bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of references in psychiatric literature: a survey of three journals
Authors: Lawson L. A. , Fosker Ruth 
Published: October 2008

Aims and methodThe prevalence of errors in reference citations and use in the psychiatric literature has not been reported as it has in other scientific literature. Fifty references randomly selected from each of three psychiatric journals were examined for accuracy and appropriateness of use by validating them against the original sources.ResultsA high prevalence of errors was found, the most common being minor errors in the accuracy of citations. Major citation errors, delayed access to two original articles and three could not be traced. Eight of the references had major errors with the appropriateness of use of their quotations.Clinical implicationsErrors in accuracy of references impair the processes of research and evidence-based medicine, quotation errors could mislead clinicians into making wrong treatment decisions.
The management of cylindrical battery ingestion in psychiatric settings
Authors: Hindley Nick , Gordon Harvey , Newrith Chris , Mohan Damian 
Published: October 2008

Aim and methodTo describe physical sequelae of cylindrical battery ingestion and their management by description of recent cases and literature review.ResultsX-rays should be performed to determine the position and integrity of the battery. In the absence of abdominal symptoms, immediate surgical opinion may not be indicated.Clinical implicationsConservative management of battery swallowing is frequently possible.
Medical students' perspective of maximum security psychiatric care
Authors: Thomson Lindsay D. G. , Gray Colin M. , Humphreys Martin S. 
Published: October 2008

Aims and methodThis study describes the effects of teaching medical students in a maximum security psychiatric setting. A questionnaire was distributed to students (n=210) at the beginning and end of their third year.ResultsFollowing the visit to the State Hospital significantly more students understood that maximum security psychiatric facilities are part of the National Health Service; that some serious offenders may require hospitalisation rather than imprisonment; that not everyone detained in such surroundings is actively violent or dangerous, or permanently detained. Twenty-three students considered forensic psychiatry to be a possible career option.Clinical implicationsThis study demonstrates that early exposure, even to such a specialised area of practice, can enhance the prospects of future recruitment. Attracting motivated, able and interested doctors is important in improving patient care.
Psychiatric features of new variant Creutzfeldt-Jakob disease
Authors: Will R. G. , Stewart G. , Zeidler M. , Macleod M. A. , Knight R. S. G. 
Published: October 2008

Aims and methodNew variant Creutzfeldt–Jakob disease is a novel prion disease of humans that may be causally linked to bovine spongiform encephalopathy. Psychiatric symptoms occur in the early stages of the illness and may be difficult to distinguish from the symptoms of more common psychiatric disorders. Cases of new variant Creutzfeldt–Jakob disease are identified through the national surveillance system. Information on psychiatric features has been obtained by review of case notes and, in the majority of cases, by interview of relatives by a member of the surveillance staff.ResultsThirty-five cases of new variant Creutzfeldt–Jakob disease have been identified in the UK and detailed information on the clinical features and investigations is currently available in 33 of these cases. All but one of the cases exhibited prominent early psychiatric symptomatology, but the diagnosis of an underlying neurological disease was not possible in the majority of cases until the development of neurological symptoms and signs. Early indications of an underlying neurological disorder included cognitive impairment, persistent sensory symptoms or limb pain and, in a minority, gait imbalance, dysarthria or visual symptoms. Limited evidence suggests that investigations such as electroencephalogram or brain imaging are unlikely to provde useful diagnostic information during the ‘psychiatric’ phase of the illness.Clinical implicationsThe early recognition of an underlying neurological disorder may be impossible in the early psychiatric phase of new variant Creutzfeldt–Jakob disease, but the suspicion of this diagnosis may be raised by the occurrence of associated neurological symptoms. The development of early diagnostic markers is an important objective.
Survey of suicides in the Fife region of Scotland
Authors: Douds Fergus , Bridges Vicky 
Published: October 2008

