scholarly journals Use of atypical antipsychotics by consultant psychiatrists working in forensic settings

2002 ◽  
Vol 26 (5) ◽  
pp. 172-174 ◽  
Author(s):  
Carol Paton ◽  
Jose A. Garcia ◽  
Deborah Brooke
Keyword(s):  
Side Effects ◽  
Serum Level ◽  
Atypical Antipsychotics ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Forensic Patients ◽  
The Uk ◽  
Level Monitoring ◽  
Typical And Atypical Antipsychotics

AIMS AND METHODAtypical antipsychotics have less neurological side-effects than the older drugs but are only available as oral preparations. This may limit their use in forensic patients. We sent a postal questionnaire to all consultant psychiatrists working in forensic settings in the UK to determine their views.RESULTSThe response rate was 60%. Respondents tended to overestimate the benefits and underestimate the side-effects of the atypical antipsychotics. The majority often prescribed atypical antipsychotics and depots together. Psychoeducation and serum level monitoring were used to optimise/monitor compliance by 50%.CLINICAL IMPLICATIONSUsing atypical antipsychotics as monotherapy is problematic in forensic settings. The extent of polypharmacy means that patients may experience the side-effects of both typical and atypical antipsychotics. More could be done to facilitate and monitor compliance.

scholarly journals Usage of clozapine and new neuroleptics

1999 ◽  
Vol 23 (12) ◽  
pp. 749-749
Author(s):  
Camilla Haw ◽  
Jean Stubbs
Keyword(s):  
Atypical Antipsychotics ◽  
Response Rate ◽  
Pharmaceutical Journal ◽  
Postal Questionnaire ◽  
First Line ◽  
Health Authorities ◽  
Number Of Patients ◽  
Containment Measures ◽  
The Uk ◽  
First Line Treatment

Sir: Bristow (Psychiatric Bulletin, August 1999, 23, 478–480) found 9.5% of psychiatrists said their trust restricted clozapine funding. By contrast, the Maudsley National Schizophrenia Fellowship (1998) survey of health authority pharmaceutical advisors reported in the Pharmaceutical Journal found clozapine funding restricted by 45% of health authorities. We have recently carried out a postal questionnaire of members of the UK Psychiatric Pharmacists Group on the use and evaluation of atypical antipsychotics. We received 82 replies giving a response rate of 45%. Eleven per cent of pharmacists reported their trust capped the number of patients prescribed clozapine. However, there was widespread use of measures by trusts to try and limit expenditure on atypicals, restricting the prescribing of atypicals to consultants only and the use of guidelines in which atypicals are not first line treatment for schizophrenia. Only 12% of trusts, our hospital among them, used no cost-containment measures.

scholarly journals Cognitive therapy training for psychiatrists: impact on individual clinical practice

2004 ◽  
Vol 28 (4) ◽  
pp. 117-119 ◽  
Author(s):  
G. Swift ◽  
I. Durkin ◽  
C. Beuster
Keyword(s):  
Clinical Practice ◽  
Cognitive Therapy ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Previous Survey ◽  
Therapy Training ◽  
Training And Supervision ◽  
Improved Outcomes ◽  
Therapy Sessions

Aims and MethodWe aimed to survey how psychiatrists with in-depth training in cognitive therapy use these skills. A postal questionnaire based on a previous survey was sent to all psychiatrists who are accredited members of the British Association for Behavioural and Cognitive Psychotherapies.ResultsThere was a 94% response rate. Psychiatrists in non-psychotherapy posts used formal cognitive therapy, with an average of 20% of new patients compared with 65% for those in psychotherapy posts, and were less satisfied with the extent to which they were able to use their skills (20%v. 80%). A total of 85% of respondents described themselves as being involved in teaching, training and supervision of cognitive therapy.Clinical ImplicationsUnless psychiatrists are planning on working in specialised psychotherapy posts, they are unlikely to use cognitive therapy training in formal therapy sessions. Further research is needed to determine whether cognitive therapy training for psychiatrists translates into improved outcomes for patients.

