bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychotherapy patients' views of treatment: on learning from the patient
Authors: Bende Brigitta , Crossley David 
Published: September 2002

Aims and MethodPsychotherapy patients' views of treatment received from two senior registrars were obtained by questionnaire. The aim of the study was to give patients an opportunity to reflect on therapy and help trainees evaluate their therapeutic style and the therapy they provided.ResultsThe response rate was 86% (25/29). All patients recalled key issues covered in therapy, 96% (24/25) found therapy valuable. Seventy-two per cent (18/25) made comments about therapists' style and 20% (5/25) made suggestions for improvement of the service.Clinical ImplicationsClinical, service and training implications are discussed and it is suggested that this form of patient survey is a useful adjunct in outcome evaluation of treatments and of training.
Drayton Park, an alternative to hospital admission for women in acute mental health crisis
Authors: Killaspy Helen , Dalton Joy , McNicholas Shirley , Johnson Sonia 
Published: September 2002

Aims and MethodTo describe Drayton Park, the first women-only residential mental health crisis facility in the UK and to investigate whether it is succeeding in its remit of providing a viable alternative to hospital admission. We randomly selected case files from 100 women admitted to Drayton Park since its opening and examined variables including demographic details, the reasons for referral, diagnosis and the source of referral.ResultsOur findings show that the service is able to respond quickly to referrals and appears to be functioning safely. The women admitted have a relatively short length of stay, half suffer from depressive episodes and one-third have a relapse of schizophrenia or bipolar disorder.Clinical ImplicationsThis project appears to be succeeding in providing a safe alternative to hospital admission for women with severe and enduring mental health problems.
Mental state examinations by psychiatric trainees in a community NHS trust
Authors: Kareem Oladimeji S. , Ashby Ceri-Anne 
Published: September 2002

Aims and MethodTo investigate the recording of Mental State Examination (MSE) findings by psychiatric trainees as well as dating, timing and signing of entries into the clinical record. Data were collected from randomly selected case notes in three acute psychiatric units.ResultsThere was an initial decline of MSE recording from 69% to 58% in the first re-audit. Introduction of a standardised format and involvement of consultant trainers in the supervision of MSE recording led to an improvement to 83% in the secondre-audit. Adherence to medico-legal standards also improved.Clinical ImplicationsThe introduction of an MSE format and consultant supervision of records improved the standard of MSE recording as well as basic medico-legal requirements by psychiatric trainees.
Benzodiazepines in schizophrenia
Authors: Paton Carol , Banham Stuart , Whitmore John 
Published: September 2002

Aims and MethodWe sought to determine the prevalence of long-term benzodiazepine prescribing in patients with schizophrenia occupying psychiatric rehabilitation beds. A cross-sectional survey was conducted in 11 National Health Service trusts.ResultsAlmost10% of patients occupying rehabilitation beds had a diagnosis of schizophrenia and received long-term benzodiazepines in combination with one or more anti-psychotics.Clinical ImplicationsOur results are consistent with those of other authors and show that benzodiazepines are frequently used inthe long-term in patients with schizophrenia despite a lack of open acknowledgement of this practice and a paucity of objective data to support its efficacy.
Suicide: a call-sheet audit – Data from SANELINE
Authors: Fakhoury Walid K. H. 
Published: September 2002

Aims and MethodThis is an audit of 10 359 calls made to the national mental health helpline SANELINE between January 1996 and June 1998 aiming at describing the profile of suicidal callers.ResultsMore calls were by, or about, women. The most common age group for suicidal callers was 25–34 years, while those under 25 were least likely to call the helpline. Fifty-five per cent of all calls related to people suffering from depression, and 31% were for people with psychosis. The majority of sufferers who were planning suicide or were in the act of suicide at the time of the call were in contact with services, and almost three-fifths of sufferers reported problems with services.Clinical ImplicationsThere is an urgent need for innovative interventions targeting males and those under 25 years of age.
A survey of stress in psychiatrists working in the Wessex Region
Authors: Rathod Shanaya , Roy Leena , Ramsay Maureen , Das Mrigendra , Birtwistle Jon , Kingdon David 
Published: September 2002

