A systematic literature review and narrative synthesis on the risk factors for developing affective disorders in open lower-limb fracture patients.

Background: Despite the advancements made in the management of the physical complications of open lower-limb fractures, few studies have been performed which investigate the association of such injuries with affective disorders. The complications resulting from this injury may result in significant psychological distress.

Aim: To evaluate the risk factors associated with the development of affective disorders, in patients with open lower-limb fractures.

Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players.

In retired professional association football (soccer) players with a past history of repetitive head impacts, chronic traumatic encephalopathy (CTE) is a potential neurodegenerative cause of dementia and motor impairments. From 1980 to 2010, 14 retired footballers with dementia were followed up regularly until death. Their clinical data, playing career, and concussion history were prospectively collected.

The experience of hepatitis C treatment for people with a history of mental health problems: An interpretative phenomenological analysis.

This qualitative study explores the experience of hepatitis C virus treatment for people with pre-existing mental health problems within a large city hospital. Four men and four women with pre-existing mental health problems who had received hepatitis C virus treatment took part in semi-structured interviews which were analysed using interpretative phenomenological analysis. A central theme of 'Self, stigma and change' was identified which interlinked with three other main themes of 'Coping and responding to treatment', 'Connectedness to others' and 'The impact of information'.

Forensic case formulation: theoretical, ethical and practical issues.

Argument: Forensic case formulation, of increasing interest to practitioners and researchers raises many ethical, theoretical and practical issues for them.

Conclusion: Systemic, contextual and individual factors which need to be considered include the multitude of staff often involved with any one individual, the pressure to 'get it right' because of the range of risk implications that are associated with individuals within forensic mental health settings, and individual parameters, for example reluctance to be engaged with services.

The case against "the evidence": a different perspective on evidence-based medicine.

Background: An evidenced-based approach to psychiatry is playing an increasingly prominent role in treatment decision-making for individual patients and for populations. Many doctors are now critical of the emphasis being placed on "the evidence" and concerned that clinical practice will become more constrained.

Aims: To demonstrate that evidence-based medicine is not new, sources of evidence are limited and psychosocial aspects of medicine are neglected in this process.

How urgent is urgent? Analysing urgent out-patient referrals to an adult psychiatric service.

Introduction: It was noticed that over some years the number of referrals to the outpatient clinic (from various sources) which were marked 'urgent' had increased. We aimed to examine who makes these urgent referrals and the clinical factors associated with 'urgent' status.

Methods: A sample of 201 referrals over a 26-month period was examined.

The use of 'dementia care mapping' as a method of evaluating care received by patients with dementia--an initiative to improve quality of life.

'Dementia care mapping' (DCM) is a method of assessing care standards as received by dementia victims. Through the application of this tool, short-comings in care practice can be highlighted in the hope of achieving improvements. The method was employed by the Elderly Mentally III (EMI) unit of a National Health Service trust in South Wales.

Trends in guardianship usage following the Mental Health Act 1983.

The Mental Health Act 1983 substantially modified Guardianship, a previously little used facility for the compulsory care of mentally ill and mentally handicapped people in the community. This paper describes the results of a survey of information based on the annual returns from Local Authorities to the Department of Health and Social Security, and examines the impact of the new legislation upon the use of Guardianship in psychiatric practice. Although the number of Guardianship Orders in force remains relatively small compared to hospital admissions, recent trends indicate a significant increase in its application to people with a mental illness, and a decline in its use for people with a mental handicap.