Aims and methodsSuicides in the Fife region were investigated over a two-year period. The timing of the final contact with general practitioners and psychiatric services was ascertained. Data were collected from procurators fiscal records, general practices, and where applicable, psychiatric records.ResultsThere were 74 suicide victims during the study period. Forty-six per cent of suicide victims saw their general practitioner in the month before death, and 55% had a history of previous contact with psychiatric services, although only 27% of this group saw a psychiatrist in the month before death.Clinical implicationsClinical audit of suicide is an important task for psychiatric services. Practitioners must continually assess risk and attempt, where possible, to reduce risk factors.
Readability of user leaflets
Authors: Humfress Harriet , Schmidt Ulrike 
Published: October 2008

Aims and methodLeaflets are commonly used as a way of providing information to users. In this study, we use a simple index of ‘readability’ to compare a range of leaflets available to people with mental health problems.ResultsThe majority of the leaflets contained passages that are likely to be beyond the comprehension of people with mental health problems.Clinical implicationsLeaflets are a cost-effective way of providing information, but only if the text can be understood by the target audience.
Traditional healers and mental illness in Uganda
Authors: Ovuga Emilio , Boardman Jed , Oluka Elizabeth G. A. O. 
Published: October 2008

Aims and methodA cross-sectional, interview survey of the beliefs, knowledge, attitudes and practice towards mental illness of 29 traditional healers in the Pallisa district of Uganda was carried out.ResultsMany of the healers had experienced emotional problems that had been treated by other healers. Almost all had a family member who was also a traditional healer. They treated a wide range of conditions and all dealt with mental illness. Most believed that mental disorders were caused by supernatural processes. Many recognised the role of environmental agents. Their diagnosis and management of mental illness was eclectic. The healers were either traditional herbalists or spirit diviners or a mixture of both. Almost all referred patients to the district hospitals and were willing to work with government health services.Clinical implicationsThe results of the survey suggest the presence of fertile ground on which to build cooperation between traditional healers and medical services. Such cooperation may harness primary care resources more effectively. Sequential or simultaneous models of collaboration (or combinations of both) may be considered. Further work on specific treatments, their outcomes and the evaluation of collaborative models is needed.
Academic psychiatry in the Deep South
Authors: Mahmood Tariq , Romans Sarah 
Published: October 2008

SummaryTo highlight the problems in the delivery of psychiatric services in rural New Zealand. We describe the innovative collaboration between the University of Otago Medical School in Dunedin and the Southland Hospital in Invercargill.Clinical implicationsForging of academic links between the regional medical schools and rural hospitals is one way of delivering specialist psychiatric services in rural areas.
Old age psychiatry: a speciality in transition
Authors: Wattis John , MacDonald Andrew , Newton Paul 
Published: October 2008

Aims and methodsWe aimed to update Information on the development of old age psychiatric services using a postal survey of consultants.ResultsThe response rate (51%) was lower than previous surveys in the 1980s. Senior academic appointments showed little increase and academic posts were largely National Health Service (NHS) funded. Services had smaller catchment areas and increased numbers of staff in medicine, nursing and social work, but not in occupational therapy, physiotherapy and psychology. Relative workload was increasing and most services included early-onset dementia. There was a decrease in provision of NHS long-stay beds with only marginal changes in other facilities.Clinical implicationsServices were offering more to patients than previously. Weakness in academic development may cause problems for the future; the results suggested that recruitment in some disciplines may already be problematical. There is a need to develop the role of NHS long-stay facilities.
Use of high-dose depot neuroleptics
Authors: Purandare N. , Aitken L. , Joshi P. , Thomas C. S. 
Published: October 2008

Aims and methodsTo identify and reduce the number of patients receiving depot neuroleptics above the British National Formulary maximum. The medical records were scrutinised and individual consultants were informed of the results.ResultsFor the team involved in this audit there was a significant reduction in the prescription of high-dose depot medication, but this did not generalise to other teams.Clinical implicationsDifferent teams should repeat the audit and a new depot card has been developed.
Home treatment in Bradford
Authors: Bracken Patrick , Cohen Bruce 
Published: October 2008

