bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of mailing strategies on response to questionnaires
Authors: Newton Kate , Stein Samuel M. , Lucey Clare 
Published: October 2008

Aims and methodA prospective study was undertaken to evaluate the effect of a stamped addressed envelope, as compared to a non-stamped but addressed envelope or no envelope, on response to a mailed questionnaire. The correlation between questionnaire response and subsequent attendance at the first appointment was also studied.ResultsThe overall response rate was 26% of 176 families offered first appointments at a local child psychiatry service. Families provided with a stamped addressed envelope were more likely to return their questionnaire and those families who returned the questionnaire were more likely to attend their first appointment.Clinical implicationsThe return of patient questionnaires has significant clinical and resource implications. Only essential questionnaires should be sent out to referred families as nearly three-quarters will not be returned. The return rate can be enhanced by providing a stamped addressed envelope but, if questionnaires are not returned within 10 days, the likelihood of return is minimal. As more than half of the families who failed to return the questionnaire also failed to attend their first appointment, questionnaires can be used as a measure of motivation and likelihood of attendance as well as a source of clinical information.
Survey of community mental health teams
Authors: Mauthner Natasha , Naji Simon , Mollison Jill 
Published: October 2008

Aims and methodThe aim of the study was to describe community mental health teams (CMHTs) working In Scotland. Interviews, a focus group, and a postal questionnaire survey of Identified CMHTs were carried out.ResultsOf the 53 teams identified, 42 (79%) completed questionnaires. The average team size was 11 people. Community psychiatric nurses were in all teams, social workers and psychiatrists were in most, but psychologists were in only half. Needs assessments occurred in only 17% of teams. Fifty-one per cent of teams had open referral systems, and 38% of referrals comprised people with long-term mental health problems. Fifteen per cent of referrals were considered by teams to be inappropriate.Clinical implicationsAmbiguities about appropriate structures, patient groups and interprofessional and inter-agency working require further consideration and evaluation if CMHT care is to be optimally effective.
Making hospitals safe for patients
Authors: Millington Amos , Carnwath Tom , McGuinness Ted 
Published: October 2008

“It may seem a strange principle to enunciate, as the very first requirement of a hospital, that it should do the sick no harm” (Nightingale, 1859).The principle is less strange today than when it was first proposed, but making hospitals safe for patients is no easier. Stepping aside from one danger, one may fall into the path of another. Legionella risks can be avoided by higher water temperatures but this in turn introduces a risk of scalding. Security measures can protect the individual and work space but may compromise fire safety. This paper describes a similar problem of conflicting safety measures and its unfortunate consequences.
Dance, communication and schizophrenia
Authors: Loftus Josephine 
Published: October 2008

“Dancing possesses all the features of a beautiful language, yet it is not sufficient to know the alphabet alone. But when a man of genius arranges the letters to form words and connects the words to form sentences, it will cease to be dumb, it will speak with both strength and energy; and the ballets will share with the best plays the merits of affecting and moving”(Noverre, 1760; cited in Copeland & Cohen, 1983. p. 290)“I should like to emphasise that some of the clinical pictures outlined are no more than attempts to present part of the material observed in a communicable form”(Kraepelin, 1920; cited in Hafner et al, 1987, pp. 29–38)
Audit of anticholinergic treatment in a psychiatric patient population
Authors: Williams Justin H. G. 
Published: October 2008

Aims and methodAn audit was performed to look at how carefully anticholinergic medication was prescribed and monitored in a population of psychiatric patients on depot medication.ResultsThe mean duration of prescription was 47 months and 44% of patients' prescriptions went unaltered for over three years. Evidence was lacking for rational initial anticholinergic prescription.Clinical implicationsAnticholinergic treatment needs to be prescribed more rationally with regular monitoring of extra-pyramidal symptoms.
Characteristics of admissions considered inappropriate by junior psychiatrists
Authors: Elwood Peter Y. 
Published: October 2008

