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BJPsych Bulletin

Richard Laugharne, Matthew Thompson, Alind Srivastava, Simon Marlow, Rohit Shankar
Mental health services in the UK National Health Service have evolved to include primary-care generalist, secondary-care generalist and secondary-care specialist services. We argue that there continues to be an important role for the secondary-care generalists as they minimise interfaces, can live with diagnostic uncertainty and support continuity of care. The lack of commissioning and clinical boundaries in secondary-care generalist services can undermine their feasibility, leading to difficulties recruiting and retaining staff...
July 17, 2018: BJPsych Bulletin
Alexander Galloway, Billy Boland, Gareth Williams
SummaryPoverty is strongly associated with mental illness. Access to state benefits can be a lifeline for people with mental health problems in times of hardship and can assist them on their journey of recovery. However, benefit application processes can discriminate against those with mental illness and can result in individuals unjustly missing out on support. Clinical evidence from mental health professionals can ameliorate these challenges and ensure that people get access to financial help.Declaration of interestDr Billy Boland is on the advisory board of the Money and Mental Health Policy Institute...
July 6, 2018: BJPsych Bulletin
Ann Collins, Antonio Muñoz-Solomando
Aims and methodThis article examines mental health disorders as individuals transition from adolescence to adulthood. Data were collected from clinical records of patients who had transitioned from child and adolescent mental health services to adult mental health services in a region in South Wales. Demographics and clinical diagnoses under both services were recorded. Patterns between adolescent and adult disorders as well as comorbidities were investigated using Pearson's χ2-test and Fisher's exact test...
June 21, 2018: BJPsych Bulletin
A Hossain, M Malkov, T Lee, K Bhui
Aims and methodThere is limited evidence on ethnic differences in personality disorder prevalence rates. We compared rates of people with personality disorder admitted to hospital in East London from 2007 to 2013. RESULTS: Of all people admitted to hospital, 9.7% had a personality disorder diagnosis. The admission rate for personality disorder has increased each year. Compared with White subjects, personality disorder was significantly less prevalent among Black and other minority ethnic (BME) groups...
June 13, 2018: BJPsych Bulletin
Josephine Fielding, Christopher Bass
Aims and methodTo describe the pattern of referrals and characteristics of people aged over 18 seeking gender reassignment in Oxfordshire over a 6-year period (2011-2016). RESULTS: A total of 153 individuals attended for assessment (of 162 referred); 97 (63.4%) were natal males and 56 (36.6%) were natal females. Mean age at referral was markedly different between the two groups, with females being younger. The number of referral significantly increased over the time period, by an average of 18% per year (95% CI 1...
June 12, 2018: BJPsych Bulletin
Caroline Guest, Stephen Crockett, Patrick Little, Anish Patel
Aims and methodThe clinical utility of the multidimensional Framework for Routine Outcome Measurement in Liaison Psychiatry (FROM-LP) has not previously been examined. We sought to establish whether referral accuracy and ability to achieve the reason(s) for referral to our liaison service improved after incorporating the Identify and Rate the Aim of the Contact (IRAC) scale of this tool into our referral process. We carried out a retrospective analysis of electronic case notes of all appropriate referrals to the team before and after this adaption...
June 1, 2018: BJPsych Bulletin
Brynmor Lloyd-Evans, Danielle Lamb, Joseph Barnby, Michelle Eskinazi, Amelia Turner, Sonia Johnson
Aims and methodA national survey investigated the implementation of mental health crisis resolution teams (CRTs) in England. CRTs were mapped and team managers completed an online survey. RESULTS: Ninety-five per cent of mapped CRTs (n = 233) completed the survey. Few CRTs adhered fully to national policy guidelines. CRT implementation and local acute care system contexts varied substantially. Access to CRTs for working-age adults appears to have improved, compared with a similar survey in 2012, despite no evidence of higher staffing levels...
May 24, 2018: BJPsych Bulletin
Felix Clay, Sophie Allan, Serena Lai, Siona Laverty, Grace Jagger, Cate Treise, Jesus Perez
Aims and methodFollowing the introduction of new standards for early intervention in psychosis (EIP) in England, EIP services are accepting referrals for people aged 35-65. The Cambridgeshire and Peterborough EIP service (CAMEO) aimed to explore the immediate implications for the service, especially with regards to referral numbers and sources. Data were collected from April 2016 to June 2017. RESULTS: Referrals for over-35s represented 25.7% of all new referrals. Fifty per cent of referrals for over-35s were accepted onto caseload (40...
May 24, 2018: BJPsych Bulletin
Gayathri Venkatesan, Scott Weich, Orla McBride, Liz Twigg, Helen Parsons, Jan Scott, Kamaldeep Bhui, Patrick Keown
Aims and methodTo compare rates of admission for different types of severe mental illness between ethnic groups, and to test the hypothesis that larger and more clustered ethnic groups will have lower admission rates. This was a descriptive study of routinely collected data from the National Health Service in England. RESULTS: There was an eightfold difference in admission rates between ethnic groups for schizophreniform and mania admissions, and a fivefold variation in depression admissions...
May 11, 2018: BJPsych Bulletin
Peter Tyrer
SummaryBob Spitzer died in December 2015 but is not likely to be forgotten quickly. His Herculean task in reforming psychiatric diagnosis, mainly by the development of the third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1980, has been acknowledged by many, but it remains unfinished. To complete the process, we need more than good diagnostic reliability, we need better veracity.Declaration of interestNone.
