Book chapters will be unavailable on Saturday 24th August between 8am-12pm BST. This is for essential maintenance which will provide improved performance going forwards. Please accept our apologies for any inconvenience caused.
To send this article to your account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send this article to your Kindle, first ensure email@example.com is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Psychiatrists make important and specific contributions to the care of those
with mental health problems and high-quality services should enable patients
to benefit optimally from a psychiatrist's distinctive skills. In this
article we seek to identify and consider the core expertise of the
To establish prevalence of domestic violence among female psychiatric
patients, including risk factors, health professional attention and
acceptability of routine enquiry. Participants were 70 adult women in an
inner-city community mental health team who received questionnaire and
case-note review. Main outcome measures were: lifetime/point prevalence
of domestic violence; attitudes to routine enquiry; past disclosure and
recording in psychiatric records; clinical and demographic risk
Lifetime prevalence was 60% for physical violence from partners, 27%
during pregnancy and 40% receiving injuries. Point prevalence was not
reported, as an insufficient number of participants were currently in a
relationship. As many as 82% regarded routine enquiry as acceptable, but
only 24% had ever been questioned. Logistic regression analysis showed
prediction by presence of children, previous overdose, and experience of
Domestic violence in female psychiatric patients is common but
undetected. Enquiry should be routine, but would require staff
There has been much uncertainty about the concept of recovery in
psychosis. The aim of this paper is to conceptualise recovery, through
service users' descriptions of their recovery stories. A qualitative
approach (interpretive phenomenological analysis) was used to guide
interviews and analysis of data.
Eight service users were interviewed about their recovery from psychosis.
Data analysis revealed four superordinate themes: ‘impacts on mental
health’, ‘self-change and adaptation’, ‘social redefinition’ and
‘individualised coping mechanisms’.
Data indicates that multiple dimensions of recovery are all important to
individuals when considering their subjective experiences of recovery
from psychosis. Recovery can only be conceptualised by the person making
the recovery journey and treatment outcome measures must reflect this
To determine female authorship of original articles and editorials
between January 1997 and December 2008 in the British Journal of
Psychiatry and the Psychiatric Bulletin.
Editorials from Advances in Psychiatric Treatment and
the geographical region of the female first author of original articles
were also included in the study.
The gender was determined for 99.2% of the 2324 first authors of original
articles and 100% of the 614 editorials. The percentage of original
articles by female first authors fluctuated over the study period,
ranging from 22.5 to 42.1% (mean 33.6) in the British Journal of
Psychiatry, and from 25.5 to 46.8% (mean 37.6) in the
Psychiatric Bulletin. There was a gross
underrepresentation of females as first authors of editorials in all
three journals. The percentage of female first authors of original
articles from low- and middle-income countries ranged from 0.3 to 3.4% in
both the British Journal of Psychiatry and the
There is an increasing trend in female first authorship of original
articles. However, females remain underrepresented, especially in
editorials, in the British psychiatric journals examined. The
representation of female first authors from low- and middle-income
countries is disproportionately low. Strategies to address these
inequalities should be implemented.
To examine the effect of taking an elective psychiatry and literature
course during the first year of medical school on performance in the
later mandatory general psychiatry curriculum. Class members were
surveyed for baseline characteristics at the time of their admission to
medical school. Following completion of their fourth year, average grades
in psychiatry were calculated and results compared for those who did and
those who did not take the course. Multiple regression analysis was used
to assess the effects of baseline characteristics that were significantly
different between the groups.
Students who took the course had statistically significant
(t = −3.34, P <0.001) higher
grades in fourth year psychiatry. They had lower admission interview
scores (t = −2.15, P <0.05) and
reported less academic stress (t = −9.55,
P <0.01) before taking the course.
Literature is an effective medium through which to teach medical students
psychiatry as it can lead to a greater understanding of the topic.
Concerns have been raised that catatonia is underdiagnosed. Prevalence
varies (1.3-32%) depending on diagnostic criteria. We used the Modified
Rogers Scale to rate catatonic signs in patients consecutively admitted
to three psychiatric wards over a 10-month period.
The prevalence of patients demonstrating any catatonic signs was at least
7.9-19.1%. The most common catatonic signs were marked underactivity (not
sedated), echolalia/palilalia, marked overactivity (not restlessness) and
gegenhalten. In those with catatonic signs, the most common diagnoses
were schizophrenia, schizoaffective disorder and dementia.
Most of the most common catatonic signs in our sample were motor signs.
Antipsychotic-induced motor signs reflect interaction between drug and
disease. Catatonic signs are not anchored in any one diagnosis and are on
a spectrum of severity and quantity. Prevalence of these signs is higher
than often presumed.
The patient's experience of the clinician is an increasingly important
area in time of ‘consumer choice’ and appraisal of the individual
practitioner. Validated, easy-to-use scales are scarce. The aim was to
validate a user-friendly, brief scale measuring patient satisfaction
(PatSat scale). Over three phases, patients were involved in developing
and validating the scale against the Verona satisfaction subscale.
A highly significant correlation was found between the two scales
(Spearman's correlation coefficient 0.97, two-tailed P
The PatSat is a new patient satisfaction scale validated in a psychiatric
out-patient population. It appeared popular with patients and took less
than 1 minute to fill in. The use of validated scales measuring patient
satisfaction is a pivotal part of mental health delivery and advancing
overall quality of care.
To explore the extent to which 2007 Department of Health guidelines on
monitoring of high-dose (⩾100 mg) methadone were followed, the reasons
for non-adherence to these and the prevalence of QTc prolongation. We
developed a simple tool for collecting data from case notes.
Out of 25 service users, 11 had had an electrocardiogram (ECG) and 7 had
evidence of requests sent to general practitioners. After implementation
of our recommendations, ten more service users had ECGs within 1 month.
All but one ECG was normal. Methadone prescribing in favour of lower
doses has been observed. QTc interval prolongation was not common.
Effective communication between primary and secondary care services is
important in identifying cases and arranging ECGs.
To identify the outcomes of patients in the obstetric screening clinic.
In 2 years, 180 women were referred by midwives to a clinic run by
specialist community perinatal team. ‘Ultra-high risk’ patients were
identified. There were four outcome measures predicated on level of
Of those referred, 69 women were managed in primary care/generic
community mental health teams, 90 by specialist perinatal team and 21 did
not attend; 23 women were ultra-high risk. The majority of the ultra-high
risk patients required treatment with specialist teams.
Specialist community perinatal screening clinics are successful at
identifying those at high risk of developing mental health problems.
Ultra-high risk women needed a higher level of service. High morbidity in
women who fail to attend the services demands more assertive follow-up.
Cumulative personal and family history is an important risk factor.