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BJPsych Bulletin

Paul J Lambe, Thomas C E Gale, Tristan Price, Martin J Roberts
Aims and methodWorkforce shortages in psychiatry are common worldwide. The international literature provides insights into factors influencing decisions to train in psychiatry but is predominately survey based. This national cohort study aimed to identify the characteristics of doctors who were most likely to apply to psychiatry training programmes. The sample comprised doctors who entered UK medical schools in 2007/8 and who made first-time specialty training applications in 2015. The association between application to psychiatry and doctors' sociodemographic and educational characteristics was examined using multivariable logistic regression...
May 10, 2019: BJPsych Bulletin
Andrew Molodynski, Sarah Hollingsworth, Louise Penzenstadler, Devon Perfect, Stephen Puntis
Aims and methodStreet triage services are now common but the population they serve is poorly understood. We aimed to evaluate a local service to determine the characteristics of those using it and their outcomes in the 90 day period following contact. RESULTS: We found that there were high levels of service use and that the vast majority of contacts were via telephone rather than in person. Street triage was used by both existing secondary mental health patients and non-patients. Follow-up rates with secondary services were high in the former and low in the latter case...
April 30, 2019: BJPsych Bulletin
Natalie Ellis, Carla-Marie Grubb, Sophie Mustoe, Eleanor Watkins, David Codling, Sarah Fitch, Lucy Stirland, Munzir Quraishy, Josie Jenkinson, Judith Harrison
Aims and methodWe assessed venous thromboembolism (VTE) risk, barriers to prescribing VTE prophylaxis and completion of VTE risk assessment in psychiatric in-patients. This was a cross-sectional study conducted across three centres. We used the UK Department of Health VTE risk assessment tool which had been adapted for psychiatric patients. RESULTS: Of the 470 patients assessed, 144 (30.6%) were at increased risk of VTE. Patients on old age wards were more likely to be at increased risk than those on general adult wards (odds ratio = 2...
April 29, 2019: BJPsych Bulletin
Harry Lei, Kirsten Barnicot, Emily Maynard, Angela Etherington, Krysia Zalewska, Alan Quirk, Rahil Sanatinia, Stephen J Cooper, Mike J Crawford
Aims and methodWe conducted a secondary analysis of data from the National Audit of Psychosis to identify factors associated with use of community treatment orders (CTOs) and assess the quality of care that people on CTOs receive. RESULTS: Between 1.1 and 20.2% of patients in each trust were being treated on a CTO. Male gender, younger age, greater use of in-patient services, coexisting substance misuse and problems with cognition predicted use of CTOs. Patients on CTOs were more likely to be screened for physical health, have a current care plan, be given contact details for crisis support, and be offered cognitive-behavioural therapy...
April 11, 2019: BJPsych Bulletin
Laura D Cook, Katie E Nichol, Jeremy D Isaacs
Aims and methodMemory services have expanded significantly in the UK, but limited performance data have been published. The aim of this programme was to determine variation in London memory services and address this through service improvement projects. In 2016 London memory services were invited to participate in an audit consisting of case note reviews of at least 50 consecutively seen patients. RESULTS: Ten services participated in the audit, totalling 590 patients. Variation was noted in neuroimaging practice, neuropsychology referrals, diagnosis subtype, non-dementia diagnoses, waiting times and post-diagnostic support...
March 22, 2019: BJPsych Bulletin
Paul Blenkiron, Lucy Goldsmith
Aims and methodWe evaluated routine use, acceptability and response rates for the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) within adult community mental health teams. Measures were repeated 3 months later. Professionals recorded the setting, refusal rates and cluster diagnosis. RESULTS: A total of 245 patients completed 674 measures, demonstrating good initial return rates (81%), excellent scale completion (98-99%) and infrequent refusal/unsuitability (11%)...
March 22, 2019: BJPsych Bulletin
Rosemary Sedgwick, Alexa Duff, Sharon Lines, Anthony Akenzua, Fergal Jones
Aims and MethodThe National Institute for Health and Care Excellence recommends involving the families of patients admitted to psychiatric hospital care, without specific guidance on how to do it. To improve family involvement in a National Health Service psychiatric intensive care unit, a relatives' and carers' clinic was set up. Fifty family members attended and completed questionnaires. Nine went on to take part in interviews, the results of which were analysed using thematic analysis. RESULTS: Families felt more informed and found the increased access to information useful...
