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...]

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...]

What impact do guidelines actually have on patient outcomes for people with schizophrenia?

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Using research findings to improve care in mental health should be easy. Notice an understudied area, do a study on it, write a guideline based on your results and watch mental health professionals modify their practice accordingly. Hooray for science. But in reality, this process is convoluted and murky. Though we’re fairly good at churning out [read the full story...]

Missing heritability: the final piece?

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Uncovering the genetic component to common disease has been challenging. Whilst we now have more reliable heritability estimates (the proportion of susceptibility to disease which is accounted for by genetics), we are far from finding all genetic variants contributing to heritability. That is to say that if a disease is 80% heritable, we may have [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...]

Psychosis and schizophrenia in adults: updated NICE guidance for 2014

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While the organisation’s name may change frequently, currently National Institute for Health and Care Excellence (NICE), its role remains constant – to provide clear published guidance on the role of treatment options within the NHS. The publication of new NICE guidance represents a significant event as clinical recommendations shape the nature of provided care nationally [read the full story...]

Pilot study suggests that CBT may be a viable alternative to antipsychotics for people with schizophrenia, or does it?

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People with schizophrenia stop taking their antipsychotics for a wide range of reasons (e.g. debilitating side effects or a belief that they will not help them), but when they do health professionals often find it extremely difficult to care for these patients, because the alternative treatment options available to them are very limited. Of course, [read the full story...]

Cochrane review finds that haloperidol is an effective antipsychotic, but its side effects can be problematic

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Schizophrenia is a serious disorder characterised by delusions (including paranoid beliefs and hallucinations) and other symptoms such as blunted affect and reduced motivation. While relatively uncommon (lifetime prevalence is less than 1%), it is associated with serious social impairment (e.g., unemployment, homelessness), which in turn can result in physical health problems. As a result, the [read the full story...]