Aims and MethodsThe study explored job-stress experienced by psychiatrists, its effect on their lives and the coping mechanisms used.ResultsThe response rate was 62%. The younger group reported higher stress levels and used more positive coping strategies than the older groups. Female doctors were more likely to report being stressed. Aspects of the job experienced as most stressful include on-call duties and dealing with difficult and hostile relatives.Clinical ImplicationsAnxietyand depressive symptoms are reported frequently in psychiatrists. Strategies to deal with the identified causes need to be put in place.
Availability and acceptability of home treatment for acute psychiatric disorders
Authors: Owen Andrew J. , Sashidharan S. P. , Edwards Lyse J. 
Published: September 2002

Aims and MethodsTo ascertain current levels of access to home treatment for those with acute mental illness and future plans of trusts and purchasing authorities to provide such services. Also, to assess the attitudes of these organisations towards this form of treatment. A postal survey of all mental health trusts and purchasing authorities within the UK was carried out.ResultsOne hundred and seventy-two trusts and 82 health authorities returned questionnaires, representing a response rate of 75% and 67% respectively. Only 27 (16%) of trusts provided home treatment but 58 (40%) had plans to do so. All health authorities and 97% of trusts were in favour of the principle of providing home treatment.Clinical ImplicationsDespite the low levels of provision of home treatment trusts and health authorities were strongly in favourof it. There is likely to be a large increase in its availability over the next 12 months.
What you don't know won't hurt you
Authors: Smith Shubulade , Henderson Max 
Published: September 2002

Aims and MethodInformation given to patients about side-effects of their medication plays a key role in future adherence. It is possible that when antipsychotic medication is prescribed routinely, insufficient information is given to them. In order to investigate the amount of information doctors feel they need to give to patients when they are prescribing conventional antipsychotic medication, all the clinical doctors at a large mental health trust were surveyed by anonymous questionnaire.ResultsOverall, doctors said they gave large amounts of information to patients about possible side-effects of anti-psychotic drugs, but some side effects we discussed far more frequently than others.ConclusionsThe selectivity of information given to patients appears to reflect the doctors perception of what is important. This might not correlate with what the patient may wish to be told. Discussions with patients about side-effects may need to be more comprehensive than they currently are.
The NHS and Community Care Act 1990
Authors: Angunawela Indra I. , Barker Andrew , Nicholson Simon D. 
Published: September 2002

Aims and MethodThe Community Care Act came into effect in April 1993. In order to see what impact this would have on the discharge profile of dementia inpatients, prospective studies of inpatient discharges from a dementia assessment ward before the Act, and five and 41 months after the Act were conducted.ResultsThe proportion of patients discharged to their own homes and to residential/nursing homecare remained unaffected by the Act. Duration of hospital stay increased after the Act in 1993 and 1996 (P=O.02) largely due to delays in placement into care homes. Placement delay was increased both in 1993 and 1996, but by 1996 the difference was no longer statistically significant. Duration of hospital stay was unaffected by the Act for those patients discharged to their own homes.Clinical ImplicationsThe new care management process by social services was found to be associated with delayed discharges for people with dementia requiring residential/nursing home placements, thus causing pressures on beds and hig her in-patient costs.
Provision of psychotherapy services for older people
Authors: Murphy Siobhan 
Published: September 2002

Aims and MethodsA postal questionnaire was sent to 100 departments of psychotherapy within the UK in an attempt to gauge the use of psychotherapy services by patients in the third and fourth age.ResultsEighty-seven per cent of respondents felt that the needs of this group for psychotherapy were not met as well as those of younger people in their catchment areas. This is most marked in people over 65 years of age who are infrequently referred to psychotherapy departments. Suggestions are made for improving services.Clinical ImplicationsThe psychotherapy needs of this group need to be considered in service planning. All professionals need educating about the availability and applicability of the psychotherapies for the older patient. Without additional resources it seems unlikely that the needs of this patient group will be met.
Comparing general practitioners and specialist alcohol services in the management of alcohol withdrawal
Authors: Naik P. C. , Lawton J. , Brownell L. W. 
Published: September 2002

