A Nonrandomized Effectiveness Comparison of Broad-Spectrum Group CBT to Individual CBT for Depressed Outpatients in a Community Mental Health Setting

Posted on February 28, 2010 by lancashirecarelibraryblog

A Nonrandomized Effectiveness Comparison of Broad-Spectrum Group CBT to Individual CBT for Depressed Outpatients in a Community Mental Health Setting, Behavior Therapy, Volume 40, Issue 3, September 2009, Pages 302-314

MOST Read Paper

Craigie, M.A.; Nathan, P.

Abstract:

Controlled trials have established the efficacy of cognitive-behavior therapy (CBT) for depression. However, the relative effectiveness of individual versus group treatment formats in real-world settings is less well established. The current study evaluated the effectiveness of group CBT (n = 157) compared to individual CBT (n = 77) for depressed outpatients in a naturalistic setting. Symptom improvements for depression, anxiety, and quality of life were compared between treatment formats in intent-to-treat and completer analyses. Effect sizes and rates of recovery were examined. Results showed that both individual and group CBT were effective, even in the presence of high levels of comorbidity. Whereas individual CBT was associated with larger effect sizes and significantly higher rates of recovery, group CBT compared favorably to outcomes established by past research. A broad-spectrum group CBT program may be a viable treatment option when depression symptoms are less severe and when this format of treatment delivery is desirable.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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Filed under: Anxiety Disorder, CBT Cognitive Behaviour Therapy, community mental health, depression | Tagged: , , , , , | Comments Off

Art Therapy & CBI – Trauma and acute stress disorder: A comparison between cognitive behavioral intervention and art therapy

Posted on February 27, 2010 by lancashirecarelibraryblog

Trauma and acute stress disorder: A comparison between cognitive behavioral intervention and art therapy, The Arts in Psychotherapy, Volume 37, Issue 1,  February 2010, Pages 8-12

Orly Sarid, Ephrat Huss

Abstract:

The aim of this paper is to initiate a comparative and theoretical study between the mechanisms of cognitive behavioral intervention (CBI) versus art therapy, in relation to the acute stress disorder (ASD) stage of trauma. The literature on CBI, art therapy, and ASD will be briefly reviewed. Similarities between these two theoretically disparate interventions will be outlined, pointing to the relevance of CBI and art therapy to alter maladaptive and traumatic sensory processing, affect excitatory reactions, modulate and challenge explicit traumatic memories and stimulate a subsequent cognitive process. Implications for mental health professionals intervening in the relatively flexible ASD period are discussed.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: art therapy, CBT Cognitive Behaviour Therapy, Post Traumatic Stress, stress | Tagged: , , , , , , | Comments Off

A randomised controlled trial of a worry intervention for individuals with persistent persecutory delusions

Posted on February 27, 2010 by lancashirecarelibraryblog

A randomised controlled trial of a worry intervention for individuals with persistent persecutory delusions, Journal of Behavior Therapy and Experimental Psychiatry, Volume 41, Issue 1, March 2010, Pages 45-51

Chloe Foster, Helen Startup, Laura Potts, Daniel Freeman

Department of Psychology, P.O. Box 077, Institute of Psychiatry, King’s College London, Denmark Hill, London SE5 8AF, UK

Department of Biostatistics, Institute of Psychiatry, Clinical Trials Unit, King’s College London, UK

Abstract:

Recent research has shown that worry is associated with distressing paranoia. Therefore, the aim was to target worry in a therapeutic intervention for individuals with delusions. It was predicted that a worry intervention would reduce levels of worry and paranoia distress. Twenty-four individuals with persistent persecutory delusions and high levels of worry were randomly assigned to receive a four session cognitive-behavioural worry intervention (W-CBT) or treatment as usual (TAU). The worry intervention was specifically designed not to target the content of delusions. In this open-label evaluation, assessments of worry and paranoia were conducted at baseline, at one month (end of treatment) and at two months. The worry intervention achieved a statistically significant reduction in worry which was maintained at two month follow up. A significant reduction in delusional distress was also reported. There was an indication that the worry intervention may also reduce the frequency of paranoid thoughts but this was not statistically significant. In the first trial specifically for persecutory delusions, a brief worry intervention was shown to have benefits. The results support a causal role for worry in paranoid experience.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: Anxiety Disorder, paranoia, Schizophrenia | Tagged: , , , , , , | Comments Off

Gardening and belonging: reflections on how social and therapeutic horticulture may facilitate health, wellbeing and inclusion

Posted on February 26, 2010 by lancashirecarelibraryblog

Gardening and belonging: reflections on how social and therapeutic horticulture may facilitate health, wellbeing and inclusion, The British Journal of Occupational Therapy, Volume 73, Number 2, February 2010 , pp. 84-88(5)

