Liraglutide and the management of overweight and obesity in people with severe mental illness: qualitative sub-study.

Background: People with severe mental illness are two to three times more likely to be overweight or have obesity than the general population and this is associated with significant morbidity and premature mortality. Liraglutide 3 mg is a once daily injectable GLP-1 receptor agonist that is licensed for the treatment of obesity in the general population and has the potential to be used in people with severe mental illness.

Aims: To record the expectations and experiences of people with schizophrenia, schizoaffective disorders or first episode psychosis taking daily liraglutide 3 mg injections in a clinical trial for the treatment of obesity.

The use of liraglutide 3.0 mg daily in the management of overweight and obesity in people with schizophrenia, schizoaffective disorder and first episode psychosis: Results of a pilot randomized, double-blind, placebo-controlled trial.

Aim: To investigate the feasibility and acceptability of using liraglutide 3.0 mg daily in the management of overweight and obesity in people with schizophrenia, schizoaffective disorder and first episode psychosis.

Materials And Methods: A double-blind, randomized, placebo-controlled pilot trial took place in mental health centres and primary care within Southern Health NHS Foundation Trust.

Using digital tools in the recruitment and retention in randomised controlled trials: survey of UK Clinical Trial Units and a qualitative study.

Background: Recruitment and retention of participants in randomised controlled trials (RCTs) is a key determinant of success but is challenging. Trialists and UK Clinical Research Collaboration (UKCRC) Clinical Trials Units (CTUs) are increasingly exploring the use of digital tools to identify, recruit and retain participants. The aim of this UK National Institute for Health Research (NIHR) study was to identify what digital tools are currently used by CTUs and understand the performance characteristics required to be judged useful.

Liraglutide and the management of overweight and obesity in people with schizophrenia, schizoaffective disorder and first-episode psychosis: protocol for a pilot trial.

Background: People with severe mental illness (SMI) are two to three times more likely to be overweight and obese than the general population and this is associated with significant morbidity and premature mortality. Although lifestyle interventions can support people with SMI to lose weight, some are unable to make the necessary lifestyle changes or, despite making the changes, continue to gain weight.

Objective: To assess the feasibility and acceptability of delivering a full-scale trial evaluating whether liraglutide 3.

Clinical and cost-effectiveness of an intervention for reducing cholesterol and cardiovascular risk for people with severe mental illness in English primary care: a cluster randomised controlled trial.

Background: People with severe mental illnesses, including psychosis, have an increased risk of cardiovascular disease. We aimed to evaluate the effects of a primary care intervention on decreasing total cholesterol concentrations and cardiovascular disease risk in people with severe mental illnesses.

Methods: We did this cluster randomised trial in general practices across England, with general practices as the cluster unit.

Evaluating the clinical and cost effectiveness of a behaviour change intervention for lowering cardiovascular disease risk for people with severe mental illnesses in primary care (PRIMROSE study): study protocol for a cluster randomised controlled trial.

Background: People with severe mental illnesses die up to 20 years earlier than the general population, with cardiovascular disease being the leading cause of death. National guidelines recommend that the physical care of people with severe mental illnesses should be the responsibility of primary care; however, little is known about effective interventions to lower cardiovascular disease risk in this population and setting. Following extensive peer review, funding was secured from the United Kingdom National Institute for Health Research (NIHR) to deliver the proposed study.

Quality of Life in Depressed Patients in UK Primary Care: The FINDER Study.

Objectives: To investigate the impact of depression and its treatment on health-related quality of life (HRQoL) in a naturalistic, primary care setting in the UK.

Methods: The Factors Influencing Depression Endpoints Research (FINDER) study was a European, 6-month, prospective, observational study designed to estimate HRQoL in patients with a clinical diagnosis of depression. This paper examines primary care patients recruited in the UK.

Antidepressant medication as a risk factor for type 2 diabetes and impaired glucose regulation: systematic review.

Objective: Antidepressant use has risen sharply over recent years. Recent concerns that antidepressants may adversely affect glucose metabolism require investigation. Our aim was to assess the risk of type 2 diabetes associated with antidepressants through a systematic review.

The relationship between depression, anxiety and cardiovascular disease: findings from the Hertfordshire Cohort Study.

Background: Previous studies suggest a link between depression, anxiety and cardiovascular disease (CVD). The aim of the study was to determine the relationship between depressive and anxiety symptoms and CVD in a population based cohort.

Methods: In total 1578 men and 1,417 women from the Hertfordshire Cohort Study were assessed for CVD at baseline and after 5.

A psychometric evaluation of an English version of the Utrecht Coping List.

Introduction And Aims: Although coping styles in individuals with eating disorders have received increased research interest in recent years, there remains a lack of brief, self-report measures that can reliably measure coping. This study developed an English version of the Utrecht Coping List (UCL) and evaluated its psychometric properties in a UK population.

Method: This was a cross-sectional study.

When a minor head injury results in enduring symptoms: a prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury.

Objective: A significant proportion (15-30%) of patients with mild traumatic brain injury (MTBI) are at risk of developing postconcussional syndrome (PCS). The aim of this study was to investigate the contributions of cognitive, emotional, behavioural and social factors to the development of PCS and identify early predictors.

Methods: A prospective cohort design was employed.

External eating, impulsivity and attentional bias to food cues.

