R. Flanagan, S. Gee, S. Belsey, L. Couchman, J. Lally
{"title":"Therapeutic monitoring of plasma clozapine and N-desmethylclozapine (norclozapine): practical considerations","authors":"R. Flanagan, S. Gee, S. Belsey, L. Couchman, J. Lally","doi":"10.1192/bja.2022.71","DOIUrl":"https://doi.org/10.1192/bja.2022.71","url":null,"abstract":"SUMMARY Clozapine dose assessment in treatment-refractory schizophrenia is complicated. There is a narrow margin between an effective and a potentially toxic dose and wide inter-individual variation in clozapine metabolic capacity. Moreover, factors such as changes in smoking habit, infection/inflammation, co-prescription of certain drugs, notably fluvoxamine, and age alter the dose requirement within individuals. Therapeutic drug monitoring (TDM) of plasma clozapine and N-desmethylclozapine (norclozapine) can help assess adherence, guide dosage and guard against toxicity. This article gives an overview of clozapine pharmacokinetics and factors affecting clozapine dose requirements. It then outlines the procedures and processes of clozapine TDM, from taking the blood sample for laboratory assay or point-of-contact (finger-prick) testing (POCT) to interpreting and acting on the results.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"26 1","pages":"92 - 102"},"PeriodicalIF":1.3,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89907255","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":"Traumatised and on TikTok: from inside the psych ward","authors":"Damon Parsons","doi":"10.1192/bja.2022.87","DOIUrl":"https://doi.org/10.1192/bja.2022.87","url":null,"abstract":"\u0000 Faster internet speeds and ever-present mobile phones present a new challenge to psychiatric wards – the ability for patients to live stream their in-patient stays. What are the benefits and the risks to the patient streaming and the ward as a whole? This article is to help start a conversation about this unique problem and how health professionals might go about addressing it.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"12 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87787064","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}
A. Barrera, Saïk J. G. N. de La Motte de Broöns de Vauvert
{"title":"Empathy and the work of clinical psychiatrists: narrative review","authors":"A. Barrera, Saïk J. G. N. de La Motte de Broöns de Vauvert","doi":"10.1192/bja.2022.80","DOIUrl":"https://doi.org/10.1192/bja.2022.80","url":null,"abstract":"\u0000 Clinical research suggests that empathy is associated with better clinical outcomes in various areas of medical care, raising the question of whether a similar effect occurs in psychiatry. The aim of this review is to explore philosophical, neuroscientific and psychological perspectives on the concept of empathy in the context of the day-to-day work of clinical psychiatrists. The definition of empathy is outlined and sociodemographic factors, working conditions and psychiatrists’ beliefs that can potentially affect empathy in clinical encounters are explored; educational and training aspects are also reviewed. The review concludes suggesting that research on empathy is needed to understand contextual, training and relational factors that could benefit mental healthcare as well as the working conditions of clinical psychiatrists, both inextricably linked.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"41 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76498431","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":"The devil is in the detail: a critique of nine editorials published by the International Task Force on Benzodiazepines","authors":"Jaden Brandt","doi":"10.1192/bja.2022.62","DOIUrl":"https://doi.org/10.1192/bja.2022.62","url":null,"abstract":"\u0000 Since 2018, the International Task Force on Benzodiazepines (ITFB), a group of academic psychiatrists and academic psychologists, has advocated that clinical guidelines should change to promote benzodiazepines from second- to first-line treatment for anxiety disorders, accept their use as maintenance treatment for anxiety conditions (in particular, panic disorder) and increase their use in gastrointestinal disorders. There is merit in much of what the ITFB argues, but in this article I analyse four major claims it has made in opinion editorials that I believe are not fully supported by the available evidence.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"248 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73372791","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":"Re-evaluating benzodiazepines for anxiety disorders – déjà-vu all over again?","authors":"I. Anderson","doi":"10.1192/bja.2022.85","DOIUrl":"https://doi.org/10.1192/bja.2022.85","url":null,"abstract":"\u0000 Benzodiazepines have attracted controversy from shortly after their introduction. They have been subject to periodic calls for their use to be re-evaluated on the basis that their risks have been overstated and their benefits underappreciated. Claims made in recent editorials from the International Task Force on Benzodiazepines in support of their wider use are critiqued in this issue. I examine here whether there is a case to change the conclusions of previous reconsiderations of the question.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"07 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77943101","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":"Integrated care systems: can they deliver?","authors":"R. Rao","doi":"10.1192/bja.2022.78","DOIUrl":"https://doi.org/10.1192/bja.2022.78","url":null,"abstract":"SUMMARY This commentary is a response to three articles on integrated care systems in this journal. It explores some aspects of the latest transformation of England's National Health Service (NHS) and raises some questions on the extent to which the proposed NHS Long Term Plan can deliver on the current challenges.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"11 1","pages":"41 - 43"},"PeriodicalIF":1.3,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75662674","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":"Psychotherapy by Reciprocal Inhibition: Wolpe's unique legacy to the evolution of cognitive–behavioural therapy","authors":"C. Carona, K. Ramos, Céu Salvador","doi":"10.1192/bja.2022.75","DOIUrl":"https://doi.org/10.1192/bja.2022.75","url":null,"abstract":"SUMMARY The book Psychotherapy by Reciprocal Inhibition (1968) is widely acclaimed as the masterwork of Joseph Wolpe, a great pioneer in the development of behavioural therapy, and is considered one of the most influential books in the history of clinical psychology. In this article, a brief biography of Wolpe is followed by a critical review of the book that illustrates his major contributions to the evolution of cognitive–behavioural therapy (CBT) as the most empirically supported model of psychotherapy.","PeriodicalId":9336,"journal":{"name":"BJPsych Advances","volume":"3 1","pages":"218 - 222"},"PeriodicalIF":1.3,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80275952","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}