Diamant, Emna; Waterhouse, Andrew

Abstract:

A sense of belonging is a key element in enabling social inclusion through meaningful occupations. This is evident in occupational science and social and therapeutic horticulture (STH) literature. How these theories interact in practice was explored at Thrive’s STH project in Battersea in London. A workshop conducted with Thrive Battersea’s therapists examined how gardening may facilitate health and wellbeing through belonging. The authors reflect on themes of belonging from the workshop. The implications for occupational therapy from this apparently rich synergy of occupational science, STH and social inclusion are considered.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: Healing Environment, OT - Evidence Based OT, OT - Occupational Therapy, well-being | Tagged: , , , , , , , | Comments Off

The interaction between perinatal factors and childhood abuse in the risk of developing anorexia nervosa

Posted on February 26, 2010 by lancashirecarelibraryblog

The interaction between perinatal factors and childhood abuse in the risk of developing anorexia nervosa, Psychological Medicine, Volume 40, Issue 04, April 2010, pp 657-665

A. Favaro, E. Tenconi and P. Santonastaso

Abstract:

Background Perinatal factors seem to be implicated in the pathogenesis of anorexia nervosa (AN) and may be involved in the programming of stress response systems in humans. Our aim was to explore one of the possible pathways to explain the association between perinatal complications and a psychiatric disorder. In particular, we tested the hypothesis that neonatal immaturity may confer an enhanced vulnerability to AN after exposure to a severe stressful event, such as childhood abuse.

Method The sample was composed of subjects who took part in a prevalence study carried out on a representative sample of the general population and cases of AN referred to an out-patient specialist unit. All subjects (n=663) were born in the two obstetric wards of Padua Hospital between 1971 and 1979. We analysed data using both a case-control and a cohort design.

Results We found that functional signs of neonatal dysmaturity, but not a low birthweight or prematurity, had a significant additive interaction with childhood abuse in determining the risk for this illness. In normal subjects, but not in subjects with AN, neonatal dysmaturity was associated with being small, short or thin for gestational age at birth.

Conclusions The synergistic effect of neonatal dysmaturity and childhood abuse in increasing the risk for AN provides evidence for the hypothesis that a prenatal programming of stress response systems can result in an impairment of the individual’s resilience to severe stressful events.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: abuse, Eating Disorders | Tagged: , , , , , | Comments Off

Dignity Action Day – Today Thursday 25th February

Posted on February 25, 2010 by lancashirecarelibraryblog

Dignity Action Day     Department of Health, 25th February 2010

Ideas and useful information on how you can support Dignity Action Day

Click on the title above to access the resources for healthcare staff

Dignity Action Day asks health and social care staff and members of the public to take action on or around February 25th to promote the dignity of people receiving care.

Filed under: Department of Health 2010, dignity in care | Tagged: , , | Comments Off

Social problem-solving among adolescents treated for depression

Posted on February 25, 2010 by lancashirecarelibraryblog

Social problem-solving among adolescents treated for depression, Behaviour Research and Therapy
Volume 48, Issue 1 January 2010, Pages 11-18Emily G. Becker-Weidman, Rachel H. Jacobs, Mark A. Reinecke, Susan G. Silva, John S. March

Abstract:

Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children’s Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire – Grades 7–9 (SIQ-Jr), and the Social Problem-Solving Inventory–Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: CAMHS, depression | Tagged: , , , , | Comments Off

Early intervention in psychotic disorders: faith before facts?

Posted on February 25, 2010 by lancashirecarelibraryblog

Early intervention in psychotic disorders: faith before facts? Psychological Medicine , Volume 40 , Issue 03 , Mar 2010 , pp 353-358

P. Bosanac, G. C. Patton and D. J. Castle

Abstract:

This paper reviews the literature on early intervention in psychotic disorders, weighs the cons of this approach, and makes suggestions for clinicians and researchers regarding how to interpret and respond to what is still an embryonic evidence-base, notably in terms of any long-term benefits.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: early intervention, Psychosis, psychotic | Tagged: , , , | Comments Off

Well-Being Directory – Directory of services from across Lancashire

Posted on February 24, 2010 by lancashirecarelibraryblog

Lancashire County Council LogoWell-being Directory

Click on the link above to access the Lancashire Directory

Welcome to our well-being directory – a directory of services from across Lancashire, to help you improve your quality of life and help you get through the day-to-day challenges you may face. The services listed are provided by a range of organisations, including voluntary organisations, private companies, and local councils.

Filed under: patient information | Tagged: , , , | Comments Off

Patient Opinion – This is our NHS lets make it better

Posted on February 24, 2010 by lancashirecarelibraryblog

Patient Opinion  This is our NHS lets make it better

Click on the title above to access this site

How do we reach the hard to reach?
 
