Combining Mindfulness Meditation with Cognitive-Behavior Therapy for Insomnia: A Treatment-Development Study

Combining Mindfulness Meditation with Cognitive-Behavior Therapy for Insomnia: A Treatment-Development Study, Behavior TherapyVolume 39, Issue 2June 2008, Pages 171-182

Abstract:

This treatment-development study is a Stage I evaluation of an intervention that combines mindfulness meditation with cognitive-behavior therapy for insomnia (CBT-I). Thirty adults who met research diagnostic criteria for Psychophysiological Insomnia (Edinger et al., 2004) participated in a 6-week, multi-component group intervention using mindfulness meditation, sleep restriction, stimulus control, sleep education, and sleep hygiene. Sleep diaries and self-reported pre-sleep arousal were assessed weekly while secondary measures of insomnia severity, arousal, mindfulness skills, and daytime functioning were assessed at pre-treatment and post-treatment. Data collected on recruitment, retention, compliance, and satisfaction indicate that the treatment protocol is feasible to deliver and is acceptable for individuals seeking treatment for insomnia. The overall patterns of change with treatment demonstrated statistically and clinically significant improvements in several nighttime symptoms of insomnia as well as statistically significant reductions in pre-sleep arousal, sleep effort, and dysfunctional sleep-related cognitions. In addition, a significant correlation was found between the number of meditation sessions and changes on a trait measure of arousal. Together, the findings indicate that mindfulness meditation can be combined with CBT-I and this integrated intervention is associated with reductions in both sleep and sleep-related arousal. Further testing of this intervention using randomized controlled trials is warranted to evaluate the efficacy of the intervention for this population and the specific effects of each component on sleep and both psychological and physiological arousal.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Are antidepressants safe in the treatment of bipolar depression? A critical evaluation of their potential risk to induce switch into mania or cycle acceleration

Are antidepressants safe in the treatment of bipolar depression? A critical evaluation of their potential risk to induce switch into mania or cycle acceleration, Early view, Acta Psychiatrica Scandinavica Published Online: 26 Aug 2008

Abstract:

To address whether switch of depression into hypomania or mania or cycle acceleration in patients with bipolar disorder is caused by antidepressants or whether this phenomenon is attributable to the natural history of bipolar disorder itself.

Method: A critical review of the literature, pointing at sources of bias that have been previously overlooked. For examining the causation in question, the Bradford–Hill criteria were applied, i.e. specificity of the potential causative agent, strength of effect, consistency in findings, dose–response relation, temporal relation with exposure to agent preceding effect and biological plausibility.

Results: There is a scarcity of randomized studies addressing the question, and the available studies all suffer from various forms of bias. However, there is some evidence suggesting that antidepressants given in addition to a mood stabilizer are not associated with an increased rate of switch when compared with the rate associated with the mood stabilizer alone.

Conclusion: When combined with a mood stabilizer, antidepressants given for acute bipolar depression seemingly do not induce a switch into hypomania or mania. Whether antidepressants may accelerate episode frequency and/or may cause other forms of destabilization in patients with bipolar disorder remain to be properly studied.

 

 

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

The use of pharmacological treatments for people with personality disorder: A systematic review of randomized controlled trials

The use of pharmacological treatments for people with personality disorder: A systematic review of randomized controlled trials, Personality and Mental Health, Volume 2, Issue 3, Date: July 2008, Pages: 119-170

Abstract:

This is a companion paper to our earlier review of psychological treatments for people with personality disorder that examined the evidence from randomized controlled trials (RCTs). Here, we report on the evidence of pharmacological treatments from RCTs for people with personality disorder. As in the previous report, this paper incorporates information from an earlier review that examined the evidence to 2002, and extends it to December 2006. As in the previous paper, this review restricts itself to the findings from RCTs, and excludes evidence from other study designs; however, details of these other studies will be posted in the National Personality Disorder Institute Website (http://www.pdinstitute.org.uk).