May 7, 2018: BJPsych Bulletin
Clare Gerada
This article focuses on doctors and suicide. It provides real examples to illustrate why doctors die by their own hand. These reasons are replicated in the general population, but also include a host of additional risk factors related to being a doctor. In each case, information about the doctor is in the public domain or, as in one case, consent from the next of kin has been obtained for a detail not in the public domain. The author is a doctors' doctor, heading up a confidential health service for doctors with mental illness or addiction, the National Health Service Practitioner Health Programme...
May 1, 2018: BJPsych Bulletin
Andrea Brown, Richard Jenkinson, Julia Coakes, Annette Cockfield, Tish O'Brien, Louise Hall
Aims and methodA cognitive-behavioural therapy in-patient treatment model for adults with severe anorexia nervosa was developed and evaluated, and outcomes were compared with the previous treatment model and other published outcomes from similar settings. RESULTS: This study showed the Pathways to Recovery outcomes were positive in terms of improvements in body mass index and psychopathology.Clinical implicationsAdults with anorexia nervosa can achieve good outcomes despite longer illness duration and comorbidities...
June 2018: BJPsych Bulletin
Simon Dein
This paper argues for the inclusion of religion and spirituality in psychiatric care. After discussing the antagonism of psychiatrists and psychologists to religion, I present a critical overview of studies examining the relationships between spirituality, religion and diverse aspects of mental health: depression, suicide, anxiety, delinquency, drug abuse and schizophrenia. The need to assesses the impact of religion in different faith groups is discussed. Measures of religious coping, both positive and negative, may provide a more accurate portrayal as to how individuals deploy religion in their lives than global measures such as belief and attendance...
June 2018: BJPsych Bulletin
Norman Poole
SummaryThe incoming editor Dr Norman Poole sets out a vision for his tenure at the helm of the BJPsych Bulletin. There will be redoubled focus on training and educational articles and an engagement with the cultural and social ramifications of this most vital of specialisms.Declaration of interestDr Poole is editor of the BJPsych Bulletin.
June 2018: BJPsych Bulletin
Dipen Patel, Manjunath Minajagi
Aims and methodVitamin D deficiency is increasing in the general population, and is linked with physical and mental illness. However, evidence on its prevalence in people with mental illness is limited. This study investigated vitamin D deficiency in 104 adult patients admitted to a psychiatric hospital in the UK. RESULTS: Forty-nine per cent were vitamin D deficient (serum 25(OH)D 50 nmol/L). There were no statistically significant differences in mean serum vitamin D between different subgroups of mental illness...
June 2018: BJPsych Bulletin
Noel Collins, Laurie Corna
Aims and methodTo understand general practitioner (GP) reticence to refer older patients to a local Improving Access to Psychological Therapies (IAPT) service providing mostly cognitive-behavioural therapy (CBT)-based interventions. Semi-structured, hour-long interviews were conducted with eight GPs and then analysed by modified grounded theory and thematic analysis. RESULTS: GP views regarding the treatability of older adults with CBT influenced their willingness to refer to a CBT-based IAPT service...
June 2018: BJPsych Bulletin
Susham Gupta, Elvan U Akyuz, Toby Baldwin, David Curtis
Aims and methodCommunity treatment orders (CTOs) have been in used in England and Wales since November 2008; however, their effectiveness has been debated widely, as has the question of which methodology is appropriate to investigate them. This paper uses national data to explore the use of CTOs in England. RESULTS: About 5500 patients are subject to CTOs at any one time. Each year, ~4500 patients are made subject to a CTO each year and ~2500 are fully discharged, usually by the responsible clinician; fewer than half of CTO patients are recalled, and two-thirds of recalls end in revocation...
June 2018: BJPsych Bulletin
H J Welstead, J Patrick, T C Russ, G Cooney, C M Mulvenna, C Maclean, A Polnay
Aims and methodCaring for patients with personality disorder is one of the biggest challenges in psychiatric work. We investigated whether mentalisation-based treatment skills (MBT-S) teaching improves clinicians' understanding of mentalising and attitudes towards personality disorder. Self-report questionnaires (Knowledge and Application of MBT (KAMQ) and Attitudes to Personality Disorder (APDQ)) were completed at baseline and after a 2-day MBT-S workshop. RESULTS: Ninety-two healthcare professionals completed questionnaires before and after training...
June 2018: BJPsych Bulletin
Else Guthrie, Mathew Harrison, Richard Brown, Rajdeep Sandhu, Peter Trigwell, Seri Abraham, Shazada Nawaz, Peter Kelsall, Rachel Thomasson
Aims and methodTo develop and pilot a clinician-rated outcome scale to evaluate symptomatic outcomes in liaison psychiatry services. Three hundred and sixty patient contacts with 207 separate individuals were rated using six subscales (mood, psychosis, cognition, substance misuse, mind-body problems and behavioural disturbance) plus two additional items (side-effects of medication and capacity to consent for medical treatment). Each item was rated on a five-point scale from 0 to 5 (nil, mild, moderate, severe and very severe)...
June 2018: BJPsych Bulletin
Mimi Mei Cheung Wong, Pui-Fai Pang, Michael Gar Chung Yiu
No abstract text is available yet for this article.
April 2018: BJPsych Bulletin
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