Acute angle-closure glaucoma (AACG) may cause symptoms including eye pain, changes in vision, or swelling and redness and can rapidly lead to permanent blindness if not treated.1 Medications can precipitate AACG through adrenergic or anticholinergic-mediated pupillary dilation that results in the physical obstruction of the outflow of intraocular fluid in susceptible individuals. Case reports and a previous large database study from Ontario, Canada,2 have suggested an association between new use of selective serotonin reuptake inhibitors (SSRIs) and AACG. The potential mechanism underlying this association is unclear but may be related to effects on norepinephrine or serotonin receptors in the iris and ciliary body of the eye.3 To read the full article, log in using your NHS OpenAthens details.
The use of coercion in the treatment of psychiatric patients is of growing concern, particularly in the context of United Nations Convention on the Rights of Persons with Disabilities (http://www.un.org/disabilities/convention/conventionfull.shtml). Increasing rates of compulsory admission are one example. It is therefore important to find interventions that can prevent compulsory admission to hospital for people with severe mental illness. To read the full article, log in using your NHS OpenAthens details.
Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have a disproportionate impact on quality of life and carer burden. Pharmacological treatment is the main approach in dealing with these symptoms, but it is limited by variable efficacy and risk of drug interactions. Non-pharmacological approaches using the cognitive–behavioural therapy (CBT) model are viable alternatives and in this review paper we summarise the evidence of CBT for three of the most common psychiatric manifestations of PD: depression and anxiety, impulse-control disorders and insomnia. To read the full article, log in using your NHS OpenAthens details.
Electroconvulsive therapy (ECT) is an effective treatment for mood disorders and a viable treatment option especially when urgency of clinical situation requires a prompt treatment response. After acute series of ECT, the ECT long-term treatment may be considered, although this practice may vary significantly between countries or even within the same country, because there is no universal consensus about its indications, duration and frequency of administration. Continuation or maintenance ECT is common in routine clinical practice and clinicians should be aware of the risks of using ECT long term. Neuropsychological assessment should be an essential part of a good clinical practice in ECT services. Cognitive side effects of ECT are sometimes underestimated and may last much longer after completed treatment than it is usually expected. These cognitive impairments associated with ECT may cause significant functional difficulties and prevent patients to return to work. Cognitive assessment during ECT treatment is usually not comprehensive enough and is limited to bedside assessment. A more proactive approach to careful neuropsychological assessment and consideration of combined maintenance medication treatment after ECT are essential. To read the full article, log in using your NHS OpenAthens details.
Attention-deficit/hyperactivity disorder (ADHD) is characterised by a persistent and impairing pattern of inattention and/or hyperactivity/impulsivity and it is one of the most common neuropsychiatric conditions. Evidence about interventions of adults with ADHD is growing rapidly and clinicians need a reliable summary of all the best available information in order to better inform their daily practice. To read the full article, log in using your NHS OpenAthens details.
The medical community disseminates information increasingly using social media. Randomised controlled trials are being conducted in this area to evaluate effectiveness of social media with mixed results so far, but more trials are likely to be published in the coming years. One recent twitter randomised control trial using Cochrane Schizophrenia Group reviews suggests that tweets increase the hits to the target web page by about threefold and time spent on the web page is also increased threefold when referrals come in via twitter. These are early findings and need further replication. Twitter appeals to professionals, entertainers and politicians among others as a means of networking with peers and connecting with the wider public. Twitter, in particular, seems to be well placed for use by the medical community and is effective in promoting messages, updating information, interacting with each other locally and internationally and more so during conferences........To read the full article, log in using your NHS OpenAthens details.
We are pleased to respond to Drs Lee and Hoge's1 commentary on our randomised controlled trial (RCT) published in JAMA (a summary of the original article can be found at https://www.ncbi.nlm.nih.gov/pubmed/26241597).2 While we readily acknowledge several limitations to the study, Drs Lee and Hoge have failed to consider or acknowledge several aspects of the study and its results. To read the full article, log in using your NHS OpenAthens details.
