Improving the quality of mental health services using patient outcome data: making the most of HoNOS [Current Practice]
Efforts to assess and improve the quality of mental health services are often hampered by a lack of information on patient outcomes. Most mental health services in England have been routinely collecting Health of the Nation Outcome Scales (HoNOS) data for some time. In this article we illustrate how clinical teams have used HoNOS data to identify areas where performance could be improved. HoNOS data have the potential to give clinical teams the information they need to assess the quality of care they deliver, as well as develop and test initiatives aimed at improving the services they provide. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Crawford, M. J., Zoha, M., Macdonald, A. J. D., Kingdon, D. Tags: Current Practice Source Type: research
Should compulsory admission to hospital be part of suicide prevention strategies? [Special articles]
The World Health Organization report Preventing Suicide: A Global Imperative provides governments with guidance for comprehensive suicide prevention strategies. However, it does not mention the role that compulsory admission to hospital of psychiatric patients should have in policies for suicide prevention. This was a missed opportunity for international discussion and guidance about a measure that, although widely used, is becoming increasingly controversial in light of the existing evidence and human rights norms. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Wang, D. W. L., Colucci, E. Tags: Special articles Source Type: research
Drug information update. Unconventional treatment strategies for schizophrenia: polypharmacy and heroic dosing [Special articles]
The majority of patients respond to antipsychotic monotherapy at standard doses, but a subset of patients will require more heroic measures that include antipsychotic polypharmacy and high-dose monotherapy. Indeed, research has shown that roughly 30% of patients with psychosis are prescribed multiple antipsychotic medications. We discuss the potential benefits and challenges of these approaches and provide a rationale for why and when they should be utilised. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Moore, B. A., Morrissette, D. A., Meyer, J. M., Stahl, S. M. Tags: Special articles Source Type: research
Known unknowns and unknown unknowns in suicide risk assessment: evidence from meta-analyses of aleatory and epistemic uncertainty [Review Article]
Suicide risk assessment aims to reduce uncertainty in order to focus treatment and supervision on those who are judged to be more likely to die by suicide. In this article we consider recent meta-analytic research that highlights the difference between uncertainty about suicide due to chance factors (aleatory uncertainty) and uncertainty that results from lack of knowledge (epistemic uncertainty). We conclude that much of the uncertainty about suicide is aleatory rather than epistemic, and discuss the implications for clinicians. (Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Large, M., Galletly, C., Myles, N., Ryan, C. J., Myles, H. Tags: Review Article Source Type: research
Civil and forensic patients in secure psychiatric settings: a comparison [Original papers]
Aims and method To evaluate differences between male patients in secure psychiatric settings in the UK based on whether they are detained under civil or forensic sections of the Mental Health Act 1983. A cohort of patients discharged from a secure psychiatric hospital were evaluated for length of stay and frequency of risk-related incidents.
Results Overall, 84 patients were included in the study: 52 in the forensic group and 32 in the civil group. Civil patients had more frequent incidents of aggression, sex offending, fire-setting and vulnerability, whereas forensic patients had more frequent episodes of self-harm.
Clini...
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Galappathie, N., Khan, S. T., Hussain, A. Tags: Original papers Source Type: research
An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist [Original papers]
This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital.
Results The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts. We deemed the involvement of a liaison psychiatrist necessary in 241 (70.1%) referrals, with medication management as the most common reason.
Clinical implications A substantial amount of liaison ward work involves the treatment and management of severe and complex mental health problems. Our ...
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Guthrie, E. A., McMeekin, A. T., Khan, S., Makin, S., Shaw, B., Longson, D. Tags: Original papers Source Type: research
Are men under-treated and women over-treated with antidepressants? Findings from a cross-sectional survey in Sweden [Original papers]
Aims and method To examine gender differences in self-reported depression and prescribed antidepressants (ADs). The Hospital Anxiety and Depression Scale was used to assess depression, and information on prescribed ADs was obtained from the Swedish Prescribed Drug Register.
