EPA guidance on the role and responsibilities of psychiatrists.

Psychiatry is that branch of the medical profession, which deals with the origin, diagnosis, prevention, and management of mental disorders or mental illness, emotional and behavioural disturbances. Thus, a psychiatrist is a trained doctor who has received further training in the field of diagnosing and managing mental illnesses, mental disorders and emotional and behavioural disturbances. This EPA Guidance document was developed following consultation and literature searches as well as grey literature and was approved by the EPA Guidance Committee.

Ameliorating Patient Stigma Amongst Staff Working With Personality Disorder: Randomized Controlled Trial of Self-Management Versus Skills Training.

Background: Patients diagnosed with a personality disorder (PD) are often stigmatized by the healthcare staff who treat them.

Aims: This study aimed to compare the impact on front-line staff of a self-management Acceptance and Commitment Therapy-based training intervention (ACTr) with a knowledge- and skills-based Dialectical Behaviour Training intervention (DBTr).

Method: A service-based randomized controlled trial was conducted comparing the effects of 2-day ACTr (N = 53) and DBTr (N = 47) staff workshops over 6 months.

The Anxiety Attitude and Belief Scale-2: Development, Measurement Model, and Initial Validity.

Unlabelled: There is a notable lack of measures of enduring beliefs, which are key etiological factors in Beck's cognitive model of anxiety. The Anxiety Attitude and Belief Scale-2 was developed to address this need. Items from the original AABS were reviewed and revised, and additional items were added to cover the range of constructs identified as reflecting anxiety related expectancies while avoiding the confounding of cognition and affect.

Red ear syndrome precipitated by a dietary trigger: a case report.

Introduction: Red ear syndrome is a rare condition characterized by episodic attacks of erythema of the ear accompanied by burning ear pain. Symptoms are brought on by touch, exertion, heat or cold, stress, neck movements and washing or brushing of hair. Diagnosis and treatment of this condition are challenging.

A comparative study of pre- and post-menopausal breast cancer: Risk factors, presentation, characteristics and management.

Objective: Breast cancer is the most common female cancer worldwide and is the second most commonly diagnosed cancer in Indian women. This study evaluates the differences between pre- and post-menopausal breast cancer women regarding risk factors, nature of disease presentation, tumor characteristics, and management.

Methods: This is a prospective observational study, conducted in the Oncology Department of St.

Atypical presentations of genital herpes simplex virus in HIV-1 and HIV-2 effectively treated by imiquimod.

Atypical presentations of genital herpes simplex virus have been described in HIV. We report two cases with hypertrophic presentations which were effectively treated with imiquimod, one of which is the first reported case occurring in a patient with HIV-2.

The use of PDSA methodology to evaluate and optimise an inner city memory clinic: a quality improvement project.

The Memory Services National Accreditation Programme states that memory services should provide "timely access to assessment and diagnosis" of dementia. We undertook a quality improvement project using Plan-Do-Study-Act methodology to improve patient access to an inner city memory service. This report focuses on the third Plan-Do-Study-Act cycle where, in 2012, we aimed to shorten the time from memory service referral to assessment and to diagnosis.

Mentalization-Based Treatment.

The concept of mentalizing has captured the interest and imagination of an astonishing range of people-from psychoanalysts to neuroscientists, from child development researchers to geneticists, from existential philosophers to phenomenologists-all of whom seem to have found it useful. According to the Thompson Reuter maintained Web of Science, the use of the term in titles and abstracts of scientific papers increased from 10 to 2,750 between 1991 and 2011. Clinicians in particular have enthusiastically embraced the idea, and have put it to innovative use in their practices.

Impact of clinical severity on outcomes of mentalisation-based treatment for borderline personality disorder.

Background: Evidence of remission from borderline personality disorder (BPD) without specialised treatment is accumulating.

Aims: To establish whether specialised treatments are indicated for patients with clinically severe disorder.

Method: The impact of clinical severity on outcomes of a randomised controlled trial of mentalisation-based treatment (MBT) was contrasted with structured clinical management (SCM).

Cognitive analytic therapy for personality disorder: randomised controlled trial.

Background: Cognitive analytic therapy (CAT) is a theoretically coherent approach developed to address common processes underlying personality disorders, but is supported by limited empirical evidence.

Aims: To investigate the effectiveness of time-limited CAT for participants with personality disorder.

Method: A service-based randomised controlled trial (trial registration: ISRCTN79596618) comparing 24 sessions of CAT (n = 38) and treatment as usual (TAU) (n = 40) over 10 months for individuals with personality disorder.

Interpersonal psychotherapy for borderline personality disorder.