Aims and MethodA postal questionnaire was used to compare the pharmacological management of alcohol withdrawal as carried out by a group of general practitioners and specialist alcohol services.ResultsGeneral practitioners were significantly more likely to prescribe chlormethiazole, less likely to use B vitamins and less likely to admit patients with a history of withdrawal complications.Clinical ImplicationsGeneral practitioners need training in order to improve their management of alcohol withdrawal.
The role of the educational supervisor
Authors: Day Edward , Brown Nick 
Published: September 2002

Aims and MethodsA postal questionnaire of all pre-membership psychiatric trainees in the West Midlands was used to investigate the role of the educational supervisor. The trainees were asked about their experience of educational supervision, and also asked to rank a number of possible roles for their supervisor in order of importance.ResultsA response rate of 70% was achieved. Trainees rated regular appraisal and assessment of skills and deficits as the most important role of the educational supervisor, but had only experienced this in 55% of their training posts thus far. Less than half of the respondents had developed a written educational plan with their educational supervisors, and trainees rated this the least important task of good educational supervision.Clinical ImplicationsThe results of this survey inform the training agenda for trainers, and emphasise the need to equip consultants with the skills to appraise their trainee's educational development.
Outcome of cosmetic surgery and ‘DIY’ surgery in patients with body dysmorphic disorder
Authors: Veale David 
Published: September 2002

Aims and MethodLittle is known about the outcome of cosmetic surgery in patients with body dysmorphic disorder (BDD). Self-reported outcome was collected on 25 patients with BDD who at the time of psychiatric assessment had reported that they had had cosmetic surgery in the past.ResultsTwenty-five patients with BDD had a total of 46 procedures. The worst outcome was found in those who had had rhinoplasty and those with repeated operations. Mammoplasty and pinnaplasty was associated with higher degrees of satisfaction. Nine patients with BDD, either in desperation at being turned down for cosmetic surgery or because they could not afford it, had performed their own ‘DIY’ surgery in which they attempted by their own hand to alter their appearance dramatically.Clinical ImplicationsCosmetic surgery cannot at present be recommended for patients with BDD. However, patients turned down for surgery or who cannot afford it, may try to alter their appearance by themselves. The study contains a selection bias of patients in favour of treatment failures in cosmetic surgery and prospective studies are required on BDD patients who obtain cosmetic surgery or dermatological treatment.
The treatment of shell-shock
Authors: Howorth Peter W. 
Published: September 2002

“I had a sister first, then a brother, then another brother – he was the one that was killed – and the next brother, who was also in the army, went out, and he got shell–shock. Of course, they didn't understand anything about it at all in those days. He was put on light duty at first, and for, I should think, two–and–a–half years, we had the most terrible life with him. I don't mean because he could help it – he couldn't help it at all – and no doctor seemed to be able to do anything with him at all.About five times a day, he'd say he was going to commit suicide. We knew he wouldn't, but he'd got to be watched, all the time, and he would wake up in the night, screaming – and my mother would go and sit with him – saying ‘Oh, I can't go back to it’ … It was absolutely terrifying when he woke up, screaming and screaming and screaming.” (Liddle Collection, Leeds University Library, further details available from author upon request)
Profile of service users attending a voluntary mental health sector service
Authors: Hutchinson Gerard , Gilvarry Catherine , Fahy Thomas A. 
Published: September 2002