Results Depression was reported by 11.7% of the participants (12.3% men and 11.2% women). ADs were prescribed for 7.6% of the participants (5.3% men, 9.8% women). Among men, 1.8% reported depression and used ADs, 10.5% reported depression but did not use ADs, and 3.6% used ADs but did not report depression. The corresponding figures for women were 2.6%,...
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Thunander Sundbom, L., Bingefors, K., Hedborg, K., Isacson, D. Tags: Original papers Source Type: research
Adherence to NICE guidance on lifestyle advice for people with schizophrenia: a survey [Original papers]
Aims and method The STEPWISE trial (STructured lifestyle Education for People WIth SchizophrEnia, schizoaffective disorder and first episode psychosis) is currently evaluating a lifestyle education programme in addition to usual care. However, it is difficult to define what constitutes ‘usual care’. We aimed to define ‘usual care’ for lifestyle management in people with schizophrenia, schizoaffective disorder and first-episode psychosis in STEPWISE study sites. Ten National Health Service (NHS) mental health trusts participated in a bespoke survey based on the National Institute for Health and Care ...
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Swaby, L., Hind, D., Gossage-Worrall, R., Shiers, D., Mitchell, J., Holt, R. I. G. Tags: Original papers Source Type: research
Vitamin D deficiency in adolescents in a tier 4 psychiatric unit [Original papers]
Aims and method To review the current clinical practice and guidelines for testing and treating vitamin D deficiency in adolescents admitted to a tier 4 adolescent psychiatric unit in north London. The blood test results of 56 patients admitted between 2012 and 2014 were examined to determine whether vitamin D levels had been tested. For those individuals who were tested for vitamin D, results were analysed by gender and ethnicity.
Results Of 56 patients admitted, 48% were tested for vitamin D deficiency and in 81.5% of cases we uncovered deficiency or severe deficiency; 18.5% had the minimum levels of vitamin D for bone h...
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Stewart, N. F., Lewis, S. N. Tags: Original papers Source Type: research
Big data in mental health research - do the ns justify the means? Using large data-sets of electronic health records for mental health research [Editorials]
Advances in information technology and data storage, so-called ‘big data’, have the potential to dramatically change the way we do research. We are presented with the possibility of whole-population data, collected over multiple time points and including detailed demographic information usually only available in expensive and labour-intensive surveys, but at a fraction of the cost and effort. Typically, accounts highlight the sheer volume of data available in terms of terabytes (1012) and petabytes (1015) of data while charting the exponential growth in computing power we can use to make sense of this. Presente...
Source: Psychiatric Bulletin - June 1, 2017 Category: Psychiatry Authors: Schofield, P. Tags: Editorials Source Type: research
Spirituality and Narrative in Psychiatric Practice: Stories of Mind and Soul [Reviews]
(Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - April 3, 2017 Category: Psychiatry Authors: Groves, P. Tags: Reviews Source Type: research
The Psychedelic Policy Quagmire: Health, Law, Freedom, and Society [Reviews]
(Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - April 3, 2017 Category: Psychiatry Authors: Van Hagen, A. G. Tags: Reviews Source Type: research
The Vegetarian [Reviews]
(Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - April 3, 2017 Category: Psychiatry Authors: Read, G. Tags: Reviews Source Type: research
The Narcissist Next Door. Understanding the Monster in Your Family, in Your Office, in Your Bed - in Your World [Reviews]
(Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - April 3, 2017 Category: Psychiatry Authors: Patrick, J. Tags: Reviews Source Type: research
Mentalisation-Based Group Therapy (MBT-G): A Theoretical, Clinical, and Research Manual [Reviews]
(Source: Psychiatric Bulletin)
Source: Psychiatric Bulletin - April 3, 2017 Category: Psychiatry Authors: Adshead, G. Tags: Reviews Source Type: research
