A history of liaison psychiatry in the UK.

Aims and method To record the development of liaison psychiatry in the UK and to summarise the current levels of activity. We also highlight the challenges the specialty may face if it is to develop further. History since the 1970s is reviewed by early pioneers and those involved in the present day, with a focus on the key role played by members of the Royal College of Psychiatrists.

Is the DSM-5 chapter on somatic symptom disorder any better than DSM-IV somatoform disorder?

DSM-5 is a modest improvement on DSM-IV, notably in abandoning the distinction between medically explained and unexplained symptoms, but problems remain. The chapter text is incoherent, contradicts the classification and will be clinically unhelpful. ICD-11 should attempt a more logical and consistent revision.

Predictive validity of acute stress disorder in children and adolescents.

Adult research suggests that the dissociation criterion of acute stress disorder has limited validity in predicting post-traumatic stress disorder (PTSD). We addressed this issue in child and adolescent survivors (n=367) of road accidents. Dissociation accounted for no significant unique variance in later PTSD, over and above other acute stress disorder criteria.

Are treatments for common mental disorders also effective for functional symptoms and disorder?

Objective: To consider whether the many types of treatments for mental disorders--both those specifically targeting illness mechanisms and nonspecific elements--are also effective in treating functional symptoms and syndromes. The paper discusses the need for well-organized care that emphasizes early treatment and recognition of more complex problems in primary and secondary medical care.

Methods: Evidence from a wide range of research and clinical experience is used to identify and illustrate general themes.

Dissociative symptoms and the acute stress disorder diagnosis in children and adolescents: a replication of the Harvey and Bryant (1999) study.

Acute stress disorder (ASD) is a good predictor of posttraumatic stress disorder in adult populations, although the emphasis on dissociation symptoms within the diagnosis has been questioned. Recent studies suggest that ASD may also have application to children and adolescents. The present study examined properties of ASD within youth.

Bodily symptoms: new approaches to classification.

Objective: To examine the current approach to classifying bodily symptoms in both psychiatry and medicine and to suggest better alternatives.

Methods: Theoretical analysis, narrative review, and theoretical proposal.

Results: The assumptions that (a) bodily pathology can always explain bodily symptoms, (b) psychopathology can always explain bodily symptoms in the absence of bodily pathology, and (c) dichotomizing bodily symptoms into "medical" and "psychiatric" types is clinically useful were all found to have questionable validity and utility.

Attitudes of women with chronic pelvic pain to the gynaecological consultation: a qualitative study.

Objective: To describe the attitudes that women with chronic pelvic pain (CPP) attending gynaecology clinics have to their consultations and to determine the ways in which their health care can be improved.

Design: Qualitative study using semistructured individual interviews.

Setting: UK gynaecology outpatient clinics in district general and teaching hospitals.

Developing a rapid access chest pain clinic: qualitative studies of patients' needs and experiences.

Objective: The aims of this study are to understand the needs and experiences of rapid access chest pain clinic attenders and to determine the acceptability and effectiveness of simple procedural changes.

Methods: Two qualitative studies of clinic attenders before and after procedural changes which were guided by the first study.

Results: Study 1: Patients wanted to be reassured, by knowing what was causing their pain, understanding the cause, and feeling able to help themselves.

Are psychological skills necessary in treating all physical disorders?

Objective: To explore both the wider issue of the need for psychological skills in the management of all physical disorders and that of the role of liaison psychiatry in providing care and in working with medical colleagues.

Method: The author draws on the literature in general, and specifically on his extensive research and clinical experience of patients with acute and chronic physical symptoms and associated psychological symptoms, particularly accident victims and those with chest pain and diabetes. He also draws on his experience in establishing national and international organizations for consultation-liaison psychiatry.

Somatoform disorders: time for a new approach in DSM-V.

Objective: DSM-III introduced somatoform disorders as a speculative diagnostic category for somatic symptoms "not explained by a general medical condition." Although retained and enlarged in DSM-IV, somatoform disorders have been the subject of continuing criticism by both professionals and patients. The extended period of preparation for DSM-V offers an important opportunity to reconsider the category of somatoform disorders.

Setting up and auditing guideline- and evidence-based cardiac rehabilitation.

Background: Rehabilitation is available to only a minority of post-myocardial infarction (MI) patients and is of variable quality. Guidelines now recommend individualised care delivered by hospital, primary care and community services, but there is little evidence of the feasibility, acceptability or effectiveness of this approach.

Aims: To demonstrate the feasibility of guideline-based rehabilitation, to audit delivery and outcome and to identify problems.

The relationship of disordered eating habits and attitudes to clinical outcomes in young adult females with type 1 diabetes.

Objective: To describe the clinical outcomes of adolescent and young adult female subjects with type 1 diabetes in relation to the disturbance of eating habits and attitudes over 8-12 years.

Research Design And Methods: Patients were recruited from the registers of pediatric and young adult diabetes clinics (including nonattenders) and interviewed in the community. A total of 87 patients were assessed at baseline (aged 11-25 years), and 63 (72%) were reinterviewed after 8-12 years (aged 20-38 years).

Psychological consequences of road traffic accidents for children and their mothers.

Background: Little is known about the psychological and behavioural consequences of road traffic accidents for children. The study aimed to determine the outcome of road traffic accidents on children and their mothers.

Method: A 1-year cohort study of consecutive child attenders aged 5-16 years at an Accident and Emergency Department.

Consultation-Liaison Psychiatry Literature Database (2003 update). Part I: Consultation - Liaison Literature Database: 2003 update and national lists.

Every day there are 10,000 scientific articles published. Since the Consultation-Liaison ("C-L") psychiatrist may be asked to consult on a patient with any medical illness, e.g.

The experiences and needs of Gujarati Hindu patients and partners in the first month after a myocardial infarction.

Background: South Asian people living in the United Kingdom are at increased risk of coronary heart disease, have higher mortality rates and are less likely to be treated when compared to the white population. There is, however, little information about the experiences and needs of this group after discharge from hospital.

Aims: To explore the experiences and needs of Gujarati Hindu patients and their partners in the first month after a myocardial infarction.

A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder.

Background: It is unclear what psychological help should be offered in the aftermath of traumatic events. Similarly, there is a lack of clarity about the best way of identifying people who are unlikely to recover from early posttraumatic symptoms without intervention.

Objective: To determine whether cognitive therapy or a self-help booklet given in the initial months after a traumatic event is more effective in preventing chronic posttraumatic stress disorder (PTSD) than repeated assessments.

Poor prognosis of young adults with type 1 diabetes: a longitudinal study.

Objective: To determine the role of early behavioral and psychological factors on later outcomes in young adults with childhood- or adolescent-onset type 1 diabetes.

Research Design And Methods: We conducted a longitudinal cohort study of patients recruited from the register of the young adult outpatient diabetes clinic, Oxford, U.K.

Consequences of road traffic accidents for different types of road user.

The study aimed to describe the immediate and later physical, social and psychological consequences of a road traffic accident for vehicle occupants, motorcyclists, cyclists and pedestrians amongst consecutive hospital attenders at an Accident and Emergency Department. Physical and accident details were collated from hospital records. Subjects completed questionnaires at hospital attendance, 3 months, 1 and 3 years.

Characteristics of patients presenting to a cardiac clinic with palpitation.

Background: Palpitation is a very common presenting symptom in primary care and in cardiac clinics, associated with marked disability. Although serious arrhythmias are uncommon causes, treatment of persistent palpitation is difficult.

Aim: To describe the cardiological, behavioural and psychological characteristics of consecutive patients presenting to a cardiac clinic with the main complaint of palpitation.

Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study.

The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther.