Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development最新文献

{"title":"Use of seclusion for managing behavioural disturbance in patients","authors":"G. Newton-Howes","doi":"10.1192/APT.BP.112.011114","DOIUrl":"https://doi.org/10.1192/APT.BP.112.011114","url":null,"abstract":"Seclusion is a tool used by psychiatrists primarily to manage aggressive and\u0000 disturbed behaviour that is presumed to be due to the patient's mental\u0000 disorder. In most parts of the world there are guidelines to using seclusion\u0000 that are designed to maximise a patient's freedoms and protect their liberty\u0000 while providing a safe environment. Arguments against the use of seclusion\u0000 revolve around the deprivation of liberty, the potential for misuse and the\u0000 concept of seclusion as a form of social control, and patients generally\u0000 report seclusion as a negative, coercive experience. There is little\u0000 evidence that seclusion provides long-term benefits in terms of treating\u0000 symptoms or reducing aggression, although the literature is mixed in this\u0000 regard. Expert opinion recommends a combination of national policy, ward\u0000 management and patient-centred interventions to reduce seclusion rates.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"422-428"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.011114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65778374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding vulnerable adults: the psychiatrist’s roles and responsibilities","authors":"R. Hodgson, Jude Rheade","doi":"10.1192/APT.BP.112.010991","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010991","url":null,"abstract":"For decades society has recognised that children are vulnerable and so it has sought to protect them. However, similar legal protection for adults who may be equally vulnerable has been neglected. The incremental introduction of legislation and reports in the UK, along with guidelines on good practice, now afford adults safeguarding procedures similar to those for children. This article offers a practical overview of these developments. In addition, it highlights some of the dilemmas that face practitioners in this evolving arena, as legislation and policy do not anticipate the diverse scenarios in which mental healthcare professionals may be involved. Decisions made can be subject to legal challenge, so it is important that psychiatrists understand their role as well as the role of their organisation in this complex area.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"437-445"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of the renal adverse effects of lithium","authors":"Sumeet Gupta, M. Kripalani, U. Khastgir, J. Reilly","doi":"10.1192/APT.BP.112.010306","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010306","url":null,"abstract":"Lithium is one of the most effective psychotropic drugs we have, but it is underused because of its low therapeutic index, the need for regular blood tests and perceptions about its adverse effects, including renal problems. The last include urinary concentration deficits and diabetes insipidus, chronic kidney disease (including renal failure), nephrotic syndrome, hyper calcaemia, hyper parathyroidism and distal tubular acidosis. This article reviews these adverse effects with special emphasis on their management.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"457-466"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young people who cut themselves: can understanding the reasons guide the treatment?","authors":"B. Wright, N. Hooke, S. Neupert, Chan Nyein, S. Ker","doi":"10.1192/APT.BP.112.011049","DOIUrl":"https://doi.org/10.1192/APT.BP.112.011049","url":null,"abstract":"Young people who cut themselves may do so for reasons that go beyond\u0000 diagnosis. Relevant processes include responses to trauma, coping, emotion\u0000 regulation and cultural identification. Some clinicians regard those who\u0000 self-harm negatively or consider one therapeutic approach to be suitable for\u0000 all. This article explores the possible mechanisms involved when young\u0000 people cut themselves and discusses therapeutic approaches in the light of\u0000 these. Clinicians and researchers are encouraged to refine, develop and\u0000 research interventions for young people who self-harm by cutting.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"446-456"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.011049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65778184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A guide to intellectual disability psychiatry assessments in the community","authors":"B. Eng, P. Addison, H. Ring","doi":"10.1192/APT.BP.113.011213","DOIUrl":"https://doi.org/10.1192/APT.BP.113.011213","url":null,"abstract":"Psychiatric assessment in the community is an important part of both the\u0000 initial assessment process and delivery of follow-up care in adult\u0000 intellectual disability services in the UK. This article examines how such\u0000 assessments can be carried out safely and explores the clinical skills\u0000 required to perform them effectively. Use of the psychiatric interview and\u0000 mental state examination to elicit information is discussed. Communication\u0000 difficulties experienced by people with intellectual disabilities and\u0000 strategies that may be employed to address these in the assessment process\u0000 are also explored. The article is directed at psychiatrists, in particular\u0000 specialty trainees, and other healthcare professionals who work with\u0000 intellectually disabled people.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"429-436"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.113.011213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65778673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Confederacy of Dunces : mental illness in the life and work of John Kennedy Toole","authors":"Abhijit Pal","doi":"10.1192/APT.BP.112.010371","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010371","url":null,"abstract":"SUMMARY This article examines the life and work of John Kennedy Toole, focusing on his 1981 Pulitzer Prize winning novel A Confederacy of Dunces . Toole finished the novel in 1966 and, after failing to rework his manuscript to his editor’s satisfaction, he shelved the project. Following this, he displayed symptoms typical of paranoid schizophrenia and he took his own life at the age of 31. In his novel, Toole parodies both psychoanalysis and the practice of psychiatry at the time, with a strong overlap with the emerging perspectives critical of psychiatry popularised by figures such as Szasz, Laing and Foucault. Toole’s life and work have relevance for psychiatrists interested in the relationship between creativity and mental illness, attitudes towards psychiatry in the 1960s, and the interplay between societal values and judgements of mental health.