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 'Psychiatric Bulletin' source. Tue, 07 Feb 2012 09:35:59 +0100 http://www.medworm.com/index.php?rid=5645193&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F80%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645193 Wed, 01 Feb 2012 05:00:00 +0100 5645193 http://www.medworm.com/index.php?rid=5645192&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F79%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645192 Wed, 01 Feb 2012 05:00:00 +0100 5645192 http://www.medworm.com/index.php?rid=5645191&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F78-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645191 Wed, 01 Feb 2012 05:00:00 +0100 5645191 http://www.medworm.com/index.php?rid=5645190&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F78%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645190 Wed, 01 Feb 2012 05:00:00 +0100 5645190 http://www.medworm.com/index.php?rid=5645189&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F71%3Frss%3D1 Aims and method To gather opinion from trainees across England about their current experiences and future career plans. This was done via an internet-based survey. Results Out of the 359 responses we received, 65.8% of trainees planned to stay in psychiatry until retirement. Trainees felt several issues were problematic, including the attitude of other specialties towards psychiatry, perceived substandard treatment of psychiatric patients by other specialties and implications of New Ways of Working. Clinical implications Despite there being many areas of training respondents were happy with, if attrition is to be minimised, issues such as how psychiatric trainees integrate with the other medical specialties and how the role of doctors in the specialty is perceived need to be addressed. (So... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645189 Wed, 01 Feb 2012 05:00:00 +0100 5645189 http://www.medworm.com/index.php?rid=5645188&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F69%3Frss%3D1 Two years of foundation training were added to the medical students’ transition from learning theory in medical school to trainee clinical practice, replacing one year of house jobs or internship. In the recent few years there has been a tremendous amount of debate about undergraduate medical training and changes in regulations which led to the Collins review in 2010. The review proposed that trainees need more exposure to community-based placements such as psychiatry, public health and community paediatrics and that they also need to learn to deal with chronic conditions. Bearing in mind that nearly a third of the general practitioner’s patients will have psychiatric problems, it is essential that all doctors gain some exposure to psychiatric practice. It is crucial that this ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645188 Wed, 01 Feb 2012 05:00:00 +0100 5645188 http://www.medworm.com/index.php?rid=5645187&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F65%3Frss%3D1 We report an audit of the provision of psychiatric postgraduate education within the foundation programme and psychiatry specialty programmes in the UK. Our primary measure was the number of foundation posts in psychiatry. Our audit standard was that all foundation doctors should receive programmed training in psychiatry via a psychiatry foundation post. Results We found a total of 413 foundation posts in psychiatry in 21 out of 22 foundation schools in England. This figure is only a fifth of that required to meet the audit standard. There is training capacity for 500 core trainees and 460 higher trainees in psychiatry per year. Currently, 13.6% of specialists other than general practitioners on the General Medical Council registers are psychiatrists. Clinical implications The provision of... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645187 Wed, 01 Feb 2012 05:00:00 +0100 5645187 http://www.medworm.com/index.php?rid=5645186&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F61%3Frss%3D1 Aims and method We examine the feasibility of the routine use of three patient-reported and one clinician-rated outcome measures (patient-identified problem, EuroQol-5D questionnaire, EuroQol Visual Analogue Scale and Health of the Nation Outcome Scales (HoNOS)) in an out-patient community psychiatric service, and discuss the associations between these variables. Results The routine collection of outcome measures was feasible in the out-patient setting. There was a general improvement in the health status from the initial assessment to the first follow-up. Subsequent scores remained stable. Clinical implications The study encourages the practical use of scales in routine community psychiatric practice. As there was correlation between HoNOS and EQ-5D index, both need not be used in routine... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645186 Wed, 01 Feb 2012 05:00:00 +0100 5645186 http://www.medworm.com/index.php?rid=5645185&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F55%3Frss%3D1 Aims and method The literature on the use of electroconvulsive therapy (ECT) in patients with an intellectual disability is scarce, despite a higher prevalence of psychiatric disorders than in the general adult population. We carried out a review of articles published before March 2010. All age ranges, severity of disability and diagnoses were included. Results We found 72 case reports, a retrospective chart review study and other reviews, but no controlled studies. Most patients (79%) showed a positive outcome following ECT. Complications were seen only in 13% and there were no reports of cognitive decline. Many patients relapsed following ECT (32%) and the majority were maintained with medication at follow-up (71%). Clinical implications Electroconvulsive therapy is a valuable treatment ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645185 Wed, 01 Feb 2012 05:00:00 +0100 5645185 http://www.medworm.com/index.php?rid=5645184&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F50%3Frss%3D1 Aims and method To select staff for a personality disorder service by exposing applicants to anticipated challenges. Applicants took part in a role play, an unstructured group with fellow applicants and numbers of the interviewing panel, and a panel interview. A service user representative was involved from the initial planning stage. Results Multiple assessment methods enabled fine discrimination between applicants. Appointed staff said they felt the interviews were a valid test of required skills and have been well regarded by patients in the programme. Clinical implications Selecting staff for a personality disorder service benefits from using multiple interview methods. The service user representative and role-play actor can contribute crucially by representing the patient’s pers... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645184 Wed, 01 Feb 2012 05:00:00 +0100 5645184 http://www.medworm.com/index.php?rid=5645183&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F45%3Frss%3D1 This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645183 Wed, 01 Feb 2012 05:00:00 +0100 5645183 http://www.medworm.com/index.php?rid=5645182&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2F41%3Frss%3D1 We describe this and make further suggestions for dealing with these requests. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645182 Wed, 01 Feb 2012 05:00:00 +0100 5645182 http://www.medworm.com/index.php?rid=5645181&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F2%2Fibc%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5645181 Wed, 01 Feb 2012 05:00:00 +0100 5645181 http://www.medworm.com/index.php?rid=5570594&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F39%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570594 Tue, 03 Jan 2012 05:00:00 +0100 5570594 http://www.medworm.com/index.php?rid=5570593&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F38%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570593 Tue, 03 Jan 2012 05:00:00 +0100 5570593 http://www.medworm.com/index.php?rid=5570592&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F37%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570592 Tue, 03 Jan 2012 05:00:00 +0100 5570592 http://www.medworm.com/index.php?rid=5570591&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F36-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570591 Tue, 03 Jan 2012 05:00:00 +0100 5570591 http://www.medworm.com/index.php?rid=5570590&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F36%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570590 Tue, 03 Jan 2012 05:00:00 +0100 5570590 http://www.medworm.com/index.php?rid=5570589&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F35-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570589 Tue, 03 Jan 2012 05:00:00 +0100 5570589 http://www.medworm.com/index.php?rid=5570588&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F35%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570588 Tue, 03 Jan 2012 05:00:00 +0100 5570588 http://www.medworm.com/index.php?rid=5570587&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F34-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570587 Tue, 03 Jan 2012 05:00:00 +0100 5570587 http://www.medworm.com/index.php?rid=5570586&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F34%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570586 Tue, 03 Jan 2012 05:00:00 +0100 5570586 http://www.medworm.com/index.php?rid=5570585&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F32%3Frss%3D1 Aims and method To carry out a survey to ascertain the role of academic clinical fellowship posts within the integrated academic training programme for academic training in child and adolescent psychiatry. Questionnaires were sent to UK academic child psychiatric units. Results A total of 18 units returned questionnaires; this identified eight university lecturers and two academic clinical fellows in post. Clinical implications Integrated academic training pathways seem unlikely to contribute substantially to academic training and to maintaining the pool of academic clinicians in child and adolescent psychiatry. It may need reappraising with regard to psychiatric specialties. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570585 Tue, 03 Jan 2012 05:00:00 +0100 5570585 http://www.medworm.com/index.php?rid=5570584&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F30%3Frss%3D1 This commentary discusses the proposed service, Fair Horizons, a new development designed to ensure comprehensive mental healthcare coverage. Although the aims of the new service are laudable and derive from recent seminal papers on changes in the National Health Service, the proposed initiatives are so far untested and there is uncertainty about how far costs will be reduced under this new system. Success is more likely to result if clinicians are committed to the new service and work harder. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570584 Tue, 03 Jan 2012 05:00:00 +0100 5570584 http://www.medworm.com/index.php?rid=5570583&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F25%3Frss%3D1 Aims and method Service access is currently determined primarily by age and intellectual function and, unwittingly, is discriminatory. Our aim is to develop a novel, person-centred, non-discriminatory model of mental healthcare delivery. We sought the views of people who use services, carers, commissioners and local politicians. Results The model represents a major change programme that commenced in September 2011. Clinical implications By integrating specialist mental health services, with a single access point, and mapping of care to the person’s needs, rather than their circumstances we hope to have developed a greatly improved and fairer service. A similar model could be adopted in other locations nationally. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570583 Tue, 03 Jan 2012 05:00:00 +0100 5570583 http://www.medworm.com/index.php?rid=5570582&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F16%3Frss%3D1 Aims and method To explore attitudes and perceptions towards workplace-based assessment (WPBA) among psychiatric trainers in Wales and to compare them with those of trainees. To identify current problems and report recommendations made by survey respondents to streamline and successfully implement WPBA. An anonymous questionnaire-based cross-sectional online survey was conducted involving consultant psychiatrists in Wales and the results compared with a previous survey of specialty registrars. Results In total, 104 of 164 consultants participated (63%), compared with 81 of 88 trainees (92%). Both surveys highlighted numerous problems and negative attitudes towards WPBA. Compared with widespread dissatisfaction among trainees, trainers appear more diverse in their opinions, although conside... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570582 Tue, 03 Jan 2012 05:00:00 +0100 5570582 http://www.medworm.com/index.php?rid=5570581&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F11%3Frss%3D1 Aims and method To audit the quality of medical recommendations for detention under the Mental Health Act 1983, Section 2 and 3. The recommendations were tested against a gold standard based on the statutory criteria. Two cycles were completed, the first containing 214 recommendations, the second 202. Relevant education took place after the first cycle. Results The percentage of medical recommendations containing clear statements of why each of the statutory criteria was met increased in the second cycle. It reached 87% for mental disorder; 87% for nature and/or degree; 75% for why community treatment was not possible; 64% for why detention was in the interests of health; 60% for safety; 55% for protection of others; and 70% why informal admission was not possible. Clinical implications Do... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570581 Tue, 03 Jan 2012 05:00:00 +0100 5570581 http://www.medworm.com/index.php?rid=5570580&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F6%3Frss%3D1 Aims and method We analysed all 1213 negligence claims made against contributing psychiatric services since the inception of the National Health Service Litigation Authority (NHSLA) in 1995 and until 1 June 2009. More than half (55%) were settled, at a cost of £47.2 million, 26% were closed without penalty and 19% were still in progress at the time of review. Five individual claims exceeded £1 million. Results By allocating 43 NHSLA-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%). Clinical implications At the individual level it is difficult to see patterns of errors, whereas increased volumes... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570580 Tue, 03 Jan 2012 05:00:00 +0100 5570580 http://www.medworm.com/index.php?rid=5570579&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F36%2F1%2F1%3Frss%3D1 This article describes the intended benefits of the reforms for bereaved relatives, coroners’ staff, public sector budgets, and the public health, and explores the reasons behind the delays. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5570579 Tue, 03 Jan 2012 05:00:00 +0100 5570579 http://www.medworm.com/index.php?rid=5466979&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F479-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466979 Wed, 30 Nov 2011 05:00:00 +0100 5466979 http://www.medworm.com/index.php?rid=5466978&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F479-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466978 Wed, 30 Nov 2011 05:00:00 +0100 5466978 http://www.medworm.com/index.php?rid=5466977&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F479%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466977 Wed, 30 Nov 2011 05:00:00 +0100 5466977 http://www.medworm.com/index.php?rid=5466976&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F478%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466976 Wed, 30 Nov 2011 05:00:00 +0100 5466976 http://www.medworm.com/index.php?rid=5466975&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F476-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466975 Wed, 30 Nov 2011 05:00:00 +0100 5466975 http://www.medworm.com/index.php?rid=5466974&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F476%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466974 Wed, 30 Nov 2011 05:00:00 +0100 5466974 http://www.medworm.com/index.php?rid=5466973&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F475%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466973 Wed, 30 Nov 2011 05:00:00 +0100 5466973 http://www.medworm.com/index.php?rid=5466972&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F474-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466972 Wed, 30 Nov 2011 05:00:00 +0100 5466972 http://www.medworm.com/index.php?rid=5466971&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F474%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466971 Wed, 30 Nov 2011 05:00:00 +0100 5466971 http://www.medworm.com/index.php?rid=5466970&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F473-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466970 Wed, 30 Nov 2011 05:00:00 +0100 5466970 http://www.medworm.com/index.php?rid=5466969&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F473%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466969 Wed, 30 Nov 2011 05:00:00 +0100 5466969 http://www.medworm.com/index.php?rid=5466968&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F468%3Frss%3D1 Aims and method We developed material for a lecture hall teaching programme in child and adolescent psychiatry for medical students. Although lecture hall settings are not traditionally seen as conducive to exploring concepts, debating positions and encouraging higher-order thinking, we aimed to integrate these processes into the programme alongside educational theory and teaching strategies. We evaluated student and teacher perception of the new material through questionnaires before and after the introduction of the teaching package. Results Six 1.5-hour teaching sessions were prepared. The evaluation study received 133 student and 4 teacher questionnaires on the previous teaching package, and 99 student and 7 teacher questionnaires on the new material. The questionnaires showed that the... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466968 Wed, 30 Nov 2011 05:00:00 +0100 5466968 http://www.medworm.com/index.php?rid=5466967&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F466%3Frss%3D1 Over many years and with various pieces of new legislation there are significant gaps in doctors’ knowledge about mental health law. It is time to ensure that doctors know the law and can apply it to the patients they see. Practising legally and not detaining or allowing people to leave hospital inappropriately should be a mandatory part of training for every doctor no matter what the specialty. Medical schools, deaneries, training programme directors and the General Medical Council should take up the challenge and ensure good-quality training for all doctors to ensure good-quality care in this area is given to all patients. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466967 Wed, 30 Nov 2011 05:00:00 +0100 5466967 http://www.medworm.com/index.php?rid=5466966&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F460%3Frss%3D1 Aims and method To assess junior doctors’ knowledge of the procedures involved in involuntary admission of patients detained under Sections 5(2), 2 and 3 of the Mental Health Act 1983. A semi-quantitative research study of junior trainees affiliated to two psychiatry training schemes was carried out. Results Trainees’ knowledge of professionally relevant sections of the Mental Health Act was patchy. Knowledge correlated significantly with experience in clinical practice and with experience of using mental health legislation. Surprisingly, in-service training in mental health legislation had no effect on participants’ knowledge. Clinical implications Lack of knowledge and understanding raises the possibility of inappropriate use of the mental health legislation. This threa... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466966 Wed, 30 Nov 2011 05:00:00 +0100 5466966 http://www.medworm.com/index.php?rid=5466965&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F454%3Frss%3D1 We examined learning outcomes, practice impacts and implementation processes for a training intervention in diagnostic skills delivered to multidisciplinary child and adolescent mental health service practitioners (n = 63). Results Training was viewed positively by most participants and associated with significant increases in practitioner self-efficacy, with the effect sustained at 8-month follow-up. A comparative audit before and after training indicated that clinicians were significantly more likely to assign an Axis I diagnosis following the training intervention. However, absolute rates of Axis I classification remained relatively low (<40%) both before and after training. Practitioners were moderately successful at following through on personal plans for implementing new learning;... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466965 Wed, 30 Nov 2011 05:00:00 +0100 5466965 http://www.medworm.com/index.php?rid=5466964&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F448%3Frss%3D1 Aims and method A cross-sectional survey was conducted to assess patient knowledge and information provision about opioid substitution treatment among individuals with opiate dependence receiving treatment at four treatment centres in South London. Results In total 118 people were recruited to the study. Participants answered a mean of 14 out of 34 questions assessing a range of factors such as medication, blood-borne viruses and overdose correctly. Participants overestimated their performance on average by almost 40%. Individuals with a history of previous treatments scored significantly higher than those in their first treatment episode. The majority reported having been given written information on most of the topics assessed. Clinical implications The results of this study highlight th... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466964 Wed, 30 Nov 2011 05:00:00 +0100 5466964 http://www.medworm.com/index.php?rid=5466963&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F445%3Frss%3D1 Aims and method Prison mental health inreach teams (PMHITs) were introduced in response to policy from 2003. This provision comes under the responsibility of the National Health Service. Service development and structure was not defined in policy. A total of 97 prisons of an estimated 100 known to have a PMHIT were targeted by postal questionnaire and responses covered 62 prisons. Team structures were captured in the data with specific regard to the number of available professional sessions. Results Findings determine there is generally no correlation between input and prison capacity, although there was some evidence of correlation in the high secure (category A) estate and that the female estate was generally better served. Clinical implications It is evident from this study that PMHITs ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466963 Wed, 30 Nov 2011 05:00:00 +0100 5466963 http://www.medworm.com/index.php?rid=5466962&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F443%3Frss%3D1 Independent sector psychiatrists believe that they work hard for the benefit of vulnerable people. Differences between them and National Health Service colleagues are not clear cut in terms of motivation or quality of care. However, unfair generalisations are made about the diverse ‘private sector’, with selective comparison such as with the worst of US healthcare. Although there are many examples of excellence in the UK state, commercial and charity sectors, global economic changes are bringing risk of care failures from which no area can be immune. We should all be working together to protect our patients from the mistakes of others. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466962 Wed, 30 Nov 2011 05:00:00 +0100 5466962 http://www.medworm.com/index.php?rid=5466961&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F12%2F441%3Frss%3D1 The Health and Social Care Bill currently going through the UK Parliament seeks to further increase cooperation in the English National Health Service (NHS). The proposals are controversial in significant part because the benefits of competition in healthcare are uncertain. Will patients benefit from innovation and choice brought about by new providers of care or will the vulnerable be faced by geographically variable, fragmented and non-integrated services? Will there be financial savings to reinvest in patient care or will there be increased administration driven by the transaction costs of market driven care? This editorial advocates a cautious targeted approach for the implementation of competition in those areas where current NHS provision is poor rather than whole scale potentially d... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5466961 Wed, 30 Nov 2011 05:00:00 +0100 5466961 http://www.medworm.com/index.php?rid=5378549&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F439%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378549 Mon, 31 Oct 2011 04:00:00 +0100 5378549 http://www.medworm.com/index.php?rid=5378548&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F438-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378548 Mon, 31 Oct 2011 04:00:00 +0100 5378548 http://www.medworm.com/index.php?rid=5378547&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F438-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378547 Mon, 31 Oct 2011 04:00:00 +0100 5378547 http://www.medworm.com/index.php?rid=5378546&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F438%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378546 Mon, 31 Oct 2011 04:00:00 +0100 5378546 http://www.medworm.com/index.php?rid=5378545&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F437%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378545 Mon, 31 Oct 2011 04:00:00 +0100 5378545 http://www.medworm.com/index.php?rid=5378544&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F436%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378544 Mon, 31 Oct 2011 04:00:00 +0100 5378544 http://www.medworm.com/index.php?rid=5378543&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F434-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378543 Mon, 31 Oct 2011 04:00:00 +0100 5378543 http://www.medworm.com/index.php?rid=5378542&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F434%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378542 Mon, 31 Oct 2011 04:00:00 +0100 5378542 http://www.medworm.com/index.php?rid=5378541&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F432-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378541 Mon, 31 Oct 2011 04:00:00 +0100 5378541 http://www.medworm.com/index.php?rid=5378540&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F432-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378540 Mon, 31 Oct 2011 04:00:00 +0100 5378540 http://www.medworm.com/index.php?rid=5378539&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F432%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378539 