Aims and MethodVery little research has been undertaken to characterise the service user groups served by the voluntary sector mental health services in Britain. In view of the high reported cases of dissatisfaction with the statutory mental health services in the population of Caribbean origin in Britain, we sought to compare the male service users attending a voluntary sector service in Brixton, South London with those attending a service run by the mental health hospital for that catchment area. The service users and their case workers were interviewed and their case notes reviewed to obtain demographic information such as employment and forensic history and contact with other services. They were also assessed using the Global Assessment of Functioning (GAF) and the Camberwell Assessment of Need (CAN).ResultsThe service users attending the voluntary sector were significantly more disadvantaged in the areas of unemployment and contact with other health services particularly general practitioners. They had significantly lower scores on the GAF and had more unmet needs on the CAN, including numeracy and literacy skills. Both patient groups, however, reported problems with intimate relationships.Clinical ImplicationsService users attending voluntary sector services are likely to be more socially and materially deprived than their counterparts attending statutory services and specific strategies are required to assist these organisations in meeting the many needs of the service users.
A postal survey of the assessment procedure for personality disorder in forensic settings
Authors: Milton John 
Published: September 2002

Aims and MethodA survey of 50 in-patient forensic health care and prison services in England, Wales and Scotland was employed to evaluate: (a) how severe personality disorder is assessed; and (b) how assessments compare with recommendations concerning standardised assessment by the Working Group on Psychopathic Disorder (Reed, 1994).ResultsSeventy per cent of services responded, of whom 40% formally assessed personality disorder. Fifty-four instruments were routinely employed. Assessments of personality structure and cognitive/emotional styles were more common than structured diagnostic instruments or ratings of interpersonal functioning. Of the assessment tools, 25.7% of services provided at least one suggested by Reed (1994).Clinical ImplicationsA nationally agreed, focused repertoire of instruments should be encouraged within secure forensic settings offering assessments to individuals with severe personality disorder.
A consultant-led group for in-patients in a medium secure unit
Authors: Lucas Philip 
Published: September 2002

Aims and MethodThe first 14 months of a consultantled weekly group for in-patients in a medium secure unit are described.ResultsThe group's (voluntary) attendance averaged more than 60% of the team's patients over 50 sessions. The weekly attendance increased significantly in the second seven-month period compared with the first (mean numbers of patients (s.d.) 10.4 (0.6) v. 8.1 (0.8)). An eclectic approach, with supportive, educational and interpretive elements, evolved as most suitable for the heterogeneous group of patients involved.Clinical ImplicationsThe group represented a safe, efficient and practical way of responding to patients' wishes for consultant contact, information, support and also of observing the individual's mental state and ability to interact in a complex social setting.
Community mental health team case-loads and diagnostic case-mix
Authors: Greenwood Nan , Chisholm Brock , Burns Tom , Harvey Kate 
Published: September 2002

Aims and MethodInformation concerning team staffing, keyworker case-loads, and keyworker diagnostic case-mix was collected from six community mental health teams caring for 1651 patients to establish the clinical burden across teams and professions.ResultsTeam case-loads varied from 427 to 121, an average of 275 patients. Over half the patients were female, and psychotic disorders constituted 44% of the sample. The most common diagnoses were schizophrenia (28.6%) and depression (23.6%). Keyworker case-loads varied across both teams and professions, averaging 30 patients per full-time equivalent. Psychiatrists' case-loads were the largest. Diagnostic case-mix varied with profession. Community psychiatric nurses had the largest proportion of patients with psychosis (73.8%).Clinical ImplicationsMulti-disciplinary community mental health teams have a shared view of appropriate work distribution. Consultant psychiatrists may underestimate the resources required by patients with non-psychotic disorders even in inner city areas.
Provision of a community pharmacist-run medication advice service at mental health resource centres
Authors: Ewan Marilyn A. , Greene Russell 
Published: September 2002