 
With initiatives like Collective Voice, a network commissioned by MHIP which is a platform for users, carers and the public to engage in discussions on the future of mental health services, effort is being put into making sure that health service providers hear from their users and consider the needs of all when planning how to deliver care to the North West region.

But who do we hear from? Inevitably, there are groups in the community who are under-represented due to communication difficulties and disabilities. MHIP have funded a collaborative project with Patient Opinion (www.patientopinion.org.uk) to enhance the ways in which people with learning disabilities are able to share their experiences. Patient Opinion spent the last year introducing mental health trusts to web-based feedback through their independent website and has established a value-based editorial policy with a strong sense of protecting and maintaining the safety of the people who share their stories on the site. There are many, many examples on www.patientopinion.org.uk  health services listening to, valuing and acting on the views of their patients and service users and they’re really keen to make sure that people with learning disabilities get the chance to have an impact on the NHS too.

Over the next year Patient Opinion will be working closely with two North West trusts and many of the major charities and learning disability groups in the region to pilot the service, simplify their website and generate postings from this group. If you want to talk to Patient Opinion about the work with people with learning disabilities, or you want to share your story contact Amy Gaskin on 01142 816256.of

Filed under: patient information | Tagged: , , , , , , | Comments Off

This is Me – Leaflet launched to help nursing staff improve care to people with dementia

Posted on February 24, 2010 by lancashirecarelibraryblog

This is Me  Alzheimer’s Society and RCN – Royal College of Nursing. February 2010

Click  on the title above to access and download the leaflet

Leaflet launched to help hospital staff improve care to people with dementia

Actor Kevin Whately is launching a new Alzheimer’s Society leaflet today (Tuesday 23 February) to help tackle poor dementia care in hospitals.

‘This is me‘ can be filled out and given to staff when a person with dementia goes into hospital and provides a ‘snapshot’ of the person behind the dementia. The leaflet will help hospital staff to learn about the person’s habits, hobbies, likes and dislikes and is being supported by the Royal College of Nursing.

‘This is me’ comes following the publication last November of Counting the Cost: caring for people with dementia on hospital wards which found large variations in the quality of care for people with dementia. The leaflet will enable staff to respond to the person with dementia’s needs and reduce their feelings of agitation and distress. For example, people with dementia can become agitated and confused when they are in an unfamiliar environment and it is this behaviour that nurses can find challenging and prevent them from providing good care.

Actor and Alzheimer’s Society Ambassador, Kevin Whately, says,

‘My mother became very ill in hospital. Someone would bring her a tray of food then collect it untouched because she’d forgotten to eat it. I think if staff had access to a leaflet like this they would have known that she needed encouragement to eat the food and maybe she wouldn’t have become so weak.’

Andrew Ketteringham, Director of External Affairs at Alzheimer’s Society, says,

‘People with dementia are staying too long in hospital and many are discharged in worse health than when they arrived. But we know that no one goes into nursing wanting to do a poor job; rather, staff are often not equipped to care for people with dementia. We hope ‘This is me’ will support staff to provide the best possible person centred dementia care, by helping them to get to know the individual and understand their needs.’

The Royal College of Nursing has given its backing to a new leaflet designed to tackle poor dementia care in hospitals.

The Alzheimer’s Society leaflet, This is me, contains a form to be completed and given to staff when a person with dementia is admitted to hospital, to provide a ‘snapshot’ of the person behind the dementia. The leaflet will help staff learn about the person’s habits, hobbies, likes and dislikes so any feelings of agitation and distress can be reduced.

RCN Head of Nursing Department Steve Jamieson says:

“In order to ensure patients with dementia experience the best possible care, it is vital that health care staff working in all settings receive sufficient training and support. It can sometimes be difficult to find out the extra little things about a patient, such as their nickname or interests, which could help make their stay in hospital more comfortable. The new form will be a useful tool to help health care staff add a more personal touch to the care they provide for patients with dementia.”

An Alzheimer’s Society report, Counting the Cost: caring for people with dementia on hospital wards, published last November found large variations in the quality of care given to people with dementia.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: alzheimers, dementia, patient information, Patients Wellbeing, Person Centred Care | Tagged: , , , , , , , , , , , | Comments Off

Realising Ambitions – Better Employment Support for People with a Mental

Posted on February 24, 2010 by lancashirecarelibraryblog

Click on the title above to access the full-text of this report

Abstract:

People with mental health conditions remain among the most excluded within our society. And nowhere is this exclusion more evident than in the workplace. Over one million people with mental health conditions are on welfare benefits and the total number who are out of work is probably double this figure.

