Investigating inequalities in patient outcomes for first-episode psychosis.

Background: Understanding inequalities in outcomes between demographic groups is a necessary step in addressing them in clinical care. Inequalities in treatment uptake between demographic groups may explain disparities in outcomes in people with first-episode psychosis (FEP).

Aims: To investigate disparities between broad demographic groups in symptomatic improvement in patients with FEP and their relationship to treatment uptake.

Predictors of positive patient-reported outcomes from 'Early Intervention in Psychosis': a national cross-sectional study.

Background: The components of care delivered by Early Intervention in Psychosis (EIP) services vary, but the impact on patient experience is unknown.

Objective: To investigate associations between components of care provided by EIP services in England and patient-reported outcomes.

Methods: 2374 patients from EIP services in England were surveyed during the National Clinical Audit of Psychosis.

Patient experience of lasting negative effects of psychological interventions for anxiety and depression in secondary mental health care services: a national cross-sectional study.

Background: Patients who undergo psychological treatment can report both negative and positive effects, but evidence of factors influencing the likelihood of negative effects is limited.

Aims: To identify aspects of the organisation and delivery of secondary care psychological treatment services that are associated with patient experiences of negative effects.

Method: Cross-sectional survey of people with anxiety and depression who ended psychological treatment delivered by 50 NHS trusts in England.

Factors associated with shorter length of admission among people with dementia in England and Wales: retrospective cohort study.

Objectives: To identify aspects of the organisation and delivery of acute inpatient services for people with dementia that are associated with shorter length of hospital stay.

Design And Setting: Retrospective cohort study of patients admitted to 200 general hospitals in England and Wales.

Participants: 10 106 people with dementia who took part in the third round of National Audit of Dementia.

Examining the effects of national initiatives to improve the physical health of people with psychosis in England: secondary analysis of data from the National Clinical Audit of Psychosis.

Aims And Methods: To examine whether national initiatives have led to improvements in the physical health of people with psychosis. Secondary analysis of a national audit of services for people with psychosis. Proportions of patients in 'good health' according to seven measures, and one composite measure derived from national standards, were compared between multiple rounds of data collection.

Impact of Substance Use Disorder on Quality of Inpatient Mental Health Services for People With Anxiety and Depression.

Substance use disorders are commonly comorbid with anxiety and depressive disorders and are associated with poor treatment outcomes. The mechanisms underlying this association remain unclear-one possibility is that patients with anxiety/depressive disorders and substance use disorders receive poorer treatment. Concerns have been raised about the quality of inpatient care received by patients with substance use disorders.

Variation in clinical care associated with weekend admission and discharge in psychiatric in-patient units: retrospective case-note review.

Background: Questions have been raised regarding differences in the standards of care that patients receive when they are admitted to or discharged from in-patient units at weekends.

Aims: To compare the quality of care received by patients with anxiety and depressive disorders who were admitted to or discharged from psychiatric hospital at weekends with those admitted or discharged during the 'working week'.

Method: Retrospective case-note review of 3795 admissions to in-patient psychiatric wards in England.

Impact of co-morbid personality disorder on quality of inpatient mental health services for people with anxiety and depression.

Introduction: Concerns have been raised about the quality of inpatient care received by patients with a diagnosis of personality disorder.

Objectives: The aim of this study was to examine the quality of care received by inpatients with an anxiety or depressive disorder, comparing subgroups with or without a co-morbid personality disorder.

Method: We used a retrospective case-note review of 3 795 patients admitted to inpatient psychiatric wards in England, utilizing data from the National Clinical Audit of Anxiety and Depression.

Quality of life, level of functioning, and its relationship with mental and physical disorders in the elderly: results from the MentDis_ICF65+ study.

Background: An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe.

Method: As part of the Ment_Dis65+ European Project, 3142 community-dwelling adults aged 65-84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders).

Affective disorders in the elderly in different European countries: Results from the MentDis_ICF65+ study.

Objectives: Affective disorders are among the most prevalent disorders in the elderly. The present study aims to examine the sociodemographic and clinical correlates of major depressive disorder (MDD) and dysthymia in different European and Associated countries using standardized interview techniques. Furthermore, service utilization for the elderly with depression is assessed.

Integrated liaison psychiatry services in England: a qualitative study of the views of liaison practitioners and acute hospital staffs from four distinctly different kinds of liaison service.

Background: Liaison psychiatry services provide mental health care for patients in physical healthcare (usually acute hospital) settings including emergency departments. Liaison work involves close collaboration with acute hospital staff so that high quality care can be provided. Services however are patchy, relatively underfunded, heterogeneous and poorly integrated into acute hospital care pathways.