Aims and methodWe describe a new home treatment service established In one sector of the city of Bradford.ResultsThere was a tendency for the patients hospitalised from this sector to have more unstable housing backgrounds. It was found that a higher percentage of patients with diagnoses of serious mental Illness were cared for at home.Clinical implicationsWe argue that even in the presence of home treatment, there Is a continuing need for asylum. However, we make the case that this does not always have to be provided In a medical environment.
In-patient management of men with schizophrenia who commit serious sexual offences
Authors: Smith Alan D. 
Published: October 2008

Aims and methodA survey of the management of all 84 restricted hospital order in-patients with schizophrenia, resident in any hospital in England and Wales, during May 1997, with an index conviction for a contact sex offence against a woman, was carried out.ResultsTreatment concentrated upon pharmacological therapy for psychiatric symptoms. Only a small minority of patients received specific psychological therapy to address sexual offending issues, despite responsible medical officers reporting that over four-fifths of patients continued to have marked social or sexual difficulties relating to women, and that non-psychotic factors appeared to make a significant contribution to index sexual offending in about three-quarters of cases.Clinical implicationsMany in-patients with schizophrenia who have committed sexual offences may not be receiving optimal management and more research is required to elucidate their treatment needs.
Maintenance pharmacotherapy of unipolar depression
Authors: Forshall Som , Nutt David J. 
Published: October 2008

Aims and methodsThe purpose of this paper is to review current evidence and opinion with regard to the long-term treatment of unipolar depression. The method employed was a Psychlit search using the search items long-term, maintenance, treatment and depression.ResultsThe search yielded 91 articles.Clinical implicationsUnipolar depression is frequently recurrent and sometimes a chronic illness. The paper identifies those at greatest risk of recurrence. It goes on to examine strategies to prevent relapse and for prophylactic treatment. It concludes that continuation treatment should be sustained at full dose for 4–6 months after full remission of symptoms. Where depression is highly recurrent the acute phase dose should be maintained in the long-term.
Good practice issues in psychiatric intensive-care units
Authors: Pereira Stephen , Beer M. Dominic , Paton Carol 
Published: October 2008

Aims and methodTo survey some aspects of care relevant to good practice in psychiatric intensive-care units.ResultsA number of areas of concern were identified, including care issues for informal and female patients, a lack of uniform clinical leadership and a paucity of policies/guidelines for high-risk areas of clinical practice.Clinical implicationsIn an attempt to provide a service for the most disturbed patients from widely varying sources, psychiatric intensive-care units are at risk of compromising the ability to provide good-quality clinical care.
Open all hours: extending the role of the psychiatric day hospital
Authors: Harrison Judy , Poynton Amanda , Marshall John , Gater Richard , Creed Francis 
Published: October 2008

Aims and methodFrom March 1997, the acute day hospital in Central Manchester was extended to 24 hours, seven days a week, with patients treated entirely at home if preferred. The development and organisation of the new service are described. Preliminary evaluation data include service activity for the first 12 months and comparison with a consecutive series of in-patients during the first three months.ResultsThere was an increase in the number of patients treated in the first year (n=214). Sixty-two per cent of patients suffered from schizophrenia, psychotic depression or bipolar disorder. Patients treated by the new service in the first three months (n=43) were more likely than in-patients (n=37) to have problems eating or drinking and to present with suicide risk, whereas the inpatients were more likely to have had adverse past experiences of services and to show behavioural disturbances.Clinical implicationsThe findings support the continued development of 24–hour alternatives to inpatient care, while emphasising that those requiring inpatient care have different presentations and needs.
Audit: prescription of ‘as required’ (p.r.n.) medication in an in-patient setting
Authors: Bowden M. F. 
Published: October 2008

Aims and methodThis audit examines the quality of ‘as required’ (p.r.n.) prescribing for in-patients before and after standard setting.ResultsThere were improvements in writing oral/intramuscular prescriptions and in the use of different drugs regularly and p.r.n. There was a trend for improvement in completion of guidelines for those on high doses but completion was not influenced by hidden p.r.n. prescribing. Writing p.r.n. prescriptions as a ranged dose was common and did not improve significantly.Clinical implicationsBy using some simple measures, improvements in some aspects of potentially problematic p.r.n. medication can be achieved.
Antipsychotic drugs for non-psychotic patients
Authors: El-Khayat Redwan , Baldwin David S. 
Published: October 2008

Aims and methodThe aim of this study was to examine the pattern and basis of use of psychotropic drug prescriptions by psychiatrists to relieve anxiety symptoms arising from non-psychotic disorders. A questionnaire survey was conducted among senior psychiatrists in the Wessex region.ResultsThe response rate was 74%. A range of psychotropic drugs was used to treat non-psychotic anxiety symptoms, most commonly selective serotonin re-uptake inhibitors, tricyclic antidepressants and antipsychotic drugs. Antipsychotic drugs are reserved for second- and third-line treatments, mainly in low doses but sometimes in high doses and for long periods. The use of antipsychotic drugs as anxiolytics was seen by the majority of responders as reasonable practice, and they are considered suitable alternatives to benzodiazepines. This practice was based mainly on personal experience.Clinical implicationsAnxiety symptoms arising from non-psychotic disorders are common in the out-patient population. Although antipsychotics are used by psychiatrists to relieve these symptoms, the ‘evidence base’ for such practice is flimsy and mainly based on clinical experience. The benefit/risk ratio should be considered carefully before prescribing antipsychotics for non-psychotic anxiety. Further research is needed in this area, contributing towards general guidelines.
A re-audit of ECT training and practice
Authors: Yousaf Farida , Lee Martin , King Jose 
Published: October 2008

Aims and methodsA re-audit of the current practice of electroconvulsive therapy (ECT) was carried out over a period of five months using the new guidelines produced by the Royal College of Psychiatrists. The areas audited included obtaining consent from the patients, information recording, training and supervision of the junior doctors and the practical aspects of ECT administration, including dose titration.ResultsAn improvement in the training and supervision of junior doctors was seen since the last audit but shortcomings were identified in areas of pre- and post-ECT preparation, information recording and correct use of stimulus-dosing policy.Clinical implicationsRecommendations include the need to improve clinical practice and recording of information.
Multi-disciplinary assessment of attention-deficit hyperactivity disorder: a tertiary assessment package
Authors: Kat H. , Frake Clay , Sawtell Rebecca 
Published: October 2008

Aims and methodA tertiary assessment package was set up for the more equivocal cases of attention-deficit hyperactivity disorder (ADHD) who present with problems of inattention, impulsivity and overactivity. The structure of the three-day package was discussed, with an analysis of our experience in assessing 12 children using the pilot project. The package and Its use in clinical practice are presented.ResultsThe pilot project described can be modified into a two-day package.Clinical implicationsAssessment of ADHD conducted in multiple settings inherently has many advantages over single clinic assessment. We suggest that such an assessment protocol can be conducted cost effectively.
Improving the accuracy of patients' expectations of the psychiatric out-patient consultation
Authors: Douglas B. C. , Noble L. M. , Newman S. P. 
Published: October 2008

Aims and methodTo investigate the impact of a video to improve the accuracy of patients' expectations of their first out-patient appointment. An intervention study was conducted in which patients watched a video before their appointment. The video provided information about the content of the consultation, the psychiatrist's role and types of treatments.ResultsThe intervention increased the accuracy of patients' expectations but had no impact on satisfaction or anxiety. The video was popular as a means of preparing patients for the consultation.Clinical implicationsThis could be offered routinely to patients attending services for the first time.
Competence of voluntary psychiatric patients to give valid consent to neuroleptic medication
Authors: Paul Moli , Oyebode Femi 
Published: October 2008