We know that:

•

 

appropriate employment actively improves mental health and well-being;

•

 

people with mental health conditions can and do pursue successful careers; and

•

 

most people with a mental health condition who are out of work would like to be in paid employment.Yet a combination of prejudice and discrimination, low expectations, and failure to provide the necessary support, continue to deny many the opportunity to work. Too often this failure leads to hopelessness and despair. In the face of the negative images that surround people with a mental health condition, too many people give up on themselves and their possibilities: they resign themselves to a life on the margins of society. It is especially important that younger people receive positive messages of hope, enabling them to contribute to society as equal citizens.

 

 

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

 

 

Filed under: vocational rehabilitation, work | Tagged: , , , , , , | Comments Off

Mindfulness a Systematic Review

Posted on February 23, 2010 by lancashirecarelibraryblog

A systematic review of neurobiological and clinical features of mindfulness meditations, Psychological Medicine, 2010

A. Chiesa and A. Serretti

Abstract:

Background Mindfulness meditation (MM) practices constitute an important group of meditative practices that have received growing attention. The aim of the present paper was to systematically review current evidence on the neurobiological changes and clinical benefits related to MM practice in psychiatric disorders, in physical illnesses and in healthy subjects.

Method A literature search was undertaken using Medline, ISI Web of Knowledge, the Cochrane collaboration database and references of retrieved articles. Controlled and cross-sectional studies with controls published in English up to November 2008 were included.

Results Electroencephalographic (EEG) studies have revealed a significant increase in alpha and theta activity during meditation. Neuroimaging studies showed that MM practice activates the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC) and that long-term meditation practice is associated with an enhancement of cerebral areas related to attention. From a clinical viewpoint, Mindfulness-Based Stress Reduction (MBSR) has shown efficacy for many psychiatric and physical conditions and also for healthy subjects, Mindfulness-Based Cognitive Therapy (MBCT) is mainly efficacious in reducing relapses of depression in patients with three or more episodes, Zen meditation significantly reduces blood pressure and Vipassana meditation shows efficacy in reducing alcohol and substance abuse in prisoners. However, given the low-quality designs of current studies it is difficult to establish whether clinical outcomes are due to specific or non-specific effects of MM.

Discussion Despite encouraging findings, several limitations affect current studies. Suggestions are given for future research based on better designed methodology and for future directions of investigation.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: mindfulness | Tagged: , , | Comments Off

The Use of Anti-psychotic Medication for People with Dementia – Time for Action

Posted on February 23, 2010 by lancashirecarelibraryblog

The Use of Anti-psychotic Medication for People with Dementia – Time for Action , 2009

A report for the Minister of State for Care Services byProfessor Sube Banerjee

Click on the title above to access the full-text of this report

Abstract:

Dementia is one of the most severe and challenging disorders we face. There are approximately 700,000 people with dementia in the UK; in 30 years, the number of people with dementia will double to 1.4 million. The national cost of dementia is about £17 billion per year; in 30 years, the cost will treble to over £50 billion.

I was asked last year to examine the use of antipsychotic medication for people with dementia in the NHS in England, and this is my review.

There have been increasing concerns over the past years about the use of these drugs in dementia. The findings of my review confirm that there are indeed significant issues in terms of quality of care and patient safety. These drugs appear to be used too often in dementia and, at their likely level of use, potential benefits are most probably outweighed by their risks overall. This is a problem across the world, not one just restricted to the NHS. It is positive that, with action, we have the means with which to sort out this problem, quickly and safely.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

 

Filed under: antidepressants, dementia, Department of Health 2009 | Tagged: , , , , | Comments Off

Integrated Care Pathways for Mental Health – Toolkit

Posted on February 22, 2010 by lancashirecarelibraryblog

Integrated Care Pathways – Toolkit  NHS Scotland

Click on the title above to access the Home page

Click on the links below to the specific pathways:

ICPs are much more than a document of care. The ICP system of care encompasses how care is organised, co-ordinated and governed.

The implementation of ICPs will improve the quality of mental health services by focusing the attention of local care providers on key steps along the journey of care. The most important aspect of ICPs is the recording, analysing and acting on variances, allowing the comparison of planned care with care actually given and enabling the implementation of continuous quality improvement.

The development of ICPs in mental health services offers new opportunities for quality improvement which are under the control of local agencies, whether from NHS Scotland, local authorities or voluntary organisations.

ICPs allow local services to assess their own practice and are the tools that help drive the redesign of services to meet the assessed needs of service users (and their informal carers) and to facilitate closer working in collaboration with other agencies to deliver a co-ordinated service.