Aims and methodThe aim of the study was to identify medical and socio-demographic characteristics of admissions considered inappropriate by psychiatrists. Appropriateness of admission was assessed by questionnaire. Medical and socio-demographic characteristics of each admission were obtained by case note review.ResultsTwenty-five per cent of admissions were considered inappropriate. These patients showed high levels of adverse socio-demographic characteristics and commonly were diagnosed as personality disordered or as substance misusers. Junior doctors commonly admitted patients despite considering admission inappropriate.Clinical implicationsRegular audit of the admission, process should be encouraged.
Solo obstetric liaison service
Authors: Smith Sue 
Published: October 2008

Aims and methodTo set up a liaison psychiatry service for an obstetric department and review how much of the work involved in such a service can be undertaken by a senior registrar in two special interest sessions.ResultsIt was clear there was a demand for a service for women with psychiatric problems associated with childbirth. Referrals from colleagues in general psychiatry meant that the available time was soon used up. This did therefore not allow time to develop efficient systems for referral and management or to then see the extra referrals this would have produced. The limited and temporary service was well received by other professionals and by patients. The number of referrals received fell far short of the expected morbidity.Clinical implicationsIn an area with this number of births and its consequent level of psychiatric morbidity, it would not seem possible, within two special interest sessions, to develop a more formalised or comprehensive system.
Determining whether senior and specialist registrars choose or reject a career in general adult psychiatry
Authors: Davies Mark , Schlich Tom 
Published: October 2008

Aims and methodFollowing concerns over recruitment into general adult psychiatry, this study was undertaken to determine which factors influence senior trainees in psychiatry with regard to whether or not they choose a career in general adult psychiatry. The method used was by postal survey of all senior and specialist registrars in the UK.ResultsOf those responding, 32.6% had chosen a career in general adult psychiatry, while 38.9% had actively rejected such a career. Twenty-six per cent of respondents had chosen another speciality without actively rejecting general adult psychiatry. For those actively rejecting general adult psychiatry, the top three factors cited were poor resources (57.6%), high workload (43.2%) and poor working conditions (30.7%).Clinical implicationsThrough an awareness of why senior trainees reject general adult psychiatry as a possible career, resources can be targeted more specifically in the future at the factors responsible, and thereby improve recruitment into this speciality.
A survey of flexible trainees in psychiatry in the North and South Thames Region
Authors: Herzberg Joe , Goldberg llfra 
Published: October 2008

Aims and methodTo review the experience, examination success and career progress of trainees on the flexible scheme in psychiatry in the North and South Thames region. Trainees in psychiatry who enrolled on the flexible training scheme 1993–1997 were Included In the retrospective survey of flexible training records.ResultsTrainees on the flexible training scheme had gained experience in a broad range of posts before entering psychiatry for a mean time of 14 months. Forty-nine per cent entered flexible training during basic specialist training and 41% during higher specialist training. This cohort of trainees performed better in the MRCPsych examinations than the national average. Forty-nine per cent of the trainees intended to become child and adolescent psychiatrists. Flexible trainees' progress to consultant status was slower.ImplicationsThe flexible training scheme attracts trainees of comparable quality to full-time trainees and encourages their retention in the workforce.
Early detection of antipsychotic side-effects
Authors: Chaplin Robert , Gordon Julie , Burns Tom 
Published: October 2008

Aims and methodsStaff from five community mental health teams (CMHTs) were trained to use structured rating scales for akathisia, tardive dyskinesia and Parkinsonism. Detection rates of these side-effects were compared for the six months before and after the intervention.ResultsFifty-seven per cent of the target professionals participated, screening 200 (52%) eligible patients. This resulted in significant increases in the recording of all three side-effects as positive but no increase in their formal diagnosis.Clinical implicationsDetection rates of these side-effects can be increased to those predicted by research with significant reductions in drug dose and non-adherence and without clinical deterioration.
The first 12 months of a perinatal outreach service
Authors: Patel Meena , Lewin Jona , Stevens Ann 
Published: October 2008