Aims and MethodTo assess what medication information long-term mentally ill patients required and acceptability of an advice service. Confidential consultations were offered by a community pharmacist at two mental health resource centres. The service was evaluated by patients and staff by questionnaire.ResultsData were collected on 33 consultations (30 users; three attended twice). Mean duration of consultations was 14.9 minutes (range 5–45). Antipsychotics and antidepressants were most commonly prescribed and enquired about. Most drug enquiries concerned adverse drug reactions (n=24) and therapy choice (n=17). All patients and staff hoped the service would be fully implemented.Clinical ImplicationsCommunity pharmacists represent an acceptable, but underutilised, information provision service. Such a service could be overseen by specialist psychiatric pharmacists. This study reflects patients' concerns about the use of antipsychotics and antidepressants and the need to address them. Further work is needed to determine the impact of the service on clinical outcome.
Investigation of the ‘cuff’ method for assessing seizure duration in electroconvulsive therapy
Authors: Wise M. E. Jan , Mackie Fiona , Zamar Antonios C. , Watson James P. 
Published: September 2002

Aims and MethodElectroconvulsive therapy should be effectively monitored and seizure duration accurately ascertained. We observed the seizure duration in both lower and upper limbs using the Hamilton ‘cuff’ method.ResultsThirty-nine seizures in 19 patients were observed. There were no statistically significant differences between cuffed and uncuffed limbs, nor between upper and lower limbs.Clinical ImplicationsAlternatives to the Hamilton cuff method to observe seizure duration need to be considered.
A survey of training experiences and attitudes of higher specialist trainees in child and adolescent psychiatry
Authors: Smart Siobhan , Cottrell David 
Published: September 2002

Aims and MethodChanges in higher specialist training in the UK have led to a revision of training guidelines in child and adolescent psychiatry. This survey studies trainees' experiences and attitudes in the light of these changes. A questionnaire covering training attitudes and experiences was distributed to all higher specialist trainees in child and adolescent psychiatry via their programme directors.ResultsEighty-eight per cent of trainees responded. Although most training experiences are well provided, there are gaps in provision in specific areas, including research and teaching. Dissemination of information about aspects of training requires improvement and clearer feedback on training could be given.Clinical ImplicationsThe implications for training in child and adolescent psychiatry and higher specialist training in general are discussed.
Psychotherapy by computer
Authors: Graham Candida , Franses Abigail , Kenwright Mark , Marks Isaac 
Published: September 2002

Aims and MethodComputerised self-help psychotherapies are fast becoming part of psychiatric practice. The aim of the study was to assess potential user preferences for the delivery of self-help psychotherapy for obsessive-compulsive disorder (OCD) and phobic anxiety disorders. A postal survey was undertaken of enquirers responding to a teletext article on self-help psychotherapies for OCD and agoraphobia. Subjects were asked their preferences for the delivery of self-help services for anxiety disorders, their acceptance or refusal of general practitioner (GP) referrals for such therapy, and how much they would be willing to pay for such a service.ResultsOf 326 questionnaires sent out 113 completed questionnaires were returned (35%). Twenty-seven per cent of respondents did not wish to access such services via their GP, 91% wanted access via a computer system and respondents were willing to pay an average of $10 per computer session (range 0–100).Clinical ImplicationsComputerised self-help psychotherapies for OCD, phobic anxiety disorders and depression are becoming part of everyday clinical practice. This may be the first survey directly asking potential users about their preferred access to self-help psychotherapies for anxiety disorders. A significant proportion of responders did not wish to go via their GP to receive therapy and the vast majority welcomed therapy delivered by some form of computer system.
First-person accounts of delusions
Authors: Stanton Biba , David Anthony S. 
Published: September 2002

Aims and MethodIn order to investigate cognitive aspects of the experience of delusions, including onset and recovery, autobiographical accounts of schizophrenia were reviewed.ResultsThe sample was self-selected and biased towards women and highly-educated patients. The delusions described were usually gradual in onset and often occurred in the context of an odd or fearful mood, which was accompanied by distorted reasoning. Recovery was also gradual with an intermediate stage of reality-testing or fluctuation between belief and disbelief. Many patients retained residual aspects of delusional thinking after recovery. Most attributed their recovery to a combination of medication, psychotherapy, social support and personal coping strategies; some felt that their illness had enhanced their self-awareness or spirituality.Clinical ImplicationsFurther exploration of spontaneous coping strategies in recovery from delusions through personal accounts of illness would be valuable.