Filed under: bipolar, dementia, depression, integrated care pathways, Personality Disorders, Schizophrenia | Tagged: , , | Comments Off

Nursing Care of Families With Parents Who Are Lesbian, Gay, Bisexual, or Transgender,

Posted on February 22, 2010 by lancashirecarelibraryblog

Nursing Care of Families With Parents Who Are Lesbian, Gay, Bisexual, or Transgender, Journal of Child and Adolescent Psychiatric Nursing. Feb 2010. Vol. 23, Iss. 1; p. 11 (6 pages)

Scott Weber –

Abstract:

Families in which parents are lesbian, gay, bisexual, or transgender are more diverse than they are similar. The numbers of parents and children in these families appear to be increasing with implications for nurses and other clinicians. This paper reviews the current literature to determine the fundamental issues facing alternate families that include sexual minority parents and their children. It also explores the unique nursing needs of families with gay, lesbian, transgender, or bisexual parents in the field, which are critically examined for direct relevance to psychiatric nursing practice. Current theoretical and research literature in nursing, child development, family law, and healthcare professional journals. Despite a relative lack of pathology noted in the literature related to families with sexual minority parents, nurses, and other healthcare professionals can incorporate current knowledge of unique child developmental, parenting, and legal issues into their work with these families. Assessments and interventions that address the unique needs of these families may help parents and children to deal with social stress from being perceived as “different” by other children, or as “problematic and threatening” by other parents.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: CAMHS, LGB, Transgender | Tagged: , , , , , , , , , , | Comments Off

Nursing Children and Adolescents With Bipolar Disorder: Assessment, Diagnosis, Treatment, and Management

Posted on February 22, 2010 by lancashirecarelibraryblog

Nursing Children and Adolescents With Bipolar Disorder: Assessment, Diagnosis, Treatment, and Management, Journal of Child and Adolescent Psychiatric Nursing, Feb 2009. Vol. 22, Iss. 1; p. 33 (7 pages)

Tim McDougall – ENB Specialist Practitioner (Mental Health), is Nurse Consultant (Tier 4 CAMHS) and Lead Nurse (Specialist CAMHS), Cheshire & Wirral Foundation NHS Trust, Cheshire, UK.

Abstract:

The role of the mental health nurse in the assessment, diagnosis, treatment, and management of children and adolescents with bipolar disorder in community and hospital settings. In many areas of clinical practice, mental health nurses have more contact with service users than any other professional group. They are therefore well placed to support children and adolescents with bipolar disorder during first contact with primary care services, through engagement with specialist mental health services, and in accessing early intervention and crisis services. This paper summarizes the contribution that child and adolescent mental health nurses make to the care of children and adolescents with bipolar disorder. This paper is based on evidence from systematic reviews; meta-analyses and best practice evidence from CINAHL; EMBASE; MEDLINE, PsychINFO; Cochrane Collaboration; National Institute for Health and Clinical Excellence; National Collaborating Centre for Mental Health; NHS Centre for Reviews and Dissemination; Oxford Centre for Evidence Based Medicine; United States Agency for Healthcare Research and Quality. Child and adolescent mental health nurses work with children and adolescents who have bipolar disorder in a range of settings. These include community mental health services, hospitals, and schools. Due to the multidisciplinary nature of the treatment and management of bipolar disorder during childhood and adolescence, nurses have a major role to play in providing frontline assessment services, monitoring treatment, and delivering psychosocial interventions.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: bipolar, CAMHS, depression | Tagged: , , , , , , , , , , | Comments Off

A literature review of family interventions for dual diagnosis: implications for forensic mental health services.

Posted on February 22, 2010 by lancashirecarelibraryblog

A literature review of family interventions for dual diagnosis: implications for forensic mental health services. British Journal of Forensic Practice, 2009 Nov; 11(4): 39-49

Richards M; Doyle M; Cook P

Greater Manchester West Mental Health Nhs Foundation Trust, UK

Abstract:

Dual-diagnosis strategies are developing in medium secure services in response to both government policies and clinical need and there has been a move towards integrated services for this patient group. Substance use that has been a feature of the index offence must be taken into account as much as psychosis or the offending behaviour. Treatment of dual diagnosis relies heavily on cognitive-behavioural therapies. Relapse in either psychosis or substance use increases risk and re-admission rates to medium security. This paper reviews the literature on family interventions in dual diagnosis and its applicability to forensic mental health inpatient services. As there appeared to be limited direct evidence, various domains were examined and extrapolated to a forensic setting as appropriate. The review indicates the potential for positive outcomes for families following family interventions in dual diagnosis, which may be beneficial in a forensic setting in lowering risk.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: carers, Drugs & Substance Misuse, dual diagnosis, Forensic Mental Healthcare, medium secure | Tagged: , , , , , , , | Comments Off