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Garden Therapy for the Senses – Turning gardens into multisensory experiences

Turning gardens into multisensory experiences , Julie Swann Nursing & Residential Care, Vol. 8, Iss. 4, 15 Mar 2006, pp 171 – 174

Abstract:

Julie Swann looks beyond the provision of a basic garden in care homes and encourages the design of a safe outdoor environment that stimulates all senses.  Most people enjoy gardens either actively
or passively, perhaps as a place to reflect, to reminisce, to contemplate or to simply to look out onto. A garden should be an integral, interesting part of a care home environment, no matter how small the area available.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Art Therapy – Invest to Save: Arts in Health Evaluation, Exploring the impact of creativity, culture and the arts, on health and well being

  Invest to Save: Arts in Health Evaluation, Exploring the impact of creativity, culture and the arts, on health and well being, MIRIAD, Arts for Health, Manchester Metropolitan University, 2007

Text Version

Report: Towards Transformation “The arts transformed my life. It did, it transformed my life, but it didn’t come without a lot of hard work on my part as well…”

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Abstract:

The Invest to Save: Arts in Health Programme is a 3-year HM Treasury funded project aimed at strengthening the capacity of the North West Regions’, Arts and Health community through networking and training opportunities and building the evidence base as to the effectiveness of creativity, culture and the arts on health and economic outcomes.

The project is a partnership between Manchester Metropolitan University, Arts Council England, North West and the Department of Health, Public Health Team, North West.

Statistics on Drug Misuse: England, 2008 (full report)

Statistics on Drug Misuse: England, 2008 (full report), NHS the Information Centre, 22nd August 2008

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Abstract:

This annual statistical report presents information on drug misuse among both adults and children. It includes a focus on young adults. The topics covered include:

  • prevalence of drug misuse, including the types of drugs used
  • trends in drug misuse over recent years
  • patterns of drug misuse among different groups of the population
  • health outcomes related to drug misuse including hospital admissions, drug treatment and deaths related to drug misuse

The bulletin also summarises government plans and targets in this area, as well as providing sources of further information and links to relevant documents. The bulletin draws together data from a variety of different sources and presents it in a user-friendly format. Most of the data contained in the bulletin have been published previously, by The NHS Information Centre, Department of Health, the Home Office, Office for National Statistics, the Health Protection Agency or the National Treatment Agency for Substance Misuse. Previously unpublished figures on drug-related admissions to hospital are presented.

NHS Choices Behind the Headlines story on Mental health after abortion

NHS Choices Behind the Headlines story on Mental health after abortion, 22nd August 2008, Department of Health

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Abstract:

“Abortion does not harm mental health” is the headline in The Times, following a recent US report of psychiatric problems that occur after abortions. The newspaper suggests that the report’s findings will hinder the latest efforts of a group of anti-abortion MPs to “make it harder for British women to obtain terminations”. These MPs have tabled an amendment to the Human Fertilisation and Embryology Bill that would require all women to be counselled about psychiatric risks before they can be cleared to have a termination. This bill is to be debated by the House of Commons in October.

The systematic review excluded unreliable research and found no “credible” evidence that single abortions directly cause more mental health problems among adults with unwanted pregnancies than in those who deliver that pregnancy. They found one well-conducted study which provided reliable evidence that there was no difference between these groups for these outcomes. The evidence regarding multiple abortions was less certain, and the interpretation of the research is complicated by the fact that the studies often did not distinguish between abortions of wanted pregnancies (e.g. detected foetal abnormalities) and unwanted pregnancies, or consider factors such as poverty and drug use that raise the likelihood both of having an abortion and suffering mental illness.

Hormone patch for schizophrenia

07 August 2008 – Hormone patch for schizophrenia, 22nd August 2008 , Department of Health

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Abstract: 

“A hormone patch may protect women with schizophrenia or other severe mental illnesses from psychotic feelings”, BBC News reported. It said that scientists had found that giving women oestrogen made them less likely to report suffering hallucinations or delusions.

The story is based on a study in 102 women with schizophrenia, half of whom wore a daily patch of estradiol, the most common form of oestrogen, for four weeks. As the researchers acknowledge, this is a small study and much further research in a greater number of women, and over a longer period of time, is needed to look at the effectiveness of this treatment alongside other standard treatments. Most importantly, future studies will need to consider the long-term safety implications of giving women a high concentration of unopposed oestrogen (i.e. not combined with a progestogen hormone, as in the contraceptive pill) for long periods of time.

Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2000 British Association for Psychopharmacology guidelines

Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2000 British Association for Psychopharmacology guidelines , British Association for Psychopharmacology, 27th August 2008, Care Guideline

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Abstract 

A revision of the 2000 British Association for Psychopharmacology evidence based guidelines for treating depressive disorders with antidepressants was undertaken to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in May 2006. Key areas in treating depression were reviewed, and the strength of evidence and clinical implications were considered. The guidelines were drawn up after extensive feedback from participants and interested parties. A literature review is provided, which identifies the quality of evidence to inform the recommendations, the strength of which are based on the level of evidence.

These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse, and stopping treatment.

Early Intervention Service – Factors influencing relapse during a 2-year follow-up of first-episode psychosis in a specialized early intervention service

Factors influencing relapse during a 2-year follow-up of first-episode psychosis in a specialized early intervention service , Psychological Medicine, First view article 2008

Abstract:

Differential association of risk factors associated with relapse following treatment of first-episode psychosis (FEP) have not been studied adequately, especially for patients treated in specialized early intervention (SEI) services, where some of the usual risk factors may be ameliorated.

Method Consecutive FEP patients treated in an SEI service over a 4-year period were evaluated for relapse during a 2-year follow-up. Relapse was based on ratings on the Scale for Assessment of Positive Symptoms (SAPS) and weekly ratings based on the Life Chart Schedule (LCS). Predictor variables included gender, duration of untreated psychosis (DUP), total duration of untreated illness (DUI), age of onset, pre-morbid adjustment, co-morbid diagnosis of substance abuse during follow-up and adherence to medication. Univariate analyses were followed by logistic regression for rate of relapse and survival analysis with the Cox proportional-hazards regression model for time to relapse as the dependent variables.

Results Of the 189 eligible patients, 145 achieved remission of positive symptoms. A high rate of medication adherence (85%) and relatively low relapse rates (29.7%) were observed over the 2-year follow-up. A higher relapse rate was associated with a co-morbid diagnosis of substance abuse assessed during the follow-up period [odds ratio (OR) 2.84, 95% confidence interval (CI) 1.24–6.51]. The length of time to relapse was not associated with any single predictor.

Conclusions Specialized treatment of substance abuse may be necessary to further reduce risk of relapse even after improving adherence to medication.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Schizophrenia – What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation

What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation  Psychological Medicine,  Volume 38, Issue 08, August 2008, pp 1121-1132

Free full-text click on the article title above

Abstract:

In recent years a close association between anxiety and persecutory ideation has been established, contrary to the traditional division of neurosis and psychosis. Nonetheless, the two experiences are distinct. The aim of this study was to identify factors that distinguish the occurrence of social anxiety and paranoid thoughts in an experimental situation.

Method Two hundred non-clinical individuals broadly representative of the UK general population were assessed on a range of psychological factors, experienced a neutral virtual reality social environment, and then completed state measures of paranoia and social anxiety. Clustered bivariate logistic regressions were carried out, testing interactions between potential predictors and the type of reaction in virtual reality.

Results The strongest finding was that the presence of perceptual anomalies increased the risk of paranoid reactions but decreased the risk of social anxiety. Anxiety, depression, worry and interpersonal sensitivity all had similar associations with paranoia and social anxiety.

Conclusions The study shows that social anxiety and persecutory ideation share many of the same predictive factors. Non-clinical paranoia may be a type of anxious fear. However, perceptual anomalies are a distinct predictor of paranoia. In the context of an individual feeling anxious, the occurrence of odd internal feelings in social situations may lead to delusional ideas through a sense of ‘things not seeming right’. The study illustrates the approach of focusing on experiences such as paranoid thinking rather than diagnoses such as schizophrenia.

Learning Difficulties – Services for Young People and Adolescents

Services for young people and adolescents: supplementary report to the national audit of specialist inpatient healthcare services for people with learning difficulties in England

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The Healthcare Commission has published a
report that gives
 supplementary details on the findings of the national audit of specialist inpatient healthcare services for people with learning difficulties in England. It relates specifically to specialist services for young people and adolescents. The report states that young people in these services were generally safe and protected from abuse and that their health needs were met overall. The audit also found that they were well supported by dedicated staff. However, the Healthcare Commission found that young people in these services should have more independence and control over their lives and the environment in which they live.

