Black patients’ first contact with mental health services is more likely to be coercive

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It is well documented that there are differences in how patients are treated, depending on their ethnicity. Previous inquiries in the UK have suggested that the NHS is institutionally racist (Blofeld et al, 2003). Some groups, for example those from African Caribbean or Aboriginal descent, experience more coercive care and poor outcomes, including higher doses of [read the full story...]

Children of older fathers have an increased risk of psychiatric and academic problems, says new cohort study

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Research suggests that the risk of developing psychiatric problems (such as autism spectrum disorder, intellectual disability or schizophrenia) may be linked to increased paternal age at the time of conception. This seems quite plausible given that advancing age in men is associated with increased genetic mutations in sperm. However, studies so far have generally not [read the full story...]

New study demonstrates effectiveness of antipsychotic Pimavanserin for Parkinson’s disease psychosis

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When we think of Parkinson’s disease (PD), hallucinations and delusions are probably not the first symptoms that come to mind. And yet, it is estimated that nearly half of all patients with PD experience psychotic symptoms at one time or another. Although deficits in motor function are seen as the hallmark of PD, it is [read the full story...]

Is the Dodo finally dead?

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There’s been a lot of chatter here in the woodlands about the role of cognitive behavioural therapy (CBT) in psychosis – what do service users think of it? Can it be used in place of antipsychotics for some people? Outside of the woodlands, CBT for psychosis has also been generating a lot of attention: Does [read the full story...]

Bereavement during childhood, but not before birth, is associated with an increased risk of psychosis

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Psychotic disorders, such as schizophrenia, are often conceptualised as arising from a complex interplay of genetic and environmental influences (Tandon 2008). The impact of social influences on the risk of psychotic experience is undeniable. Recent reviews of this topic have called for a focus on maternal wellbeing as a means of primary prevention for mental [read the full story...]

Insufficient evidence for sexual health promotion interventions in people with severe mental illness

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People with serious mental illness (SMI) such as schizophrenia and bipolar disorder have higher morbidity and mortality rates due to physical illness. It’s estimated that people with SMI die 10-15 years earlier than the general population (DeHert et al, 2011). Increasingly attention is being paid to ways to improve the physical health of people with [read the full story...]

Service user perspectives on individual CBT for psychosis

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I have been procrastinating about writing this blog for a while. This is, in part, caused by hesitancy about involving myself in the CBT for psychosis (CBTp) debate. Regular readers of the Mental Elf will be aware that in recent months Jauhar and colleagues presented results of a meta-analysis that called into question the effectiveness [read the full story...]

Does staying in hospital longer make you better?

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De-institutionalisation, the advent of community care and development of psychotropic medicines are implicated in the reduction in hospital bed numbers and mean length of stay. There remains a huge variance in length of stay and outcomes across the UK and beyond (NHS Confederation, 2011). Figures on length of stay and service configuration are difficult to [read the full story...]

Physical health monitoring in serious mental illness is a priority in psychiatry, but where is the evidence that it works?

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It is widely acknowledged that individuals with serious mental illnesses (SMI) such as schizophrenia, bipolar disorder and severe depression have increased rates of mortality, due to poor physical health. As well as reducing quality of life and function and decreasing life expectancy, physical illness can worsen these mental illnesses. The reasons for this include lifestyle [read the full story...]

Bullying is bad for your mental health, even if you are the bully

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Clinicians and mental health researchers have long recognised that there is a link between traumatic experiences in childhood and symptoms of psychosis or non-clinical psychotic experiences presenting in adolescence or adulthood. One type of traumatic experience is the experience of abuse, whether physical, emotional or social in nature.  When it comes to bullying, any or [read the full story...]