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...]

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...]

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...]

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...]

Cochrane review finds no evidence to support the use of user held records for patients with severe mental illness

The reviewers can't have been too pleased with the paucity of research in this field

The use of care plans and Wellness Recovery Action Plans (WRAP®) (Cook et al, 2009) within mental health is commonplace. In Wales, care planning is covered by legislation in the form of the Mental Health Measure (Welsh Government website, 2013). The care plans are designed to be developed and agreed in a collaborative way with input [read the full story...]

Long term maintenance treatment with antipsychotics: a cautionary note from recent research

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The support of individuals with experience of psychosis is complex and relies on a combination of psychopharmacology (antipsychotic drugs), psychological therapies and social interventions. Antipsychotics will often be the first line treatment offered, with the intention of reducing psychotic symptom burden. Following the resolution of immediate symptoms the role of antipsychotics becomes less clear; should [read the full story...]

Atypical antipsychotics no better than typicals for adolescents with psychosis, but atypicals may have fewer short-term side effects

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Schizophrenia is a serious neurodevelopmental disorder that often starts during adolescence. Current treatment guidelines (NICE, 2013) recommend atypical antipsychotics for adolescents with this condition, but this is based largely on studies of adults with the condition. The Cochrane Schizophrenia Group conducted this systematic review to synthesise the current evidence base for atypical antipsychotic medication in [read the full story...]