scholarly journals Severe and enduring eating disorders: recognition and management

2014 ◽  
Vol 20 (6) ◽  
pp. 392-401 ◽  
Author(s):  
Paul Robinson
Keyword(s):  
Eating Disorders ◽  
Crisis Management ◽  
Learning Objectives ◽  
Psychological State ◽  
Service Development ◽  
List Type ◽  
Type Number ◽  
Specific Group ◽  
Definition Of

SummaryPatients with severe and enduring eating disorders (SEED) may constitute a specific group. It is proposed that patients with anorexia nervosa (SEED-AN) or bulimia nervosa (SEED-BN) that requires the regular attention of a multidisciplinary team and is of a duration known to have a low recovery rate should be included in the SEED group. These patients present with a combination of severe symptoms and long-term illness, and may experience serious chronic physical sequelae (e.g. osteoporosis and renal failure), marked social isolation and stigma. Their carers suffer from the stress of caring for them over a prolonged period. Symptoms, treatment and crisis management of SEED-AN are discussed. SEED is a relatively recently described area of eating disorders psychiatry that requires research and service development so that patients and carers are helped to cope with very serious chronic, but not incurable, conditions.Learning Objectives•Understand the definition of SEED-AN and SEED-BN.•Be able to assess the physical and psychological state of patients with SEED-AN and SEED-BN.•Be able to plan the monitoring and treatment of patients with SEED, involving their carers and families.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

scholarly journals The interface between general and forensic psychiatry: the present day

2014 ◽  
Vol 20 (5) ◽  
pp. 359-365 ◽  
Author(s):  
Vivek Khosla ◽  
Phil Davison ◽  
Harvey Gordon ◽  
Verghese Joseph
Keyword(s):  
Forensic Psychiatry ◽  
Clinical Care ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
England And Wales ◽  
Adult Psychiatry ◽  
The Republic ◽  
Definition Of ◽  
The Uk

SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.

The definition of a multi-dimensional generalization of shot noise

1971 ◽  
Vol 8 (01) ◽  
pp. 128-135 ◽  
Author(s):  
D. J. Daley
Keyword(s):  
Stochastic Process ◽  
Probability Distribution ◽  
Absolute Convergence ◽  
List Type ◽  
Type Number ◽  
Homogeneous Poisson Process ◽  
Cauchy Principal ◽  
Principal Value ◽  
Definition Of ◽  
Image Position

The paper studies the formally defined stochastic process where {tj } is a homogeneous Poisson process in Euclidean n-space En and the a.e. finite Em -valued function f(·) satisfies |f(t)| = g(t) (all |t | = t), g(t) ↓ 0 for all sufficiently large t → ∞, and with either m = 1, or m = n and f(t)/g(t) =t/t. The convergence of the sum at (*) is shown to depend on (i) (ii) (iii) . Specifically, finiteness of (i) for sufficiently large X implies absolute convergence of (*) almost surely (a.s.); finiteness of (ii) and (iii) implies a.s. convergence of the Cauchy principal value of (*) with the limit of this principal value having a probability distribution independent of t when the limit in (iii) is zero; the finiteness of (ii) alone suffices for the existence of this limiting principal value at t = 0.

scholarly journals Health anxiety: detection and treatment

2018 ◽  
Vol 24 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Peter Tyrer ◽  
Helen Tyrer
Keyword(s):  
Health Anxiety ◽  
Behavioural Therapy ◽  
Learning Objectives ◽  
List Type ◽  
Psychological Treatments ◽  
Cognitive Behavioural ◽  
New Diagnosis ◽  
Changing Attitudes ◽  
Term Benefit

SUMMARYHealth anxiety is an important new diagnosis that is increasing in frequency because of changing attitudes towards health, particularly excessive use of health information on the internet (cyberchondria). People with abnormal health anxiety become over-diligent monitors of their health, misinterpret most somatic sensations as evidence of disease, consult medical professionals unnecessarily and frequently, and are often over-investigated. Relatively few patients with health anxiety present to psychiatrists; most are seen in primary and secondary medical care. This paper reviews the diagnosis and presenting features of health anxiety, its identification in practice and its treatment. A range of simple psychological treatments have been shown to have long-lasting benefit for the disorder but are greatly under-used.LEARNING OBJECTIVES•To be able to identify abnormal health anxiety with the aid of probe questions•To respond to people whom you have identified with excessive health anxiety in a way that facilitates its treatment•To learn a few simple techniques derived from cognitive–behavioural therapy that can lead to long-term benefitDECLARATION OF INTERESTNone.

How “DUP” and “EE” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Cechnicki ◽  
R. Polczyk ◽  
A. Bielańska
Keyword(s):  
Repeated Measures ◽  
First Episode ◽  
First Year ◽  
List Type ◽  
Type Number ◽  
Long Term Outcomes ◽  
Course Of Illness ◽  
Negative Syndrome

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. The Follow-Up Chart, BPRS, and CFI were used. As the outcome criteria only dynamic of symptoms were included. The dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). The negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. In long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. After the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. The dynamic of negative syndrome was not modified by DUP and EE.

scholarly journals Managing delirium in everyday practice: towards cognitive-friendly hospitals

2014 ◽  
Vol 20 (6) ◽  
pp. 380-389 ◽  
Author(s):  
Henry O'Connell ◽  
Sean P. Kennelly ◽  
Walter Cullen ◽  
David J. Meagher
Keyword(s):  
Healthcare System ◽  
Clinical Care ◽  
Cognitive Disorder ◽  
Learning Objectives ◽  
Everyday Practice ◽  
List Type ◽  
Type Number ◽  
Hospital Environments ◽  
Cognitive Problems ◽  
The Way

SummaryProviding optimal healthcare for increasingly elderly hospital populations who have high rates of cognitive disorder is a great challenge. Using delirium as an example, we describe how improved management of acute cognitive problems through a multifaceted hospital-wide programme can promote cognitive-friendly hospital environments. A specific plan of action is described that spans interventions in day-to-day clinical care of individual patients all the way to wider organisational practices.Learning Objectives•Understand the concept of cognitive friendliness and how addressing the problem of delirium can contribute to this in our healthcare system.•Become more aware of specific aspects of a cognitive-friendly programme and how these can be implemented in practice.•Explore the key outstanding issues for research that can further enhance our awareness of cognitive-friendly practices.