Aims and methodThis paper describes and evaluates a new community treatment service for women suffering from mental Illness during the perinatal period. Data about referrals, treatment methods and outcome were analysed for the first year of Its service.ResultsThe service was acceptable to patients and effective in improving the mental health and parenting skills of mothers but less successful in improving relationship problems.Clinical implicationsA specialised perinatal outreach service is likely to be more acceptable to new mothers than the traditional psychiatric service and may also be able to reduce the need for hospital admission and length of admission.
Diagnosis, assessments and admissions from a community treatment team
Authors: Brimblecombe Neil , O'Sullivan Geraldine H. 
Published: October 2008

Aims and methodA community treatment team, offering rapid assessment and intensive home treatment as an alternative to admission is described. The relationship between diagnosis and outcome was examined, in terms of initial ‘take on’ rates, admissions to in-patient areas at both initial assessment and subsequently.ResultsThere was a significant relationship between diagnosis and outcome, with marked variation between diagnostic categories.Clinical implicationsHome treatment teams prevent admissions with the majority of people from all diagnostic groups, but less successfully with people with personality disorder.
Monitoring lithium treatment: evaluation of current management
Authors: Kotak Anita , Arnold Ann Elaine , Frost Peter 
Published: October 2008

Aims and methodA postal survey of 81 general practitioners (GPs) who were Involved in lithium monitoring was undertaken, to compare their views on lithium therapy with their monitoring practice, and with the practice of psychiatrists.ResultsForty-seven replied (response rate 50.6%). There was considerable variation in GP knowledge of lithium therapy. GPs made fewer requests but wanted more information.Clinical implicationsWritten reminders and information on lithium would be useful to GPs.
Psychotherapy experience in Ireland
Authors: Rooney Siobhan , Kelly Gabrielle 
Published: October 2008

Aims and methodA questionnaire was sent to members of the Psychotherapy Section of the Irish Division of the Royal College of Psychiatrists to assess psychotherapy training.ResultsMembers from Northern Ireland, compared with those from the Republic, had more mandatory psychotherapy experience in a variety of psychotherapies, had attended more lectures on the theories of the psychotherapies, had cases longer in analysis and were more satisfied with their level of supervision. Few non-consultant hospital doctors had obtained mandatory psychotherapy training as outlined by the College guidelines and they were also generally dissatisfied with their basic training in psychotherapy.ImplicationsAlthough there were clear qualitative differences in psychotherapy training between Northern Ireland and the Republic, 100% of members believed there should be improvements in the training of psychotherapy in Ireland. If the Royal College guidelines are to be adhered to, these results would imply that changes in the structure of psychotherapy training in Ireland particularly for non-consultant hospital doctors are required.
Information and advice received by carers of younger people with dementia
Authors: Husband Hilary J. , Shah Meera N. 
Published: October 2008

Aims and methodRetrospective information on advice and information received post-diagnosis was obtained from 40 carers of younger people with dementia, using a semi-structured interview.ResultsTwelve carers received services from old age psychiatry, the remaining 28 from predominantly adult psychiatry or neurology. Those in receipt of old age services reported greater adequacy of diagnostic information, higher levels of advice giving and more frequent referral to social services.Clinical implicationsWhile old age services were more successful on the parameters examined, the gradually emergent nature of the diagnosis may be a crucial factor in the lack of information and advice received by the comparison group.
Facilitating a staff support group on an oncology ward: some observations
Authors: Montgomery Charles 
Published: October 2008

Aims and methodIn this paper an experience of facilitating a weekly support group for nursing staff on an oncology ward is described. A brief overview of burnout among oncology nurses is followed by a description of the processes by which the support group was established.ResultsSome of the functions that the group has come to provide and recurring themes are highlighted along with a more theoretical understanding of the nature of groups within institutions.Clinical implicationsSupport groups can help prevent isolation and demoralisation.
New community mental health team for acute psychiatric illness
Authors: Brown S. J. , Guthrie M. F. , Shepherd B. M. 
Published: October 2008

