Publications by authors named "Michael Marriott"

There is a pressing need for simulated forms of medical, and in particular, anatomical learning. Current modalities of teaching are limited to either traditional 2-dimensional forms of learning, such as textbook, research papers and lectures, or more costly 3-dimensional modes including cadaveric dissection. Despite the overwhelmingly 3-dimensional nature of plastic surgery, virtual 3D models are limited.

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Objective: When considering psychosis, the concept of narrative insight has been offered as an alternative to clinical insight in determining individuals' responses to their difficulties, as it allows for a more holistic and person-centred framework to be embraced within professional practice. This study aims to explore the validity of the narrative insight construct within a group of people who have experienced psychosis.

Design: Inductive qualitative methods were used to explore how eight participants utilized spiritual or religious explanatory frameworks for their experiences of psychosis and to consider these in relation to the construct of narrative insight.

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Background: Recent UK initiatives have advocated the use of session-by-session outcome measurement in CAMHS. However, little is known about the feasibility of this approach.

Method: The PROMPT study (Patient Reported Outcome Monitoring Progress Tracker) piloted an iPad administered brief session-by-session measure (S × S) related to the Strengths and Difficulties Questionnaire impact supplement in three CAMHS teams.

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Background: Regular monitoring of patient progress is important to assess the clinical effectiveness of an intervention. Recently, initiatives within UK child and adolescent mental health services (CAMHS) have advocated the use of session-by-session monitoring to continually evaluate the patient's outcome throughout the course of the intervention. However, the feasibility and acceptability of such regular monitoring is unknown.

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Background: Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research).

Methods: With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013.

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Conspiracist ideation has been repeatedly implicated in the rejection of scientific propositions, although empirical evidence to date has been sparse. A recent study involving visitors to climate blogs found that conspiracist ideation was associated with the rejection of climate science and the rejection of other scientific propositions such as the link between lung cancer and smoking, and between HIV and AIDS (Lewandowsky et al., in press; LOG12 from here on).

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Background: Adolescents with anorexia nervosa rarely present themselves as having a problem and are usually reliant on parents to recognise the problem and facilitate help-seeking. This study aimed to investigate parents' experiences of recognising that their child had an eating problem and deciding to seek help.

Methods: A qualitative study with interpretative phenomenological analysis applied to semi-structured interviews with eight parents of adolescents with a diagnosis of anorexia nervosa.

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Objectives: To compare the performance of depressed patients to healthy control subjects on discrete cognitive domains derived from factor analysis and to examine the factors that may influence the performance of depressed patients on cognitive domains in a large sample.

Methods: We compared the cognitive performance of 149 patients with major depression to 104 healthy control subjects using multivariate ANCOVA. We used principal component factor analysis to group the cognitive variables into cognitive domains.

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Nicotinic acetylcholine receptor stimulation is a potential target for controlling symptoms in several psychiatric disorders. Galantamine is a cholinesterase inhibitor that can modulate the nicotinic receptor sites. In this study, we examined the effect of galantamine on the quantitative EEG in patients with major depression.

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Objectives: Evaluations of the clinical effectiveness of cognitive analytic therapy (CAT) are scarce and therefore represent an urgent service and research need. This paper sought to evaluate a CAT service by profiling CAT clients, examining the outcomes achieved by the CAT service and also comparing such outcomes with those achieved by other services, namely the person-centred service and the cognitive-behavioural service.

Design: Patients in routine practice were matched according to the amount of therapy time received (either brief or medium-term contracts) and the degree of initial presenting psychological distress.

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Objective: Electroconvulsive therapy (ECT) has been controversially associated with long-lasting memory problems. Verbal learning and memory deficits are commonly reported in studies of people with bipolar disorder (BD). Whether memory deficits can be exacerbated in patients with BD who receive ECT has, to our knowledge, not been systematically examined.

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Substitution of T4 with T3 for T4 replacement in patients with hypothyroidism was undertaken using a randomized placebo controlled study design. Forty individuals were included who had depressive symptoms on stable doses of levothyroxine. Combined T4 plus T3 did not have a significantly different effect on mood and well-being scores than did T4 alone.

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Background: Cognitive dysfunction is evident in some euthymic patients with established bipolar disorder (BD), including deficits in visual backward masking (VBM) tasks which map to a specific neural pathway. A high-risk paradigm would clarify the temporal relation of cognitive dysfunction to clinical course.

Method: We compared euthymic offspring (age range: 18-32 years) of lithium-responsive bipolar parents with and without a previous lifetime history of psychiatric illness to healthy comparison subjects with a negative family history, on a VBM task that requires target location.

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Background: High rates of comorbid anxiety disorders have been described in individuals with bipolar disorder. Although it is well recognized that anxiety disorders often co-occur with bipolar disorder, few studies have examined the impact of more than 1 anxiety disorder on long-term outcome in patients with bipolar disorder.

Method: The rates of DSM-IV generalized anxiety disorder, panic disorder, social phobia, obsessive-compulsive disorder, and posttraumatic stress disorder were determined using structured clinical interviews in 138 patients with bipolar disorder who presented consecutively between 1994 and 1999.

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Objective: A number of studies have used magnetic resonance imaging to examine volumetric differences in temporal structures in subjects suffering from major depressive disorder. Studies have reported lower hippocampal and amygdala volume, but results have been inconsistent. The authors were interested, therefore, in examining these studies in the aggregate in order to determine whether hippocampal volume is lower in major depressive disorder.

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Background: There is a recent appreciation that patients with bipolar disorder spend a substantial period of time with minor or subsyndromal mood symptoms both manic and depressive. This study examined time spent in minor and subsyndromal mood states as well as with mania and depression in a cohort of well characterized bipolar I and II patients who were followed prospectively for an average of three years.

Method: Detailed life-charting data were obtained from 138 patients with bipolar disorder.

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Background: Many patients with bipolar disorder (BD) do not regain full function following an acute illness episode, but the extent to which this impairment is the result of persistent symptoms has not been well established. This study examined factors associated with persistent subsyndromal symptoms in a well characterized group of BD patients who were prospectively followed for an average of 3 years.

Methods: Detailed life charting data from 138 patients with BD were reviewed.

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Objective: The treatment of bipolar depression is a significant clinical problem that remains understudied. The role for antidepressant (AD) agents vs. mood stabilizers has been particularly problematic to ascertain.

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Grepafloxacin is a new broad-spectrum fluoroquinolone characterized by having a methyl-substituted piperazine at the 7 position. It is a water-soluble racemate with both stereoisomers having the same activity. Its mode of action involves inhibition of topoisomerases II and IV.

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Current series of depression suggests that episodes of major depression sensitize a patient to further episodes so that the illness adopts a recurrent course. This suggested pathophysiological process may also lead to increased risk of treatment resistance and a chronic course of illness. This hypothesis has received little empirical support and, if correct, would suggest that greater number of episodes would lead to a decreased response to antidepressants.

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