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...]

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...]

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...]

Psychiatric illnesses and some chronic physical illnesses are associated with an increased risk of self-harm and suicide

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Last month, the Department of Health published the ‘Closing the Gap’ report, which highlighted the importance of better integration of physical and mental health care at every level. The report specifically flagged up the need for frontline services to respond better to people who self-harm, and cited statistics that emphasise the cyclical nature of the [read the full story...]

Extended therapy with varenicline reduces rates of smoking relapse in people with serious mental health issues

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People with serious mental health issues such as schizophrenia have higher rates of cigarette smoking than the general population, with estimates suggesting more than 50% are current smokers. When people in this population do manage to quit during treatment we then see particularly high rates of relapse after treatment ends. A new randomised control trial (Evins [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 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...]