How “DUP” and “ee” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Cechnicki ◽  
R. Polczyk ◽  
A. Bielańska
Keyword(s):  
Repeated Measures ◽  
First Episode ◽  
First Year ◽  
List Type ◽  
Type Number ◽  
Long Term Outcomes ◽  
Course Of Illness ◽  
Negative Syndrome

Objective:The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.Subjects and methods:58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. the Follow-Up Chart, BPRS, and CFI were used. as the outcome criteria only dynamic of symptoms were included. the dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.Results:1.General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). the negative syndrome decreased less rapidly during the first year.2.The dynamic of general and positive syndrome were modified by the DUP and by EE. in long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. after the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).3.The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).Conclusion:The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. the dynamic of negative syndrome was not modified by DUP and EE.

The definition of a multi-dimensional generalization of shot noise

1971 ◽  
Vol 8 (1) ◽  
pp. 128-135 ◽  
Author(s):  
D. J. Daley
Keyword(s):  
Stochastic Process ◽  
Probability Distribution ◽  
Absolute Convergence ◽  
List Type ◽  
Type Number ◽  
Homogeneous Poisson Process ◽  
Cauchy Principal ◽  
Principal Value ◽  
Definition Of ◽  
Image Position

The paper studies the formally defined stochastic process where {tj} is a homogeneous Poisson process in Euclidean n-space En and the a.e. finite Em-valued function f(·) satisfies |f(t)| = g(t) (all |t | = t), g(t) ↓ 0 for all sufficiently large t → ∞, and with either m = 1, or m = n and f(t)/g(t) =t/t. The convergence of the sum at (*) is shown to depend on (i)(ii)(iii). Specifically, finiteness of (i) for sufficiently large X implies absolute convergence of (*) almost surely (a.s.); finiteness of (ii) and (iii) implies a.s. convergence of the Cauchy principal value of (*) with the limit of this principal value having a probability distribution independent of t when the limit in (iii) is zero; the finiteness of (ii) alone suffices for the existence of this limiting principal value at t = 0.

scholarly journals A coding theoretic study of MLL proof nets

2012 ◽  
Vol 22 (3) ◽  
pp. 409-449 ◽  
Author(s):  
SATOSHI MATSUOKA
Keyword(s):  
Error Detection ◽  
Coding Theory ◽  
Linear Logic ◽  
List Type ◽  
Type Number ◽  
Intelligent Search ◽  
Novel Approach ◽  
Proof Nets ◽  
Enumeration Algorithms ◽  
Definition Of

In this paper we propose a novel approach for analysing proof nets of Multiplicative Linear Logic (MLL) using coding theory. We define families of proof structures called PS-families and introduce a metric space for each family. In each family: (1)an MLL proof net is a true code element; and(2)a proof structure that is not an MLL proof net is a false (or corrupted) code element. The definition of our metrics elegantly reflects the duality of the multiplicative connectives. We show that in our framework one-error-detection is always possible but one-error-correction is always impossible. We also demonstrate the importance of our main result by presenting two proof-net enumeration algorithms for a given PS-family: the first searches proof nets naively and exhaustively without help from our main result, while the second uses our main result to carry out an intelligent search. In some cases, the first algorithm visits proof structures exponentially, while the second does so only polynomially.

scholarly journals Autoimmune encephalitis: a potentially treatable cause of mental disorder

2014 ◽  
Vol 20 (2) ◽  
pp. 92-100 ◽  
Author(s):  
Hugh Rickards ◽  
Saiju Jacob ◽  
Belinda Lennox ◽  
Tim Nicholson
Keyword(s):  
Autoimmune Encephalitis ◽  
Mental States ◽  
Learning Objectives ◽  
First Episode ◽  
List Type ◽  
Type Number ◽  
Red Flags ◽  
Episode Psychosis ◽  
Autonomic Instability ◽  
Red Flag

SummaryAutoimmune encephalitides can present with altered mental states, particularly psychosis and delirium. Psychiatrists need to be particularly vigilant in cases of first-episode psychosis and to look out for other, sometimes subtle, features of encephalitis. Encephalitis related to N-methyl-d-aspartate (NMDA) receptor autoantibodies is the most common autoimmune cause of isolated psychosis, the second being related to voltage-gated potassium channel (VGKC)-complex antibodies. Psychiatrists should note ‘red flag’ signs of seizures, autonomic instability, movement disorders and sensitivity to antipsychotic medication (including neuroleptic malignant syndrome). They should also be aware that, in some cases, encephalitis is a non-metastatic manifestation of malignancy. Treatment primarily involves suppression of immunity and is often successful if delivered early. There is accumulating evidence that isolated psychiatric syndromes can be caused by autoimmunity and this could potentially signal a significant change in the approach to disorders such as schizophrenia. Psychiatrists and neurologists need to work together to diagnose, manage and understand this group of conditions.LEARNING OBJECTIVES•Consider ‘red flags' for the diagnosis of autoimmune encephalitis presenting to general psychiatric practice.•Understand the investigations required to diagnose autoimmune encephalitis.•Become familiar with the basics of treatment of autoimmune encephalitis.

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