Whole Life: a feasibility study of a recovery-focussed intervention in patients with stabilised schizophrenia.

Background: The Recovery Approach is about supporting people to live the best life they possibly can. This paper reports on a 2008-11 study of a recovery-focussed, one-to-one coaching programme called Whole Life (WL) in a group of people with stabilised schizophrenia. WL comprises 15 modules, each addressing an aspect of life that may pose challenges for someone with mental illness.

To admit or not to admit? The effect of framing on risk assessment decision making in psychiatrists.

Background: The way that information is presented is well known to induce a range of biases in human decision tasks. Little research exists on framing effects in psychiatric decision making, but it is reasonable to assume that psychiatrists are not immune and, if so, there may be implications for the welfare of patients, staff and the general public.

Aims: To investigate whether presentation of risk information in different formats (frequency, percentage and semantic) influences inpatient admission decisions by psychiatrists.

Equations for converting scores between depression scales (MÅDRS, SRS, PHQ-9 and BDI-II): good statistical, but weak idiographic, validity.

Background: A variety of depression rating scales are currently used in clinical and research practice. As these scales are generally thought to correlate well, there may be some benefit in deriving equations to translate the score on one scale to that on another.

Method: Using pairwise ratings, we compared the Montgomery-Åsberg Depression Rating Scale (MÅDRS), Beck Depression Inventory II (BDI-II), Patient Health Questionnaire (PHQ-9) and Zung Self Rated Scale (SRS).

The effect of single-sex wards in mental health.

Background: The need for single-sex accommodation in mental health trusts has been widely expressed in documents from the NHS Executive and in national and local policies. This case study describes the effects of changing two mixed-sex wards into single-sex wards.

Methods: Two mixed-sex inpatient wards were reorganised into two single-sex wards.

Classification of risk in psychiatry.

Psychiatric risk-assessments generally quantify risk using broad, categorical, indicators (e.g., high-risk, low-risk).

Risk assessment in mental health: staff attitudes and an estimate of time cost.

Background: Risk assessment is a routine part of mental health services, with professionals being required to complete a risk assessment proforma (RAP) for every patient under their care.

Aims: This study was designed to investigate staff attitudes to, and beliefs about, the completion of risk assessment paperwork.

Method: We surveyed 300 professionals across one county to examine: (i) the amount of time taken to complete RAPs; (ii) attitudes towards completing such paperwork; and (iii) beliefs about the quality and usefulness of the information recorded.

Excessive daytime sleepiness in psychiatric disorders: Prevalence, correlates and clinical significance.

This study examined the prevalence of excessive daytime sleepiness, as measured by the Epworth Sleepiness Scale (ESS), in a cohort of adult psychiatric patients. A total of 300 psychiatric outpatients and an additional 300 healthy controls completed the ESS. Excessive sleepiness was defined by a score of > or =10.

Sideline management of facial injuries.

Physicians who cover sporting events frequently encounter facial injuries. These injuries include contusions, hematomas, abrasions, lacerations, ruptured tympanic membranes, and fractures. For most physicians covering events, the diagnoses and decisions on returning athletes to play must be made without many of the diagnostic tools available in the office, such as radiographs, nasopharyngoscopes, or CT scans.

Sideline skin and wound care for acute injuries.

The management of acute skin trauma in sports is reviewed from the perspective of the sideline medical provider. Skin injuries covered in this article include abrasions, lacerations, blisters, chafing, and sunburn. Sideline evaluations, treatment techniques, recommended equipment, and prevention are discussed.

Are placebo-controlled trials still important for obsessive compulsive disorder?

The use of placebos as reference agents in randomised controlled trials for psychiatric disorders has come under question for ethical reasons. Alternative methods for validating the efficacy of new treatments exist, but may not be as reliable as placebo. In this paper we examine arguments for and against the ongoing use of placebo agents in the development of new treatments for obsessive compulsive disorder in the context of evidence from randomised controlled trials.

Excessive daytime sleepiness in psychiatry: a relevant focus for clinical attention and treatment?

Excessive daytime sleepiness is a feature of many general medical disorders and is associated with significant impairment in function and well-being. It has, however, received little attention in psychiatry although it may be a common and clinically important problem. The opinions of two expert groups, and a survey of the literature, were used to form views about the prevalence and clinical significance of excessive sleepiness in psychiatric populations.