Pub Date : 2013-07-01DOI: 10.1192/APT.BP.112.010389
J. Wallace
Using a new treatment is not an instantaneous act. There is a gap between research and practice and carefully evaluated evidence often fails to achieve widespread use. Various factors intercede along the pathway from knowledge generation to knowledge utilisation. These can hinder, or indeed facilitate, the use of research evidence in psychiatry. Knowledge translation is a discipline that attempts to identify and understand these barriers and facilitators to knowledge transfer. In this article, the terminology and key concepts of knowledge translation will be outlined, the evidence transfer pipeline described and obstacles and facilitators to uptake of evidence explored. The article also identifies sources of information on knowledge transfer. Innovative approaches designed to enhance the uptake of evidence from research, such as summaries, systematic reviews and targeted messaging, are also described.
{"title":"Lost in translation: transferring knowledge from research to clinical practice","authors":"J. Wallace","doi":"10.1192/APT.BP.112.010389","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010389","url":null,"abstract":"Using a new treatment is not an instantaneous act. There is a gap between research and practice and carefully evaluated evidence often fails to achieve widespread use. Various factors intercede along the pathway from knowledge generation to knowledge utilisation. These can hinder, or indeed facilitate, the use of research evidence in psychiatry. Knowledge translation is a discipline that attempts to identify and understand these barriers and facilitators to knowledge transfer. In this article, the terminology and key concepts of knowledge translation will be outlined, the evidence transfer pipeline described and obstacles and facilitators to uptake of evidence explored. The article also identifies sources of information on knowledge transfer. Innovative approaches designed to enhance the uptake of evidence from research, such as summaries, systematic reviews and targeted messaging, are also described.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"250-258"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776608","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.112.010462
A. Watkin, S. Sikdar, Biswadeep Majumdar, A. Richman
This article gives an overview of the profile of Alzheimer’s disease, its pathophysiology and recent developments in technology that enable better understanding of the mechanism of disease. The diagnostic criteria and role of biomarkers proposed are explained. The new subgroups described are outlined in table form for easy reference. Subtypes of mild cognitive impairment (MCI) are reviewed and the conversion of amnestic MCI to Alzheimer’s disease is considered. The implications and change to current clinical practice form the basis of the conclusion of the article.
{"title":"New diagnostic concepts in Alzheimer’s disease","authors":"A. Watkin, S. Sikdar, Biswadeep Majumdar, A. Richman","doi":"10.1192/APT.BP.112.010462","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010462","url":null,"abstract":"This article gives an overview of the profile of Alzheimer’s disease, its pathophysiology and recent developments in technology that enable better understanding of the mechanism of disease. The diagnostic criteria and role of biomarkers proposed are explained. The new subgroups described are outlined in table form for easy reference. Subtypes of mild cognitive impairment (MCI) are reviewed and the conversion of amnestic MCI to Alzheimer’s disease is considered. The implications and change to current clinical practice form the basis of the conclusion of the article.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"242-249"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777161","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.107.004689
M. Deahl, R. Siddiquee
Few of us have first-hand experience of military psychiatry. However, as a result of recent conflict and the imminent downsizing of the armed forces we will almost certainly be seeing increasing numbers of ex-servicemen in our clinics. This paper explains what civilian mental health professionals should know when dealing with service and ex-service men and women.
{"title":"What civilian psychiatrists should know about military psychiatry","authors":"M. Deahl, R. Siddiquee","doi":"10.1192/APT.BP.107.004689","DOIUrl":"https://doi.org/10.1192/APT.BP.107.004689","url":null,"abstract":"Few of us have first-hand experience of military psychiatry. However, as a result of recent conflict and the imminent downsizing of the armed forces we will almost certainly be seeing increasing numbers of ex-servicemen in our clinics. This paper explains what civilian mental health professionals should know when dealing with service and ex-service men and women.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"268-275"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.107.004689","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65763570","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.111.009142
B. Rosenbaum, B. Martindale, A. Summers
The UK National Institute for Health and Care Excellence guidance suggests that psychodynamic principles may be used to understand the experiences of people with psychosis. In this article we consider the application of psychodynamic principles in psychotherapy for psychosis, focusing on one particular model: supportive psychodynamic psychotherapy (SPP). We describe this approach with a detailed fictitious case example and discuss how SPP has developed through significant modifications of classical psychoanalytic therapy and the evidence base for it. We consider its overlap with cognitive–behavioural therapy, its advantages and disadvantages, and the arguments for making SPP available as a treatment option in services for psychosis.