Mon, 31 Oct 2011 04:00:00 +0100 5378539 http://www.medworm.com/index.php?rid=5378538&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F431-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378538 Mon, 31 Oct 2011 04:00:00 +0100 5378538 http://www.medworm.com/index.php?rid=5378537&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F431%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378537 Mon, 31 Oct 2011 04:00:00 +0100 5378537 http://www.medworm.com/index.php?rid=5378536&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F430-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378536 Mon, 31 Oct 2011 04:00:00 +0100 5378536 http://www.medworm.com/index.php?rid=5378535&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F430%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378535 Mon, 31 Oct 2011 04:00:00 +0100 5378535 http://www.medworm.com/index.php?rid=5378534&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F425%3Frss%3D1 Aims and method This cross-sectional study investigated the evolution of intentions among medical students to pursue a career in psychiatry and the factors that might discourage them from becoming a psychiatrist. A questionnaire survey was sent to medical students in years 1-5 at Aberdeen University. Results From 918 students, 467 (51%) returned useable responses. Proportions of students across the 5-year groups who definitely or probably intended to become psychiatrists remained fairly stable at 4-7%. In their final year, psychiatry remained a possible career option for a further 17% of students. The most potent discouraging factor was the perception of poor prognoses among psychiatric patients. Perceptions of a lack of scientific/evidence base reduced enthusiasm for becoming a psychiatri... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378534 Mon, 31 Oct 2011 04:00:00 +0100 5378534 http://www.medworm.com/index.php?rid=5378532&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F419%3Frss%3D1 We describe our systematic review of psychiatric WPBAs, including a ‘surgical dissection’ of their format and process. From our review, we identified seven overarching WPBA themes, and have drawn on these to make further recommendations to strengthen the wider acceptability of WPBAs in psychiatric settings. We hope this will encourage further debate on ways of improving these tools, rather than them becoming side-lined as ‘top-down’ tick-box exercises. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378532 Mon, 31 Oct 2011 04:00:00 +0100 5378532 http://www.medworm.com/index.php?rid=5378531&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F413%3Frss%3D1 Risk assessment has been widely adopted in mental health settings in the hope of preventing harms such as violence to others and suicide. However, risk assessment in its current form is mainly concerned with the probability of adverse events, and does not address the other component of risk - the extent of the resulting loss. Although assessments of the probability of future harm based on actuarial instruments are generally more accurate than the categorisations made by clinicians, actuarial instruments are of little assistance in clinical decision-making because there is no instrument that can estimate the probability of all the harms associated with mental illness, or estimate the extent of the resulting losses. The inability of instruments to distinguish between the risk of common but l... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378531 Mon, 31 Oct 2011 04:00:00 +0100 5378531 http://www.medworm.com/index.php?rid=5378530&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F408%3Frss%3D1 Aims and method To investigate the complementarities of staff and service users’ experiences of shame in psychiatric in-patient settings. Qualitative methods were used by means of focus group interviews in two compositions - staff and service users. Data were transcribed and thematically analysed. Results Service user group transcripts revealed four prominent themes: ‘loss of value’, ‘loss of adulthood and autonomy’, ‘loss of subjectivity’ and ‘shaming or blaming of others’. Staff group transcripts also revealed two themes one of which overlapped with service users (‘shaming or blaming of others’) and one of which was distinct (‘entrapment’). Clinical implications Shame processes may be elicited by caregiving and... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378530 Mon, 31 Oct 2011 04:00:00 +0100 5378530 http://www.medworm.com/index.php?rid=5378529&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F404%3Frss%3D1 Aims and method Tackling discrimination, stigma and inequalities in mental health is a major UK government objective yet people with intellectual disability (also known as learning disability in UK health services) continue to suffer serious stigma and discrimination. We examine the effect of viewing pictures of a person with intellectual disability on stigmatised attitudes. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes. Members of the general public were randomised to complete the questionnaire having looked at a good (attractive) or bad (unattractive) photograph of a person with intellectual disability. Results Questionnaires were received from 187 participants (response rate 74%). The mean AMIQ stigma score for the bad photo group ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378529 Mon, 31 Oct 2011 04:00:00 +0100 5378529 http://www.medworm.com/index.php?rid=5378528&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F11%2F401%3Frss%3D1 In this editorial we look at the implications of organisational changes to the National Health Service and financial constraints on addiction psychiatrists, and how creativity and adaptability could be the key to fostering survival and sustainability of subspecialties in danger of extinction. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5378528 Mon, 31 Oct 2011 04:00:00 +0100 5378528 http://www.medworm.com/index.php?rid=5271272&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F400%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271272 Fri, 30 Sep 2011 04:00:00 +0100 5271272 http://www.medworm.com/index.php?rid=5271271&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F399-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271271 Fri, 30 Sep 2011 04:00:00 +0100 5271271 http://www.medworm.com/index.php?rid=5271270&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F399%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271270 Fri, 30 Sep 2011 04:00:00 +0100 5271270 http://www.medworm.com/index.php?rid=5271269&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F398%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271269 Fri, 30 Sep 2011 04:00:00 +0100 5271269 http://www.medworm.com/index.php?rid=5271268&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F397%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271268 Fri, 30 Sep 2011 04:00:00 +0100 5271268 http://www.medworm.com/index.php?rid=5271267&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F396%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271267 Fri, 30 Sep 2011 04:00:00 +0100 5271267 http://www.medworm.com/index.php?rid=5271266&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F395%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271266 Fri, 30 Sep 2011 04:00:00 +0100 5271266 http://www.medworm.com/index.php?rid=5271265&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F394-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271265 Fri, 30 Sep 2011 04:00:00 +0100 5271265 http://www.medworm.com/index.php?rid=5271264&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F394%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271264 Fri, 30 Sep 2011 04:00:00 +0100 5271264 http://www.medworm.com/index.php?rid=5271263&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F389%3Frss%3D1 Aims and method We explored the views of foundation doctors on psychiatry placements to inform further post development. Following criticism of some South Thames Foundation School (STFS) psychiatry placements, STFS staff reviewed existing information on post quality and 21 foundation doctors in psychiatry posts took part in three focus groups. Results Trainees are concerned about the general quality of posts (including supervision and induction); isolation of mental health trusts from ‘acute’ trusts; the professional position of junior psychiatrists; and responsibilities related to the Mental Health Act and risk assessment. Requirements for posts to address these issues have been developed and are now being implemented locally. Clinical implications The conclusions are relevant... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271263 Fri, 30 Sep 2011 04:00:00 +0100 5271263 http://www.medworm.com/index.php?rid=5271262&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F384%3Frss%3D1 Aims and method To examine the association between the use of cholinesterase inhibitors (ChEIs) and time to care home placement. We compared patients who were prescribed ChEIs in 2006 with those who were not with respect to their placement in care homes over a 4-year period, using survival analysis. Results During the first 30 months of follow-up there was a delay in care home placement by a median of 12 months in those who took ChEIs compared with those who did not. However, at the end of the follow-up there was no significant reduction in the probability of being in a care home setting between those who had taken ChEIs compared with those who had not (hazard ratio 0.75, 95% CI 0.25-6, P = 0.1). Clinical implications The study provides some evidence to suggest that prescribing ChEIs may b... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271262 Fri, 30 Sep 2011 04:00:00 +0100 5271262 http://www.medworm.com/index.php?rid=5271261&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F380%3Frss%3D1 Aims and method To appraise the value of additional information from objective measurements (QbTest system) in the clinical assessment of children and adolescents with attention-deficit hyperactivity disorder (ADHD). Two groups of ADHD assessments were compared. In the first group, assessments were undertaken without objective measures, whereas in the second group objective measures were added to the assessment. Practice outcomes were followed up over 1 year. Results Objective measures improve differentiating between ADHD and other conditions whose symptoms are known to overlap with ADHD. Objective measurements reduce the risk of unidentified ADHD (P<0.0035) as measured by subsequent rates of revised diagnosis over a 12-month period. Clinical implications Introducing objective measureme... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271261 Fri, 30 Sep 2011 04:00:00 +0100 5271261 http://www.medworm.com/index.php?rid=5271260&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F374%3Frss%3D1 Aims and method The provision of 24-hour specialist child and adolescent mental health services (CAMHS) is a key target for service commissioners. However, a lack of data exist on models of service delivery or levels of need for out-of-hours specialist CAMHS to guide service development. We aim to describe a model of 24-hour service provision and provide information on the demand for and outcome of assessments of a service in Dublin, Ireland, using a 6-year retrospective case study design. Results A total of 468 emergency presentations occurred during the study period; 80% presented with self-harm or suicidal ideation. Two-thirds presented outside of working hours. All presentations received a specialist CAMHS consultation. Over 50% required admission to a paediatric ward and 80% required ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271260 Fri, 30 Sep 2011 04:00:00 +0100 5271260 http://www.medworm.com/index.php?rid=5271259&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F370%3Frss%3D1 Aims and method Tackling discrimination, stigma and inequalities in mental health is a major objective of the UK government. The project aimed to determine the effect of presenting a person with a mental illness as having either a biological illness or a disorder that arose from psychosocial stress to a randomised representative panel of members of the general public. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes. Results Overall, 187 individuals returned their questionnaires (74% response rate). The mean AMIQ stigma score for the ‘ill’ group was 1.4 (s.e. = 0.3; n = 94). The mean AMIQ score for the ‘stress’ group was 0.5 (s.e. = 0.3; median n = 106; P = 0.0837, median difference = 1; power (for 5% significance... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271259 Fri, 30 Sep 2011 04:00:00 +0100 5271259 http://www.medworm.com/index.php?rid=5271258&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F368%3Frss%3D1 A generation of digital natives are living their lives in fundamentally different ways from previous generations. The rapid advance of the internet and mobile telephones, and the adoption of online social media, mean that substantial parts of the social lives of young people are played out in online settings. This has implications for how young people discuss and seek help for mental health problems. This commentary discusses the role of online forums for young people who self-harm. Practitioners need to understand the potential harms and benefits, and explore how benefits can be harnessed and harms minimised. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271258 Fri, 30 Sep 2011 04:00:00 +0100 5271258 http://www.medworm.com/index.php?rid=5271257&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F364%3Frss%3D1 Aims and method To explore what young people who self-harm think about online self-harm discussion forums. SharpTalk was set up to facilitate shared learning between health professionals and young people who self-harm. We extracted themes and illustrative statements from the online discussion and asked participants to rate statements. Results Of 77 young people who participated in the forum, 47 completed the questionnaire. They said they learned more about mental health issues from online discussion forums than from information sites, found it easier to talk about self-harm to strangers than to family or friends, and preferred to talk online than face-to-face or on the telephone. They valued the anonymity the forums provided and reported feeling more able to disclose and less likely to be ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271257 Fri, 30 Sep 2011 04:00:00 +0100 5271257 http://www.medworm.com/index.php?rid=5271256&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2F361%3Frss%3D1 Blogs have become increasingly popular over the past 15 years, especially with young people. In this editorial we discuss how the blogosphere is reshaping information exchange in healthcare. More specifically, blogs may change the doctor-patient relationship and provide clinically relevant information to mental health practitioners. However, the use of blogs as a source of clinical material raises ethical and legal issues. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271256 Fri, 30 Sep 2011 04:00:00 +0100 5271256 http://www.medworm.com/index.php?rid=5271255&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F10%2Fibc%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5271255 Fri, 30 Sep 2011 04:00:00 +0100 5271255 http://www.medworm.com/index.php?rid=5181367&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F360%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181367 Wed, 31 Aug 2011 23:00:00 +0100 5181367 http://www.medworm.com/index.php?rid=5181366&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F359%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181366 Wed, 31 Aug 2011 23:00:00 +0100 5181366 http://www.medworm.com/index.php?rid=5181365&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F358%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181365 Wed, 31 Aug 2011 23:00:00 +0100 5181365 http://www.medworm.com/index.php?rid=5181364&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F357-c%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181364 Wed, 31 Aug 2011 23:00:00 +0100 5181364 http://www.medworm.com/index.php?rid=5181363&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F357-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181363 Wed, 31 Aug 2011 23:00:00 +0100 5181363 http://www.medworm.com/index.php?rid=5181362&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F357-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181362 Wed, 31 Aug 2011 23:00:00 +0100 5181362 http://www.medworm.com/index.php?rid=5181361&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F357%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181361 Wed, 31 Aug 2011 23:00:00 +0100 5181361 http://www.medworm.com/index.php?rid=5181360&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F356%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181360 Wed, 31 Aug 2011 23:00:00 +0100 5181360 http://www.medworm.com/index.php?rid=5181359&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F355-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181359 Wed, 31 Aug 2011 23:00:00 +0100 5181359 http://www.medworm.com/index.php?rid=5181358&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F355%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181358 Wed, 31 Aug 2011 23:00:00 +0100 5181358 http://www.medworm.com/index.php?rid=5181357&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F354-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181357 Wed, 31 Aug 2011 23:00:00 +0100 5181357 http://www.medworm.com/index.php?rid=5181356&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F354%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181356 Wed, 31 Aug 2011 23:00:00 +0100 5181356 http://www.medworm.com/index.php?rid=5181355&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F350%3Frss%3D1 Aims and method An online survey was used to examine the attitudes of clinical, academic and trainee psychiatrists on the delivery of undergraduate education and why students are not choosing psychiatry as a career. This paper explores whether attitudes to teaching psychiatry to medical students is a factor in poor recruitment to the specialty. Results Overall, 390 psychiatrists completed the survey. All groups were highly committed to psychiatry education, but there were significant differences in attitudes that may have an impact on the delivery of medical student teaching, which in turn may influence recruitment. Five major themes emerged from the survey, the most dominant being stigmatisation of psychiatric patients and professionals by the medical profession. These divergent attitudes... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181355 Wed, 31 Aug 2011 23:00:00 +0100 5181355 http://www.medworm.com/index.php?rid=5181354&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F344%3Frss%3D1 Aims and method A group of lawyers, psychiatrists, best interest assessors and independent mental capacity advocates were asked to make binary judgements about whether real-life situations in 12 vignettes amounted to deprivation of liberty. Kappa coefficients were calculated to describe the level of agreement within each professional group and for the total group of professionals. Results There was total agreement between all professionals about deprivation of liberty in only 1 of the 12 cases. The overall level of agreement for judgements made by all professionals was ‘slight’ (=0.16, P<0.01). Clinical implications There are practical difficulties involved in making reliable deprivation of liberty judgements within the Deprivation of Liberty Safeguards (DoLS) legislation. A... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181354 Wed, 31 Aug 2011 23:00:00 +0100 5181354 http://www.medworm.com/index.php?rid=5181353&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F339%3Frss%3D1 Aims and method To examine the effects of implementing the individual placement and support (IPS) approach within four community mental health teams (CMHTs). Demographic, clinical and vocational data were collected through a repeated cross-sectional survey. Additionally, a service user experience survey was conducted. Results The IPS approach appears to have a significant effect on the employment rates of service users; a higher proportion felt able to return to employment and a smaller proportion believed they were unable to work because of their mental health problems. Employment rates for service users appear to be independent of general employment rates. Clinical implications Implementing IPS appears to increase the employment rates in CMHTs resulting in increased service user expectat... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181353 Wed, 31 Aug 2011 23:00:00 +0100 5181353 http://www.medworm.com/index.php?rid=5181352&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F334%3Frss%3D1 We question whether adult attention-deficit hyperactivity disorder (ADHD) represents a discrete condition that is distinguishable from ordinary behaviour and other psychiatric disorders, and whether it is related to the childhood disorder, since adult and childhood ADHD are said to be characterised by a different range of symptoms. Although studies of stimulant drugs find marginal short-term effects, which can be explained by their known psychoactive properties, there is little evidence that there are any sustained long-term benefits of drug therapy. We suggest that adult ADHD represents one of the latest attempts to medicalise ordinary human difficulties, and that its popularity is partly dependent on marketing and the reinforcing effects of stimulants. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181352 Wed, 31 Aug 2011 23:00:00 +0100 5181352 http://www.medworm.com/index.php?rid=5181351&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F328%3Frss%3D1 Aims and method To ascertain the views and experiences of psychiatrists in England and Wales regarding community treatment orders (CTOs). We mailed 1928 questionnaires to members of the Royal College of Psychiatrists. Results In total, 566 usable surveys were returned, providing a 29% response rate. Respondents were generally positive about the introduction of the new powers, more so than in previous UK studies. They reported that their decision-making regarding compulsion was based largely on clinical grounds. Clinical implications In the absence of research evidence or a professional consensus about the use of CTOs, multidisciplinary input in decision-making is essential. Further research and training are urgently needed. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181351 Wed, 31 Aug 2011 23:00:00 +0100 5181351 http://www.medworm.com/index.php?rid=5181350&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F325%3Frss%3D1 Aims and method To evaluate the characteristics of individuals seeking gender reassignment, the frequency of subsequent referrals to a specialist centre, and funding approval. Cases were identified from a local referrals database and data were extracted from case notes. Results Fifty-four individuals attended for assessment; 70% were biological males and 30% were biological females. Mean age at referral was significantly different between the two groups. Over half were taking hormone supplementation and three had already had surgery. Further, 24% had a current and 30% a past mental illness. The majority of individuals were referred to a specialist centre for gender reassignment but only two had funding for surgery approved. Paedophilia was a rare but concerning finding. Clinical implicatio... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181350 Wed, 31 Aug 2011 23:00:00 +0100 5181350 http://www.medworm.com/index.php?rid=5181349&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2F321%3Frss%3D1 Thousands of papers have been published on the biological associations with psychosis yet this has had a limited impact on the routine clinical care of people with psychosis. Cognitive dysfunction, genetics and neuroimaging are the research areas likely to integrate into clinical practice in psychosis most rapidly. Clinical and academic collaborations in partnership with patients and carers are necessary to make progress, along with an acceptance that not all new approaches will necessarily prove effective in the longer term. Most discoveries do not just jump from bench to bedside, but require active interactions between scientists and clinicians. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181349 Wed, 31 Aug 2011 23:00:00 +0100 5181349 http://www.medworm.com/index.php?rid=5181348&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F9%2Fibc%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5181348 Wed, 31 Aug 2011 23:00:00 +0100 5181348 http://www.medworm.com/index.php?rid=5085942&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F320-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085942 Sun, 31 Jul 2011 23:00:00 +0100 5085942 http://www.medworm.com/index.php?rid=5085941&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F320%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085941 Sun, 31 Jul 2011 23:00:00 +0100 5085941 http://www.medworm.com/index.php?rid=5085940&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F319%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085940 Sun, 31 Jul 2011 23:00:00 +0100 5085940 http://www.medworm.com/index.php?rid=5085939&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F317-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085939 Sun, 31 Jul 2011 23:00:00 +0100 5085939 http://www.medworm.com/index.php?rid=5085938&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F317%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085938 Sun, 31 Jul 2011 23:00:00 +0100 5085938 http://www.medworm.com/index.php?rid=5085937&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F316-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085937 Sun, 31 Jul 2011 23:00:00 +0100 5085937 http://www.medworm.com/index.php?rid=5085936&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F316%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085936 Sun, 31 Jul 2011 23:00:00 +0100 5085936 http://www.medworm.com/index.php?rid=5085935&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F315-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085935 Sun, 31 Jul 2011 23:00:00 +0100 5085935 http://www.medworm.com/index.php?rid=5085934&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F315-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085934 Sun, 31 Jul 2011 23:00:00 +0100 5085934 http://www.medworm.com/index.php?rid=5085933&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F315%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085933 Sun, 31 Jul 2011 23:00:00 +0100 5085933 http://www.medworm.com/index.php?rid=5085932&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F314-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085932 Sun, 31 Jul 2011 23:00:00 +0100 5085932 http://www.medworm.com/index.php?rid=5085931&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F314-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085931 Sun, 31 Jul 2011 23:00:00 +0100 5085931 http://www.medworm.com/index.php?rid=5085930&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F314%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085930 Sun, 31 Jul 2011 23:00:00 +0100 5085930 http://www.medworm.com/index.php?rid=5085929&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F308%3Frss%3D1 Aims and method To evaluate the effectiveness of two psychodynamic psychotherapy teaching methods, a student psychotherapy scheme (SPS) and participation in a Balint group, in teaching first-year clinical medical students about doctor-patient communication and the doctor-patient relationship. The 28 students, who were randomly allocated to three groups (SPS group, Balint group starting at baseline and Balint group starting at 3 months and acting as partial controls), were rated on a questionnaire testing their knowledge of emotional and psychodynamic aspects of the doctor-patient relationship administered at baseline, at 3 months and at 1 year. Results At 3 months, students in the SPS and Balint groups scored higher than the partial control group, the difference approaching significance at... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085929 Sun, 31 Jul 2011 23:00:00 +0100 5085929 http://www.medworm.com/index.php?rid=5085928&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F305%3Frss%3D1 We examined the effect on civil sections and the rate of appeals against them of the amendments made to the Mental Health Act 1983 as a result of the Mental Health Act 2007. We gathered data for the year before and after the introduction of these changes. Results We found increased use of Section 2 (56.8% before and 65.8% after (P < 0.001)) and decreased use of Section 3 (39.5% before and 31.2% after (P < 0.001)). The number of appeals against civil sections decreased (697 before and 692 after) but there was an 8.0% increase in the proportion of appeals to mental health tribunals. There was a decrease in admissions under these sections (817 before and 733 after). Clinical implications These changes may be unintended consequences of the new law, resulting in increased workloads for ps... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085928 Sun, 31 Jul 2011 23:00:00 +0100 5085928 http://www.medworm.com/index.php?rid=5085927&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F301%3Frss%3D1 If many patients having multiple difficulties are to receive the integral and efficient psychotherapies they require, they need attention from psychiatrists who have specialised training in psychotherapy. This paper sets out the roles to which existing holders of the Certificate of Completion of Training have already moved to, as they work with patients, families, teams and organisations. The General Medical Council has recognised that the understanding of medical psychotherapists is also vital to the future clinical teaching of all psychiatric trainees. This paper summarises key components of the knowledge and roles of future specialists in medical psychotherapy. It recommends that the term ‘medical psychotherapy’ be used widely to clearly differentiate psychiatrists with this... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085927 Sun, 31 Jul 2011 23:00:00 +0100 5085927 http://www.medworm.com/index.php?rid=5085926&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F297%3Frss%3D1 I examine here the activity of ‘unsolicited diagnosis’ of psychiatric disorder - the act of informing a person that they show signs and symptoms of mental disorder, outside of a patient-professional relationship. Whether unsolicited psychiatric diagnosis is a legitimate ethical activity for psychiatrists (and other healthcare professionals) in which to engage is an issue founded upon the trade-off between potential benefits and harm to the recipient of the diagnosis. However, potential harm specific to a psychiatric diagnosis (such as issues related to stigma, confidentiality and paternalism) suggests that making unsolicited diagnoses of psychiatric disorder is even more ethically fraught than making unsolicited diagnoses of physical disorder. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085926 Sun, 31 Jul 2011 23:00:00 +0100 5085926 http://www.medworm.com/index.php?rid=5085925&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F293%3Frss%3D1 Aims and method To systematically review the published literature with respect to formulating a dose-response curve for flupentixol decanoate. A systematic literature search using the Cochrane Database was performed for studies that published both dosage information and data on relapse rates. Results The data showed modest effects of dose on survival rates. Increasing dose may be associated with increased survival rates up to around 50-60 mg of flupentixol decanoate every 4 weeks. There was no evidence of increased survival rates at higher doses and higher doses may be associated with lower rates of survival. There is considerable uncertainty as to the true effects of dose of flupentixol decanoate on relapse rates. Clinical implications There is no evidence that survival rates improve for ... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085925 Sun, 31 Jul 2011 23:00:00 +0100 5085925 http://www.medworm.com/index.php?rid=5085924&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F288%3Frss%3D1 Aims and method To determine the extent of prescribed antipsychotic polypharmacy and high-dose antipsychotics at the time of discharge from an acute psychiatric ward. Copies of discharge summaries for patients between the ages of 18 and 65 were examined; only those that had antipsychotic medications at the time of discharge were included. Names and doses of antipsychotics and all other medications concurrently prescribed were recorded. Results A total of 651 discharge summaries were included in the study. Nearly a quarter of individuals were discharged on one antipsychotic as the only medication to take home; only 6.8% were discharged on a high-dose antipsychotic and of those on combinations 59.6% were on depot medications. Combining antipsychotics significantly predicted the use of high d... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085924 Sun, 31 Jul 2011 23:00:00 +0100 5085924 http://www.medworm.com/index.php?rid=5085923&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F283%3Frss%3D1 This study aimed to ascertain whether there was an association between perceived support shortly after the 2004 Indian Ocean tsunami and later mental health symptoms in those affected, and to explore the factors associated with this. A survey, semi-structured interviews and focus group were used to explore the experiences and perceptions of 116 individuals severely affected by the tsunami. Results Agency or official support was perceived as poor overall. Perceived ineffectiveness of support available within a few days after the tsunami was associated with increased symptoms of post-traumatic stress disorder 15-19 months later. The strongest themes that emerged from our study were that support provided in a humane manner was perceived as effective and that uncoordinated support, poor commun... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085923 Sun, 31 Jul 2011 23:00:00 +0100 5085923 http://www.medworm.com/index.php?rid=5085922&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F8%2F281%3Frss%3D1 Mitchell discusses the moral responsibilities of psychiatrists who, when outside professional settings, suspect that a person might benefit from psychiatric help. Is making an unsolicited psychiatric diagnosis ever the right thing to do? The American Psychiatric Association’s guidance is that it is not, unless the psychiatrist has been granted authorisation. Although sensitive to harms from ‘unsolicited diagnoses’, Mitchell argues that this guidance is too blunt: the benefits may outweigh the harms. We foresee, however, the possibility that psychiatrists may become pressured to make unsolicited diagnoses to protect or improve society rather than serve the best interests of the individual. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=5085922 Sun, 31 Jul 2011 23:00:00 +0100 5085922 http://www.medworm.com/index.php?rid=4992408&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F280%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992408 Wed, 29 Jun 2011 23:00:00 +0100 4992408 http://www.medworm.com/index.php?rid=4992407&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F279%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992407 Wed, 29 Jun 2011 23:00:00 +0100 4992407 http://www.medworm.com/index.php?rid=4992406&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F278%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992406 Wed, 29 Jun 2011 23:00:00 +0100 4992406 http://www.medworm.com/index.php?rid=4992405&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F277-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992405 Wed, 29 Jun 2011 23:00:00 +0100 4992405 http://www.medworm.com/index.php?rid=4992404&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F277%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992404 Wed, 29 Jun 2011 23:00:00 +0100 4992404 http://www.medworm.com/index.php?rid=4992403&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F276-b%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992403 Wed, 29 Jun 2011 23:00:00 +0100 4992403 http://www.medworm.com/index.php?rid=4992402&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F276-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992402 Wed, 29 Jun 2011 23:00:00 +0100 4992402 http://www.medworm.com/index.php?rid=4992401&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F276%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992401 Wed, 29 Jun 2011 23:00:00 +0100 4992401 http://www.medworm.com/index.php?rid=4992400&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F275-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992400 Wed, 29 Jun 2011 23:00:00 +0100 4992400 http://www.medworm.com/index.php?rid=4992399&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F275%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992399 Wed, 29 Jun 2011 23:00:00 +0100 4992399 http://www.medworm.com/index.php?rid=4992398&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F272%3Frss%3D1 Newly appointed consultants should not ‘simply drift into (medico-legal) work because solicitors have asked them to’. They should already have had expert witness training. This is a challenge for training scheme organisers and consultant trainers. There should be no shortage of training opportunities. Core training should include the preparation of ‘ghost’ reports drafted by trainees but owned by the consultant. Higher training should provide opportunities for trainees to prepare reports in their own right albeit under supervision. Background reading and experience of court are also needed. Such training should avoid newly appointed consultants having to decline solicitors’ requests to prepare psychiatric reports. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992398 Wed, 29 Jun 2011 23:00:00 +0100 4992398 http://www.medworm.com/index.php?rid=4992397&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F269%3Frss%3D1 Medico-legal training received during core and specialist training in psychiatry may not equip a consultant psychiatrist newly appointed in the National Health Service with an ability to decide whether to accept or decline requests to prepare medico-legal reports. This paper draws together some of the key principles, legislation and knowledge which will help guide such decisions. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992397 Wed, 29 Jun 2011 23:00:00 +0100 4992397 http://www.medworm.com/index.php?rid=4992396&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F266%3Frss%3D1 Aims and method To evaluate the effectiveness of the Harrow Assertive Outreach Team in reducing hospital admissions. We compared first- and second-year admissions of a cohort of 76 patients. Results Significant reductions in the number of admissions and number of days admitted were noted in the second year. In the subcohort of patients admitted in both years, the reduction in the number of admissions was significant but reduction in number of days admitted was not. Clinical implications Hospital admissions may be reduced by appointment of consultant psychiatrist and approved mental health practitioner, home treatment approach and intensive case management. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992396 Wed, 29 Jun 2011 23:00:00 +0100 4992396 http://www.medworm.com/index.php?rid=4992395&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F261%3Frss%3D1 The Sexual Offences Act 2003 repealed and revamped almost all of the existing statute law in relation to sexual offences. The purpose of this was to strengthen and modernise the law in this area. Incorporated within the Act were new and specific offences providing for ‘Offences against persons with a mental disorder impeding choice’ and offences involving ‘Inducement, threat or deception to procure sexual activity with a person with a mental disorder’. Psychiatrists may be involved in such cases to provide assessment and opinion as to whether the alleged victim had a mental disorder and because of this lacked the capacity to consent to sexual activity. Knowledge of the intricacies and implementation of these offences against people with mental disorder can aid clini... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992395 Wed, 29 Jun 2011 23:00:00 +0100 4992395 http://www.medworm.com/index.php?rid=4992394&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F256%3Frss%3D1 Aims and method A cross-sectional study aiming to assess the prevalence of trauma and post-traumatic stress disorder (PTSD) in a community substitution treatment sample, and to assess and compare the characteristics of traumatic experience, substance use, and psychological and social factors in those with and without PTSD. All assessments were completed during the interview which took approximately 1.5 h. Results The prevalence for current PTSD was 26.2% and for lifetime PTSD 42.9%. Traumatic experiences were extremely common, with two or more reported by 92.9% of the sample. The two groups differed significantly on the majority of psychological functioning and social variables, with women experiencing higher rates of PTSD and the non-PTSD group having lower rates of psychological impairme... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992394 Wed, 29 Jun 2011 23:00:00 +0100 4992394 http://www.medworm.com/index.php?rid=4992393&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F248%3Frss%3D1 Aims and method To share evaluation findings of a new decentralised mental healthcare system addressing Axis I disorders, developed in four subdistricts of Aceh Besar in Indonesia following the 2004 Asian tsunami. Two complementary methodologies were employed: an adequacy survey that assessed whether agreed programme implementation tasks were completed, and an outcome study that utilised patient, caregiver and staff assessment of the programme to determine what changes, if any, resulted from participation in the programme. Results The system is functional in 3 of 4 subdistricts, and 47 of 53 subdistrict clinics (puskesmas) have trained mental healthcare nurses. Both patients and caregivers reported statistically significant differences when ranking patient well-being and were able to quali... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992393 Wed, 29 Jun 2011 23:00:00 +0100 4992393 http://www.medworm.com/index.php?rid=4992392&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F244%3Frss%3D1 Aims and method A retrospective case-note review was undertaken at five English prisons between June 2008 and March 2009 to estimate the proportion of psychiatric medicines (antidepressants, antipsychotics and hypnotics/anxiolytics) reported at prison reception that are discontinued on entry to prison. Results Of the 1006 records sampled, the review showed that 18% of prisoners had been prescribed psychiatric medication before being placed in custody. Altogether, 240 separate psychiatric medicines were recorded among prisoners at reception. Of these, 47% were not prescribed during the first week of custody. In only 11% of cases where medication was discontinued had psychiatric assessment been completed. Clinical implications Prison mental health policy states that psychiatric medication sh... Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992392 Wed, 29 Jun 2011 23:00:00 +0100 4992392 http://www.medworm.com/index.php?rid=4992391&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F7%2F241%3Frss%3D1 Substance misuse is widespread among individuals with early-phase psychotic disorders and is associated with a worse illness course. Thorough assessment of patterns of substance misuse at admission for psychiatric care is often lacking and can compromise the accuracy of a diagnostic assessment that distinguishes between a primary psychosis and one that is substance induced. Given the risk to recovery from psychosis posed by substance misuse, close monitoring of the course and treatment of early-phase psychosis that is accompanied by substance misuse is indicated and could inform the development of more effective dual-diagnosis treatments. (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4992391 Wed, 29 Jun 2011 23:00:00 +0100 4992391 http://www.medworm.com/index.php?rid=4883323&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F6%2F240%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4883323 Mon, 30 May 2011 23:00:00 +0100 4883323 http://www.medworm.com/index.php?rid=4883322&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F6%2F239%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4883322 Mon, 30 May 2011 23:00:00 +0100 4883322 http://www.medworm.com/index.php?rid=4883321&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F6%2F238-a%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4883321 Mon, 30 May 2011 23:00:00 +0100 4883321 http://www.medworm.com/index.php?rid=4883320&cid=s_27158_172_f&fid=27158&url=http%3A%2F%2Fpb.rcpsych.org%2Fcgi%2Fcontent%2Fshort%2F35%2F6%2F238%3Frss%3D1 (Source: Psychiatric Bulletin) Psychiatric Bulletin journals http://www.medworm.com/rss/comments.php?id=4883320 Mon, 30 May 2011 23:00:00 +0100 4883320