Improving Inpatient services for Black and Minority Ethnic patients

Posted on February 21, 2010 by lancashirecarelibraryblog

Improving Inpatient services for Black and Minority Ethnic patients , Royal College of Psychiatrists, 2010

Click on the title to access the full-text of this report

Abstract:

If staff are able to understand how a patient perceives and makes sense of their own mental health problems, this can significantly help in delivering care and treatment which meets users’ needs. However, as Bhui and Bhugra observecachieving this understanding can be extremely challenging. This is because mental health workers and service users often do not share a common cultural background, which may mean they sometimes think and talk about mental illness in different ways. This can make discussions and assessments difficult (even where the worker and user speak the same language), as words can carry various meanings, and different ideas or ‘models’ about what mental illness means may be used.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: Equality & Diversity, ethnic minorities | Tagged: , , , | Comments Off

Bipolar disorder (manic depression) – Factsheet from RETHINK

Posted on February 21, 2010 by lancashirecarelibraryblog

Bipolar disorder (manic depression)  RETHINK

Click on the title above to access the full-text of this factsheet, (9 pages)

Abstract:

Bipolar disorder, formerly known as manic depression, is a mood (affective) disorder that causes unusual shifts in a person’s mood, energy, and ability to function. This factsheet answers the following questions:

1. What are the symptoms of bipolar disorder?
2. What are the different types of bipolar disorder?
3. How is bipolar disorder caused?
4. How is bipolar disorder treated?

Lancashire Care staff can click on the link above, or email: susan.jennings@lancashirecare.nhs.uk

Filed under: bipolar, depression, patient information | Tagged: , , , , , | Comments Off

The Mental Health Act – Essential information for patients and carers

Posted on February 21, 2010 by lancashirecarelibraryblog

The Mental Health Act – Essential information for patients and carers   RETHINK, 2008

Click on the title above to access the full-text of this informative guide

Abstract:

This booklet is for parents and carers of children and young people who need to be admitted to hospital for treatment of a mental disorder.  It provides an overview of how some important parts of the mental health act may affect you and your child and what rights you have under this act.  

Lancashire Care staff can click on the link above of email: susan.jennings@lancashirecare.nhs.uk

Filed under: Acts - Mental Health, patient information | Tagged: , , , , , , | Comments Off

Diabetes – Six years on: delivering the Diabetes National Service Framework

Posted on February 21, 2010 by lancashirecarelibraryblog

Six years on: delivering the Diabetes National Service Framework, Department of Health, February 2010

Click on the title above to access the full-text of this report

Abstract:

The Diabetes National Service Framework (NSF) set out the first ever set of national standards for the treatment and care of people with diabetes. The report reviews the development and delivery of diabetes services and identifies the progress made over the past six years towards meeting the Diabetes NSF.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: Department of Health 2010, diabetes | Tagged: , , , , | Comments Off

Change4Life one year on – Healthy Weight, Healthy Lives

Posted on February 20, 2010 by lancashirecarelibraryblog

Change4Life one year on  Department of Health, February 2010

Click on the title to access the full-text of this report

Abstract:

This document reports on the first twelve months of the Change4Life campaign. Change4Life, which launched to the public in January 2009, is the social marketing part of the Healthy Weight, Healthy Lives cross-governmental strategy for England. In its first year, Change4Life focussed on those families with children aged 5-11, who were at greatest risk of becoming overweight or obese. One year on reports back on how Change4Life has performed against the targets set out in the Change4Life marketing strategy, together with what had been learned about using marketing to influence behaviour one year on.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: Department of Health 2010, Exercise and Health, well-being | Tagged: , , , , | Comments Off

A ward manager’s toolkit for service user engagement – Communication partnership between staff and patients

Posted on February 20, 2010 by lancashirecarelibraryblog

A ward manager’s toolkit for service user engagement, Nursing Management – UK, Nov2009, Vol. 16 Issue 7, p30-34

Wilson, Christine; Kenkre, Joyce  – UK

Abstract:

The government suggests that improvements in patient care will come about as a direct result of a communicative partnership between staff and patients. Clinical staff are therefore encouraged to listen actively to patients and their relatives and respond to the needs and aspirations of patients. This article describes how a ward manager and her deputy, as clinical leads, have encouraged staff to engage with patients and carers by designing innovative and different communication approaches. The article also shows how staff incorporated the lessons learned from listening to patients and carers into everyday nursing practice.

 

Lancashire care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: Patients Wellbeing, Person Centred Care | Tagged: , , , , , , , | Comments Off

Psychological Treatments of Binge Eating Disorder

Posted on February 20, 2010 by lancashirecarelibraryblog

Psychological Treatments of Binge Eating Disorder, Archives of General Psychiatry. 2010;67(1):94-101.