New Patient Information for Manic Depression and Bipolar

    Publications - New helpful Patient Information Leaflet from MDF The BiPolar Organisation  who work to enable people affected by bipolar disorder / manic depression to take control of their lives. Their aim is to fulfil this mission by:

  • Supporting and developing self-help opportunities for people affected by manic depression;
  • Expanding and developing the information services about manic depression;
  • Influencing the improvement of treatments and services to promote recovery;
  • Decreasing the discrimination against, and promoting the social inclusion and rights of people affected by manic depression;
  • Being an effective and efficient organisation with sufficient resources to sustain and develop our activities, thereby ensuring members receive a unique, high quality service.

Click Here on the Lancashire Care Patient Information Site where you can download or print of the leaflets

Activity & Dementia – Activities enjoyed by patients with dementia together with their spouses and psychological morbidity in carers

Activities enjoyed by patients with dementia together with their spouses and psychological morbidity in carers, Aging & Mental Health, Volume 12, Issue 2 March 2008 , pages 276 – 282

Abstract:

Caring for a spouse with dementia is stressful and respite care is sometimes used to reduce this burden. Spouses may find some aspects of caring rewarding but the literature on positive aspects of caring is limited. To describe activities enjoyed by patients with dementia together with their spouses, and examine their relationship with psychological morbidity in carers. A convenience sample of 46 patients with mild to moderate dementia (91% with Alzheimer’s disease, AD) and their spouses were interviewed at home. Spouses completed the Pleasant Events Schedule (PES-AD) to identify activities enjoyed by patients and spouses on their own and together. Psychological morbidity in spouses was assessed using the General Health Questionnaire (GHQ-12). Cognitive functions, and non-cognitive symptoms were also assessed in patients. Multiple regression analysis using age, Mini-Mental State Examination, Cornell Scale for Depression in Dementia, Revised Memory and Behaviour Problems (RMBP) checklist frequency, and PES-AD- together scores as independent variables found PES-AD-together and RMBP-frequency to be independent predictors of GHQ-12 scores in spouses, but the model could explain only 28% of variance. Facilitating activities that are enjoyed by both patients with dementia and spouses may be an alternative intervention strategy to reduce carer burden.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Forensic & Living Skills – Assessing living skills in forensic mental health care with the behavioural status index: A European network study

Assessing living skills in forensic mental health care with the behavioural status index: A European network study , Psychotherapy Research, Volume 18 Issue 3 May 2008 , pages 334 – 344

Abstract:

Assessment of living skills and violence risk in forensic psychiatric patients is a priority for clinicians. Suitably fine-grained instruments are rare. The goal of this study was to compare a norm-based psychometric assessment battery (the Behavioural Status [BEST] Index) with known valid instruments. Parallel cohort studies were undertaken in four European countries. Inpatients from 24 forensic psychiatric clinics were assessed three times using five instruments measuring living skills, psychological symptoms, aggression, and violence risk. Positive clinical changes were noted in insight, empathy, and some behaviors related to communication and living skills, with little change in violence risk, which was low to medium for most patients. Clinical congruence was observed between logically cognate items of the BEST Index and comparison instruments. Evidence for the scientific and clinical utility of the BEST Index as an effective tool for forensic psychiatric practice is discussed.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Mental Health Nurses – The lived experience and meaning of stress in acute mental health nurses

The lived experience and meaning of stress in acute mental health nurses , Thomas Joseph Currid
British Journal of Nursing, Vol. 17, Iss. 14, 24 Jul 2008, pp 880 – 884

Abstract:

While studies into stress in mental health nursing are small, studies specifically looking at acute mental health nurses are even fewer. Acute mental health nurses work in environments that are challenging and unpredictable, and care for some of the most seriously ill patients. This area, therefore, needs staff that are physically and psychologically fit for purpose. However, little is known about this cohort of nurses. Aim: In an attempt to address this imbalance, this study aims to ascertain the stressors – the lived experience and meaning – for acute qualified mental health staff. Methodology: Using a hermeneutical phenomenological tradition, eight qualified staff from a London mental health Trust were interviewed. Results: Heavy workloads and violent and aggressive behaviours were among the stressors giving rise to staff experiencing difficulties with switching off from work, poor support from management and fear of blame. These experiences culminated in feeling professionally compromised, less valued and struggling for recognition of the therapeutics of nursing interventions. Conclusion: There is an urgent need to implement stress reduction strategies in this nursing specialty.

