CLEAR - clozapine in early psychosis: study protocol for a multi-centre, randomised controlled trial of clozapine vs other antipsychotics for young people with treatment resistant schizophrenia in real world settings.

Background: Clozapine is an antipsychotic drug with unique efficacy, and it is the only recommended treatment for treatment-resistant schizophrenia (TRS: failure to respond to at least two different antipsychotics). However, clozapine is also associated with a range of adverse effects which restrict its use, including blood dyscrasias, for which haematological monitoring is required. As treatment resistance is recognised earlier in the illness, the question of whether clozapine should be prescribed in children and young people is increasingly important.

Dementia services for people from Black, Asian and Minority Ethnic and White-British communities: Does a primary care based model contribute to equality in service provision?

This study set out to investigate whether there were disparities in service provision for people from Black, Asian and Minority Ethnic (BAME) communities compared to White British (WB) communities within a primary care led dementia service in the UK. Data were extracted from 30 cases from three BAME (African-Caribbean, South Asian and Chinese) communities who had been referred to a dementia service between April 2016 and December 2017. We then extracted data from 30 WB cases matched for gender, age (within 5 years) and General Practitioner surgery.

Variation in ambulance call rates for care homes in Torbay, UK.

Emergency ambulance calls represent one of the routes of emergency hospital admissions from care homes. We aimed to describe the pattern of ambulance call rates from care homes and identify factors predicting those homes calling for an ambulance most frequently. We obtained data from South Western Ambulance Service NHS Foundation Trust on 3138 ambulance calls relating to people aged 65 and over from care homes in the Torbay region between 1 April 2012 and 31 July 2013.

Narcissistic disorder and the failure of symbolisation: a Relational Affective Hypothesis.

The psychoanalytic concept of narcissistic disorder is broader than that of Narcissistic Personality Disorder (DSM-5 [1]), underlying a range of Personality Disorders (PD) and their co-morbidities. Existing Mentalisation, Psychoanalytic and Cognitive models, fail to account fully for the emerging evidence of biological, developmental, relational and defensive contributions to narcissistic disorder, nor do they account for the common and variant features of co-morbidities namely Anorexia Nervosa, Somatisation, Substance Misuse and Autistic Spectrum Disorder. Alexithymia and concrete modes of relating are common findings in narcissistic disorder and these co-morbid conditions.

Service innovation: a comparison of two approaches for physical screening of psychiatric inpatients.

Objective: Psychiatric medications have clear links to obesity, diabetes, dyslipidaemia, hypertension, hyperprolactinaemia and movement disorders. These disorders are a common cause of morbidity and mortality in psychiatric patients but physical screening by health services is often haphazard.

Methods: We report the findings of an audit of physical screening across two hospital wards.

Attitudes toward psychiatry among final-year medical students in kumasi, ghana.

Objective: Most sub-Saharan African countries have fewer psychiatrists than one per one million people. One possible reason could be that medical students have a negative attitude toward the specialty. The authors evaluated the attitudes toward a career in psychiatry of final-year medical students in Kumasi, Ghana, and compare these with attitudes of medical students in Spain and the United States.

SCOFF, the development of an eating disorder screening questionnaire.

Objective: This article describes the three-stage development of the SCOFF, a screening tool for eating disorders.

Method: Study 1 details questionnaire development and testing on cases and controls. Study 2 examines reliability of verbal versus written administration in a student population.

Satisfaction and burnout among staff of crisis resolution, assertive outreach and community mental health teams. A multicentre cross sectional survey.

Background: The NHS Plan required extensive changes in the configuration of mental health services in the UK, including introduction of crisis resolution teams, CRTs. Little is known about the effects of these changes on mental health staff and their recruitment and retention.

Aims: To assess levels of burnout and sources of satisfaction and stress in CRT staff and compare them with assertive outreach team (AOT) and community mental health team (CMHT) staff.

Psychological factors that impact on women's experiences of first-time motherhood: a qualitative study of the transition.