Aims and methodThe aim was to provide effective time-limited management of acute episodes of mental illness in the community, thus reducing dependency on the psychiatric services. A multi-disciplinary team supplied intensive psychological and pharmacological interventions.ResultsFifty-nine per cent were discharged within 12 weeks to the care of their general practitioner. Twelve per cent were admitted to in-patient care.Clinical implicationsA time limited multi-disciplinary approach will have benefits to patients and the service.
Disruption of children's lives by maternal psychiatric admission
Authors: Hawes Valerie , Cottrell David 
Published: October 2008

Aims and methodThe aim of the study was to investigate changes in child care arrangements after admission of mothers to acute psychiatric wards. Data were collected by interview where possible and from case notes.ResultsTwelve out of 63 children of mothers interviewed had to move house. Chronicity of psychiatric disorder was evident in half the mothers.Clinical implicationsChildren's lives are affected by maternal psychiatric admission with the likelihood of repeated disruption where psychiatric disorder is chronic.
Reducing the time you and your patients wait
Authors: Srivatsa Kadiyali M. , Allen Danny 
Published: October 2008

Aims and methodsIn an attempt to reduce patient non-attendance at first appointments, consultant referrals were handled differentially over three years. From referral letters some patients were referred elsewhere, some sent appointments and some invited to make appointments.ResultsThere was a reduction in patients who did not attend an appointment and an increase in the proportion of patients, not referred elsewhere who were seen.Clinical implicationsThis system reduces consultant waiting time in clinics and the interval before a patient is seen.
Psychiatrists' views of evidence-based psychiatric practice
Authors: Carey Stephen , Hall David J. 
Published: October 2008

Aims and methodTo determine the attitudes of psychiatrists towards the practice of evidence-based medicine by use of a postal questionnaire. A survey was sent to Consultant Psychiatrists and to Higher Trainees in Psychiatry in the West of Scotland Region.ResultsWhile older influences on decision-making such as tradition and deference still play a part, almost all respondents consider the adoption of more effective care based on best available external evidence desirable; most think it attainable. The technology is generally available, but further training is desired to access the information and its critical analysis.Clinical implicationsEducational activities should increasingly focus on skills for data search and critical analysis.
The outcome of rough sleepers with mental health problems admitted to a psychiatric ward
Authors: Graham Zoë C. , Salton-Cox Frankie S. , White Peter D. 
Published: October 2008

Aims and methodTo describe the outcome of rough sleepers admitted to an acute psychiatric ward; the professional most involved with the person was interviewed.ResultsEleven out of 12 people admitted with a psychosis were accommodated and in touch with mental health services at follow-up (median of 21 months) compared with two out of 10 people, admitted without a psychosis, accommodated and four out of 10 people in touch with mental health services.Clinical implicationsPsychiatric admission with good aftercare is worthwhile for rough sleepers with a psychosis, even if it requires involuntary admission.
Cognitive therapy of psychosis in clinical practice
Authors: Bishay Nagy Riad 
Published: October 2008

Aims and methodThe study aimed at developing a brief cognitive intervention suitable for everyday management of psychotic patients. A brief cognitive therapy package was developed and tested on different patients with psychosis.ResultsIn conjunction with medication, a brief cognitive intervention helped some patients with psychosis at different stages of the illness.Clinical implicationsThis encouraging report justifies more detailed studies.
Olanzapine in practice: a prospective naturalistic study
Authors: Taylor David , Mir Shameem , Mace Shubra 
Published: October 2008

Aims and methodThe study aimed to evaluate the effectiveness of the naturalistic use of olanzapine. Prescribers of olanzapine were asked to provide baseline and six-week Brief Psychiatric Rating Scale scores for 56 in-patients. Withdrawals from treatment were also noted.ResultsOlanzapine was not effective in any of the 12 patients with refractory schizophrenia and four patients worsened. In 36 patients with non-refractory schizophrenia, 16 (44%) improved and 10 (28%) were categorised as treatment failures. of eight patients with non-schizophrenic psychosis, only one improved and two were treatment failures.Clinical implicationsOlanzapine is effective in treating non-refractory schizophrenia, but appears to have no beneficial effect in refractory schizophrenia.
Supervised discharge orders in England
Authors: Pinfold Vanessa , Bindman Jonathan , Friedli Karin , Beck Andrew , Thornicroft Graham 
Published: October 2008