 For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Anger & CBT – The Development of CBT Programmes for Anger: The Role of Interventions to Promote Perspective-Taking Skills

The Development of CBT Programmes for Anger: The Role of Interventions to Promote Perspective-Taking Skills, Behavioural and Cognitive Psychotherapy 2008, 36: 299-312

Abstract:

Although the emotion of anger has, in recent years, been the subject of increasing theoretical analysis, there are relatively few accounts of how interventions designed to reduce problematic anger might be related to cognitively oriented theories of emotion. In this review of the literature we describe how a cognitive-behavioural approach to the treatment of those with anger-related problems might be understood in relation to conceptualizations of anger from a cognitive perspective. Three additional interventions (visual feedback, chair-work, forgiveness therapy) are identified that aim to improve the perspective-taking skills of angry clients. It is concluded that such interventions might be considered for use within the context of cognitive-behavioural treatment.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Eating Disorders – Service users’ feedback on cognitive training in the treatment of anorexia nervosa: A qualitative study

Service users’ feedback on cognitive training in the treatment of anorexia nervosa: A qualitative study, International Journal of Eating Disorders, Volume 41 Issue 6, Pages 542 - 550

Abstract:  There is little evidence to guide the treatment of anorexia nervosa (AN). Cognitive Remediation Therapy (CRT) may be helpful in reducing perfectionism and rigidity and preparing patients for involvement in later psychological interventions. The aim of this study was to examine service users’ experiences of participating in CRT.

Written feedback, following 10 CRT sessions, from 19 AN patients wasanalyzed using grounded theory approach.

Patients’ feedback was generally positive. They found CRT refreshing and appreciated that it did not revolve around food. Patients found CRT helpful in reducing perfectionism and rigidity. The majority expressed how they were able to implement skills in their real life. Some changes were suggested, these included varying levels of difficulty and more guidance in implementing skills.

CRT is a promising component in the treatment of AN. Further research is being conducted to evaluate CRT.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Violence education in nursing: critical reflection on victims’ stories

Violence education in nursing: critical reflection on victims’ stories, Journal of Forensic Nursing, Volume 4 Issue 1, Pages 12 - 18

Abstract:

Violence against women is a major public health concern. This paper describes an educational strategy to increase nursing students’ understanding of the experience of violence and to foster recognition and intervention with victims of violence. Students in an elective course were asked to critically reflect on the personal stories of victims/survivors of violence. The assignment provided four learning opportunities that include examination of societal myths on sexual victimization, understanding the lived experience of the victim, exploration of personal beliefs and values, and the relationship of the individual’s experience to theoretical content of the course. Students gave permission for the use of quotes from papers to illustrate the learning opportunities.

 

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Relaxation training for anxiety: a ten-years systematic review with meta-analysis

Relaxation training for anxiety: a ten-years systematic review with meta-analysis, BMC Psychiatry June 2008, 8:41 Highly Accessed Article

Click on the title above for free full-text access

Abstract:

Background: Relaxation training is a common treatment for anxiety problems. Lacking is a recent
quantitative meta-analysis that enhances understanding of the variability and clinical significance of
anxiety reduction outcomes after relaxation treatment.

Conclusion: The results show consistent and significant efficacy of relaxation training in reducing
anxiety. This meta-analysis extends the existing literature through facilitation of a better
understanding of the variability and clinical significance of anxiety improvement subsequent to
relaxation training.

Bulimia Nervosa and Substance Use Disorder: Similarities and Differences

Bulimia Nervosa and Substance Use Disorder: Similarities and Differences, Eating Disorders, Volume 16, Issue 3 May 2008 , pages 224 – 240

Abstract:

The purpose of this study was to compare bulimia nervosa (BN) and substance use disorders (SUD) in cognitive-motivational terms. The cognitive orientation theory was used as a framework for testing the hypothesis that the commonality between BN and SUD consists of a similar motivational disposition for eating disorders, rather than for addiction, as was previously claimed. It was expected that BN and SUD patients would differ from controls but not from each other. The participants were 31 BN, 20 SUD, and 20 healthy controls. They were administered questionnaires for assessing anxiety, depression, addiction and the cognitive orientation for eating disorders. On most parameters BN and SUD scored higher than controls but did not differ from each other except in norm beliefs. Treatment of BN should consider the similarity of BN to SUD in the pathological tendency for eating disorders.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Prisons & Older People – Doing time: the experiences and needs of older people in prison

Doing time: the experiences and needs of older people in prison, 10th July 2008, Prison Reform Trust, UK

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This briefing aims to give older people in prison a voice. The Prison Reform Trust believe that to develop more effective ways of working with older prisoners, an important first step is to hear directly from them. Although noting a general improvement in prison healthcare, the report finds older prisoners can face difficulties continuing their medication when imprisoned and routinely fail to receive preventative and screening services.