Objective: childbearing is a significant transition, especially for first-time mothers. The objectives of this study were to explore the maternal transition from womens' perspectives and to identify any unmet needs for support.

Design: grounded theory was chosen as the most appropriate method of analysis due to its ability to identify social processes in an inductive way.

Trust, choice and power in mental health: a literature review.

Trust, choice and empowerment of patients are emerging as important issues in mental health care. This may be due to an increasingly consumerist attitude amongst patients and as a consequence of postmodern cultural changes in society. This study aimed to find evidence for the influence of trust, patient choice and patient empowerment in mental health care.

Cross-sectional survey of the use of section 5(2), Mental Health Act 1983, within a psychiatric hospital.

A survey of the use of section 5(2), Mental Health Act 1983 within a psychiatric hospital was carried out between January and December 2001. Using computer-based patient records, it was found that 89 patients were placed on a section 5(2) between January and December 2001. Data on patient demographics, hospital admission date, date of implementation of section 5(2), date of reassessment after section 5(2) and outcome of the assessment was obtained from these records.

Predicting psychological distress in patients with leukaemia and lymphoma.

This study examines the relationship between coping style, quality of life (QOL) and psychological distress in a sample of patients with leukaemia and lymphoma. Fifty-one consecutive in-patients, day cases and haematology out-patient attenders entered the study and completed a 10-item self-report questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Mental Adjustment to Cancer Scale (MACS) and the Schedule for the Evaluation of Individual Quality of Life (SEIQOL). Fifty-one percent of patients reached caseness for moderate distress.

Individual quality of life in patients with leukaemia and lymphoma.

With increasingly sophisticated chemotherapy regimes being prescribed the quality of life of cancer patients has become a key outcome measure. Little has been reported concerning the experience of patients with haematological malignancy receiving chemotherapy. The objective of this study was to evaluate the clinical usefulness of a novel quality of life measure-the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) in a sample of patients with either leukaemia or lymphoma.

A national survey of violence experienced by community mental health researchers.

Background: In recent years there has been a vigorous debate concerning the relationship between violence and mental illness. Psychiatric hospital staff are especially likely to experience violence. 'Detached staff' working in the community appear to be at greatest risk.

The burden of personality disorder: a district-based survey.

Patients with a clinical diagnosis of personality disorder (PD) often suffer prolonged distress. They are a considerable burden on psychiatric services and they are experienced as difficult to manage by their keyworkers. This paper describes the creation of a community-based case register of patients suffering from PD.

Psychological distress among cancer patients and informed consent.

This study examines the relationships between satisfaction with information provided, understanding of consent procedures, and levels of anxiety/depression in a sample of patients undergoing radiotherapy for cancer. One hundred patients completed a 13-item self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Twenty-two percent of patients could not recall signing a consent form and, for those who did recall, the level of understanding for what they had consented to was patchy.

Focus groups.

This paper introduces focus group methodology and discusses its relevance to those researching health care provision. As a qualitative data collection technique, the focus group has advantages over other qualitative methods, such as the in-depth interview and nominal group technique. This paper highlights these advantages after providing guidelines on group composition, the management of group discussion and the process of analysing results.

Psychotherapy assessment and treatment selection.

Background: Current acceptance of the need for a wide range of treatments and growing pressure for cost-effectiveness suggest the need for a more discriminating approach to assessment of psychotherapy.

Method: Medline and manual literature searches, and personal experience of over 1000 assessments in a district psychotherapy service.

Results: There is substantial evidence for the general efficacy of psychotherapy; differential benefits are beginning to be identified.

Three cases of Capgras' syndrome.

Three cases of Capgras' syndrome were identified in one psychiatric hospital within a 1-year period. These are presented and their psychopathology discussed. The traditional assumption that this is a rare syndrome is challenged.

A study of psychotropic medication given 'as required' in a regional secure unit.

Within the setting of a regional secure unit, all doses of medication given p.r.n.