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186 results

Page 1 of 10

  • The history and development of community psychiatry
  • Graham Thornicroft, Michele Tansella
  • Journal: European Psychiatry / Volume 13 / Issue S4 / 1998
  • Published online by Cambridge University Press: 16 April 2020, p. 179s
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  • Preface: an evolving perspective of mental health outcome measures
  • Edited by Graham Thornicroft, { Author Role= exceeds the limit of 5 characters including spacing}, Michele Tansella, { Author Role= exceeds the limit of 5 characters including spacing}
  • Book: Mental Health Outcome Measures
  • Published by: Royal College of Psychiatrists
  • Published online: 25 February 2017, pp xv-xviii
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    Summary

    Since the appearance of the two previous editions of Mental Health Outcome Measures (first published by Springer Verlag in 1996, with a second edition published by the Royal College of Psychiatrists in 2001), there have been several intriguing developments in the field. First, an even wider range of important outcome domains are now measurable using well standardised instruments than were measurable before. Second, a greater emphasis upon positive outcomes has evolved (for example referring to the concept of recovery) among researchers, service users and clinicians. Third, the voice of the service user/consumer is now centre stage to a much greater extent than in earlier years. This third edition refers to these three core themes throughout its pages. Nevertheless, the fundamentals remain unchanged, namely:

    1. • the scales used must have known and strong psychometric properties (Chapter 2)

    2. • evidence (both qualitative and quantitative) needs to be ascertained from the most rigorously scientifically designed studies (Chapter 3), taking into account the complexity of the intervention (Campbell et al, 2000, 2007; Tansella et al, 2006)

    3. • in many outcome studies, symptom and social domains (such as quality of life and employment) need to be assessed concurrently (Chapters 5, 8, 9, 11, 13, 14 and 16)

    4. • scales need to be applicable and relevant to a wide of settings to allow valid international comparisons (Chapter 17)

    5. • an inclusive approach to the whole range of mental disorders is required, so that people are included whose conditions have sometimes been excluded from care, such as personality disorders (Chapter 15).

    At the same time, a clear trend is now identifiable not so much to look at mental disorders in terms of their producing chronicity, impairment and severe disability but instead to emphasise the hope of recovery (Chapter 4). Central to this view is the participation of service users in research (Chamberlin, 2005) and a more nuanced approach to potential collaboration between people disclosing experience of mental illness, and others, in the development and use of outcome measures (Sweeney et al, 2009).

  • The balanced care model: the case for both hospital- and community-based mental healthcare
  • Graham Thornicroft, Michele Tansella
  • Journal: The British Journal of Psychiatry / Volume 202 / Issue 4 / April 2013
  • Published online by Cambridge University Press: 02 January 2018, pp. 246-248
  • Print publication: April 2013
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    The balanced care model proposes that a comprehensive mental health system needs to include both community-and hospital-based care. The model is based on a structured review of scientific evidence, and is also informed by the experience of experts active in mental health system change in many countries worldwide.

  • Schizophrenia severity, social functioning and hippocampal neuroanatomy: three-dimensional mapping study
  • Paolo Brambilla, Cinzia Perlini, Priya Rajagopalan, Priyanka Saharan, Gianluca Rambaldelli, Marcella Bellani, Nicola Dusi, Roberto Cerini, Roberto Pozzi Mucelli, Michele Tansella, Paul M. Thompson
  • Journal: The British Journal of Psychiatry / Volume 202 / Issue 1 / January 2013
  • Published online by Cambridge University Press: 02 January 2018, pp. 50-55
  • Print publication: January 2013
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    Background

    Hippocampal shrinkage is commonly reported in schizophrenia, but its role in the illness is still poorly understood. In particular, it is unclear how clinical and psychosocial variables relate to hippocampal volumes.

    Aims

    To investigate neuroanatomic differences in the hippocampus using three-dimensional (3D) computational image analysis.

    Method

    We used high-resolution magnetic resonance imaging and surface-based modelling to map the 3D profile of hippocampal differences in adults with schizophrenia (n=67) and a healthy control group (n = 72). Manual tracings were used to create 3D parametric mesh models of the hippocampus. Regression models were used to relate diagnostic measures to maps of radial distance, and colour-coded maps were generated to show the profile of associations.

    Results

    There was no detectable difference between the schizophrenia and control groups in hippocampal radial distance. In the schizophrenia group, however, bilateral shape deflation was associated with greater illness severity (length of illness, positive and negative symptoms) and with poorer social functioning (educational level, quality of life and health status), which survived Bonferroni correction.

    Conclusions

    Illness severity and poor social functioning may be associated with hippocampal deflation in schizophrenia. As a structural sign of poor outcome, imaging measures might help to identify a subgroup of patients who may need specific treatment to resist hippocampal shrinkage, such as cognitive rehabilitation or physical exercise.

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