LGB – A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people

A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people, BMC Psychiatry 2008, 8:70 18 August 2008

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Abstract: Background: Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people.

Method: We conducted a systematic review and meta-analysis of the prevalence of mental disorder, substance misuse, suicide, suicidal ideation and deliberate self harm in LGB people. We searched Medline, Embase, PsycInfo, Cinahl, the Cochrane Library Database, the Web of Knowledge, the Applied Social Sciences Index and Abstracts, the International Bibliography of the Social Sciences, Sociological Abstracts, the Campbell Collaboration and grey literature databases for articles published January 1966 to April 2005. We also used Google and Google Scholar and contacted authors where necessary. We searched all terms related to homosexual, lesbian and bisexual people and all terms related to mental disorders, suicide, and deliberate self harm. We included papers on population based studies which contained concurrent heterosexual comparison groups and valid definition of sexual orientation and mental healthoutcomes.

Self Injury & Guideline – Development of mental health first aid guidelines for deliberate non-suicidal self-injury: A Delphi study

Development of mental health first aid guidelines for deliberate non-suicidal self-injury: A Delphi study,      Claire M Kelly, Anthony F Jorm, Betty A Kitchener, Robyn L LanglandsBMC Psychiatry 2008, 8:62 23 July 2008

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Abstract:   Background: It is estimated that around 4% of the population engages, or has engaged, in deliberate non-suicidal self-injury. In clinical samples, the figures rise as high as 21%. There is also evidence to suggest that these figures may be increasing. A family member or friend may suspect that a person is injuring themselves, but very few people know how to respond if this is the case. Simple first aid guidelines may help members of the public assist people to seek and receive the professional help they require to overcome self-injury.

Conclusion: There are a number of actions which are considered to be useful for members of the
public when they encounter someone who is engaging in deliberate, non-suicidal self-injury. These
guidelines will be useful in revising curricula for mental health first aid and NSSI first aid training
programs. They can also be used by members of the public who want immediate information about
how to assist a person who is engaging in such behaviour.

Mindfulness with Children and Adolescents: Effective Clinical Application

Mindfulness with Children and Adolescents: Effective Clinical Application Clinical Child Psychology and Psychiatry 2008 13: 395-407

Abstract:    Mindfulness interventions within adult populations are becoming increasingly popular. Research suggests that mindfulness can deliver lasting improvements in self-awareness and emotional stability to adults with severe and chronic conditions. As yet, research within child and adolescent populations is in its initial stages, although mindfulness shows great clinical promise for young people. This article aims to provide an overview of mindfulness to professionals who are working in child or adolescent settings. Initially, it will provide the reader with some orientation to and definitions from the field, before summarizing the current evidence for the utility of the approach. The article recommends specific clinical modifications for mindfulness with children and adolescents, as well as reviewing how to monitor and enhance the development of this skill. Finally, it highlights important differences among mindfulness, relaxation and other meditative techniques.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Thankyou to Dr. Alistair Smith for recommending this article 

Hawton & Suicide – Help is at hand for people bereaved by suicide and other traumatic death

Help is at hand for people bereaved by suicide and other traumatic death, Psychiatric Bulletin 2008 32: 309-311

Keith Hawton, Professor of Psychiatry and Director Centre for Suicide Research, Oxford University, Department of Psychiatry, Warneford Hospital, Headington, Oxford OX3 7JX, email: keith.hawton@psych.ox.ac.uk

Sue Simkin, Researcher and Coordinator Centre for Suicide Research, Oxford University

Sian Rees, Senior Policy Adviser Department of Health

Abstract:

Bereavement following suicide is traumatic. Guilt, shame, stigma and feelings of rejection and isolation set it apart from the sadness following other kinds of death and may make it difficult for the bereaved person to obtain help (Harwood et al, 2002; Hawton & Simkin, 2003; Beautrais, 2004). The necessary official processes surrounding death by suicide, like the police and coroner’s
investigations, can add to the trauma (Biddle, 2003). This may be compounded by inaccurate or insensitive media reporting. Bereaved individuals are at risk of increased morbidity from abnormal grief reactions (Mitchell et al, 2005) and suicide (Qin et al, 2002), and they often need
considerable support (de Groot et al, 2006; 2007).