March 11, 2019: BJPsych Bulletin
Ranjita Howard, Catherine Kirkley, Nicola Baylis
Aims and methodThe concept of personal resilience is relevant to physician well-being, recruitment and retention, and to delivering compassionate patient care. This systematic review aims to explore factors affecting personal resilience among psychiatrists, in particular, those that may impair well-being and those that facilitate resilience practice. A literature search was performed of the OvidĀ®, EmbaseĀ®, CINAHL and PsycINFO databases, using keywords to identify empirical studies involving psychiatrists that examined resilience, stress and burnout from the past 15 years...
March 11, 2019: BJPsych Bulletin
Giri Madhavan
Aims and MethodThe aims of this review were to explore the effectiveness and patient and provider acceptability of telepsychiatry consultations in intellectual disability, contrasting this with direct face-to-face consultations and proposing avenues for further research and innovation. Computerised searches of databases including AMED and EMBASE were conducted. RESULTS: Four USA studies of intellectual disability telepsychiatry services have been reported. The majority (75%) focused on children with intellectual disability...
March 7, 2019: BJPsych Bulletin
Lambros Malafouris
SummaryConsensus is growing, in many areas of the humanities and social sciences, that aspects of the material world we live in have causal efficacy on our minds - the major dynamic being the plasticity of the brain linked to the affordances of our bodily engagements with things. The implications of that on how we approach and understand important mental health issues have not been adequately addressed. This paper proposes a material engagement approach to the study of the processes by which different forms of materiality achieve their effects...
March 6, 2019: BJPsych Bulletin
Jennifer Collom, Emma Patterson, Geoff Lawrence-Smith, Derek K Tracy
Aims and methodTo understand the experience of companions of patients seen in the emergency department by liaison psychiatry teams. Participants were recruited via purposive sampling following a recent visit to the emergency department of an inner- or outer-London hospital. Semi-structured interviews were administered to all participants. RESULTS: Two major themes were generated. The first concerned the appropriateness of the clinical space, in which 'noise', 'privacy' and the 'waiting area' were subthemes...
March 4, 2019: BJPsych Bulletin
John L Taylor
SummaryThe Transforming Care national plan for England to develop community services and close hospital beds for people with intellectual disabilities and/or autism was published in October 2015 and is due to finish in March 2019. In this editorial the key plan objectives are evaluated, with particular reference to people with intellectual disabilities and/or autism who offend or are at risk of offending. The conclusion is that, to date, the plan has failed to meet its targets to reduce the number of in-patients with intellectual disabilities and/or autism and to invest in community services, and the number of patients in independent sector beds is increasing...
February 21, 2019: BJPsych Bulletin
Daniel Robinson, Samuel Dearman
No abstract text is available yet for this article.
June 2019: BJPsych Bulletin
John L Taylor
No abstract text is available yet for this article.
June 2019: BJPsych Bulletin
Jean O'Hara
No abstract text is available yet for this article.
June 2019: BJPsych Bulletin
David Kingdon
The Care Programme Approach (CPA) has been instrumental in embedding principles of holistic collaborative assessment and management into mental health care. Initially, its implementation was assisted by targeting those at greatest need. However dichotomising patients into more and less severe is now considered unhelpful and has been demonstrated to be unreliable. Division of patients into severe and not severe categories is no more logical than such a division of patients with physical health problems. CPA principles are now applied to all patients in mental health services and practice needs to move to individualised care, focusing on meeting quality standards and achieving positive outcomes...
June 2019: BJPsych Bulletin
(no author information available yet)
No abstract text is available yet for this article.
April 2019: BJPsych Bulletin
Alla Rubitel
No abstract text is available yet for this article.
April 2019: BJPsych Bulletin
Ann Maria Albert, Karel Wildschut, Marinos Chatzopoulos, Johanna Selway
No abstract text is available yet for this article.
April 2019: BJPsych Bulletin
Simon Vann Jones, Rick McCollum
Aims and methodFew studies have looked at subjective memory impairment from electroconvulsive therapy (ECT) after treatment completion. We aimed to systematically review all available evidence for subjective post-treatment effects. RESULTS: We included 16 studies in this review. There was considerable between-study heterogeneity in clinical population, ECT modality and assessment scales used. The most common assessment scale (eight studies) was the Squire Subjective Memory Questionnaire. The majority of studies reported an improvement in subjective memory after ECT, which correlated with improved depression scores...
April 2019: BJPsych Bulletin
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