Predicting the past or risk management?

Within mental health services, the development of risk assessment templates has been driven by a desire to reduce the rates of major adverse events. A number of theoretical problems exist with such an approach. Empirical and observational evidence suggests the exercise may be paradoxically counter productive, partly by distracting from comprehensive clinical management planning and partly by contributing to inefficiencies.

Religion, spirituality and psychiatry: steps towards rapprochement.

Objectives: To consider the claim that there is a fundamental epistemological conflict between religion and psychiatry over what constitutes rational explanation, and what impediment this might be to rapprochement between the two.

Conclusions: An epistemological gap most certainly exists, but there is a growing acceptance of the importance of religion and spirituality to psychiatry. Rapprochement may best be achieved by increasing psychiatric awareness and knowledge of the issues, and by a willingness to embrace intellectual, cultural and religious pluralism.

Nonconvulsive generalised status epilepticus following electroconvulsive therapy.

Objective: To describe a case of nonconvulsive generalised status epilepticus (NGS) following electroconvulsive therapy (ECT).

Clinical Picture: A 40-year-old woman suffering from a major depressive episode was treated with ECT following treatment with clonazepam, haloperidol and paroxetine. After her fifth treatment she became acutely confused.