre resources. The article provides recommendations on specific issues related to interventions, biological and psychosocial, and training of psychiatrists. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118353 Thu, 28 Oct 2010 23:00:00 +0100 4118353 http://www.medworm.com/index.php?rid=4118352&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F420%3Frss%3D1 (No abstract is available for this citation) (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118352 Thu, 28 Oct 2010 23:00:00 +0100 4118352 http://www.medworm.com/index.php?rid=4118351&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F413%3Frss%3D1 This article analyses the diverse role of the Human Rights Act 1998 in these cases and illustrates key underlying Human Rights Act principles that can be applied in clinical practice. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118351 Thu, 28 Oct 2010 23:00:00 +0100 4118351 http://www.medworm.com/index.php?rid=4118350&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F402%3Frss%3D1 Major depression and bipolar disorder in children and adolescents are serious conditions associated with considerable morbidity as well as increased risk of suicide. The treatment of depression in young people is currently controversial and this article reviews the evidence base and potential risks and benefits of antidepressants. Although the diagnosis of bipolar disorder is also controversial, medication is the first-line treatment of choice in cases that meet diagnostic criteria. The limited evidence base in children and adolescents is presented, along with current treatment guidelines. Despite the controversies in this field, this article concludes that medication remains an important part of the treatment approach for both disorders, although the risks and benefits of pharmacotherapy ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118350 Thu, 28 Oct 2010 23:00:00 +0100 4118350 http://www.medworm.com/index.php?rid=4118349&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F398%3Frss%3D1 Health reform in America will lead to major changes in medical care in the USA, with opportunities for improved access to care, especially for psychiatric patients. Combined with recently enacted ‘parity’ legislation, health reform will expand public and private insurance coverage to an additional 33 million Americans, leading to increased pressure on the psychiatrists who are willing to practise with the insured population and on opportunities for subspecialisation within the field. Some essential non-medical tasks will not be funded by insurance, and these must be given due consideration. A major emphasis of health reform is to integrate general health and mental health services. The reform will have an impact on the use of the hospital and emergency room as well. A major con... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118349 Thu, 28 Oct 2010 23:00:00 +0100 4118349 http://www.medworm.com/index.php?rid=4118348&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F397%3Frss%3D1 (No abstract is available for this citation) (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=4118348 Thu, 28 Oct 2010 23:00:00 +0100 4118348 http://www.medworm.com/index.php?rid=3920598&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F388%3Frss%3D1 There are many difficulties associated with the diagnostic guidelines for personality disorder in the current international classificatory systems such as ICD–10 and DSM–IV. These lead not only to significant overlap with DSM Axis I disorders, resulting in high rates of diagnoses of comorbidities and multiple personality disorders, but also to lack of adequate capture of core personality pathology. The current classifications are also unhelpful in treatment selection, presumably the prime reason for assessing individuals in the first place. In this article we highlight various deficits and inadequacies related to the nosology of the current systems and suggest some strategies for dealing with these. We offer an integrated model of assessing and diagnosing personality disorders.... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920598 Tue, 31 Aug 2010 22:00:39 +0100 3920598 http://www.medworm.com/index.php?rid=3920597&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F380%3Frss%3D1 Developmental dyslexia (reading disability) is a specific impairment in learning to read that affects 3–6% of school children in English-speaking countries. It is overrepresented in clinical populations referred to child and adolescent mental health services because of its high comorbidity with conduct disorder, attention-deficit hyperactivity disorder and other developmental disorders. Clinicians may fail to identify it unless they maintain a high degree of awareness and make specific inquiries. A three-stage approach (routine screening, in-depth examination and referral for further testing) is described. The features of dyslexia and the clues to its diagnosis are discussed. A number of simple tests for identifying it are available and familiarity with these should improve diagnosti... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920597 Tue, 31 Aug 2010 22:00:39 +0100 3920597 http://www.medworm.com/index.php?rid=3920596&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F369%3Frss%3D1 This article focuses primarily on blood, urine and oral fluids, which are specimens more commonly used in mental health settings, although hair and sweat are increasingly used in medico-legal cases and in child protection issues. The main drugs and their metabolism are discussed to gain a better understanding of the methods used and for accurate interpretation. Methods to ensure validity during sample collection are explored. False-positive and false-negative tests are common and possible confounders are discussed. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920596 Tue, 31 Aug 2010 22:00:39 +0100 3920596 http://www.medworm.com/index.php?rid=3920595&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F361%3Frss%3D1 The United Nations’ 1959 Declaration of the Rights of the Child states that ‘the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth’. In the UK, children and young people are afforded protection by two important pieces of legislation: the UN Convention on the Rights of the Child and the Human Rights Act 1998. There have been plentiful and varied challenges involving children and young people, in particular under Article 8 of the Human Rights Act. This review of Article 8 cases demonstrates both its use and key principles underpinning its use. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920595 Tue, 31 Aug 2010 22:00:39 +0100 3920595 http://www.medworm.com/index.php?rid=3920594&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F349%3Frss%3D1 In this article we review the evidence base and practical experience supporting the use of psycho-pharmacological treatments for autism-spectrum disorders across the lifespan. Recent advances in knowledge are highlighted, as are the shortcomings of published data in this field. Psychosocial and educational interventions remain the core of treatment, but there is now evidence that medication management is a good option for certain domains of behaviour. We discuss the evidence in terms of symptom clusters, including the underlying social deficit of autism and common psychiatric comorbidities. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920594 Tue, 31 Aug 2010 22:00:39 +0100 3920594 http://www.medworm.com/index.php?rid=3920593&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F339%3Frss%3D1 Aggression is common in older people with mental illness, with 15–43% of community referrals to old age psychiatry services and 44–65% of older people with Alzheimer’s disease living in the community exhibiting such behaviour. In psychiatric in-patient units, assaults on staff are most common on wards for elderly people with organic mental illness. There is little high-quality research into the management of aggressive behaviour in dementia. We consider the available literature, which has shown certain behavioural measures and different classes of medication to be of benefit. We discuss factors associated with violence in elderly people with mental illness and potential management options. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920593 Tue, 31 Aug 2010 22:00:39 +0100 3920593 http://www.medworm.com/index.php?rid=3920592&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F336%3Frss%3D1 This commentary explores the issue of personality disorder and mental health legislation from a UK perspective, highlighting the differences between its four countries and three mental health acts. It discusses data from Scotland that support the contention that the addition of the term ‘personality disorder’ to mental health legislation is not alone sufficient to change current practice. The legislative criterion of risk to others is discussed and the varying responses in the UK to the contentious issue of preventive detention, highly likely to be relevant to serious offenders with personality disorder, are described, including the indeterminate sentence of imprisonment for public protection and the order of lifelong restriction. It is concluded that, regardless of location, c... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920592 Tue, 31 Aug 2010 22:00:39 +0100 3920592 http://www.medworm.com/index.php?rid=3920591&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F329%3Frss%3D1 This article explores features of the amended Act that affect the treatment of patients with personality disorder in England and Wales. It discusses issues such as the broad definition of mental disorder, treatability and professional roles, with specific reference to how they might, or might not, affect usual practice concerning patients with personality disorder. It also comments on elements within the Act that could positively affect people with personality disorder, such as community treatment orders, provision to change their ‘nearest relative’ and statutory advocacy services. The political climate in which the Act has been amended is commented on, as well as how this might potentially compromise some of the positives within the Act. (Source: Advances in Psychiatric Treatm... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920591 Tue, 31 Aug 2010 22:00:39 +0100 3920591 http://www.medworm.com/index.php?rid=3920590&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F318%3Frss%3D1 Bipolar disorder is arguably a pivotal diagnosis in adult psychiatry bounded by schizophrenia on one side and unipolar depression on the other. It represents a wide spectrum of disorders, all sharing common features of elated and depressed mood. The early descriptions of symptom-free euthymia have long been dismissed and the chronic and enduring deficits associated with the disorder are beginning to be better understood. We review the current literature with regard to the course of the disorder, factors that may influence prognosis and common comorbidities. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920590 Tue, 31 Aug 2010 22:00:39 +0100 3920590 http://www.medworm.com/index.php?rid=3920589&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F317%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3920589 Tue, 31 Aug 2010 22:00:39 +0100 3920589 http://www.medworm.com/index.php?rid=3713966&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F316-a%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713966 Wed, 30 Jun 2010 22:00:46 +0100 3713966 http://www.medworm.com/index.php?rid=3713965&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F316%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713965 Wed, 30 Jun 2010 22:00:46 +0100 3713965 http://www.medworm.com/index.php?rid=3713964&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F308%3Frss%3D1 This article highlights the relevance of attachment theory for psychiatric rehabilitation services and discusses practice implications derived from the theory. Attachment theory can guide the development of interpersonal relationships during recovery and this aspect of rehabilitation is emphasised here. Attachment theory can also be used to help staff predict and understand problematic behaviours such as violence and aggression, and different styles of recovery. The theory can help promote positive staff–service-user relationships by highlighting the qualities of effective caregivers and the way in which people with different attachment styles might benefit from different approaches. We conclude by suggesting ways of teaching rehabilitation staff to become more effective attachment f... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713964 Wed, 30 Jun 2010 22:00:46 +0100 3713964 http://www.medworm.com/index.php?rid=3713963&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F299%3Frss%3D1 This article examines these recent findings. A second article to appear in Advances will focus on clinical aspects of the disorder. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713963 Wed, 30 Jun 2010 22:00:46 +0100 3713963 http://www.medworm.com/index.php?rid=3713962&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F288%3Frss%3D1 This article explores the striking similarities between a recovery-oriented approach and person-centred care, the particular challenge posed in dementia care and the benefits of a collaborative approach in pursuit of common purposes. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713962 Wed, 30 Jun 2010 22:00:46 +0100 3713962 http://www.medworm.com/index.php?rid=3713961&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F281%3Frss%3D1 The prevalence of tattoos is higher among people with mental disorders and those likely to come in contact with mental health services. The motivations for acquiring a tattoo are varied and tattoos can give clues to the presence of particular psychiatric conditions and to the inner world of patients. Psychiatrists need to be aware of the health and safety issues surrounding the tattooing procedure and be able to give appropriate advice to their patients if they wish to acquire a tattoo. The issue of capacity must be considered. This may be particularly relevant for clinicians working with adolescents, the most common age group for acquiring tattoos. Owing to the high proportion of adults who subsequently regret their tattoos and the associated psychological and social distress, clinicians ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713961 Wed, 30 Jun 2010 22:00:46 +0100 3713961 http://www.medworm.com/index.php?rid=3713960&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F280%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713960 Wed, 30 Jun 2010 22:00:46 +0100 3713960 http://www.medworm.com/index.php?rid=3713959&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F279%3Frss%3D1 Nearly a decade ago, the Department of Health published its strategic development plan for mental healthcare for women. It focused on the ways in which mental health services for women should be configured to take account of the context of women’s lives and the complexity of their health needs. This commentary argues that attention to the reproductive and sexual health of women in mental healthcare is at the centre of a gender-sensitive and modern mental health service. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713959 Wed, 30 Jun 2010 22:00:46 +0100 3713959 http://www.medworm.com/index.php?rid=3713958&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F272%3Frss%3D1 Pregnancies in women with serious mental illness are high risk and such women are also less likely to engage in the recommended health screening for women of reproductive age. Hence, reproductive health issues are important aspects of physical healthcare that should be assessed in women accessing mental health services. Pregnancy planning and management are crucial in reducing risk of relapse in women with affective disorders, and psychiatrists should acquaint themselves with the screening programmes and reproductive and sexual health services in their area and encourage their patients’ uptake of these. Clinicians should be aware of the reproductive impact of medications and the needs of specific groups of women. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713958 Wed, 30 Jun 2010 22:00:46 +0100 3713958 http://www.medworm.com/index.php?rid=3713957&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F263%3Frss%3D1 The introduction of the supervised community treatment order (CTO) was a major and significant change to the Mental Health Act 1983 following the 2007 amendments to the Act. Owing to paternalistic aspects of psychiatry, such new legislation brings with it the potential to impinge on the human rights of patients. Any new legislation must be read and implemented to be compliant with the Human Rights Act 1998. Of all the articles comprising the Human Rights Act, Article 3 (the right to freedom from inhuman and degrading treatment), Article 5 (the right to liberty and security) and Article 8 (the right to respect for family and private life, home and correspondence) are of particular relevance to CTOs. We consider here the potential implications of the use of CTOs with regard to the Human Righ... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713957 Wed, 30 Jun 2010 22:00:46 +0100 3713957 http://www.medworm.com/index.php?rid=3713956&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F260%3Frss%3D1 Despite the lack of supportive scientific evidence, the uptake of community treatment orders (CTOs) in England and Wales since their introduction in late 2008 has been higher than expected, although there has been a relative dearth of second opinion appointed doctors. In Scotland, CTOs now constitute about 30% of all long-term civil detentions, with lack of insight and lack of treatment adherence given as the major reasons for CTO use. Ethical considerations such as balancing autonomy against health needs will continue to be weighed by clinicians considering compulsory treatment in the community. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713956 Wed, 30 Jun 2010 22:00:46 +0100 3713956 http://www.medworm.com/index.php?rid=3713955&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F253%3Frss%3D1 This article describes the background to the introduction of supervised community treatment (SCT) in the 2007 amendments to the Mental Health Act 1983 for England and Wales. The evidence base for the use of SCT in the UK and in other countries to date is considered, and guidance from the literature regarding the decision to impose it is reviewed. Early local experience of SCT is described, in part through a number of fictitious vignettes. Finally, we present a set of guidelines which may be used by clinicians when considering SCT. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713955 Wed, 30 Jun 2010 22:00:46 +0100 3713955 http://www.medworm.com/index.php?rid=3713954&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F245%3Frss%3D1 This article considers how SCT fits into the established legislative framework and how it may affect the care delivered by mental health practitioners. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713954 Wed, 30 Jun 2010 22:00:46 +0100 3713954 http://www.medworm.com/index.php?rid=3713953&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F238%3Frss%3D1 This article outlines the multiple threats to an asylum-seeking person’s sense of identity and associated mental health problems. Ways in which mental health professionals can support the person’s sense of identity during this transition are discussed. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713953 Wed, 30 Jun 2010 22:00:46 +0100 3713953 http://www.medworm.com/index.php?rid=3713952&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F237%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3713952 Wed, 30 Jun 2010 22:00:46 +0100 3713952 http://www.medworm.com/index.php?rid=3522474&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F228%3Frss%3D1 This article reviews sensory impairment in intellectual disability and its association with autism-spectrum disorder and mental illness. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522474 Fri, 30 Apr 2010 22:00:43 +0100 3522474 http://www.medworm.com/index.php?rid=3522473&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F219%3Frss%3D1 This article outlines the different forms that group CBT takes, the way in which it may benefit people and the current evidence base supporting its use for anxiety and depression. It also outlines the advantages of group or individual CBT and describes those patients who appear to be best suited to a specific delivery. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522473 Fri, 30 Apr 2010 22:00:43 +0100 3522473 http://www.medworm.com/index.php?rid=3522472&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F207%3Frss%3D1 This article reports the results of a synthesis of qualitative research articles about lay perspectives on prescribed psychotropic medicines. It updates and elaborates on a model of medicine-taking developed by Pound and colleagues. In this model, the concept of resistance refers to the various ways in which people take prescribed medicines while trying to minimise their intake. The synthesis included 12 papers published since 1992. The findings are presented at the societal level, in terms of the social meanings of mental health problems and medication, and at the individual level; the latter covers active engagement and lay evaluation, as well as the outcomes of evaluation, including the doctor–patient relationship. Although it can be difficult to achieve in the current clinical en... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522472 Fri, 30 Apr 2010 22:00:43 +0100 3522472 http://www.medworm.com/index.php?rid=3522471&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F199%3Frss%3D1 This article provides an in-depth update on recent Article 3 case law, but more importantly describes new developments in its application in the clinical setting. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522471 Fri, 30 Apr 2010 22:00:43 +0100 3522471 http://www.medworm.com/index.php?rid=3522470&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F193%3Frss%3D1 In England and Wales diminished responsibility is a partial defence to the charge of murder. If successfully argued by the defence, it reduces the charge from murder to manslaughter and thus avoids the mandatory life sentence. Alcohol has been reported to be a feature in up to 80% of all homicides but for many years the judiciary have set an almost unattainable threshold for the disease of alcoholism to amount to a finding of diminished responsibility, in accordance with other aspects of criminal law. Reform of the law on murder is likely to take many years but it is timely to recap the current law on diminished responsibility and review advances in case law in England and Wales on alcohol. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522470 Fri, 30 Apr 2010 22:00:43 +0100 3522470 http://www.medworm.com/index.php?rid=3522469&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F192%3Frss%3D1 (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522469 Fri, 30 Apr 2010 22:00:43 +0100 3522469 http://www.medworm.com/index.php?rid=3522468&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F184%3Frss%3D1 The Royal College of Psychiatrists’ guidelines for the psychotherapy training of trainee psychiatrists include a supervised case experience in supportive psychotherapy. There is, however, a lack of clarity over the concept of supportive psychotherapy and how this might be taught and supervised, and this may discourage trainers from offering formal clinical supervision in this modality. In this article we briefly describe the history of supportive psychotherapy, the various ways in which it has been conceptualised, and some of the research in the area. We discuss the case for training and make practical suggestions for how this experience might be offered by consultant psychiatrists in an everyday psychiatric setting. (Source: Advances in Psychiatric Treatment) Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522468 Fri, 30 Apr 2010 22:00:43 +0100 3522468 http://www.medworm.com/index.php?rid=3522467&cid=s_27086_172_f&fid=27086&url=http%3A%2F%2Fapt.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F176%3Frss%3D1 Taking hostages has a long history as a method, with variable effectiveness, of securing concessions from individuals, organisations and governments. More recently, it has become a popular tactic among terrorist organisations. Although the resilience of individuals should never be underestimated, there is evidence that being taken hostage can have enduring effects, particularly on children. Individuals vary in how they cope with such an experience, both during and subsequent to it. The literature demonstrates that the research base is limited, and many important questions remain to be answered. Hostage-taking is an area of clinical and scientific interest. Apart from the need to establish the most effective post-incident interventions for individual hostages and their families, there are o... Advances in Psychiatric Treatment journals http://www.medworm.com/rss/comments.php?id=3522467 Fri, 30 Apr 2010 22:00:43 +0100 3522467