General adult psychiatry 1: Questions

2009 ◽  
pp. 9-30
Keyword(s):  
Adult Psychiatry

Can Early Onset Schizophrenia be Prevented by Early Recognition and Treatment?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F. Resch ◽  
P. Parzer ◽  
R. Oelkers-Ax ◽  
R. Brunner
Keyword(s):  
Late Onset ◽  
Early Recognition ◽  
Event Related Potentials ◽  
Subjective Experiences ◽  
Prodromal Phase ◽  
Basic Symptoms ◽  
Delayed Initiation ◽  
Adult Psychiatry ◽  
Related Potentials ◽  
Psychotic Features

In adult psychiatry early recognition and treatment of schizophrenia has become a major goal because of manifold evidence of a relation between delayed initiation of treatment and an unfavourable developmental course. The duration of untreated psychosis (DUP) seems to be significantly prolonged in adolescents compared to adults due to both a protracted sub-threshold development of psychotic features and the failure of families and health professionals to take seriously the initial signs of psychosis that mimic quasi normal adolescent emotional perturbations. Although in adults studies have shown a subset of prodromal signs and attenuated psychotic features to have predictive evidence for the development of schizophrenia, these symptoms however seem of limited specificity in adolescence. Basic symptoms represent subjective experiences of the prodromal phase and will be presented in a sample of schizophrenic adolescents in comparison to non-psychotic patients and normal controls. Results reveal that basic symptoms do not show any specificity for schizophrenia, but schizophrenics present with higher amounts of basic symptoms in the prodromal phase compared to non-psychotic controls. For early recognition a combination of psychopathological and biological markers seems fruitful. First data on perceptual closure and event related potentials of the optic system will be presented that seem to differentiate between early and late onset schizophrenia.

scholarly journals A new opportunity: three tales of training in liaison psychiatry of old age

2002 ◽  
Vol 26 (11) ◽  
pp. 433-435 ◽  
Author(s):  
John Holmes ◽  
Jon Millard ◽  
Susie Waddingham
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Specialist Training ◽  
Liaison Psychiatry ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Hospital Wards ◽  
And Training

Liaison psychiatry has emerged as a sub-speciality within general adult psychiatry, with specific experience and training being required to develop the skills and knowledge to address comorbid physical and psychiatric symptoms and illness (House & Creed, 1993; Lloyd, 2001). Older people often present with significant physical and psychiatric comorbidity (Ames et al, 1994; Holmes & House, 2000) and most old age psychiatry services receive one-quarter to one-third of referrals from general hospital wards (Anderson & Philpott, 1991). Despite this, there are no specific requirements for training in liaison psychiatry for old age psychiatrists at any level. The experience gained in assessing and treating general hospital referrals during basic and higher specialist training is felt to be adequate (Royal College of Psychiatrists, 1998).

scholarly journals Supporting general adult psychiatry higher trainees to develop research competencies: a training improvement project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S131-S132
Author(s):  
Annalie Clark ◽  
John Stevens ◽  
Sarah Abd El Sayed
Keyword(s):  
Evidence Based Medicine ◽  
Baseline Survey ◽  
Evidence Based ◽  
North West ◽  
The North ◽  
Research Competencies ◽  
Adult Psychiatry ◽  
Based Medicine ◽  
Training Opportunities ◽  
Research Studies