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Thanks to Jacqueline Turnbull, for this suggestion, cheers

NICE Guidance – Interventions to reduce substance misuse among vulnerable young people

Interventions to reduce substance misuse among vulnerable young people, NICE, August 2008

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Summary

The NICE guidance on community-based interventions to reduce substance misuse among vulnerable and disadvantaged children and young people calls for anyone who works with young people to identify those who are vulnerable to drug problems and intervene at the earliest opportunity.  It gives advice on stepping in and helping young people access the right support and services and outlines effective individual, family and group-based support which can improve motivation, family interaction and parenting skills.

Designing a CBT service for an acute inpatient setting: A pilot evaluation study

Designing a CBT service for an acute inpatient setting: A pilot evaluation study, Clinical Psychology & Psychotherapy, Volume 14, Issue 2,  March/April 2007, Pg: 117-125

Abstract:

A frequent complaint by service-users of psychiatric inpatient units is the unavailability of talking therapy at precisely the time when they need to make sense of their situation. However, conventional models of cognitive-behavioural therapy (CBT) delivery, with set numbers of sessions and diagnostic specificity, are not well suited to the conditions of the acute ward, with variable and unpredictable lengths of stay and multiple and indistinct presentations. This pilot study describes a modification of CBT designed to deliver an effective, brief therapy in these conditions. The approach is grounded on the cognitive science-based model, interacting cognitive subsystems, and draws on dialectical behaviour therapy and other recent, mindfulness-based CBT approaches to provide a combination of simple formulation and skills-based treatment. Evaluation in the inpatient setting also presents challenges, and these have been met by choosing measures that tap into self-efficacy and confidence in the management of emotions rather than symptomatic change. The evaluation data on a small number of cases suggest the effectiveness of the approach and the need for wider testing of the model.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Suicide Resource & Keith Hawton – Help is at hand: a resource for people bereaved by suicide and other sudden, traumatic death

Help is at hand: a resource for people bereaved by suicide and other sudden, traumatic death, Department of Health, Revised 2007

This guide was developed by Professor Keith Hawton and Sue Simkin at the Centre for Suicide Research, University of Oxford,† in collaboration with an advisory group established by the Department of Health. It drew on the bereavement pack previously developed by the Centre and published by the Royal College of Psychiatrists.

Click on the title above for full-text access

Abstract: This guide is aimed at the wide range of people who are affected by suicide or other sudden, traumatic death. It aims firstly to help people who are unexpectedly bereaved in this way. It also provides information for healthcare and other professionals who come into contact with bereaved people, to assist them in providing help and to suggest how they themselves may find support if they need it.

Additional Material

Mindfulness-based stress reduction training for oncology patients: Patients’ appraisal and changes in well-being

Mindfulness-based stress reduction training for oncology patients: Patients’ appraisal and changes in well-being, Patient Education and Counseling, Volume 72, Issue 3 September 2008, Pages 436-442

Abstract:

This study explores satisfaction and changes in well-being in cancer patients following mindfulness-based stress reduction training.

Method

Data were collected in 47 cancer patients before and after the training, and also 1 year later. Standardized questionnaires were used to measure quality of life, joy in life, mood disturbances (depression, anger, vigor, fatigue, and tension), meaning in life and physical symptoms.

Results

Participants were highly satisfied and said they had reached their goals with the training. The results show that directly after the training patients reported a better quality of life, more joy in life, less tension, and fewer physical symptoms. These effects appeared even stronger at follow-up. A year after the training a decrease was also found in depression, anger, vigor and total mood disturbance. No changes could be established for meaning in life and fatigue. Effect sizes varied between 0.28 and 0.60, indicating small-to-moderate changes.

Conclusion

Mindfulness training potentially supports cancer patients in handling the stress due to their life-threatening disease and increases their well-being. Several suggestions for further research are discussed.

Practice implications

Mindfulness training provides cancer patients with tools to deal with their limitations and worries, both during and after their treatment.

  

 

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

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