Aims and methodTo ascertain the competence of voluntary psychiatric patients to consent to neuroleptic medication and whether there is a hierarchy of tests of competence. A prospective, observational study of consecutive, voluntary admissions to an acute ward using a questionnaire designed to test four levels of competence, the Mini-Mental State Examination and the Brief Symptom Inventory.ResultsAll subjects (n=40) could communicate a choice; 5% were competent at all levels. Tests were arbitrary and not hierarchical. Symptom relief/trust in doctors motivated most decisions to accept treatment.Clinical implicationsThe number and identity of individuals identified as competent will vary with the test set, and tests limited to cognitive criteria will not cover the complexity of the task.
Patients' knowledge and views of their depot neuroleptic medication
Authors: Goldbeck R. , Tomlinson S. , Bouch J. 
Published: October 2008

Aims and methodThis study examined the attitudes and knowledge of patients regarding their depot neuroleptic medication. All patients were attending a community mental health centre in Clydebank, Scotland.ResultsMany patients had limited knowledge of their medication, its benefits and side-effects as well as the rationale for its use. The biggest gaps were found in patients' knowledge of the long-term side-effects of their medication.Clinical implicationsOur findings raise doubts as to the capacity of some patients to give informed consent to their treatment. A number of steps are outlined in order to raise patients' standard of knowledge.
Onset of clinical improvement of depressive illness following electroconvulsive therapy
Authors: Ogundipe Laofe Oladele , Jorsh Mike , Wain B. , Lea J. 
Published: October 2008

Aims and methodTo examine the onset and course of clinically observable improvement in patients receiving electroconvulsive therapy (ECT). A prospective design was used In which 19 consecutive patients receiving ECT were followed up from commencement to termination of ECT. The Clinical Global Improvement Scale was administered at every ECT session to monitor their Improvement.ResultsEleven of the 19 subjects Improved minimally and another subject Improved substantially after the first two ECT treatments.Clinical implicationsECT produces clinically observable improvement in depression within a few days of starting treatment perhaps earlier than is generally acknowledged.
Higher psychiatric trainees and the Caiman reforms
Authors: Cavanagh Paul , Haut Fabian 
Published: October 2008

Aims and methodThe specialist registrar (SpR) grade was introduced in 1996, taking the place of the senior registrar (SR) grade. We surveyed higher trainees in Scotland in order to draw comparisons between the two grades and assess satisfaction with the changes. A postal questionnaire was sent to all higher trainees (n=129) in Scotland seeking Information on structure of training, work patterns and views.ResultsSixty-two per cent of trainees responded. There was little difference in the activity and structure of training between SRs and SpRs. Seventy per cent of responders felt that the SpR grade had not improved training.Clinical implicationsThe survey uncovered dissatisfaction with the new grade, but little objective evidence of differences between SRs and SpRs. More flexibility for time in higher training and restoring the SR title would help to improve morale.
In-patient liaison psychiatry in the UK
Authors: Protheroe David , House Allan 
Published: October 2008

Aims and methodWe argue the case for In-patient liaison psychiatry In the UK. We undertook a case note review of the characteristics of a consecutive series of in-patient and day patient admissions to a specialist liaison psychiatry unit in Leeds. We reviewed the literature on in-patient units for the treatment of similar patients, most of which came from the USA.ResultsPhysical morbidity was high in the sample. Forty-four per cent had been admitted for physical problems in the year before admission to the unit. Twenty-three per cent were taking five or more drugs for physical disorders at the time of admission, 86% were not in paid employment at the time of admission. Treatment involved integrating treatment for physical Illness, and physical and psychosocial treatments for mental disorder. We identified no reports of in-patient units in the UK doing similar work.Clinical implicationsIn-patient liaison psychiatry is neglected in the UK, to the detriment of a small but important group of patients with coexistent severe physical and mental disorder.