Impact of secondary care financial incentives on the quality of physical healthcare for people with psychosis: a longitudinal controlled study.

Background: Concerns have repeatedly been expressed about the quality of physical healthcare that people with psychosis receive.

Aims: To examine whether the introduction of a financial incentive for secondary care services led to improvements in the quality of physical healthcare for people with psychosis.

Method: Longitudinal data were collected over an 8-year period on the quality of physical healthcare that people with psychosis received from 56 trusts in England before and after the introduction of the financial incentive.

Factors influencing use of community treatment orders and quality of care that people receive: results of a national survey in England and Wales.

Aims and methodWe conducted a secondary analysis of data from the National Audit of Psychosis to identify factors associated with use of community treatment orders (CTOs) and assess the quality of care that people on CTOs receive. RESULTS: Between 1.1 and 20.

Recognition and treatment of depression in older adults admitted to acute hospitals in England.

Levels of awareness and treatment of depression in older adults admitted to acute hospitals are unclear. This study aims to examine the proportion of older adults diagnosed with depression in acute hospitals, treatment, referral, and communication between secondary and primary healthcare services following discharge. Retrospective examination of records of 766 older adults admitted to 27 acute hospitals in England was carried out.

Impact of a peer-review network on the quality of inpatient low secure mental health services: cluster randomised control trial.

Background: Peer-review networks aim to help services to improve the quality of care they provide, however, there is very little evidence about their impact. We conducted a cluster randomized controlled trial of a peer-review quality network for low-secure mental health services to examine the impact of network membership on the process and outcomes of care over a 12 month period.

Methods: Thirty-eight low secure units were randomly allocated to either the active intervention (participation in the network n = 18) or the control arm (delayed participation in the network n = 20).

A programme theory for liaison mental health services in England.

Background: Mechanisms by which liaison mental health services (LMHS) may bring about improved patient and organisational outcomes are poorly understood. A small number of logic models have been developed, but they fail to capture the complexity of clinical practice.

Method: We synthesised data from a variety of sources including a large national survey, 73 in-depth interviews with acute and liaison staff working in hospitals with different types of liaison mental health services, and relevant local, national and international literature.

Organisation and delivery of liaison psychiatry services in general hospitals in England: results of a national survey.

Objectives: To describe the current provision of hospital-based liaison psychiatry services in England, and to determine different models of liaison service that are currently operating in England.

Design: Cross-sectional observational study comprising an electronic survey followed by targeted telephone interviews.

Setting: All 179 acute hospitals with an emergency department in England.

Alcohol use, abuse and dependence in an older European population: Results from the MentDis_ICF65+ study.

Background: Alcohol use disorders (AUD) in older people have been the subject of increasing interest in Europe and worldwide. However, thus far, no reliable data exist regarding the prevalence of AUD in people over the age of 65 years in Europe.

Objective: To assess the current (past month), 12-month and lifetime prevalence of alcohol use, abuse and dependence in people aged 65-84 years.

Predisposing, enabling, and need factors of service utilization in the elderly with mental health problems.

Unlabelled: ABSTRACTBackground:Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.

Methods: As part of the MentDis_ICF65+ study, N = 3,142 people aged 65-84 living in the community in six European and associated countries were interviewed.

Quality of intervention delivery in a cluster randomised controlled trial: a qualitative observational study with lessons for fidelity.

Background: Understanding intervention fidelity is an essential part of the evaluation of complex interventions because fidelity not only affects the validity of trial findings, but also because studies of fidelity can be used to identify barriers and facilitators to successful implementation, and so provide important information about factors likely to impact the uptake of the intervention into clinical practice. Participant observation methods have been identified as being particularly valuable in studies of fidelity, yet are rarely used. This study aimed to use these methods to explore the quality of implementation of a complex intervention (Safewards) on mental health wards during a cluster randomised controlled trial.

Study approach and field work procedures of the MentDis_ICF65+ project on the prevalence of mental disorders in the older adult European population.

Background: This study describes the study approach and field procedures of the MentDis_ICF65+ study, which aims to assess the prevalence of mental disorders in older adults.

Methods: An age-appropriate version of the Composite International Diagnostic Interview (CIDI65+) was developed and tested with regard to its feasibility and psychometric properties in a pre-test and pilot phase. In the cross-sectional survey an age-stratified, random sample of older adults (65-84 years) living in selected catchment areas of five European countries and Israel was recruited.

Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life, and Prevalence According to Age, Gender, and Country.

Objectives: Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life.

Design: The study used a cross-sectional multicenter survey.