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"467-469"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010371","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of foundation year 1 psychiatry posts: implications for practice","authors":"R. Steele, Sharon Beattie","doi":"10.1192/APT.BP.112.010678","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010678","url":null,"abstract":"Most literature discussing the introduction of foundation year 1 (F1) psychiatry posts has focused on recruitment. However, for F1 posts to offer a valuable learning experience and a potential recruitment boost, psychiatrists and employing organisations should be aware of general issues arising in the first postgraduate year. These include the inherently stressful student-to-doctor transition, the need for bespoke induction programmes for new graduates, F1 doctors’ specific needs for support, supervision and peer support, and the centrality of the relationship with the consultant supervisor to the new doctor. Understanding these themes will enable psychiatrists and mental health organisations to offer better F1 psychiatry experiences, which may boost recruitment and could maximise the opportunities for F1 doctors to develop skills and qualities that will be of value in their future careers, whatever specialty they end up working in.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"410-419"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La interfaz entre neurología y psiquiatría: el caso de la esclerosis múltiple [translation of “The interface between neurology and psychiatry: the case of multiple sclerosis” by Rodolfo Zaratiegui]","authors":"E. Wong, R. Krishnadas, J. Cavanagh","doi":"10.1192/s1355514600018770","DOIUrl":"https://doi.org/10.1192/s1355514600018770","url":null,"abstract":"Los avances en la genética y las neuroimágenes de las últimas décadas nos han permitido entender los procesos biológicos que subyacen a muchas enfermedades que originalmente se creían puramente ‘funcionales’ (Kandel 1998). La patofisiología de enfermedades tales como el Parkinson y la epilepsia, por ejemplo – previamente entendidas como enfermedades mentales sin base física identificable para el diagnóstico o tratamiento – se entiende ahora más claramente. Sin embargo, como sucede con muchas de estas enfermedades ‘funcionales’, el manejo y tratamiento de la mayoría de los pacientes con enfermedad de Parkinson y epilepsia se tornó seguidamente la responsabilidad de neurólogos. Más recientemente, los medios de comunicación han mostrado un interés creciente en pacientes con diagnóstico de enfermedad psiquiátrica en los que subsecuentemente se encontró encefalitis producida por anticuerpos, y esto ha llegado a sugerir que una proporción de tales pacientes pudieran tener una etiopatogénesis mediada por anticuerpos (Barry 2011, Lennox 2012). El optimismo en nuestras capacidades científicas, junto con la tendencia de reclasificar las enfermedades mentales como neurológicas a medida de los avances de los conocimientos biológicos, ha provocado preocupación por la supervivencia de la Psiquiatría como especialidad por derecho propio (Oyebode 2011), y puede marcar también el comienzo de una era en la que tanto el cerebro como la mente (aun la Psiquiatría y la Neurología) sean considerados esenciales en el entendimiento de cada uno. Es sabido que hay un riesgo aumentado de desarrollar un trastorno depresivo mayor en un número de enfermedades médicas – por ejemplo, afecta a un 30% de los sobrevivientes de accidente cerebrovascular (Hackett 2005) y hasta el 17% de personas con artritis reumatoidea, con tasas similares en cáncer y enfermedad cardiovascular (Dickens 2002)En la esclerosis múltiple (EM), la prevalencia vital de la depresión mayor es de hasta un 50%, con tasas de suicidio de hasta 15% (Lo Fermo 2010). En este artículo, examinamos el proceso fisiopatológico de la depresión, particularmente en la enfermedad física, utilizando la EM como un ejemplo. El artículo está dividido en tres secciones:","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66142698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving transparency in forensic risk assessment: a multimodal approach","authors":"Amy Horstead, A. Cree","doi":"10.1192/APT.BP.112.010645","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010645","url":null,"abstract":"SUMMARY The Department of Health’s best practice guidelines on risk management and violence prevention in UK mental health services highlight the importance of transparency and collaboration with service users. The recovery philosophy echoes the importance of service user inclusion and empowerment in treatment. Our experience in a medium and low secure hospital was that patients were largely excluded from the risk assessment process. In this article, we describe a model for achieving inclusion and transparency in the use of risk assessment tools based on structured professional judgement.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"351-357"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting self-management in early dementia: a contribution towards ‘living well’?","authors":"Jo Cheffey, L. Hill, Glenn Roberts, R. Marlow","doi":"10.1192/APT.BP.112.011023","DOIUrl":"https://doi.org/10.1192/APT.BP.112.011023","url":null,"abstract":"There has been increasing interest in how to assist people to ‘live well’ with advancing and incurable conditions late into life. This article considers the progress made in mental health services for adults of working age which promote active involvement in their care and how these principles can be applied to older adults with dementia. The concept of ‘recovery’ and its applicability to dementia care are discussed. The Wellness Recovery Action Plan (WRAP) and how it could be translated and modified to the needs of people with dementia are explored. This is especially important in light of the UK National Dementia Strategy, which emphasises early diagnosis and intervention to promote improved care and quality of life.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"344-350"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.011023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}