Commentary by Lee & Hoge. Of six major international post-traumatic stress disorder (PTSD) treatment guidelines, only two mention mindfulness-based treatments, and none recommend their routine use.1 ,2 Few mindfulness-based intervention studies exist for PTSD, and all have significant limitations in design, outcome measures and/or data handling.1 However, these interventions remain widely used. A core-component of PTSD treatment addresses autonomic hyperarousal, and many clinicians apply mindfulness techniques for this or in facilitating treatment for patients too avoidant for trauma-focused psychotherapies (TFPs).To read the full article, log in using your NHS OpenAthens details.
Individuals with schizophrenia die ∼15–20 years prematurely compared to the general population, mostly due to cardiovascular disease, obesity-related cancer, diabetes and chronic obstructive pulmonary disease.1 Owing to the known metabolic effects of antipsychotics,2 clarifying their role in increased mortality is important. Paradoxically, prior studies in schizophrenia have suggested a relative decrement in mortality with moderate antipsychotic doses compared to no antipsychotic exposure. Cohort studies have indicated an elevated mortality risk with benzodiazepines in several populations, but adjustment for other treatment variables has been limited. To read the full article, log in using your NHS OpenAthens details.
Several meta-analyses of about 20 year’s work on randomised controlled trials (RCTs) with mindfulness-based cognitive therapy for depression (MBCT)1 have concluded that MBCT is efficacious in reducing relapse/recurrence where people have had at least three major depressive episodes (MDEs). To read the full article, log in using your NHS OpenAthens details.
The available treatments can only moderately reduce the enormous burden of disease associated with depression.1 Prevention of the transition from subthreshold depression to a full-blown disorder is therefore highly needed. Offering accessible and affordable preventive interventions at a large scale, such as web-based interventions, could be an indispensable strategy to reduce the global burden of depression. To read the full article, log in using your NHS OpenAthens details.
Persistent negative symptoms which do not respond to antipsychotic regimens are experienced by 15–20% of patients with schizophrenia.1 Antidepressants have been the most studied augmentation strategy in these patients;2 however, previous findings are inconsistent in terms of their potential benefits. To read the full article, log in using your NHS OpenAthens details.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by impaired social communication and restricted/repetitive behaviours.1 Although arguably less cited, delayed adaptive functioning and disruptive behaviours are also considered hallmark features of this disorder. Parent training (PT) is a common treatment for youth with ASD, with previous research demonstrating reduced disruptive behaviour in young children.2 However, the extent to which PT positively influences adaptive behaviour has yet to be investigated. To read the full article, log in using your NHS OpenAthens details.
Depression and anxiety in young people are major causes of disability. There is potential for prevention by using effective treatment strategies for the disorders, but previously effects for depression and anxiety have not been aggregated. In this paper, the combined effects of prevention programmes on depression and anxiety are examined. To read the full article, log in using your NHS OpenAthens details.
To evaluate the preliminary validity and reliability of the myTREEHOUSE Self-Concept Assessment for children with cerebral palsy (CP) aged 8 to 12 years. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Over the last 2 years the world has woken up to something that we in the world of children and young people's mental health have known for a very long time – the best correlate of adult life satisfaction is not income but physical and mental health, and we can predict adult life satisfaction best, not from academic qualifications but from the emotional health of 16-year olds (Clark, Fleche, Layard, Powdthavee, & Ward, 2016). The overwhelming burden of disease associated with mental ill health suggests that early intervention focused on child mental health is probably the most effective social investment any government could make both from economic and ethical perspectives. We are now at the moment of national insight – so how will we translate this into real goals and action, and drive our own effective strategies? Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Patient-reported outcome measures (PROMs) are recommended by healthcare systems internationally, but there are a number of barriers to implementation. The aim of this research was to examine the impact of training supervisors in using PROMs on clinical practice, given the importance of leadership when changing behaviour. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
With cases of dementia on the rise, it's more important than ever that services give people the support they need. Read our briefing to find out what people have told local Healthwatch about their experiences of care.