{"title":"Supportive psychodynamic psychotherapy for psychosis","authors":"B. Rosenbaum, B. Martindale, A. Summers","doi":"10.1192/APT.BP.111.009142","DOIUrl":"https://doi.org/10.1192/APT.BP.111.009142","url":null,"abstract":"The UK National Institute for Health and Care Excellence guidance suggests that psychodynamic principles may be used to understand the experiences of people with psychosis. In this article we consider the application of psychodynamic principles in psychotherapy for psychosis, focusing on one particular model: supportive psychodynamic psychotherapy (SPP). We describe this approach with a detailed fictitious case example and discuss how SPP has developed through significant modifications of classical psychoanalytic therapy and the evidence base for it. We consider its overlap with cognitive–behavioural therapy, its advantages and disadvantages, and the arguments for making SPP available as a treatment option in services for psychosis.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"310-318"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.111.009142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65774265","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.110.008789
A. Cole-King, Victoria Parker, H. Williams, S. Platt
Healthcare professionals require an understanding of how the behaviour and characteristics of both patients and assessors can affect suicide risk identification and response. This article reviews the literature on how we currently assess suicide risk and considers the need for a paradigm shift in how healthcare professionals engage with and assess suicidal patients. It also reviews some of the evidence base for interventions to mitigate the risk of suicide and promotes pragmatic and compassionate interventions.
{"title":"Suicide prevention: are we doing enough?","authors":"A. Cole-King, Victoria Parker, H. Williams, S. Platt","doi":"10.1192/APT.BP.110.008789","DOIUrl":"https://doi.org/10.1192/APT.BP.110.008789","url":null,"abstract":"Healthcare professionals require an understanding of how the behaviour and characteristics of both patients and assessors can affect suicide risk identification and response. This article reviews the literature on how we currently assess suicide risk and considers the need for a paradigm shift in how healthcare professionals engage with and assess suicidal patients. It also reviews some of the evidence base for interventions to mitigate the risk of suicide and promotes pragmatic and compassionate interventions.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"284-291"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.110.008789","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65773112","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.112.010363
R. Steele, P. Henderson, Frances Lennon, D. Swinden
Many psychiatric in-patients report boredom. Such complaints may appear trivial, but this literature review by a clinical librarian suggests that boredom is more complex than may initially appear and relates to wider areas of importance for in-patient psychiatric teams. Boredom may relate to the internal experience of meaning, which itself encompasses meaningful relationships and roles and a sense of control. Although meaningful therapeutic activities are vital, mental health professionals should focus on the internal as well as the external dimensions of boredom. Medications, particularly dopamine antagonist antipsychotics, may be a contributing factor. This article highlights the benefits of the clinical librarian role in synthesising research in mental health. Research can illuminate psychiatric practice in a more holistic way than purely by applying ‘scientific’ evidence in the practice of ‘biological’ psychiatry.
{"title":"Boredom among psychiatric in-patients: does it matter?","authors":"R. Steele, P. Henderson, Frances Lennon, D. Swinden","doi":"10.1192/APT.BP.112.010363","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010363","url":null,"abstract":"Many psychiatric in-patients report boredom. Such complaints may appear trivial, but this literature review by a clinical librarian suggests that boredom is more complex than may initially appear and relates to wider areas of importance for in-patient psychiatric teams. Boredom may relate to the internal experience of meaning, which itself encompasses meaningful relationships and roles and a sense of control. Although meaningful therapeutic activities are vital, mental health professionals should focus on the internal as well as the external dimensions of boredom. Medications, particularly dopamine antagonist antipsychotics, may be a contributing factor. This article highlights the benefits of the clinical librarian role in synthesising research in mental health. Research can illuminate psychiatric practice in a more holistic way than purely by applying ‘scientific’ evidence in the practice of ‘biological’ psychiatry.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"259-267"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776537","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.111.009878
K. Hines, A. Cole-King, Margaret E. Blaustein
Kevin Hines gives a high-impact and deeply poignant account of his suicidal crisis, which culminated in an attempt to end his life, and an inspirational account of his recovery and return to mental well-being.