G. Terence Wilson; Denise E. Wilfley; W. Stewart Agras; Susan W. Bryson

Abstract:

Context  Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED. Objective  To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up.

Design  Randomized, active control efficacy trial.

Setting  University outpatient clinics.

Participants  Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED.

Intervention  Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months.

Main Outcome Measures  Binge eating assessed by the Eating Disorder Examination.

Results  At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.

Conclusions  Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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Role of clinical nurse leadership in improving patient care

Posted on February 19, 2010 by lancashirecarelibraryblog

Role of clinical nurse leadership in improving patient care, Nursing Management – UK, Dec2009, Vol. 16 Issue 8, p26-28

Murphy, Jill; Quillinan, Bernie; Carolan, Mary

Abstract:

Leadership in nursing plays a crucial part in the provision of good patient care. However, the terms ‘nursing leadership’ and ‘nursing management’ are often confused. This article discusses the difficulties in defining ‘clinical leadership’, outlines its development in the Republic of Ireland, and identifies issues that must be addressed if clinical nurse leaders are to be effective.

Lancashire care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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A randomized, double-blind, placebo-controlled study of maintenance treatment with adjunctive risperidone long-acting therapy in patients with bipolar I disorder who relapse frequently

Posted on February 19, 2010 by lancashirecarelibraryblog

A randomized, double-blind, placebo-controlled study of maintenance treatment with adjunctive risperidone long-acting therapy in patients with bipolar I disorder who relapse frequently, Bipolar Disorders, Volume 11, Number 8, December 2009 , pp. 827-839(13

Macfadden, Wayne et al..

Abstract:

No large controlled trials have evaluated adjunctive maintenance treatment with long-acting injectable antipsychotics in patients with bipolar disorder. This study assessed whether adjunctive maintenance treatment with risperidone long-acting therapy (RLAT), added to treatment-as-usual (TAU) medications for bipolar disorder, delays relapse in patients with bipolar disorder type I. Methods: 

This study included patients with bipolar disorder type I with ≥ four mood episodes in the 12 months prior to study entry. Following a 16-week, open-label stabilization phase with RLAT plus TAU, remitted patients entered a 52-week, double-blind, placebo-controlled, relapse-prevention phase. Randomized patients continued treatment with adjunctive RLAT (25-50 mg every two weeks) plus TAU (n = 65) or switched to adjunctive placebo injection plus TAU (n = 59). The primary outcome measure was time to relapse to any mood episode. Results: 

Of 240 enrolled patients, 124 entered double-blind treatment. Time to relapse was longer in patients receiving adjunctive RLAT (p = 0.010). Relapse rates were 23.1% (n = 15) with adjunctive RLAT versus 45.8% (n = 27) with adjunctive placebo; relative relapse risk was 2.3-fold higher with adjunctive placebo (p = 0.011). Completion rates were: adjunctive RLAT, 60.0% (n = 39) and adjunctive placebo, 42.4% (n = 25; p = 0.050). Adverse event (AE)-related discontinuations were 4.6% (n = 3) and 1.7% (n = 1), respectively. Common AEs (adjunctive RLAT versus adjunctive placebo) were: tremor (24.6% versus 10.2%), insomnia (20.0% versus 18.6%), muscle rigidity (12.3% versus 5.1%), weight increased (6.2% versus 1.7%), and hypokinesia (7.7% versus 0.0%). Conclusions: 

Adjunctive RLAT significantly delayed time to relapse in patients with bipolar disorder type I who relapse frequently. Safety and tolerability of RLAT were generally consistent with that previously observed. No large controlled trials have evaluated adjunctive maintenance treatment with long-acting injectable antipsychotics in patients with bipolar disorder. This study assessed whether adjunctive maintenance treatment with risperidone long-acting therapy (RLAT), added to treatment-as-usual (TAU) medications for bipolar disorder, delays relapse in patients with bipolar disorder type I. Methods: 

This study included patients with bipolar disorder type I with ≥ four mood episodes in the 12 months prior to study entry. Following a 16-week, open-label stabilization phase with RLAT plus TAU, remitted patients entered a 52-week, double-blind, placebo-controlled, relapse-prevention phase. Randomized patients continued treatment with adjunctive RLAT (25-50 mg every two weeks) plus TAU (n = 65) or switched to adjunctive placebo injection plus TAU (n = 59). The primary outcome measure was time to relapse to any mood episode. Results: 

