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 'Psychiatry' source. Sat, 30 Jan 2010 16:45:02 +0100 http://www.medworm.com/index.php?rid=3029699&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002146%2Fabstract%3Frss%3Dyes Abstract: The United Nations Convention on the Rights of Persons with Disabilities (CRPD) took effect on 3 May 2008. Here, I survey the content of the CRPD, noting that much of it will buttress existing policy initiatives. It places obligations on states (including the UK) to implement its provisions, which include standard human rights protection, rights to service provision particularly in the community, and protection from exploitation. Amendment of the Mental Health Act 1983 and Mental Capacity Act 2005 will be required to meet these standards. Although some of these changes are consistent with existing policy directions, others on their face provide a direct challenge to how we have thought about mental health law. In particular, the requirement that mental disability can never justif... Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029699 Thu, 26 Nov 2009 16:38:53 +0100 3029699 http://www.medworm.com/index.php?rid=3029698&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002080%2Fabstract%3Frss%3Dyes Abstract: In 2008, Community Treatment Orders (CTOs) became available under the amended Mental Health Act 2007 as a means of supervizing people with severe mental disorders in the community following involuntary hospital stays. The orders were intended to prevent relapse following discharge from hospital by requiring the patient to comply with treatment. Patients can be recalled to hospital should they not comply. The introduction of CTOs has been subject to fierce debate, which is still ongoing. This is, in part, due to a lack of convincing evidence for efficacy. The guidance from the Department of Health and from some NHS Trusts seems to favour CTOs over other means of supporting patients in the community. Early figures indicate that CTOs have already been used extensively, despite a lac... Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029698 Thu, 26 Nov 2009 16:38:53 +0100 3029698 http://www.medworm.com/index.php?rid=3029697&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002158%2Fabstract%3Frss%3Dyes Abstract: The article reviews some of the possible factors, namely the existence of special legal provisions, the facility for compulsory treatment and the role of the media and academic publications, which may contribute to the enhanced perception of risk to others from those with mental disorder and the relative neglect of mentally disordered people as victims of crime. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029697 Thu, 26 Nov 2009 16:38:53 +0100 3029697 http://www.medworm.com/index.php?rid=3029696&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002079%2Fabstract%3Frss%3Dyes Abstract: The Mental Capacity Act Deprivation of Liberty Safeguards have been introduced to provide a framework for people who are, or may become, deprived of their liberty. Here, I describe the background to the legislation and the assessment process that leads to authorisation of deprivation of liberty. I also outline the review and appeal processes and consider some of the challenges that may be associated with implementing the new legislation. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029696 Thu, 26 Nov 2009 16:38:53 +0100 3029696 http://www.medworm.com/index.php?rid=3029695&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002092%2Fabstract%3Frss%3Dyes Abstract: Policies and procedures for ‘adult safeguarding’ aim to protect adults against the harm posed to them by other individuals. In England, safeguarding adults from abuse is a public duty, and psychiatrists have an important role to play in upholding this duty through their involvement in this process. Here, we outline ethical, legal and social issues raised by current procedures for adult safeguarding in England and consider proposals for policy reform alongside parallel developments in the law in Scotland. Addressing these issues adequately involves (a) clarifying who will require the support of safeguarding services, (b) defining the nature of the putative harm they face, (c) determining which interventions are justifiable, and (d) ascertaining the circumstances in which these... Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029695 Thu, 26 Nov 2009 16:38:53 +0100 3029695 http://www.medworm.com/index.php?rid=3029694&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900216X%2Fabstract%3Frss%3Dyes Abstract: The Mental Capacity Act 2005 provides the legal framework within which we must now make decisions for adults who lack capacity to make decisions for themselves. It lays out a statutory test of capacity. If the person lacks capacity, it requires us to make decisions in their ‘best interests’, which means that a range of relevant factors must be considered and weighed up to come to a conclusion as to what is best for the person. The framework allows for others to be consulted and the previously known views of the person themselves to be considered. It also provides protection from liability for routine acts of care or treatment, providing that it can be demonstrated that the acts are in the person's best interests. It will require a change in the way that decisions are made and... Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029694 Thu, 26 Nov 2009 16:38:53 +0100 3029694 http://www.medworm.com/index.php?rid=3029693&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900189X%2Fabstract%3Frss%3Dyes Abstract: The Mental Health Act (1983) and the Mental Capacity Act (2005) (both amended by the Mental Health Act (2007)) together provide a comprehensive framework for the care and treatment of people with a mental disorder in England and Wales. The Mental Health Act relates solely to the treatment of mental disorders whilst the Mental Capacity Act has much wider applicability to decisions surrounding treatment and care where a person lacks capacity. Psychiatrists require a good working knowledge of relevant mental health and mental capacity legislation whatever jurisdiction they work in: here, key legal issues for England and Wales are briefly reviewed. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029693 Thu, 26 Nov 2009 16:38:53 +0100 3029693 http://www.medworm.com/index.php?rid=3029692&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002067%2Fabstract%3Frss%3Dyes Abstract: Mental capacity is a difficult yet fundamental concept that is becoming more influential in psychiatric practice. Assessment of mental capacity for research purposes has proven possible but empirical research into this area is relatively new. I report on empirical studies that have assessed the reliability of capacity assessments and the associations with psychopathology. Such information can help to guide decision-making both at a clinician–patient level and also at a policy level. The decision-making at issue is some of the most fundamental we face in medicine. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029692 Thu, 26 Nov 2009 16:38:53 +0100 3029692 http://www.medworm.com/index.php?rid=3029691&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900202X%2Fabstract%3Frss%3Dyes Abstract: Despite our intuitions, there is no generally agreed definition of criminal responsibility. Here, the relevant English legal background, the mental condition defences, and the main philosophical theories of criminal responsibility are reviewed. The latter are the choice and capacity theories, character theory, agency theory, social theory, and the definitional theory. The psychiatric defences of insanity and diminished responsibility are considered in respect of each of these theories. Although criminal responsibility does not have any explicit role in English criminal law, it does pervade the system, and the problem with the lack of any generally agreed approach is perhaps most starkly exposed when the mental condition defences are contested in court. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029691 Thu, 26 Nov 2009 16:38:53 +0100 3029691 http://www.medworm.com/index.php?rid=3029690&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002031%2Fabstract%3Frss%3Dyes Abstract: Truth-telling has been part of one of the great bioethical shifts of the 20th century, from medical paternalism to respect for patient autonomy. Some argue that there are psychiatric cases where truth-telling is less necessary, however. The three standard justifications for medical deception – that the truth can be anti-therapeutic, that patients don't want to know the truth, and that telling the truth is ultimately impossible – seem to be more compelling in psychiatry, and there are additional justifications that apply when psychiatric patients lack the capacity to make their own decisions. Here, I consider those justifications, and argue that truth-telling is paramount even in psychiatry. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029690 Thu, 26 Nov 2009 16:38:53 +0100 3029690 http://www.medworm.com/index.php?rid=3029689&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002018%2Fabstract%3Frss%3Dyes Abstract: The question of definition of mental disorder and the related question of its boundaries have been, and remain, of crucial importance in many contexts. Two approaches were evident from the beginnings of modern psychiatry approximately 100 years ago: the medical and the psychological models, differing in several critical respects, particularly on whether or not psychiatric conditions are meaningful and understandable, and the related question of whether or not the abnormal is clearly differentiated from the normal. A third approach, the sociological, emphasized the strong connexion between so-called mental disorder and social deviance, and appeared forcefully in the 1960s as critiques of mainstream psychiatry. These controversial issues remain alive, sharpened by major changes sin... Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029689 Thu, 26 Nov 2009 16:38:53 +0100 3029689 http://www.medworm.com/index.php?rid=3029688&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002043%2Fabstract%3Frss%3Dyes Abstract: The Mental Capacity Act 2005 has put the assessment of mental capacity for decision-making at the forefront of psychiatric practice. This capacity is commonly linked within philosophy to (personal) autonomy, that is, to the idea, or ideal, of self-government. However, philosophers disagree deeply about what constitutes autonomy. This contribution brings out how the competing conceptions of autonomy would play out in psychiatric practice, taking anorexia nervosa as a test case. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029688 Thu, 26 Nov 2009 16:38:53 +0100 3029688 http://www.medworm.com/index.php?rid=3029687&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002109%2Fabstract%3Frss%3Dyes After almost a decade of debate, sometimes acrimonious, the Mental Health Act 1983 was amended to create the Mental Health Act (MHA) 2007. The recommendations of the Richardson Committee (1999), set up by the government to ‘scope’ the changes that would ‘modernise’ mental health law by taking account of changes in practice, particularly its community focus, were mostly rejected. What started as a call for a ‘root and branch’ reform ended as a set of amendments, some of which sit uncomfortably with the 1983 Act, and with the Mental Capacity Act (MCA) 2005, passed a little earlier. This was the best the government could achieve in the face of vigorous opposition to two Mental Health Bills (2002 and 2004) from an unprecedented alliance of almost every stakeholder group involved in... Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029687 Thu, 26 Nov 2009 16:38:53 +0100 3029687 http://www.medworm.com/index.php?rid=3029686&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002328%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029686 Thu, 26 Nov 2009 16:38:53 +0100 3029686 http://www.medworm.com/index.php?rid=3029685&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002304%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=3029685 Thu, 26 Nov 2009 16:38:53 +0100 3029685 http://www.medworm.com/index.php?rid=2950615&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002171%2Fabstract%3Frss%3Dyes Psychiatry 2009; 8: 376–381. Unfortunately, in the article Mental ill-health in adults with learning disabilities in part 1 of the Learning Disabilities chapter (October 2009), the first author's biography contained an error: ‘His research interests…’ should have been ‘Her research interests…’. The correct author biography is reproduced here. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950615 Sun, 01 Nov 2009 00:00:00 +0100 2950615 http://www.medworm.com/index.php?rid=2950614&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001645%2Fabstract%3Frss%3Dyes Abstract: Research in mental health learning disabilities has advanced significantly in recent years. Many important papers have helped to change practice and to pursue innovative ideas that cut across the nature/nurture divide. Several new journals have been launched that cover an array of subjects from basic sciences to policy and practice. The advent of evidence-based practice has been slow to develop in mental health learning disabilities but rigorous epidemiological studies and related developments such as the more precise calibration of diagnostic tools have been some of the notable outcomes. The scope of this article, written from the perspective of a clinical academic in the psychiatry of learning disability, is not to report on the whole of the research field in learning disabilit... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950614 Sun, 01 Nov 2009 00:00:00 +0100 2950614 http://www.medworm.com/index.php?rid=2950613&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001682%2Fabstract%3Frss%3Dyes Abstract: Since the 1990s, many publications have provided a description of the status of care for persons with intellectual disability in Europe. This set of documents constitutes a unique case of international description and follow-up of care systems for intellectual disabilities in a single world region. The main information sources on care systems for persons with intellectual disability in Europe are presented with a special focus on projects funded by the European Commission during the past 15 years, which incorporate information on care systems (MEROPE, IDRESNET, POMONA, DECLOC). Following this knowledge base, a set of priorities has been identified as regards to training, care planning and provision, assessment and monitoring, empowerment and other related issues. These European p... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950613 Sun, 01 Nov 2009 00:00:00 +0100 2950613 http://www.medworm.com/index.php?rid=2950612&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001864%2Fabstract%3Frss%3Dyes Abstract: Although psychiatry in the United States owes its origins to the treatment of persons with intellectual disabilities (ID) and developmental disabilities (DD), over the past 50 years, clinical services, education of professionals and research in psychiatry of ID have consistently lagged behind other fields in psychiatry. The historical and contemporary reasons for this development are discussed with recommendations for establishment of a fully credentialed subspecialty of Psychiatry of Intellectual and Developmental Disabilities in the United States. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950612 Sun, 01 Nov 2009 00:00:00 +0100 2950612 http://www.medworm.com/index.php?rid=2950611&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001657%2Fabstract%3Frss%3Dyes Abstract: Specific traumas, such as abuse and bereavement, and overall extent of potentially stressful life experiences are associated with increased levels of a range of behavioural and affective difficulties in people with learning disabilities. Although causality is probably complex and variable across diagnostic groups, evidence for a causal role for life events in the incidence of mental ill-health is growing. Even salient events, however, may not be perceived by carers as relevant to emotional and behavioural disturbance. Preventative strategies including use of social stories may reduce distress when life events can be anticipated. Supportive groupwork and a number of behavioural and cognitive–behavioural interventions offer promising interventions to reduce affective and other sy... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950611 Sun, 01 Nov 2009 00:00:00 +0100 2950611 http://www.medworm.com/index.php?rid=2950610&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001670%2Fabstract%3Frss%3Dyes Abstract: Here, we review the role of carers in general and specifically within the learning disability services. The role of carers is recognized but not always appreciated by the healthcare services despite guidance from the Department of Health and the Royal College of Psychiatrists. Service users in learning disability have complex needs, and carers provide life-long care. Carers have reported positive and negative experiences in their caring role; however, the negative experiences of caring can be minimized by providing better support and education to the carers. The resources available to provide this support are not equally accessible to all carers, e.g. respite care. Carers will have to go through many changes in service provisions. In return for the care they provide, carers would... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950610 Sun, 01 Nov 2009 00:00:00 +0100 2950610 http://www.medworm.com/index.php?rid=2950609&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001694%2Fabstract%3Frss%3Dyes Abstract: Choices, rights and control are aspects of healthcare that most take for granted. For many people with a learning disability, however, these are not a reality, with them being denied choice, their rights and control over the healthcare that they are given. Following on from the Mencap report Death by Indifference, which highlighted some of the shortfalls in the provision of healthcare for people with learning disability, it was the Royal College of Psychiatrist's Service User Group's intention to look into a more personalised account of experiences of accessing healthcare services. To do this, the group garnered the views of the pan-UK membership of the group, asking them about their experiences of healthcare. We wanted them to share both good and bad practice of receiving servic... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950609 Sun, 01 Nov 2009 00:00:00 +0100 2950609 http://www.medworm.com/index.php?rid=2950608&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001700%2Fabstract%3Frss%3Dyes Abstract: Research with representative samples of children with intellectual disabilities and their parents has consistently demonstrated much higher levels of psychopathology and poorer well-being amongst both children with intellectual disabilities and their parents compared with those without intellectual disabilities. Although these differences in psychopathology are often assumed to be an inevitable consequence of the child's intellectual disability and therefore to result in an inherently stressful parenting role, here, we briefly review the research evidence for an alternative proposition, namely that poverty and socio-economic position may play an important part in the development and maintenance of psychopathology in both children with intellectual disabilities and their parents. ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950608 Sun, 01 Nov 2009 00:00:00 +0100 2950608 http://www.medworm.com/index.php?rid=2950607&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002055%2Fabstract%3Frss%3Dyes Abstract: This contribution reviews recent developments in the law and policy of healthcare decision-making by, with and for adults with learning disabilities. In particular, it considers the impact of the Mental Capacity Act 2005 and the reforms outlined in the Department of Health's (2005) White Paper Our Health, Our Care, Our Say: A New Direction for Community Services, and the Local Authority Circular (2008) Transforming Social Care. Pressing issues such as the concept of choice for vulnerable adults and the challenges for professionals in assessing decision-making ability are assumed within these policy frameworks. Other issues, such as the importance of creating time to engage and involve vulnerable adults in decision-making about their health, continue to present challenges for heal... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950607 Sun, 01 Nov 2009 00:00:00 +0100 2950607 http://www.medworm.com/index.php?rid=2950606&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001888%2Fabstract%3Frss%3Dyes Abstract: For many people with learning disabilities, the presence of ill health may impair their ability to achieve the best possible quality of life. The attainment of a good standard of health (at least as good as the rest of the population) is a reasonable goal. Primary care teams are central to the provision of good-quality healthcare. This provision is based on an ability to assess, investigate and manage a range of common and complex conditions, which requires an awareness of the specific needs of this population. The expected health needs of people with learning disabilities in the community and how best to identify and address these needs are described here. These needs include improved access to health promotion, identification of common but unidentified illness and the common co... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950606 Sun, 01 Nov 2009 00:00:00 +0100 2950606 http://www.medworm.com/index.php?rid=2950605&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001669%2Fabstract%3Frss%3Dyes Abstract: Epilepsy, the experience of learning disability and the experience of mental health problems frequently occur in the same individual and can cause severe disadvantage, distress and vulnerability to the individual, together with a burden of care on families or carers. The challenges posed to clinicians include unpicking the complexities involved in understanding symptoms and presentations as well as the very limited evidence-based guiding management strategies. While evidence for service provision, care giving, and specific treatments is very limited, there are some themes that emerge from a review of the literature. The evidence that does exist indicates that the combination of these experiences is common, and attention must be paid to individual circumstances if one is to effect... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950605 Sun, 01 Nov 2009 00:00:00 +0100 2950605 http://www.medworm.com/index.php?rid=2950604&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001876%2Fabstract%3Frss%3Dyes This second part of the Learning Disability chapter is mainly dedicated to service issues and a perspective beyond the UK. We have now had a revised edition of Valuing People (DH, 2001), Valuing People Now (DH, 2009), and the results of an enquiry into access to healthcare of people with learning disabilities (DH, 2008). Both documents advocate greater access to facilities and addressing the barriers that hinder the full integration of a person with learning disabilities. It is shocking to think that, in the 21st century, we are still confronted by examples of unacceptable care standards for people with learning disabilities, but it is also important to recognize successes where and when they occur. It is often at conferences abroad, when I hear colleagues lament the lack of specialist se... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950604 Sun, 01 Nov 2009 00:00:00 +0100 2950604 http://www.medworm.com/index.php?rid=2950603&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002201%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950603 Sun, 01 Nov 2009 00:00:00 +0100 2950603 http://www.medworm.com/index.php?rid=2950602&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309002183%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2950602 Sun, 01 Nov 2009 00:00:00 +0100 2950602 http://www.medworm.com/index.php?rid=2838796&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001438%2Fabstract%3Frss%3Dyes Abstract: Cognitive behavioural therapy (CBT) assumes that psychological disorders are characterized by distorted or dysfunctional thinking, and can be treated by working with the patient to modify thinking in the direction of more realistic or adaptive evaluations of events. CBT has been evaluated extensively and is now the first-line treatment of choice for many psychological disorders. It is increasingly being used with people with learning disabilities, although the evidence base with this population is relatively weak, consisting largely of case studies and case series. There are also controlled trials in anger and depression, for which all published studies report significant clinical improvements that are well maintained over 3–6-month follow-up periods. There are many barriers to... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838796 Mon, 28 Sep 2009 18:46:29 +0100 2838796 http://www.medworm.com/index.php?rid=2838795&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001608%2Fabstract%3Frss%3Dyes Abstract: Psychiatric medications are often used in the treatment of mental disorders as well as for problem behaviours in people with learning disabilities. However, there is little evidence directly relating to people with learning disability, and most treatment decisions and experience of medication are based on research in the general population. Good practice demands that clinicians make every effort to ascertain whether the presenting complaints are those of a diagnosable mental disorder and that there is multidisciplinary support to ameliorate problem behaviours. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838795 Mon, 28 Sep 2009 18:46:29 +0100 2838795 http://www.medworm.com/index.php?rid=2838794&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001475%2Fabstract%3Frss%3Dyes This article promotes positive behavioural support as an over-arching service model, and describes how it can help address the needs of members of this population and those who support them. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838794 Mon, 28 Sep 2009 18:46:29 +0100 2838794 http://www.medworm.com/index.php?rid=2838793&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001396%2Fabstract%3Frss%3Dyes Abstract: The presence of a learning disability in an individual from an ethnic minority group raises several issues that, if not recognized and addressed, can be detrimental to the mental health of the affected individual. Affected individuals have been said to face a double disadvantage, arising from having a learning disability and being from an ethnic minority group. This disadvantage has been largely neglected both in terms of research and service provision. In order to cater effectively for people with learning disabilities from ethnic minority groups, several obstacles have to be recognized and addressed, specifically and deliberately. More research is required in this area. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838793 Mon, 28 Sep 2009 18:46:29 +0100 2838793 http://www.medworm.com/index.php?rid=2838792&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001451%2Fabstract%3Frss%3Dyes Abstract: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder and symptoms often persist in adult life resulting in significant impairment. ADHD is increasingly recognized as occurring in children and adults with learning disability. ADHD symptoms were found to affect everyday life performance and to increase the impairment imposed by the learning disability, suggesting a double vulnerability and indicating the need for treatment. Although treatment of ADHD in this population has not been tested widely and randomized controlled trials are sparse, there is some evidence that pharmacological treatment can be effective. Thorough assessment of ADHD and comorbid conditions, and appropriate management is warranted. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838792 Mon, 28 Sep 2009 18:46:29 +0100 2838792 http://www.medworm.com/index.php?rid=2838791&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001402%2Fabstract%3Frss%3Dyes Abstract: Autism spectrum disorders (ASDs) are characterized by restricted, repetitive behaviour and abnormalities in social interaction and communication. A prevalence rate of ASD of up to 116/10,000 has been reported. The prevalence and range of psychiatric disorders are increased in people with ASD, including those with intellectual disability. Risk factors for psychiatric disorders in this group include genetic factors, communication problems, loneliness and low self-esteem. Mental health problems may be difficult to assess, and range from attention deficit hyperactivity disorder (ADHD) and tic disorders to psychotic and mood disorders, and catatonia. Prevalence of ADHD and tic disorders is increased in people with ASD. While the presentation of depressive and bipolar disorders may be ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838791 Mon, 28 Sep 2009 18:46:29 +0100 2838791 http://www.medworm.com/index.php?rid=2838790&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900144X%2Fabstract%3Frss%3Dyes Abstract: Genetic disorders account for a sizeable proportion of learning disabilities. Several disorders are associated with mental ill-health. The commonest examples of psychiatric morbidity include psychosis, depression and dementia. Here, three examples of chromosomal abnormalities that have significant research evidence are used to discuss the origins and management of mental disorders. Adults with Down syndrome may suffer from mood disorders and dementia, which has a prevalence rate of 32% by 59 years of age. Personality changes and behavioural disorders can signal the onset of dementia. Prader–Willi syndrome (PWS) has a complex genetic aetiology. A characteristic behavioural phenotype has been described for the syndrome, which includes psychiatric and psychological manifestations.... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838790 Mon, 28 Sep 2009 18:46:29 +0100 2838790 http://www.medworm.com/index.php?rid=2838789&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001414%2Fabstract%3Frss%3Dyes Abstract: Epidemiological studies confirm that children and adolescents with learning disabilities are at risk of developing a range of mental health or behavioural problems. The presentation of these problems is complicated by a variety of factors including the child's level of cognitive functioning, diagnostic overshadowing, and psychiatric comorbidities. Expert multidisciplinary assessment is required in order to understand the underlying aetiology of the child's problems and the nature of any psychopathological processes. Appropriate interventions can then be planned and implemented. Child and adolescent mental health services and commissioners need to ensure that a comprehensive package of services is developed for this group of children as any unassessed and untreated problems are li... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838789 Mon, 28 Sep 2009 18:46:29 +0100 2838789 http://www.medworm.com/index.php?rid=2838788&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001426%2Fabstract%3Frss%3Dyes This article describes the mental health problems in older adults with learning disabilities with a focus on dementia, and highlights current evidence-based practice. To date, the main focus of research and service initiatives related to ageing has been on dementia in Down syndrome, despite the fact that a substantial proportion of older people with learning disabilities in general suffer from a variety of health problems. Clinical practice varies considerably within UK, and the link between community learning disability teams and mental health services for older people is not well established in many areas. The clinical challenges are related to a lack of standardized assessment processes and difficulties in carrying out the full range of investigations in some cases. The recently publish... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838788 Mon, 28 Sep 2009 18:46:29 +0100 2838788 http://www.medworm.com/index.php?rid=2838787&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001384%2Fabstract%3Frss%3Dyes Abstract: A learning disability is a lifelong condition. Mental ill-health is common in people with learning disabilities, and several epidemiological studies have shown higher rates of psychiatric disorder in people with learning disabilities compared with the population as a whole. Biological, psychological, and social influences may account for this excess of mental ill-health. Presentation of symptoms differs across the range of learning disabilities. Nevertheless, there are several understudied areas, especially in the epidemiology (prevalence and incidence) of various types of mental disorder and the predictors of those disorders. Further investigation into the aetiology and course of mental ill-health may lead to better care and suitable interventions for this population. (Source: P... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838787 Mon, 28 Sep 2009 18:46:29 +0100 2838787 http://www.medworm.com/index.php?rid=2838786&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001463%2Fabstract%3Frss%3Dyes Abstract: ‘Learning disability’ is a term used in the UK that corresponds to the internationally used ‘mental retardation’. It is determined by low IQ, impaired social adaptation and onset within the developmental period; classification is primarily by IQ. The prevalence of learning disability is rising, mainly due to improved longevity. Several psychiatric disorders are very common among people with learning disability. Promoting the social inclusion of this vulnerable group is one of the greatest challenges to any developed society. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838786 Mon, 28 Sep 2009 18:46:29 +0100 2838786 http://www.medworm.com/index.php?rid=2838785&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900192X%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838785 Mon, 28 Sep 2009 18:46:29 +0100 2838785 http://www.medworm.com/index.php?rid=2838784&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001906%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2838784 Mon, 28 Sep 2009 18:46:29 +0100 2838784 http://www.medworm.com/index.php?rid=2761719&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001219%2Fabstract%3Frss%3Dyes Abstract: The Delivering Race Equality (DRE) in mental health action plan endorses the need for a balanced range of effective therapies including psychotherapeutic and counselling treatments that are culturally appropriate and effective. Cognitive–behavioural therapy (CBT) is a widely used and acceptable therapy for most mental health disorders, but explanations used in CBT are based on Western concepts and illness models. For reasons explained here, CBT remains the psychotherapeutic model of choice across cultures if adapted appropriately. Dissemination of cognitive therapy across widely diverse cultures is increasingly occurring. The evidence to support this is explored as are problems associated with using therapy that is not culturally adapted. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761719 Mon, 31 Aug 2009 23:00:00 +0100 2761719 http://www.medworm.com/index.php?rid=2761718&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001207%2Fabstract%3Frss%3Dyes Abstract: Cultures influence individual identities and cognitive schema that influence the way help is sought and how the inner world of the individual is explored. Help-seeking and sources for help are identified through cultural explanations and expectations. Traditional ego-based psychotherapy may not work with various ethnic and cultural groups. Here, we highlight some of the factors that clinicians must be aware of when providing therapies related to relationships. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761718 Mon, 31 Aug 2009 23:00:00 +0100 2761718 http://www.medworm.com/index.php?rid=2761717&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001141%2Fabstract%3Frss%3Dyes Abstract: Cultural factors play an important role not only at a biological level: the pharmacodynamics and pharmacokinetics of drugs but non-biological factors also play a role. These factors include religious factors, taboos, diet, smoking and expectations from the medication. Some of these factors are described in this paper so that clinicians are aware of response to drugs. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761717 Mon, 31 Aug 2009 23:00:00 +0100 2761717 http://www.medworm.com/index.php?rid=2761716&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001165%2Fabstract%3Frss%3Dyes Abstract: Pathways into psychiatric care are determined by a number of factors. These include cultural explanations of illness, systems of healthcare and resources available. Of these, explanatory models of illness are perhaps the most significant. Patients from ethnic minorities may also feel that they are prejudiced against. Clinicians, therefore, must be aware of potential obstacles into healthcare. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761716 Mon, 31 Aug 2009 23:00:00 +0100 2761716 http://www.medworm.com/index.php?rid=2761715&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001153%2Fabstract%3Frss%3Dyes Abstract: The proportion of ethnic minority individuals over the age of 65 is increasing in the UK. This will lead to a concomitant increase in the absolute number of cases of dementia and depression among ethnic minority elders. The epidemiology of suicide in ethnic minority elders is also changing with some ethnic minority elderly groups at higher risk of suicide than previously thought. Despite the prevalence of dementia and depression being similar or higher in ethnic minority groups than the indigenous group, and ethnic minority elders having high general practice consultation rates, the prevalence of ethnic minority elders in contact with Old Age Psychiatry Services is low. Several factors may explain this discrepancy, including factors related to patients and their families, general... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761715 Mon, 31 Aug 2009 23:00:00 +0100 2761715 http://www.medworm.com/index.php?rid=2761714&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001189%2Fabstract%3Frss%3Dyes Abstract: Here, we provide an overview of the cultural aspects of epidemiological findings and provision of mental health care to people with intellectual disability (ID). The prevalence of intellectual disability may vary between cultural and ethnic groups, but this depends to a large extent on the definition and assessment methods used. Although human-rights-based policies have led to de-institutionalization and community care, stigmatization and discrimination of individuals with ID and health inequalities are common across cultures, which may be associated with the high rates of mental illness in this population. Negative attitudes of mental-health professionals towards those with ID or minority groups may lead to double discrimination and diagnostic overshadowing, and communication is... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761714 Mon, 31 Aug 2009 23:00:00 +0100 2761714 http://www.medworm.com/index.php?rid=2761713&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001177%2Fabstract%3Frss%3Dyes Abstract: The numbers of refugees and asylum seekers shows little sign of decreasing. An increased prevalence of stress-related common mental disorders in these populations is well documented. The causes of these conditions vary according to stresses experienced and the journeys individuals take in their migration to new countries and cultural settings. The mental health practitioner must be informed of the cultural idioms by which suffering is expressed in the refugee's community, the social stigma associated with particular traumatic experiences and with mental illness. Because of their experiences of victimization, refugees may be reluctant to disclose experiences of trauma and, as is typical of common mental disorder worldwide, the presentation of mental distress in the first instance ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761713 Mon, 31 Aug 2009 23:00:00 +0100 2761713 http://www.medworm.com/index.php?rid=2761712&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001190%2Fabstract%3Frss%3Dyes Abstract: The cultivation of the body ideal and promotion of thinness values in fashion, media and the diet industry have been repeatedly shown to account for the increased prevalence of eating disorders. It is evident in women in certain sub-cultures where the demand for thinness for career advancement is endemic. There is also a correlation between eating disorders and the level of modernization and urbanization characteristic of western industrialized societies, linking it to increased social mobility, dietary changes as well as changes within family structures. Eating disorders were, therefore, thought to be unique to the ‘western culture’, an impression that was initially substantiated by the apparent absence of these disorders in non-western societies. However, the notion of the ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761712 Mon, 31 Aug 2009 23:00:00 +0100 2761712 http://www.medworm.com/index.php?rid=2761711&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001104%2Fabstract%3Frss%3Dyes Abstract: The common mental disorders, predominantly anxiety and depression, constitute a significant public health problem and are associated with significant morbidity. When detected, these disorders are managed almost exclusively in primary care. Research into common mental disorders and ethnicity to date raises important questions about the understanding, nature and course of common mental disorders, access to services, treatment received and the perceived value of consulting for emotional problems across cultural groups. It also emphasizes the complex interactions between ethnicity, socioeconomic status, social inclusion, age and sex. Ethnicity is thus one of several important explanatory variables. Much has been written about the development of culturally sensitive services and the d... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761711 Mon, 31 Aug 2009 23:00:00 +0100 2761711 http://www.medworm.com/index.php?rid=2761710&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001116%2Fabstract%3Frss%3Dyes Abstract: Multiple studies performed over the past few decades using various methodologies have reported 5–10-fold incidence rates for schizophrenia in African-Caribbean communities in Europe, findings that hold across generations. Increased incidences of lesser degree have also been reported in other ethnic minority migrant groups in Europe. Various explanations of this phenomenon have been proposed – such as misdiagnosis, differing nature and course of psychotic illness in different ethnic groups, genetics, predisposition to migration, early life influences and later childhood developmental risk factors, drug use, urbanicity, racism, as well as neurobiological factors. They are reviewed here. Relevant literature from North America is also discussed. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761710 Mon, 31 Aug 2009 23:00:00 +0100 2761710 http://www.medworm.com/index.php?rid=2761709&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001128%2Fabstract%3Frss%3Dyes Abstract: All individuals have cultural identity, but this aspect may be more relevant in patients from black and ethnic minority backgrounds. In this paper, some of the key issues are highlighted and suggestions are made for assessment. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761709 Mon, 31 Aug 2009 23:00:00 +0100 2761709 http://www.medworm.com/index.php?rid=2761708&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900113X%2Fabstract%3Frss%3Dyes Abstract: Culture plays an important role in precipitating, perpetuating and preventative factors in relation to any illness. Cultures also determine how individuals seek help and how resources are allocated. Clinicians must be aware of idioms that patients use and explanatory models used by them and their carers to describe their symptoms. Culture influences pathways that patients choose in looking for help. Culturally appropriate interventions are more likely to be accepted. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761708 Mon, 31 Aug 2009 23:00:00 +0100 2761708 http://www.medworm.com/index.php?rid=2761707&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001487%2Fabstract%3Frss%3Dyes Cultural Psychiatry has continued to evolve rapidly with recent research and changes in policy not only in the UK but elsewhere as well. These changes have made it inevitable that the clinicians, no matter where they practice, are aware of the needs of the populations that they serve and have a good working knowledge of the cultures of the patients and families they serve. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761707 Mon, 31 Aug 2009 23:00:00 +0100 2761707 http://www.medworm.com/index.php?rid=2761706&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001736%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761706 Mon, 31 Aug 2009 23:00:00 +0100 2761706 http://www.medworm.com/index.php?rid=2761705&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001712%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2761705 Mon, 31 Aug 2009 23:00:00 +0100 2761705 http://www.medworm.com/index.php?rid=2645127&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000871%2Fabstract%3Frss%3Dyes This article attempts to outline the issues that military veterans commonly present with and describes a model of working with traumatized veterans. The model is a phase-oriented approach to trauma which views stabilization as an essential part of the treatment, moving on to processing the trauma and then reintegration from military to civilian life. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645127 Tue, 28 Jul 2009 12:41:13 +0100 2645127 http://www.medworm.com/index.php?rid=2645126&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000962%2Fabstract%3Frss%3Dyes This article begins with the legal definition of a refugee, an account of the scale of the problem worldwide and in the UK, and proceeds to consider mental health and cultural implications. Assessment and diagnosis should be undertaken in the usual way, but there may be a need to learn more about diverse cultural backgrounds and to work with interpreters in assessment and treatment. In the intervention, a phased approach is often appropriate, engaging different professionals at different stages of treatment. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645126 Tue, 28 Jul 2009 12:41:13 +0100 2645126 http://www.medworm.com/index.php?rid=2645125&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000883%2Fabstract%3Frss%3Dyes This article describes some key issues related to good practice in therapeutic work with children with both simple and complex trauma-related disorders. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645125 Tue, 28 Jul 2009 12:41:13 +0100 2645125 http://www.medworm.com/index.php?rid=2645124&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000895%2Fabstract%3Frss%3Dyes Abstract: In recent years a number of authors have proposed that traumatic events, particularly childhood sexual abuse, can lead to psychotic symptoms or psychotic illness, including schizophrenia. There does appear to be an association, but the research to date has not clearly demonstrated a causal relationship. Traumatic events, like other genetic and environmental influences, can make individuals vulnerable to the development of all types of psychiatric illness, including psychosis. Trauma may well cause psychosis-like symptoms, perhaps through dissociation, but any presumed causal relationship between trauma and psychotic illness may be due to poor understanding of phenomenology, inadequate history-taking and clinical examination, and lack of diagnostic clarity. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645124 Tue, 28 Jul 2009 12:41:13 +0100 2645124 http://www.medworm.com/index.php?rid=2645123&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000913%2Fabstract%3Frss%3Dyes This article reviews the literature and highlights conceptual evolution and differences from simple PTSD, as well as discussing differential diagnoses and clinical management. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645123 Tue, 28 Jul 2009 12:41:12 +0100 2645123 http://www.medworm.com/index.php?rid=2645122&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001098%2Fabstract%3Frss%3Dyes Abstract: Since the last edition of this review, there has been an impressive body of new evidence adding to our knowledge of psychological treatments. There have also been two new major reviews covering the complete range of available treatments: the second edition of the guidelines from the International Society for Traumatic Stress Studies (ISTSS) and the US Institute of Medicine's review. The National Institute for Clinical Excellence (NICE) guidelines were published before the last edition of this article, and there are currently no plans to revise them. However, the Australian guidelines build on the NICE guidelines, and provide the most comprehensive and user-friendly clinical guidance currently available. It is fascinating that such major and thorough reviews have arrived at differ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645122 Tue, 28 Jul 2009 12:41:12 +0100 2645122 http://www.medworm.com/index.php?rid=2645121&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000925%2Fabstract%3Frss%3Dyes This article describes potential methods of early intervention and summarizes the available evidence of their effectiveness. It is argued that there is currently little evidence to support the routine use of preventative interventions, such as psychological debriefing, prophylactic medication or multiple-session preventative psychological interventions. However, there is evidence to support the use of brief trauma-focused cognitive behavioural Intervention for individuals whose traumatic stress symptoms are not improving. There is consensus that interventions that aim to promote safety and connectedness, and address immediate physical and social needs should take priority in the acute phase after disaster. Early psycho-social intervention programmes should ideally be part of coordinated di... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645121 Tue, 28 Jul 2009 12:41:12 +0100 2645121 http://www.medworm.com/index.php?rid=2645120&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000901%2Fabstract%3Frss%3Dyes This article argues that, while emergencies and disasters are distressing for most people and may result in mental disorders for a substantial minority of affected persons at some time in the following months and years, there are personal and collective sources of psychosocial resilience. The concepts, bases, and practical potential of resilience have been explored for more than 40 years. However, studies of pathology, which emphasizes people’s vulnerability over their adaptive capacities, have predominated. The nature and basis of personal psychosocial resilience are outlined, and a new approach to collective resilience that has been developed through recent research on crowd psychology is described. The article concludes with some implications for managing disasters and practice, inclu... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645120 Tue, 28 Jul 2009 12:41:12 +0100 2645120 http://www.medworm.com/index.php?rid=2645119&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000974%2Fabstract%3Frss%3Dyes This article reviews psychological and social theories that have been influential. The most prominent current theories – emotional processing, dual representation, and the cognitive model of PTSD – draw on earlier work, in particular conditioning, information processing, and classical cognitive theory. Psychodynamic and attachment theory have also influenced thinking in this area. The latest theories combine stimulus and response elements with meaning, interpretation, and appraisal; they argue that successful processing depends on being able to access and assimilate new information within pre-existing schemas. Social factors are also recognized as playing a significant role in the development and maintenance of PTSD. These are considered along with the contention that PTSD is a socio-p... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645119 Tue, 28 Jul 2009 12:41:12 +0100 2645119 http://www.medworm.com/index.php?rid=2645118&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000949%2Fabstract%3Frss%3Dyes This article provides an overview of current knowledge in this area. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645118 Tue, 28 Jul 2009 12:41:12 +0100 2645118 http://www.medworm.com/index.php?rid=2645117&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000950%2Fabstract%3Frss%3Dyes Abstract: The history of trauma research is a relatively short one, dating back to the introduction of post-traumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. Whilst the introduction of PTSD has provided a major impetus for the scientific investigations of post-traumatic conditions in a variety of samples, fewer epidemiological studies have been conducted in the general population for both adults and children. Large differences in the lifetime prevalence rates reported for adult exposure to traumatic events (3.9–89.6%) as well as for PTSD (1.0–11.2%) have been observed owing to variations in the design, sampling strategies, and method of diagnostic assessments used. Despite these differences, however, several consistent fi... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645117 Tue, 28 Jul 2009 12:41:12 +0100 2645117 http://www.medworm.com/index.php?rid=2645116&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000937%2Fabstract%3Frss%3Dyes Since its inclusion in the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), in 1980, post-traumatic stress disorder (PTSD) has become a widely recognized psychiatric disorder that appears to be commoner than originally thought. Large epidemiological studies indicate a lifetime prevalence of 5–10%, with females having twice the lifetime prevalence compared with males. The 12-month prevalence rate is probably in the 1–4% range. PTSD causes considerable distress to the individual and those around them, interferes with social, educational, and occupational functioning, and seems to be more difficult to treat over time. It is therefore important to detect and treat PTSD as soon as practicable after a traumatic event. More than 50% of individuals with acute PTS... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645116 Tue, 28 Jul 2009 12:41:12 +0100 2645116 http://www.medworm.com/index.php?rid=2645115&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001517%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645115 Tue, 28 Jul 2009 12:41:12 +0100 2645115 http://www.medworm.com/index.php?rid=2645114&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001499%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2645114 Tue, 28 Jul 2009 12:41:12 +0100 2645114 http://www.medworm.com/index.php?rid=2552883&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900086X%2Fabstract%3Frss%3Dyes Abstract: Physician-assisted suicide (PAS) is the death of an individual that occurs as a result of deliberate, purposive actions taken by that individual, with the assistance of a physician. In the UK, assisting with the death of another individual is illegal, but other parts of the world, such as the state of Oregon in the USA, have laws that permit PAS in certain circumstances. In the Netherlands, PAS may be provided for either physical or psychiatric illness, although requests for PAS emanating from psychiatric practice rarely tend to be granted. PAS, especially in the context of psychiatric illness, raises a range of clinical, ethical, and legal issues for patients, families, healthcare providers. and society at large. Even in jurisdictions where PAS is not provided on the grounds of ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552883 Mon, 29 Jun 2009 16:51:57 +0100 2552883 http://www.medworm.com/index.php?rid=2552882&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000664%2Fabstract%3Frss%3Dyes Abstract: Suicide is one of the leading causes of death globally. Suicide prevention has become a policy priority in many countries. Some countries have implemented national suicide prevention strategies, in line with guidance from the United Nations and the World Health Organization. However, there are still several issues that require further attention in relation to suicide prevention strategies. First, although a growing number of countries have adopted national suicide prevention strategies, suicide prevention is still not a health priority globally. Second, there is an ongoing debate regarding the efficacy and effectiveness of individual interventions. Although evidence on interventions from ‘gold standard’ studies (e.g. randomized controlled trials) is desirable, this is often n... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552882 Mon, 29 Jun 2009 16:51:57 +0100 2552882 http://www.medworm.com/index.php?rid=2552881&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900072X%2Fabstract%3Frss%3Dyes Abstract: Around 100 studies have been conducted to examine the ‘Werther effect’ – the phenomenon whereby there is an increased rate of completed or attempted suicide following the depiction of an individual’s suicide in the media. These ‘media influence studies’ provide strong evidence for the existence of the Werther effect in the news media, and equivocal evidence for its existence in the entertainment media. Having established this, there is now a need to complement these media influence studies with inter-related studies that draw on approaches from a range of disciplines, particularly that of communication. The studies can be thought of as investigating the full spectrum of news and entertainment media processes and content, from how suicide stories are produced (news/ent... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552881 Mon, 29 Jun 2009 16:51:57 +0100 2552881 http://www.medworm.com/index.php?rid=2552880&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000652%2Fabstract%3Frss%3Dyes Abstract: Suicide in prison is a major concern. Previous research showed that the factors associated with prison suicide were being white, male, and on remand. The most common method was asphyxiation, and around half of the suicides occurred in the first month of imprisonment. Most individuals had a history of drug and/or alcohol misuse, had received a psychiatric diagnosis at reception into prison, and several prisoners had secondary diagnoses, suggesting complex mental health needs. The current prison suicide prevention policy aims to monitor risk and plan the care of at-risk individuals using the Assessment, Care in Custody, Teamwork (ACCT) plan, which was fully implemented across the whole prison estate in 2007. The ACCT plan ensures a fast first response and the provision of flexible ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552880 Mon, 29 Jun 2009 16:51:57 +0100 2552880 http://www.medworm.com/index.php?rid=2552879&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001062%2Fabstract%3Frss%3Dyes Abstract: Since earliest recorded times people have attempted and completed suicide. The reasons and methods of suicide show variations across cultures. UK censuses carried out in 2001 revealed that the proportion of the UK population belonging to a non-white minority ethnic group increased, from 3 million to 4.6 million (or 7.9% of the total UK population). This population is diverse in terms of age, education and occupation. Based on available research over the years, an increase in number of suicides, particularly among Asians, has been reported. Social and cultural factors, mainly social integration and religion, play an important part in determining varying rates of suicide. Cross-sectional surveys suggest that factors to do with people's attempts to commit suicide relate to both thei... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552879 Mon, 29 Jun 2009 16:51:57 +0100 2552879 http://www.medworm.com/index.php?rid=2552878&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000688%2Fabstract%3Frss%3Dyes Abstract: Patients with mental illness are at a greatly increased risk of suicide. Approximately 90% of those who die by suicide are suffering from a psychiatric disorder at the time of death. The relationship between mental illness and psychiatric disorder can be investigated by the retrospective collection of detailed information from interviews with informants (psychological autopsy study) or by following up those with mental illness and recording the incidence of suicide (cohort study). Affective disorder is probably associated with the greatest increase in suicide risk. Risk factors for suicide may vary from diagnosis to diagnosis, between age groups, by treatment setting, and by country. Much of what we know about suicide in the mentally ill in the UK is based on data collected for a... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552878 Mon, 29 Jun 2009 16:51:57 +0100 2552878 http://www.medworm.com/index.php?rid=2552877&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000858%2Fabstract%3Frss%3Dyes Abstract: Adolescent suicidal behaviour is a significant public health problem presenting complex challenges to Health and Welfare professionals, which, in some cases, may continue from adolescence into adulthood. Severe and continuing depression, in particular, may serve as one of a number of markers for subsequent, adverse adult outcomes. A comprehensive psycho-social assessment is crucial to identifying and modifying the individual, familial, peer group and wider social contexts in which the behaviour occurs, and helps in formulating strategies for successful therapeutic intervention. As many suicidal adolescents live with their families, and are physically and economically dependent upon their parents, therapeutic techniques that use the family context as a platform from which to explo... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552877 Mon, 29 Jun 2009 16:51:57 +0100 2552877 http://www.medworm.com/index.php?rid=2552876&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000676%2Fabstract%3Frss%3Dyes This article sets out a little of the evidence for these potentially beneficial interventions, including recent developments in research evidence and implications for future research. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552876 Mon, 29 Jun 2009 16:51:57 +0100 2552876 http://www.medworm.com/index.php?rid=2552875&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000706%2Fabstract%3Frss%3Dyes Abstract: The ability of health professionals and other professionals in contact with people at risk of suicide to assess and respond appropriately to suicide risk is central to any public health programme to reduce suicide in the local population. The sharing of similar concepts concerning suicide risk is essential if services staffed by different professionals from different agencies are to communicate effectively and respond appropriately to an individual risk of suicide. This contribution outlines the clinical assessment and management of suicide risk in an individual (whatever their sociodemographic background or diagnosis), outlining factors that make the risk of suicide (as opposed to self-harm or mental illness) more or less likely. The assessment of a person who has recently self-... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552875 Mon, 29 Jun 2009 16:51:57 +0100 2552875 http://www.medworm.com/index.php?rid=2552874&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900069X%2Fabstract%3Frss%3Dyes Abstract: Self-injury is now recognized as a form of behaviour in its own right, distinct from self-harm and attempted suicide. It can be defined as a behaviour that involves deliberately injuring one’s own body, without suicidal intent and with or without pain. Self-injury takes many different forms, with cutting the most common. Although its prevalence is impossible to determine accurately, self-injury is common, widespread, and probably on the increase. Self-injury is in general more common in younger women, but men and older women also self-injure. The causes are multifactorial, with biological, psychological, and social explanatory theories. Self-injury does serve many different functions for the individual, acting as a way of coping with stress, regulating unpleasant emotions, calm... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552874 Mon, 29 Jun 2009 16:51:57 +0100 2552874 http://www.medworm.com/index.php?rid=2552873&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000718%2Fabstract%3Frss%3Dyes Abstract: Suicide is a major cause of death across the world. Self-harm refers to a deliberate non-fatal act, whether physical, drug overdose, or poisoning, carried out in the knowledge that it is potentially harmful. Self-harm is strongly associated with the risk of suicide but is an important public health problem in its own right. The epidemiology of suicide and self-harm is changing. Suicide in England and Wales is becoming less common, but rates for young men have doubled in the last 20 years. With respect to self-harm, paracetamol overdoses have decreased but alcohol misuse has increased. In most centres, almost as many men as women now present with self-harm. Risk factors for suicide and self-harm overlap to an extent, but the clinical prediction of these behaviours is difficult bec... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552873 Mon, 29 Jun 2009 16:51:57 +0100 2552873 http://www.medworm.com/index.php?rid=2552872&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001244%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552872 Mon, 29 Jun 2009 16:51:57 +0100 2552872 http://www.medworm.com/index.php?rid=2552871&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001220%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2552871 Mon, 29 Jun 2009 16:51:57 +0100 2552871 http://www.medworm.com/index.php?rid=2509096&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000470%2Fabstract%3Frss%3Dyes Abstract: The number of transplant procedures undertaken in the UK is increasing steadily, although the number of potential recipients is rising at a faster rate. Psychiatrists in substance misuse, alcohol, and general adult services are increasingly likely to encounter patients who await or possess a solid organ transplant, often for reasons causally related to their mental disorder, such as alcoholic liver disease. They therefore need to understand the roles of the small number of highly specialized transplant psychiatrists who work alongside transplant teams. Transplant psychiatrists are often required to help select among recipients, guided in part by protocols that set out absolute and relative psychosocial contraindications to transplant listing, such as continuing substance dependen... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509096 Sun, 31 May 2009 23:00:00 +0100 2509096 http://www.medworm.com/index.php?rid=2509095&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900041X%2Fabstract%3Frss%3Dyes This article provides the reader with an overview of the current evidence-based concepts regarding the nature and treatment of disorders within the field of psychodermatology. Psychiatric comorbidity is high in patients with dermatological conditions and stress has a significant impact on the presentation and course of skin disease. Many of the psychophysiological disorders respond to a bio-psychosocial model of management where the reduction of stress in a key therapeutic target. In addition, psychodermatologists are often called upon to treat complex psychiatric disorders such as body dysmorphic disorder and delusional parasitosis. Managing such a patient group requires considerable clinical skill but treatment options are slowly gathering bodies of evidence to support their efficacy and... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509095 Sun, 31 May 2009 23:00:00 +0100 2509095 http://www.medworm.com/index.php?rid=2509094&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000639%2Fabstract%3Frss%3Dyes Abstract: HIV affects 33.2 million people worldwide, including 2.5 million children. An estimated 77,000 people are affected in the UK, a quarter of whom are unaware of their diagnosis; each year there are more than 7000 new cases. HIV results in slowly progressive immunodeficiency and/or progressive neurodegeneration. Disease markers are CD4 count and viral load. With a CD4 count below 500 cells/ml, generalized symptoms of decreased immunological function occur including fatigue and minor cognitive decline. With a count below 200 cells/ml, opportunistic infections, neoplasms, and HIV-related dementia develop. When the count falls below 50 cells/ml, fatal HIV-related illnesses develop. HIV is treated with three main classes of antiretroviral; often three or more drugs are required. Antiret... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509094 Sun, 31 May 2009 23:00:00 +0100 2509094 http://www.medworm.com/index.php?rid=2509093&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000482%2Fabstract%3Frss%3Dyes This article describes the key features of palliative care and some of the specific presentations of psychiatric disorders in this setting, including withdrawal, requests for physician-assisted suicide or euthanasia, assessment of mental capacity, and patients with denial about their disease and its poor prognosis. The remainder of the chapter describes the problem of depression in the context of advanced disease. This includes a discussion of definitions and diagnosis, the potential adverse consequences of depression, and the assessment and management of depression. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509093 Sun, 31 May 2009 23:00:00 +0100 2509093 http://www.medworm.com/index.php?rid=2509092&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000445%2Fabstract%3Frss%3Dyes This article provides an overview of the area, referred to as psycho-oncology, from a psychiatric clinician’s point of view. The most common psychiatric problem in the management of patients with cancer is that of emotional disorders. These are very common but still remain under-diagnosed and under-treated. Systematic screening using self-report measures can improve their detection, and is recommended in cancer centres. However, the effective delivery of treatments for these conditions to the large number of patients with cancer remains a challenge. Initial evaluation of a new approach in which cancer nurses deliver treatment for depression under psychiatric supervision has shown promising initial results. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509092 Sun, 31 May 2009 23:00:00 +0100 2509092 http://www.medworm.com/index.php?rid=2509091&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000433%2Fabstract%3Frss%3Dyes Abstract: There is an epidemic of diabetes mellitus, mainly due to the increasing prevalence of type 2 diabetes, and, as for other chronic medical conditions, the rates of depressive disorder in patients with diabetes are increased two-fold. Depression is associated with multiple adverse biomedical, economic, and psychological outcomes. There may be other psychiatric conditions, such as eating problems, that coexist with depression in diabetes. The pathogenesis of co-morbidity is likely to be complex; there is emerging interest in shared genetic and environmental factors that contribute to both conditions. The well-known problem of poor detection and treatment of depression in the medical setting also applies to people with diabetes. There have been few well-conducted studies evaluating th... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509091 Sun, 31 May 2009 23:00:00 +0100 2509091 http://www.medworm.com/index.php?rid=2509090&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000494%2Fabstract%3Frss%3Dyes Abstract: Food is a naturally occurring, nurturing and comforting substance that is also essential to survival. Over-consumption of food without compensatory increased activity in developed countries has led to epidemic proportions of obesity, with enormous healthcare implications. Often seen as resulting from emotional disturbance, obesity also carries huge stigma for sufferers, who are often disabled by the physical and psychiatric consequences of their condition. People who seek help for their obesity have high levels of depression, anxiety, binge eating disorder, and personality disorder. The neurological and psychological aspects of appetite and obesity are currently being explored in the fields of behavioural neuroscience and neuroimaging in an effort to understand the underpinnings ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509090 Sun, 31 May 2009 23:00:00 +0100 2509090 http://www.medworm.com/index.php?rid=2509089&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000408%2Fabstract%3Frss%3Dyes This article highlights the most important principles of the Mental Capacity Act 2005 and some of the amendments to the Mental Health Act 1983 that are relevant to the general hospital setting. The article focuses on how capacity should be assessed and how best interest decisions for someone lacking capacity should be made. It also discusses the role of independent mental capacity advocates, advance decisions relating to refusal of treatment, the role of the Court of Protection, and the new deprivation of liberty safeguards that have been introduced to the Mental Capacity Act. Changes to the Mental Health Act that are likely to affect practice, such as changes to professional roles, are also discussed. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509089 Sun, 31 May 2009 23:00:00 +0100 2509089 http://www.medworm.com/index.php?rid=2509088&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000391%2Fabstract%3Frss%3Dyes Abstract: Self-harm is a major public health problem and makes up a large proportion of the workload of many departments of liaison psychiatry. This paper focuses on self-harm from a general hospital perspective. It discusses the epidemiology of self-harm, hospital services, recent guidance, assessment, management, and prevention. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509088 Sun, 31 May 2009 23:00:00 +0100 2509088 http://www.medworm.com/index.php?rid=2509087&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS147617930900038X%2Fabstract%3Frss%3Dyes This article discusses the commonest psychiatric presentations to EDs, including self-harm, acute psychosis, and alcohol and substance misuse. It also describes common clinical problems in EDs, including frequent attenders, patients who do not wait to be seen, violence and aggression, and psychological responses to trauma. Issues of service delivery and safety are also discussed. The key to a successful ED psychiatric service is a good working relationship between ED and mental health staff. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509087 Sun, 31 May 2009 23:00:00 +0100 2509087 http://www.medworm.com/index.php?rid=2509086&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309001001%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509086 Sun, 31 May 2009 23:00:00 +0100 2509086 http://www.medworm.com/index.php?rid=2509085&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.psychiatryjournal.co.uk%2Farticle%2FPIIS1476179309000986%2Fabstract%3Frss%3Dyes (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=2509085 Sun, 31 May 2009 23:00:00 +0100 2509085 http://www.medworm.com/index.php?rid=231834&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.180 Psychiatry 5(5): 180-182 Mood disorders are among the most common psychiatric disorders, yet little is known about their neuropathology. Until recently, the neuropathology of mood disorders has been elucidated using macroscopic investigations, predominantly through neuroimaging studies and histological investigations using post-mortem tissue. Evidence from neuroimaging studies implicates a dysfunction of specific regions of the brain together with histological findings demonstrating subtle morphological and molecular changes within neuronal and glial synapses. Impressive advances have been made over the last decade in the genetics and neuropathology of mood disorders. This contribution discusses both the relevant neuroimaging and histological investigations carried out to date and provides... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231834 Thu, 12 Oct 2006 19:34:01 +0100 231834 http://www.medworm.com/index.php?rid=231833&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.176 Psychiatry 5(5): 176-179 Several brain regions are involved in emotional processing and in the integration of emotion with cognition and visceral functions. These include the prefrontal cortex, the anterior cingulated cortex, the amygdala, the parahippocampal gyrus and the hippocampus. These regions are heavily interconnected and also connected with other brain structures, particularly the thalamus, hypothalamus and striatum. Our understanding of the neural circuitry involved in mood disorders is rapidly expanding through the ever-increasing application of functional brain imaging techniques. Such techniques include positron electron tomography (PET) or single photon emission computed tomography (SPECT) and functional magnetic resonance imaging (fMRI). Compared with other techniques, fMRI ... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231833 Thu, 12 Oct 2006 19:34:01 +0100 231833 http://www.medworm.com/index.php?rid=231832&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.174 Psychiatry 5(5): 174-175 Brain-imaging studies offer the possibility of advancing our knowledge of the neural correlates of mood regulation, which may ultimately lead to a more biologically meaningful approach to mood disorders. Knowledge of the pathophysiology of mood disorders is increasing steadily and will continue to do so as more sophisticated brain-imaging techniques become available. At present, most studies use magnetic resonance imaging, which allows for excellent grey- and white-matter resolution in cortical and subcortical areas and detection of brain tissue pathology. In spite of the diversity of experimental designs, the functional neuroanatomy of mood disorders is beginning to emerge. The majority of studies do not support the idea of generalized brain volume changes in mood... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231832 Thu, 12 Oct 2006 19:34:01 +0100 231832 http://www.medworm.com/index.php?rid=231831&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.170 Psychiatry 5(5): 170-174 The enormous public health importance of mood disorders, when considered alongside their substantial heritabilities, has stimulated much work, predominantly in bipolar disorder but increasingly in unipolar depression, aimed at identifying susceptibility genes using molecular genetic approaches. Several chromosomal regions of interest have emerged in linkage studies and, recently, evidence implicating specific genes has been reported; the best supported include BDNF and DAOA but further replications are required and phenotypic relationships and biological mechanisms need investigation. The complexity of psychiatric phenotypes is demonstrated by (a) the evidence accumulating for an overlap in genetic susceptibility across the traditional classification systems that d... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231831 Thu, 12 Oct 2006 19:34:01 +0100 231831 http://www.medworm.com/index.php?rid=231830&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.166 This article reviews the evidence suggesting that HPA axis dysfunction and maladaptive responses to stress may have a central role in the pathophysiology of mood disorders. Recent novel therapeutic strategies that target the HPA axis are also discussed. Author Biography Stuart Watson MBBS MD MRCPsych is a Consultant in General Adult Psychiatry and an Honorary Senior Lecturer at the University of Newcastle, UK. His research interests are in the neuroendocrinology and treatment of severe psychiatric disorders. Paul Mackin MBBS PhD MRCPsych is a Department of Health Clinician Scientist based at the University of Newcastle, UK. He qualified in Medicine at the University of Newcastle, after gaining his PhD in diabetology. His research interests include the neurobiology of mood disorders, and me... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231830 Thu, 12 Oct 2006 19:34:01 +0100 231830 http://www.medworm.com/index.php?rid=231829&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.162 Psychiatry 5(5): 162-166 The pharmacological treatment of mood disorders remains focused around the use of monoamine potentiating agents for the management of depression. There are, however, a growing number of agents available for management of bipolar disorder, with both anticonvulsants and atypical antipsychotic drugs showing promise in the management of bipolar depression. Author Biography Sarah Gartside BSc DPhil is Lecturer in the School of Neurology, Neurobiology and Psychiatry at Newcastle University, UK. Her research interests include effects of antidepressants on brain 5-HT systems and interactions between the HPA axis and 5-HT function. Philip Cowen MD FRCPsych FMedSci is Professor of Psychopharmacology and MRC Clinical Scientist in the Department of Psychiatry at the University... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231829 Thu, 12 Oct 2006 19:34:01 +0100 231829 http://www.medworm.com/index.php?rid=231828&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.158 Psychiatry 5(5): 158-162 In this review, we discuss the importance of neuropsychological deficits in unipolar and bipolar depression. Cognitive impairments are a key component of both disorders, and while a number of deficits exist in the depressed state, many of these disappear on remission. We propose that state-dependent deficits in the depressed state may be explicable in terms of alterations in emotion-dependent, or ‘hot’, processing, particularly in tasks that utilise feedback. In bipolar disorder, where impairments are also common in the euthymic state, cognitive deficits may provide putative endophenotypes, which may aid research into the biological underpinnings of mood disorders. Author Biography Jonathan P Roiser PhD holds the Raymond Way Fellowship at the Institute of Neuro... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231828 Thu, 12 Oct 2006 19:34:01 +0100 231828 http://www.medworm.com/index.php?rid=231827&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.154 Psychiatry 5(5): 154-158 Epidemiological differences in rates of mood disorders – higher prevalence among females and those of lower socioeconomic status – can be traced to intermediate psychosocial processes such as stressful life events. Greater vulnerability to such stressors has been traced to lack of support in responding to these, both currently in adulthood and in childhood, the latter particularly associated with low self-esteem in adulthood. Latterly such vulnerability to stressors has also been linked with a functional polymorphism in the promoter region of the serotonin transporter gene, with recent evidence of this gene–environment interaction. Preventive psychosocial interventions providing social support have been developed based upon this aetiological model. One succes... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231827 Thu, 12 Oct 2006 19:34:01 +0100 231827 http://www.medworm.com/index.php?rid=231826&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.151 Psychiatry 5(5): 151-154 In this review, the diagnostic and management issues related to mood disorders across cultures are illustrated. Culture can play several roles in the genesis and maintenance of mood disorders. Author Biography Dinesh Bhugra MA MSc MPhil MBBS FRCPsych PhD is Professor of Mental Health and Cultural Diversity at the Institute of Psychiatry, King’s College London, UK. He has authored/co-authored/edited 15 books. He is instrumental in developing various training packages for health service professionals and developing strategies for psychiatric education. He was elected Dean of The Royal College of Psychiatrists in July 2003. He is an Honorary Consultant at the Maudsley Hospital in London and runs the sexual and couple therapy clinic. (Source: Psychiatry) Psychiatry journals http://www.medworm.com/rss/comments.php?id=231826 Thu, 12 Oct 2006 19:34:01 +0100 231826 http://www.medworm.com/index.php?rid=231825&cid=s_33865_172_f&fid=33865&url=http%3A%2F%2Fwww.atypon-link.com%2FMPC%2Fdoi%2Fabs%2F10.1383%2Fpsyt.2006.5.5.147 Psychiatry 5(5): 147-150 A number of psychological models for depression and bipolar disorder have at least some empirical support, are in common use and spawned effective psychological treatments for mood disorder. The article will discuss cognitive behaviour therapy and life events and social support models for unipolar depressive episodes, and more briefly review psychodynamic and medication adherence models for depression, and the development of psychological models in bipolar disorder. These models fit well with the view of many patients that their mood disorder is at least in part psychologically and socially caused. They also promote active self-management of their condition rather than passive compliance with treatment. As a result, these psychological approaches tend to improve th... Psychiatry journals http://www.medworm.com/rss/comments.php?id=231825 Thu, 12 Oct 2006 19:34:01 +0100 231825