{"title":"Hey kid, are you OK? A story of suicide survived","authors":"K. Hines, A. Cole-King, Margaret E. Blaustein","doi":"10.1192/APT.BP.111.009878","DOIUrl":"https://doi.org/10.1192/APT.BP.111.009878","url":null,"abstract":"Kevin Hines gives a high-impact and deeply poignant account of his suicidal crisis, which culminated in an attempt to end his life, and an inspirational account of his recovery and return to mental well-being.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"292-294"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.111.009878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65775759","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}
Pub Date : 2013-07-01DOI: 10.1192/APT.BP.112.010595
Jaydip Sarkar
Making potentially critical clinical decisions in complex cases with the real risk of death by suicide is a most challenging job in psychiatry. Sadly, risk assessment and management of harm to self is a largely ignored area compared with risk of harm to others. The legal and ethical challenges are more nuanced, and contemporary training schemes and textbooks on psychiatry have not always done justice to this area, where front-line clinicians require probably most assistance. This article is an attempt to integrate the seemingly disparate threads from legal, ethical and clinical realms to assist decision-making, and it introduces a set of principles for managing these in clinical practice. It refers in particular to legislation in England and Wales, but the clinical and ethical issues discussed are universal.
{"title":"To be or not to be: legal and ethical considerations in suicide prevention","authors":"Jaydip Sarkar","doi":"10.1192/APT.BP.112.010595","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010595","url":null,"abstract":"Making potentially critical clinical decisions in complex cases with the real risk of death by suicide is a most challenging job in psychiatry. Sadly, risk assessment and management of harm to self is a largely ignored area compared with risk of harm to others. The legal and ethical challenges are more nuanced, and contemporary training schemes and textbooks on psychiatry have not always done justice to this area, where front-line clinicians require probably most assistance. This article is an attempt to integrate the seemingly disparate threads from legal, ethical and clinical realms to assist decision-making, and it introduces a set of principles for managing these in clinical practice. It refers in particular to legislation in England and Wales, but the clinical and ethical issues discussed are universal.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"295-301"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65777265","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}
Pub Date : 2013-05-01DOI: 10.1192/APT.BP.112.010405
D. McQueen, Sarah Cohen, P. John-Smith, H. Rampes
This article outlines proximate (physical and mental) and ultimate mechanisms of placebo effects. Interpersonal processes contributing to placebo effects are reviewed and illustrated through research into the process of psychotherapy. Evolutionary theories of how and why the capacity for placebo effects might have evolved are described. The components of treatment and placebo effects are defined. It is concluded that maximising therapeutic placebo effects is effective and a valid clinical goal.
{"title":"Rethinking placebo in psychiatry: how and why placebo effects occur †","authors":"D. McQueen, Sarah Cohen, P. John-Smith, H. Rampes","doi":"10.1192/APT.BP.112.010405","DOIUrl":"https://doi.org/10.1192/APT.BP.112.010405","url":null,"abstract":"This article outlines proximate (physical and mental) and ultimate mechanisms of placebo effects. Interpersonal processes contributing to placebo effects are reviewed and illustrated through research into the process of psychotherapy. Evolutionary theories of how and why the capacity for placebo effects might have evolved are described. The components of treatment and placebo effects are defined. It is concluded that maximising therapeutic placebo effects is effective and a valid clinical goal.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"19 1","pages":"171-180"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.112.010405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776835","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}
Pub Date : 2013-05-01DOI: 10.1192/APT.BP.111.010041
B. Green
SUMMARY As many as 10% of the population experience post-traumatic stress disorder (PTSD) at some time in their lives. It often runs a severe, chronic and treatment-resistant course. This article reviews the evidence base for typically recommended treatments such as cognitive–behavioural therapy (CBT), eye movement desensitisation and reprocessing and selective serotonin reuptake inhibitors (SSRIs). It tabulates the major randomised controlled trials of SSRIs and trauma-focused CBT and reviews research on novel treatments such as ketamine, MDMA, quetiapine, propranolol and prazosin.
{"title":"Post-traumatic stress disorder: new directions in pharmacotherapy","authors":"B. Green","doi":"10.1192/APT.BP.111.010041","DOIUrl":"https://doi.org/10.1192/APT.BP.111.010041","url":null,"abstract":"SUMMARY As many as 10% of the population experience post-traumatic stress disorder (PTSD) at some time in their lives. It often runs a severe, chronic and treatment-resistant course. This article reviews the evidence base for typically recommended treatments such as cognitive–behavioural therapy (CBT), eye movement desensitisation and reprocessing and selective serotonin reuptake inhibitors (SSRIs). It tabulates the major randomised controlled trials of SSRIs and trauma-focused CBT and reviews research on novel treatments such as ketamine, MDMA, quetiapine, propranolol and prazosin.","PeriodicalId":89879,"journal":{"name":"Advances in psychiatric treatment : the Royal College of Psychiatrists' journal of continuing professional development","volume":"8 1","pages":"181-190"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/APT.BP.111.010041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65776249","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}
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