Liaison Psychiatry for all!!

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When I am not being an elf, I am very proud to work within Liaison Psychiatry and to be actively developing Liaison services across Kent and Medway. For those of you who haven’t come across Liaison before,  we work within the overlapping area between physical health and mental health, so dealing with physical health problems and [read the full story…]

Meta-analysis finds that pituitary volume is not affected in people with first episode psychosis or schizophrenia

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* Declaration; I have published articles with two of the authors of this article, including on this topic, and know most of them professionally One influential model of the onset of psychotic disorders such as schizophrenia is the stress-vulnerability model, first put forward by Zubin and Spring in 1977. This model proposes that people at [read the full story…]

No evidence that behavioural therapies are any better than other psychological therapies for depression

Depression is a big problem.  In fact, it’s the third leading cause of disease burden worldwide (WHO, 2004 – as cited in Shinohara et al, 2013) and the largest source of nonfatal disease burden in the world (Ustun, 2004 – as cited in Shinohara et al, 2013).   What’s more, the number of people affected by it [read the full story…]

Atypical antipsychotics no better than typicals for adolescents with psychosis, but atypicals may have fewer short-term side effects

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Schizophrenia is a serious neurodevelopmental disorder that often starts during adolescence. Current treatment guidelines (NICE, 2013) recommend atypical antipsychotics for adolescents with this condition, but this is based largely on studies of adults with the condition. The Cochrane Schizophrenia Group conducted this systematic review to synthesise the current evidence base for atypical antipsychotic medication in [read the full story…]

Reality orientation and skills training may improve cognition in dementia, but don’t jump to conclusions

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Well this is an interesting one. The abstract of a recent review by Carrion et al concludes that cognitive psychosocial interventions such as reality orientation and skills training improve cognition (Carrion, 2013). Woohoo, I thought; fantastic!  And then I read the review… Methods The authors searched the usual bibliographic databases for randomised and non-randomised controlled trials, [read the full story…]

Cognitive therapy is a non-stigmatising intervention for people at risk of psychosis

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Criteria to identify subgroups experiencing an at-risk mental state (ARMS) have been developed and are widely adopted internationally, but this has fueled recent debates about unintended stigmatising consequences of identifying and providing treatment to people at risk of psychosis. While the Early Detection and Intervention Evaluation 2 (EDIE-2) trial has shown that cognitive therapy (CT) [read the full story…]

Do smoking cessation treatments increase the risk of depression and suicide?

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Smoking is a major preventable cause of morbidity and premature mortality throughout the world. There are an estimated 460,000 hospital admissions attributable to smoking in people aged over 35 every year, with an average annual cost to the NHS of £2.7 billion. Many strategies exist to help people give up smoking. The most common are [read the full story…]

Which psychological therapies work best for borderline personality disorder?

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This systematic review of psychological therapies for borderline personality disorder (BPD), conducted in Spain, takes an interesting approach to reviewing the literature. Unfortunately, there appear to have been challenges in translating the systematic review from Spanish and the text can be difficult to follow at times. This is a real shame as it is an [read the full story…]

Varenicline, smoking cessation and neuropsychiatric adverse events

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Varenicline is a prescription drug to help people stop smoking that works by stimulating the nicotine receptors in the brain to reduce cravings and decrease the pleasure that results from smoking. Quit attempts aided by varenicline are up to 2-3 times more successful than those without (Cahill et al 2009 and 2012). However, following the [read the full story…]

Counselling is as effective as CBT for depression, according to a reanalysis of RCT data

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In recent years, cognitive-behavioural therapy (CBT) has become the most widely delivered therapy for depression within the NHS.  CBT interventions are recommended by NICE for people with mild, moderate and severe depression. By contrast, recent NICE guidelines recommend counselling only for people with persistent subthreshold depressive symptoms or mild to moderate depression who decline another [read the full story…]