Retirement intentions of older consultant psychiatrists

2004 ◽  
Vol 28 (4) ◽  
pp. 130-132 ◽  
Author(s):  
Alex Mears ◽  
Tim Kendall ◽  
Cornelius Katona ◽  
Carole Pashley ◽  
Sarah Pajak
Keyword(s):  
Early Retirement ◽  
Response Rate ◽  
Important Determinant ◽  
Clinical Implications ◽  
Consultant Psychiatrist ◽  
Health Officer ◽  
Decisions To Leave ◽  
The Mean ◽  
The Uk ◽  
Retirement Intentions

Aims and MethodThis survey gathered data on the retirement intentions of consultant psychiatrists over the age of 50 years, in order to address retention issues. A questionnaire was sent to all 1438 consultants over this age in the UK.ResultsA total of 848 questionnaires were returned, an adjusted response rate of 59%. The mean age at which consultants intended to retire in this sample was 60 years (s.d. 4.16), suggesting a potential loss of 5725 consultant years. Reasons for early retirement are complex: factors encouraging retirement include too much bureaucracy, lack of free time and heavy case-loads; those discouraging retirement include enjoyment of work, having a good team and money. Mental Health Officer status is an important determinant in the decision to retire early.Clinical ImplicationsWith numerous vacancies in consultant psychiatrist posts throughout the UK, premature retirement is a cause for concern, possibly contributing to an overall reduction in consultant numbers of 5%. Addressing factors that influence consultants' decisions to leave the health service early should form an important part of an overall strategy to increase consultant numbers.

scholarly journals Attitudes of psychiatrists to evidence-based guidelines

2002 ◽  
Vol 26 (11) ◽  
pp. 421-424 ◽  
Author(s):  
Harvey Rees ◽  
Attila Sipos ◽  
Matthew Spence ◽  
Glynn Harrison
Keyword(s):  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Evidence Based ◽  
Previous Survey ◽  
Health Partnership ◽  
Improved Outcomes ◽  
Actual Use ◽  
Evidence Based Guidelines ◽  
Improving Patient Care

Aims and MethodWe aimed to survey clinicians' attitudes on using evidence-based guidelines. A postal questionnaire based on a previous survey of general practitioners was sent to 105 psychiatrists working within Avon and Western Wiltshire Mental Health Partnership NHS Trust.ResultsThere was a 91% response rate. Respondents were generally in favour of clinical guidelines, with scores indicating a positive attitude to guidelines in 13 of the 18 statements. The majority felt that guidelines were effective in improving patient care, could be used flexibly to suit individual patients and did not impinge on their clinical judgement.Clinical ImplicationsPsychiatrists welcomed the increasing use of guidelines. Further research is needed to determine whether this will translate into actual use and improved outcomes for patients.

scholarly journals Civil and forensic patients in secure psychiatric settings: A comparison

2017 ◽  
Vol 41 (3) ◽  
pp. 156-159 ◽  
Author(s):  
Nuwan Galappathie ◽  
Sobia Tamim Khan ◽  
Amina Hussain
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Clinical Implications ◽  
Treatment Needs ◽  
Forensic Patients ◽  
Adult Services ◽  
Frequent Episodes ◽  
Self Harm ◽  
Male Patients ◽  
The Uk

Aims and methodTo evaluate differences between male patients in secure psychiatric settings in the UK based on whether they are detained under civil or forensic sections of the Mental Health Act 1983. A cohort of patients discharged from a secure psychiatric hospital were evaluated for length of stay and frequency of risk-related incidents.ResultsOverall, 84 patients were included in the study: 52 in the forensic group and 32 in the civil group. Civil patients had more frequent incidents of aggression, sex offending, fire-setting and vulnerability, whereas forensic patients had more frequent episodes of self-harm.Clinical implicationsSecure hospitals should ensure treatment programmes are tailored to each patient's needs. Civil patients require greater emphasis on treatment of their mental illness, whereas forensic patients have additional offence-related treatment needs. Regular liaison between forensic and general adult services is essential to help ensure patients can return to appropriate settings at the earliest opportunity in their recovery.

scholarly journals Availability and acceptability of home treatment for acute psychiatric disorders

2000 ◽  
Vol 24 (5) ◽  
pp. 169-171 ◽  
Author(s):  
Andrew J. Owen ◽  
S. P. Sashidharan ◽  
Lyse J. Edwards
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Postal Survey ◽  
Home Treatment ◽  
Clinical Implications ◽  
Health Authorities ◽  
Low Levels ◽  
The Uk ◽  
Do So ◽  
Future Plans