Of 240 enrolled patients, 124 entered double-blind treatment. Time to relapse was longer in patients receiving adjunctive RLAT (p = 0.010). Relapse rates were 23.1% (n = 15) with adjunctive RLAT versus 45.8% (n = 27) with adjunctive placebo; relative relapse risk was 2.3-fold higher with adjunctive placebo (p = 0.011). Completion rates were: adjunctive RLAT, 60.0% (n = 39) and adjunctive placebo, 42.4% (n = 25; p = 0.050). Adverse event (AE)-related discontinuations were 4.6% (n = 3) and 1.7% (n = 1), respectively. Common AEs (adjunctive RLAT versus adjunctive placebo) were: tremor (24.6% versus 10.2%), insomnia (20.0% versus 18.6%), muscle rigidity (12.3% versus 5.1%), weight increased (6.2% versus 1.7%), and hypokinesia (7.7% versus 0.0%). Conclusions: 

Adjunctive RLAT significantly delayed time to relapse in patients with bipolar disorder type I who relapse frequently. Safety and tolerability of RLAT were generally consistent with that previously observed.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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The process of recovery from bipolar I disorder: A qualitative analysis of personal accounts in relation to an integrative cognitive model

Posted on February 19, 2010 by lancashirecarelibraryblog

The process of recovery from bipolar I disorder: A qualitative analysis of personal accounts in relation to an integrative cognitive model, British Journal of Clinical Psychology, 2009

Warren Mansell, Seth Powell, Rebecca Pedley, Nia Thomas and Sarah Amelia Jones

University of Manchester

Abstract:

Objectives This study explored the process of recovery from bipolar I disorder from a phenomenological and cognitive perspective. Design A semi-structured interview was coded and analysed using interpretative phenomenological analysis. Methods Eleven individuals over the age of 30 with a history of bipolar disorder were selected on the basis of having remained free from relapse, and without hospitalization for at least 2 years, as confirmed by a diagnostic interview (Standardised Interview for DSM-IV; SCID-I). This arbitrary and equivocal criterion for ‘recovery’ provided an objective method of defining the sample for the study. Results The analysis revealed two overarching themes formed from four themes each. Ambivalent approaches referred to approaches that participants felt had both positive and negative consequences: avoidance of mania, taking medication, prior illness versus current wellness, and sense of identity following diagnosis. Helpful approaches referred to approaches that were seen as universally helpful: understanding, life-style fundamentals, social support and companionship, and social change. Conclusions These themes were then interpreted in the light of the existing literature and an integrative cognitive model of bipolar disorder. Limitations and future research directions are discussed.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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Early intervention in bipolar disorders: Clinical, biochemical and neuroimaging imperatives

Posted on February 19, 2010 by lancashirecarelibraryblog

Early intervention in bipolar disorders: Clinical, biochemical and neuroimaging imperatives, Journal of Affective Disorders, Volume 114, Issues 1-3, April 2009, Pages 1-13

Michael Berk, Gin S. Malhi, Karen Hallam et al..

Abstract:

In the absence of clear targets for primary prevention of many psychiatric illnesses, secondary prevention becomes the most feasible therapeutic target, and is best encompassed by the concept of early intervention. This construct encompasses the goals of minimising diagnostic delay and the prompt initiation of clinically appropriate therapy. This paper develops the rationale for early intervention in bipolar disorder. Three interrelated themes are discussed; the clinical data supporting the value of prompt diagnosis and treatment in bipolar disorder, the putative biochemical mechanisms underlying the pathophysiological processes, and the parallel concept of neuroprotection, and the developing neuroimaging data that supports early intervention. Early initiation of appropriate therapy may potentially facilitate improved clinical outcomes, and further might allow the secondary prevention of the sequelae of untreated illness, which include the deleterious impact on family relationships, psychosexual and vocational development, identity and self-concept and self-stigma.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Filed under: bipolar, depression, early intervention | Tagged: , , , , , | Comments Off

Evidence-based Guidelines for Treating Bipolar Disorder

Posted on February 19, 2010 by lancashirecarelibraryblog

Evidence-based Guidelines for Treating Bipolar Disorder,  Journal of Psychopharmacology, 2009,

 GM Goodwin – University Department of Psychiatry, Warneford Hospital, Oxford, UkClick on the title above to access the full-text

Abstract:

The British Association for Psychopharmacology guidelines specify the scope and target of treatment for bipolar disorder. The second version, like the first, is based explicitly on the available evidence and presented, like previous Clinical Practice guidelines, as recommendations to aid clinical decision making for practitioners: they may also serve as a source of information for patients and carers. The recommendations are presented together with a more detailed but selective qualitative review of the available evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from participants and interested parties. The strength of supporting evidence was rated. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in treatment of episodes, relapse prevention and stopping treatment.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Filed under: antidepressants, bipolar, CBT Cognitive Behaviour Therapy, depression | Tagged: , , , , , , , , | Comments Off

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