Tom Burns

..Our aim was to assess the effectiveness of IPS, and to examine whether its effect is modified by local labour markets and welfare systems...

..We tested whether CTOs reduce admissions compared with use of Section 17 leave when patients in both groups receive equivalent levels of clinical contact but different lengths of compulsory supervision...

..So far there has been little research on this...

..The aim of this study was to identify and explore facilitators and barriers perceived to influence continuity of care by health and social care professionals working in and closely associated with CMHTs...

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..We aimed measuring general practitioners' attitudes to antipsychotic drugs and their adverse side effects and comparing these with the attitudes of the general population...

..To explain why clinical trials of intensive case management for people with severe mental illness show such inconsistent effects on the use of hospital care...

..Newer antipsychotics are increasingly used in schizophrenia maintenance. The UK change has been slow with little known on switching patterns. We aimed to investigate antipsychotic prescribing patterns in schizophrenia patients...

..However, there has been limited empirical work to explore this specifically...

..Coercion has usually been equated with legal detention. Non-statutory pressures to adhere to treatment, 'leverage', have been identified as widespread in US public mental healthcare. It is not clear if this is so outside the USA...

..Its use has delayed recognising that CMHTs are the more cost-effective, evidence-based approach. The term should be abandoned and trials should compare two equally well-defined services...

..We aimed to operationalize a multi-axial model of continuity of care and to use factor analysis to determine its validity for severe mental illness...

..Evidence of the effectiveness of IPS in these conditions, and its potential variation across them, would guide local policy and provide possible insights into its mechanism...

..OBJECTIVe: Deficits in social functioning are a core feature of schizophrenia...

..Several studies of Individual Placement and Support (IPS), however, have found associations between working and better nonvocational outcomes. IPS has been found to double the return to work of people with SMI in 6 European countries...

..g. assertive outreach, crisis resolution). Reduction in hospitalisation has been the most consistent outcome measure in these studies, but results are inconsistent...

..Evidence of the effectiveness of IPS in these conditions, and its potential variation across them, would guide local policy and provide possible insights into its mechanism...

..These are needed to help clinicians utilize the powers available to them in an informed and judicious fashion and to ensure adequate training...

..The evidence base for forensic mental health (FMH) services has been developing since the late 1990s. Are outcome measures sound enough for the evaluation tasks?..

..Explanations cite poor UK 'model fidelity' and/or better UK standard care. No international model-fidelity comparisons exist...

..Caregiver burden in mental illness is believed to differ between ethnic groups, but few studies have examined this in schizophrenia in the UK...

..Our aim was to identify the correlates of burden in a UK sample of first-generation North Indian Punjabi Sikh parents and their white British counterparts...

..The recent UK government policy decision to concentrate this programme in prisons may, in part, reflect the significance of these findings...

..Age, previous employment and diagnosis influenced outcome. CONCLUSION: Training in IPS at team level did not improve employment status. A dedicated, vocational worker appears to be essential for successful IPS...

..The paper concludes by considering the implications of these arguments, setting out a pathway designed to assist community mental healthcare practitioners to determine whether making a specific proposal to a patient is right or wrong...

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..In this article we present the different types of pressure that we identified from patients' accounts, and a set of criteria derived for the purpose of distinguishing between these different types of pressure...

..Our data suggest that long term risk of a recurrence may be high, but with recurrence delayed...

..Ordinary CMHTs' share most of the organizational aspects of ACT and appear to deliver equal outcomes with much reduced resources. The value of investing in high fidelity ACT teams must, therefore, be in doubt...

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..Despite equivocal results, in the UK and Europe, this approach is becoming accepted policy. We assessed the effect of smaller case loads...

..A total of 62% of patients received amisulpride doses in the range 400-800 mg/day and most (72%) required no dose adjustment. The great majority of patients (87%) switched to amisulpride without problems...

..Amisulpride caused fewer neurological side-effects than conventional anti-psychotics and less weight gain than risperidone, both of which are crucial factors for long-term compliance...