Aims and MethodsTo ascertain current levels of access to home treatment for those with acute mental illness and future plans of trusts and purchasing authorities to provide such services. Also, to assess the attitudes of these organisations towards this form of treatment. A postal survey of all mental health trusts and purchasing authorities within the UK was carried out.ResultsOne hundred and seventy-two trusts and 82 health authorities returned questionnaires, representing a response rate of 75% and 67% respectively. Only 27 (16%) of trusts provided home treatment but 58 (40%) had plans to do so. All health authorities and 97% of trusts were in favour of the principle of providing home treatment.Clinical ImplicationsDespite the low levels of provision of home treatment trusts and health authorities were strongly in favourof it. There is likely to be a large increase in its availability over the next 12 months.

scholarly journals Psychotherapy training experience in an inner-city psychiatry rotation

2003 ◽  
Vol 27 (5) ◽  
pp. 179-182
Author(s):  
Maria Podlejska-Eyres ◽  
Julian Stern
Keyword(s):  
Inner City ◽  
Response Rate ◽  
Psychotherapy Training ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Basic Training ◽  
Specialist Training ◽  
Training Experience ◽  
Training Scheme ◽  
Royal London Hospital

Aims and MethodA postal questionnaire was circulated to all psychiatrists who had completed their basic specialist training on the Royal London Hospital training scheme within the last 7.5 years. The aim of the questionnaire was to explore their psychotherapy experience while on the rotation.ResultsThe response rate was 95%. The respondents had a broad experience of both didactic and case work that they valued highly. Over half of them wished for an even greater exposure to psychotherapy during their basic training.Clinical ImplicationsThe results of our survey suggest that with the dedication of both the trainees and trainers, it is possible to have a comprehensive psychotherapy experience while working on a busy inner-city rotation.

scholarly journals Clozapine – a survey of patient perceptions

2000 ◽  
Vol 24 (12) ◽  
pp. 450-452 ◽  
Author(s):  
D. Taylor ◽  
L. Shapland ◽  
G. Laverick ◽  
J. Bond ◽  
J. Munro
Keyword(s):  
Response Rate ◽  
Patient Perceptions ◽  
Large Majority ◽  
Clinical Implications ◽  
Blood Testing ◽  
Clozapine Therapy ◽  
Clozapine Treatment ◽  
The Uk ◽  
Adherence To Therapy ◽  
Structured Questionnaire

Aims and MethodWe aimed to find out how patients on clozapine felt about clozapine treatment. A structured questionnaire was given to 1284 consecutive patients attending 27 clozapine clinics in the UK.ResultsThe response rate was 44.4% (570 forms returned). This cohort of responders to the questionnaire consisted, for the most part, of Caucasian males who had been taking clozapine for more than 2 years. Respondents expressed largely favourable views on clozapine treatment. For example, 86.1% claimed to feel better on clozapine and 88.6% claimed to prefer to remain on clozapine than to change to another drug. Many patients stated that they disliked having to undergo blood testing, but a large majority (87.0%) felt that the advantages of clozapine outweighed disadvantages. All other responses supported this overall favourable view of clozapine therapy.Clinical ImplicationsPatients stabilised on clozapine are largely content with their treatment. These results suggest that clozapine is effective as assessed by patients' own standards and that adherence to therapy is likely to be good.

scholarly journals Provision of psychotherapy services for older people

2000 ◽  
Vol 24 (5) ◽  
pp. 181-184 ◽  
Author(s):  
Siobhan Murphy
Keyword(s):  
Older People ◽  
Patient Group ◽  
Postal Questionnaire ◽  
Service Planning ◽  
Clinical Implications ◽  
Older Patient ◽  
The Third ◽  
Catchment Areas ◽  
The Uk ◽  
Psychotherapy Services

Aims and MethodsA postal questionnaire was sent to 100 departments of psychotherapy within the UK in an attempt to gauge the use of psychotherapy services by patients in the third and fourth age.ResultsEighty-seven per cent of respondents felt that the needs of this group for psychotherapy were not met as well as those of younger people in their catchment areas. This is most marked in people over 65 years of age who are infrequently referred to psychotherapy departments. Suggestions are made for improving services.Clinical ImplicationsThe psychotherapy needs of this group need to be considered in service planning. All professionals need educating about the availability and applicability of the psychotherapies for the older patient. Without additional resources it seems unlikely that the needs of this patient group will be met.

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