Unlabelled: This paper outlines an approach to the treatment of borderline personality disorder (BPD) based on principles of interpersonal psychotherapy. The rationale for using a modified version of interpersonal psychotherapy (IPT) is described-BPD is a disorder of attachment, depression is commonly associated with BPD and the primary symptoms of BPD such as rapid mood fluctuations, impulsivity and cognitive distortions are manifested within interpersonal relationships. A focus on interpersonal dysfunction between self and others may improve the quality of relationships for these patients and improve their capacity to manage the instability engendered by depressed mood.

[Comorbid antisocial and borderline personality disorders: mentalization-based treatment].

Mentalization is the process by which we implicitly and explicitly interpret the actions of ourselves and others as meaningful based on intentional mental states (e.g., desires, needs, feelings, beliefs, and reasons).

Immunisations among school leavers: is there a place for measles-mumps-rubella vaccine?

To ascertain measles-mumps-rubella (MMR) immunisation coverage among school leavers in an inner city London borough following a local MMR catch-up initiative, a questionnaire was sent to parents and guardians of adolescents who attended the 12 secondary schools in Haringey and were due for the school leavers' vaccination. The questionnaire enquired about previous history of MMR vaccination and a history of adverse events or contraindications to the vaccine. The electronic immunisation records of 400 children (30-35 students from each school) included in the catch up initiative were randomly selected.

Tinnitus in children: an uncommon symptom?

Tinnitus in children is regarded as an uncommon problem rarely noted by general paediatricians. Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with hearing loss and approximately 3-10% of children have been reported troubled by tinnitus. Some children do not spontaneously complain of it, but may demonstrate behavioural problems at school and home.

Mentalization based treatment for borderline personality disorder.

Mentalizing is the process by which we make sense of each other and ourselves, implicitly and explicitly, in terms of subjective states and mental processes. It is a profoundly social construct in the sense that we are attentive to the mental states of those we are with, physically or psychologically. Given the generality of this definition, most mental disorders will inevitably involve some difficulties with mentalization, but it is the application of the concept to the treatment of borderline personality disorder (BPD), a common psychiatric condition with important implications for public health, that has received the most attention.

Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder.

Objective: This randomized controlled trial tested the effectiveness of an 18-month mentalization-based treatment (MBT) approach in an outpatient context against a structured clinical management (SCM) outpatient approach for treatment of borderline personality disorder.

Method: Patients (N=134) consecutively referred to a specialist personality disorder treatment center and meeting selection criteria were randomly allocated to MBT or SCM. Eleven mental health professionals equal in years of experience and training served as therapists.

Outcome of an online mutual support group for college students with psychological problems.

This study set up and evaluated an online mutual support group for college students with psychological problems. In a 2 x 2 pre-post design, participants (N = 238) were randomly assigned to either the Information Only condition, giving access to a Web site containing information about student problems, or to the Support Group condition, giving access to an identical Web site with the addition of an online mutual support group. Participants in both conditions improved on two of the three outcome measures, the CORE-OM and the Satisfaction with Life Scale, but there was no evidence of differential outcome between the two conditions.

Time out: an analysis.

Ensuring patient safety in the OR includes performing a time out to help prevent wrong site surgery. The circulating nurse, in the role of patient advocate, usually is the OR team member who initiates the time out. A correctly performed time out includes verifying the correct patient; procedure; site (eg, organ, limb, vertebral level, laterality); surgeon; and position, as well as that proper equipment, instrumentation, and implants are available.

Postintubation tracheal rupture: case report.

Tracheobronchial rupture after tracheal intubation has been infrequently reported. Successful diagnosis often requires a high level of suspicion. A laceration of the distal membranous trachea usually has been repaired through a right thoracotomy.

8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual.

Objective: This study evaluated the effect of mentalization-based treatment by partial hospitalization compared to treatment as usual for borderline personality disorder 8 years after entry into a randomized, controlled trial and 5 years after all mentalization-based treatment was complete.

Method: Interviewing was by research psychologists blind to original group allocation and structured review of medical notes of 41 patients from the original trial. Multivariate analysis of variance, chi-square, univariate analysis of variance, and nonparametric Mann-Whitney statistics were used to contrast the two groups depending on the distribution of the data.

Comorbid antisocial and borderline personality disorders: mentalization-based treatment.

Mentalization is the process by which we implicitly and explicitly interpret the actions of ourselves and others as meaningful based on intentional mental states (e.g., desires, needs, feelings, beliefs, and reasons).

Explanations of depression among Irish migrants in Britain.

Irish geographical and cultural propinquity to the UK might be considered as an advantage to migrants. However, research over 40 years shows Irish migrants to have consistent high vulnerability to mental disorders. Only recently have researchers begun to explore the reasons for this morbidity.