..This study aims to identify features which predict help-seeking behaviour in symptomatic individuals and to explore failure of help seeking in those who did not...

..Only one study has examined bipolar disorder and schizophrenia in this way, and it was restricted to one database...

..To describe and assess outcome measures in forensic mental health research, through a structured review and a consensus panel...

..The supposition that day hospitals would provide an acute service, while day centres would offer social support for a more chronic population has been contentious and there is little evidence of how they are currently used...

..Identifying the optimal clinical profile for patients likely to benefit from intensive case management remains a pressing need for further studies...

..We aimed to compare a patient-rated subjective QoL scale with an observer-rated QoL scale by measuring their degree of correlation and their respective associative profiles with outcome measures...

..To investigate the contribution of processing speed in the prediction of various domains of outcome in psychosis...

..An international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes...

..Suggestions that ethnic minority patients are much more likely to have engaged in serious violence and need high-security placement were not borne out...

..To investigate how doctors engage with patients with psychotic illness in routine consultations...

..This supplement tracks those changes and examines the merits and use of structured approaches to understand this most complex disorder...

..The higher acquisition cost of quetiapine was offset by savings in other medical costs. Quetiapine could significantly improve the management of this patient group, without increasing the economic burden on the health service...

..The impact of comorbid personality disorder on the occurrence of violence in psychosis has not been fully explored...

..Although the model of assertive outreach has been widely adopted, it is unclear who receives assertive outreach in practice and what outcomes can be expected under routine conditions...

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..Little is known about what characteristics of teams, staff and patients are associated with a favourable outcome of severe mental illness managed by assertive outreach...

..In view of the increasing integration of health and social care, there is an urgent need to know how health service day hospitals and social service day centres are being used, and by whom...

..Important lessons about the need to focus on treatments rather than structures seem not to have been learnt. Psychiatry's recent excessive focus on service structures may have had unintended consequences for our professional identity...

..It also examined whether relatives of patients receiving intensive case management appraised caregiving less negatively and experienced less psychological distress than relatives of patients receiving standard case management...

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..The combinations of information were: a) age and sex, b) age, sex and history of criminality/violence c) age, sex, history of violence and drug use and d) age, sex, history of violence, drug use and personality disorder...

..Most recent phase II and phase III PCTs of antipsychotics in schizophrenia have been conducted outside Europe. This development needs to be better understood...

..Assertive outreach teams have been introduced in the UK, based on the assertive community treatment (ACT) model. It is unclear how models of community care translate from one culture to another or the degree of adaptation that may result...

..Despite these findings, greater psychological distress in primary caregivers indicated greater psychological distress in nonprimary caregivers...

..Since de-institutionalisation, much has been written about the risk posed to the community by those with severe mental illness. However, violent victimisation of people with mental illnesses has received little attention...

..In conclusion there is a need to support nurses in difficult intensive care situations, for example, by mentoring, as a step towards developing moral action knowledge in the context of intensive care nursing...

..Overall clinical improvements were similar for both groups as were costs. Social networks of the discharged patients decreased. CONCLUSIONS: Closures of services need to be as carefully evaluated as new developments...

..The role of journals in disseminating research to clinicians is increasingly debated. Current measures of esteem for journals (e.g. impact factors) may not indicate clinical penetration...

..ICD-10 has introduced the diagnostic group acute and transient psychotic disorders (ATPDs; F23)...

..The social networks of people with mental illness have received much attention, but users of day care services have rarely been considered...

..Further research is required to compare such models in large prospective epidemiologic studies of other psychiatric populations...

..Little is known about the determinants of violence in women with psychosis...

..A durable therapeutic relationship is central to mental health practice. The Working Alliance Inventory (WAI) and the Helping Alliance Questionnaire (HAQ) are established instruments for measuring such a relationship...

..Moreover, the sustainability of experimental services beyond their research studies is rarely reported...

..The concept of social exclusion is now widely used in discussions about the nature of disadvantage, and there are ongoing initiatives to promote social inclusion among those with mental health problems...