AimsEvidence shows that research-active trusts have better clinical patient outcomes. Psychiatric trainees are required to develop knowledge and skills in research techniques and critical appraisal to enable them to practice evidence-based medicine and be research-active clinicians. This project aimed to evaluate and improve the support for developing research competencies available to general adult psychiatry higher trainees (HT) in the North-West of England.MethodGeneral Adult HT in the North–West of England completed a baseline survey in November 2019 to ascertain trainee's experience of research training provision. The following interventions were implemented to address this feedback:A trainee research handbook was produced, containing exemplar activies for developing research competencies and available training opportunities, supervisors and active research studies.The trainee research representative circulated research and training opportunities between November 2019 – August 2020.Research representatives held a trainee Question and Answer session in September 2020.All General Adult HT were asked to complete an electronic survey in November 2020 to evaluate the effect of these interventions.Result18 General Adult HT completed the baseline survey in November 2019. 29.4% of trainees thought they received enough information on research competencies and 88.9% wanted more written guidance. 38.9% of trainees knew who to contact about research within their NHS Trust and 33.3% were aware of current research studies. Identified challenges for meeting research competencies included lack of time, difficulty identifying a mentor and topic and accessibility of projects.20 General Adult HT completed the repeat survey in November 2020. 50% of trainees wanted to be actively involved in research and 35% wanted to develop evidence-based medicine skills. A minority of trainees aimed to complete only the minimum ARCP requirements. All trainees thought the handbook was a useful resource for meeting research competencies and would recommend it to other trainees. In trainees who received the handbook, 94.7% thought they had received adequate support on meeting research competencies and 94.7% knew who to contact about research in their trust. 68.4% of trainees would like further written guidance on meeting research competencies. Trainees highlighted ongoing practical difficulties with engaging with research and concern about lacking required skills for research.ConclusionTrainees are motivated to engage with research on various different levels, not purely for ARCP purposes. Simple interventions can help trainees feel adequately supported with meeting research competencies. Further work to support trainee involvement in research and improve trainee confidence in engaging with research is required.

scholarly journals An audit: fitness to drive assessment in inpatients of general adult and old age psychiatry

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S200-S201
Author(s):  
Ismail Khan ◽  
Nneamaka Asiodu ◽  
Dr Divyanish ◽  
Anum Yaqoob ◽  
Hasanain Qureshi
Keyword(s):  
Old Age ◽  
Social Withdrawal ◽  
Data Collection Tool ◽  
Fitness To Drive ◽  
Good Medical Practice ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Duty To Inform ◽  
The Impact ◽  
Physical Health Screening

AimsTo determine if fitness to drive is assessed on admission and discharge, if applicable, and for this to be documented during clerking and on discharge notifications.To determine if patients are being educated about the impact of their condition on the ability to safely drive.To ascertain if patients are aware of the duty to inform the DVLA if they for any reason are not fit to drive.BackgroundRisk factors include social, behavior and iatrogenic factors such as social withdrawal, increased likelihood of substance abuse and side effects of anti-psychotic medication.MethodThis trust wide audit involved the random sampling of a total of 71 case notes, 4 case notes per Consultant team in general adult psychiatry and old age psychiatry across Dudley and Walsall sites (total of 3 sites). A data collection tool was developed and included relevant questions regarding fitness to drive. Data were collected between October and December 2019.Result18/49 patients had physical health screening prior to medication initiation.ConclusionAn important aspect of good medical practice is to educate patients about their condition, this includes their fitness to drive as this can be affected both by their diagnosis and medication. It is clear that clinicians also need to be educated about this responsibility to ensure assessment is performed especially on inpatient discharge.

Diagnosis on the way out – personality on the way in? Priorities in treatment in child and adolescent psychiatry

2021 ◽  
pp. 135910452110481
Author(s):  
Simon R. Wilkinson
Keyword(s):  
Precision Medicine ◽  
Child Psychiatry ◽  
Adolescent Psychiatry ◽  
Good Practice ◽  
Child And Adolescent ◽  
Scientific Basis ◽  
Child And Adolescent Psychiatry ◽  
Adult Psychiatry ◽  
The Way

The scientific basis for practice in child psychiatry has developed apace. And has thrown up several quandries for an accepted paradigm for good practice anchored to the diagnostic schema developed in adult psychiatry. This paper hopes to stimulate discussion about where alternative paradigms might lead us on a path to precision medicine as applied to child psychiatry.

Pharmacotherapy for the Treatment of Aggressive Behavior in General Adult Psychiatry

2006 ◽  
Vol 67 (07) ◽  
pp. 1013-1024 ◽  
Author(s):  
Laurette E. Goedhard ◽  
Joost J. Stolker ◽  
Eibert R. Heerdink ◽  
Henk L. I. Nijman ◽  
Berend Olivier ◽  
...  
Keyword(s):  
Aggressive Behavior ◽  
Adult Psychiatry
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