Aims and methodSupervised discharge orders were introduced in April 1996. This paper describes two national surveys of their use in all mental health provider trusts in England. Data were collected from key informants in mental health provider trusts using a postal survey in 1997, and a follow-up telephone survey in 1998.ResultsThe total number of patients subject to supervised discharge in 1997 was 160, a mean of one per trust. In 1998, there were 378 cases, a mean of two cases per trust. The annual period prevalence in 1998 can be estimated as 510 cases, approximately one per 100000 total population per year. Seventeen applications of the ‘power to convey’ were identified.Clinical implicationsSupervised discharge is regarded as suitable for very few patients, though its use is growing. The controversial power to convey is seldom used in practice and barriers to its use are described.
Experience and application of HoNOS65+
Authors: Allen Lesley , Bala Sushila , Carthew Richard , Daley Stephanie , Doyle Eugene , Driscoll Pat , Grey Barbara , Macdonald Alastair 
Published: October 2008

Aims and methodThe implementation of the Health of the Nation Outcomes Scales for Old Age Psychiatry services (HoNOS66+) in a National Health Service trust is described. Some preliminary data are reported for illustrative purposes.ResultsLessons learnt from this process are identified, and further work needed both on the glossary for the scales and on systems for trapping data is suggested.Clinical implicationsThese remain uncertain. It may be that HoNOS65+ will remain a purely administrative tool.
Children's needs when their mothers are admitted to psychiatric units
Authors: Tamarit Leonor Montoliu , Lau A. Yin-Har 
Published: October 2008

Aims and methodsDue to a concern over the low level of referrals of children to the child and adolescent psychiatry team, an audit was designed to investigate the possible causes. An audit was undertaken in which the case notes of 100 consecutive adult female admissions to acute wards in Goodmayes Hospital were screened. The case notes were screened for mention of children, any actions taken on their behalf, in addition to a number of demographic and social factors.ResultsThe findings of the audit indicate that children of psychiatrically ill mothers do not receive the attention they need, as indicated by the literature on the topic.ImplicationsMore detailed case history-taking by the parent's psychiatrist and closer cooperation between adult and child psychiatry departments are suggested as two methods of addressing this need.
Malaise in psychiatric recruitment and its remedy
Authors: Thompson D. J. , Sims A. C. P. 
Published: October 2008

Aims and methodSurveys of career intention among medical students, Membership Examination results and manpower figures are used to examine trends in recruitment to psychiatry over the last 10 years.ResultsProblems of recruitment to psychiatry have increased. Consultant expansion contrasts with a fall in the number of medical students. The increase in the number of career senior house officers and specialist registrars is insufficient to fill existing consultant vacancies notwithstanding new and replacement posts. The popularity of general psychiatry and psychotherapy have declined.Clinical implicationsProposals include an increase in the number of medical students, the introduction of psychiatry in the pre-registration year, increased specialisation and closer integration of general adult psychiatry with general medicine.
Adolescent counselling services in the voluntary sector
Authors: Mitchell Mary 
Published: October 2008

Aims and methodWhile Youth Access attempts to organise voluntary counselling services for young people on a national level research describing such agencies is lacking. In order to investigate their activity with a view to multi-agency collaboration, a questionnaire was distributed to eight agencies in Hampshire.ResultsThe responses demonstrate a strong emphasis on accessibility and informality. Although agencies have reported increasing numbers of service user contacts little attempt has been made to quantify and evaluate the service provided.Clinical implicationsEfforts to organise, evaluate and improve accountability in the voluntary sector might spoil these fundamental components for the disaffected adolescent.