Cognitive and behavioural responses to food reward, such as attentional biases and overeating, have been associated with individual differences in reward-responsiveness and impulsivity. This study investigated relationships between external eating, impulsivity and attentional bias to food cues, assessed using the pictorial visual-probe task. As previously reported, attentional bias correlated positively with external eating.

Guidelines for the management of depression: NICE work?

The National Institute for Health and Clinical Excellence (NICE) recently updated its guidance on managing depression, adding specific guidance for depression in people with physical illness. The guidance should help improve the targeting of treatments, although implementation of the guidance on depression in physical illness is challenging in the National Health Service (NHS) context of separate primary and secondary care services.

Relationship between loneliness and proangiogenic cytokines in newly diagnosed tumors of colon and rectum.

Objective: To investigate the association of serum levels of proangiogenic cytokines with different indices of social support and loneliness by measuring the levels of expression of two important proangiogenic cytokines, vascular endothelial growth factor (VEGF), and interleukin-6 in tumors of colon and rectum. Lack of social support has been prospectively associated with cancer progression.

Methods: Fifty-one newly diagnosed patients with colorectal tumors (mean age, 68.

Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management.

Hyperprolactinaemia is a common side effect in people receiving antipsychotics. The propensity to cause hyperprolactinaemia differs markedly between antipsychotics as a result of differential dopamine D(2) receptor-binding affinity and ability to cross the blood-brain barrier. Sexual dysfunction is common and under-recognized in people with severe mental illness and is in part caused by hyperprolactinaemia.

The clinical features of EDNOS: relationship to mood, health status and general functioning.

Study Purpose: Eating disorder not otherwise specified (EDNOS) remains poorly evaluated in terms of eating disorder features and relationship to mood, health status and general functioning. This study investigated the clinical profiles of a sample of EDNOS patients, and how they compared to patients with anorexia nervosa (AN) and bulimia nervosa (BN).

Method: The sample consisted of 178 patients.

A new approach to clustering eating disorder patients: assessing external validity and comparisons with DSM-IV diagnoses.

Introduction: This study assessed the external validity of four statistically distinct clusters identified in a sample of eating disorder patients, derived from eating disorder features, attachment and coping styles. It also compared clusters with DSM-IV diagnoses.

Methods: Eating disorder psychopathology, attachment, coping, mood, health status and general functioning were measured in 165 patients.

Social support and cancer progression: a systematic review.

Objective: The variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic review identifies and summarizes the evidence for the significance of two important indices of social support in progression of different cancers.

Method: We used systematic and replicable methods to search, select, and evaluate findings.

Obesity, serious mental illness and antipsychotic drugs.

The prevalence of overweight and obesity is higher in people with mental illness than in the general population. Body weight is tightly regulated by a complex system involving the cortex and limbic system, the hypothalamus and the gastrointestinal tract. While there are justifiable concerns about the weight gain associated with antipsychotic medication, it is too simplistic to ascribe all obesity in people with serious mental illness (SMI) to their drug treatment.

An approach to sub-grouping the eating disorder population: adding attachment and coping style.

Objective: To investigate whether clinically meaningful sub-groups of patients can be identified by clustering eating disorder features, attachment and coping styles.

Method: 165 patients completed the Eating Disorder Examination (EDE), Attachment Style Questionnaire (ASQ) and Utrecht Coping List (UCL). Cluster analysis was used to identify sub-groups across the sample.

Antipsychotics and hyperprolactinaemia: clinical recommendations.

A group of international experts in psychiatry, medicine, toxicology and pharmacy assembled to undertake a critical examination of the currently available clinical guidance on hyperprolactinaemia. This paper summarises the group's collective views and provides a summary of the recommendations agreed by the consensus group to assist clinicians in the recognition, clinical assessment, investigation and management of elevated plasma prolactin levels in patients being treated for severe mental illness. It also deals with the special problems of particular populations, gives advice about information that should be provided to patients, and suggests a strategy for routine monitoring of prolactin.

A review of the association between antipsychotic use and hyperprolactinaemia.

Recent evidence linking hyperprolactinaemia to longer-term clinical sequelae, including osteoporosis, hip fractures and possibly breast cancer, is increasing clinical awareness of the relevance of hyperprolactinaemia. A review of the literature finds clinical trials reporting some degree of comparative prolactin data among antipsychotics. Many of the randomised clinical trials (RCTs) do not report categorical rates of hyperprolactinaemia in contrast with the naturalistic studies, making it complex for clinicians to evaluate the extent and severity of hyperprolactinaemia.

Attentional bias towards health-threat information in chronic fatigue syndrome.

Objective: To investigate whether individuals with chronic fatigue syndrome (CFS) show an attentional bias towards health-threat information.

Methods: Attentional bias (AB) was assessed in individuals with CFS and healthy controls using a visual probe task which presented health-threat and neutral words and pictures for 500 ms. Self-report questionnaires were used to assess CFS symptoms, depression, anxiety, and social desirability.

Qualitative study of depression management in primary care: GP and patient goals, and the value of listening.

Background: Guidelines for depression management have been developed but little is known about GP and patient goals, which are likely to influence treatment offers, uptake, and adherence.

Aim: To identify issues of importance to GPs, patients, and patients' supporters regarding depression management. GP and patient goals for depression management became a focus of the study.