scholarly journals The psychiatry of children aged 0–4: advances in assessment, diagnosis and treatment

2015 ◽  
Vol 21 (6) ◽  
pp. 377-386 ◽  
Author(s):  
David Foreman
Keyword(s):  
Mental Illness ◽  
Preschool Children ◽  
Early Intervention ◽  
Cost Effectiveness ◽  
Secondary Care ◽  
Psychiatric Illness ◽  
Psychiatric Services ◽  
Assessment Tools ◽  
Age Group ◽  
Very Young Children

SummaryMental illness in very young children is relatively rare and the number of 0- to 4-year-olds seen in secondary care psychiatric services has recently declined. Conceptualisation of mental illness in this age group is shifting towards a model that views disorders as part of the wider spectrum of diagnoses, rather than distinct, developmentally specific conditions. This article discusses the epidemiology of psychiatric illness in preschool children, evaluates assessment tools that have only recently been validated for use in secondary care and considers evidence of the efficacy and cost-effectiveness of early intervention using treatments encompassing pharmacological, psychological and social approaches.

scholarly journals Suicide prevention: A study of patients' views

2003 ◽  
Vol 182 (3) ◽  
pp. 261-265 ◽  
Author(s):  
John M. Eagles ◽  
Dawn P. Carson ◽  
Annabel Begg ◽  
Simon A. Naji
Keyword(s):  
Social Networks ◽  
Mental Illness ◽  
Suicide Prevention ◽  
Psychiatric Illness ◽  
Structured Interview ◽  
Psychiatric Services ◽  
Prevention Strategies ◽  
Psychiatric Illnesses ◽  
Service Models ◽  
The Media

BackgroundSuicide prevention strategies are usually formulated without seeking the views of people with psychiatric illnesses.AimsTo establish what helped patients with severe psychiatric illness when they felt suicidal.MethodA semi-structured interview was constructed following transcribed interviews with 12 patients. This was administered to 59 out-patients with serious and enduring mental illness, focusing on factors they found helpful or unhelpful when at their most despairing.ResultsThree-quarters of patients were in contact with psychiatric services when feeling at their lowest, and this contact was generally deemed to be helpful. Social networks were considered just as helpful as psychiatric services by the half of patients who discussed their feelings with friends or relatives. Religious beliefs and affiliations were helpful. Negative influences included the media and the stigma of psychiatric illness.ConclusionsEfforts at suicide prevention might usefully focus on enhancing patients' social networks, increasing the likelihood of early contact with psychiatric services and decreasing the stigma attached to psychiatric illness. Larger studies of patients exposed to different service models would be informative.

Where next for early intervention programmes?

2019 ◽  
pp. 201-208
Author(s):  
Dinesh Bhugra ◽  
Antonio Ventriglio ◽  
Eric Y.H. Chen
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Early Intervention ◽  
Community Mental Health ◽  
Social Care ◽  
Psychiatric Services ◽  
Early Interventions ◽  
Duration Of Untreated Illness

Early intervention treatments and approaches are reaching across the globe. There is no doubt though that these services are a low priority, especially in countries where adequate resources are not available. The practice of psychiatry has, in the last 50 years, moved from asylums, to community mental-health teams, to home treatments and early intervention. There appears to be an increasing body of evidence to suggest that early interventions can work in reducing the duration of untreated illness and aiding better recovery, but this needs to be researched in conditions other than psychoses, for which evidence is strong. This chapter provides recommendations for researchers, clinicians, and policymakers. All these recommendations are based on the principle of equity between physical and mental illness, and better integration between psychiatric services and social care and between primary care and psychiatric services.

Psychiatric Illness in Patients with Persistent Somatisation

1995 ◽  
Vol 166 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Per Fink
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Personality Disorder ◽  
Broad Spectrum ◽  
Psychiatric Illness ◽  
Psychiatric Services ◽  
Psychiatric Diagnoses ◽  
Mental Health Care System ◽  
Icd 10

BackgroundThis study explores the incidence and nature of mental illness among persistent somatisers, and analyses their use of mental health services.MethodIndividuals with at least ten admissions to non-psychiatric departments during an 8-year period were studied. Persistent somatisers (n = 56) were compared with other frequent users (n = 57) of non-psychiatric services.ResultsOf the persistent somatisers, 82% had been examined by a psychiatrist at least once (median, 3 times). Sixteen per cent were mentally retarded, 48% were dependent on alcohol or drugs, and 48% had DSM–III–R personality disorder. The most prevalent ICD–10 diagnoses were anxiety states (54%), depressions (30%), phobias (18%) and psychoses (20%).ConclusionsPersistent somatisation is associated with severe mental illness and a broad spectrum of heterogeneous psychiatric diagnoses and syndromes. Persistent somatisers impose a serious burden on the mental health care system.

scholarly journals Using routinely recorded data in a UK RCT: a comparison to standard prospective data collection methods

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
G. A. Powell ◽  
L. J. Bonnett ◽  
C. T. Smith ◽  
D. A. Hughes ◽  
P. R. Williamson ◽  
...  
Keyword(s):  
Case Report ◽  
Cost Effectiveness ◽  
Missing Data ◽  
Antiepileptic Drugs ◽  
Secondary Care ◽  
Significant Degree ◽  
New Antiepileptic Drugs ◽  
Optimal Mix ◽  
Recorded Data ◽  
Randomised Controlled

Abstract Background Routinely recorded data held in electronic health records can be used to inform the conduct of randomised controlled trials (RCTs). However, limitations with access and accuracy have been identified. Objective: Using epilepsy as an exemplar condition, we assessed the attributes and agreement of routinely recorded data compared to data collected using case report forms in a UK RCT assessing antiepileptic drug treatments for individuals newly diagnosed with epilepsy. Methods The case study RCT is the Standard and New Antiepileptic Drugs II (SANAD II) trial, a pragmatic, UK multicentre RCT assessing the clinical and cost-effectiveness of antiepileptic drugs as treatments for epilepsy. Ninety-eight of 470 eligible participants provided consent for access to routinely recorded secondary care data that were retrieved from NHS Digital Hospital Episode Statistics (N=71) and primary and secondary care data from The Secure Anonymised Information Linkage Databank (N=27). We assessed data items relevant to the identification of individuals eligible for inclusion in SANAD II, baseline and follow-up visits. The attributes of routinely recorded data were assessed including the degree of missing data. The agreement between routinely recorded data and data collected on case report forms in SANAD II was assessed using calculation of Cohen’s kappa for categorical data and construction of Bland-Altman plots for continuous data. Results There was a significant degree of missing data in the routine record for 15 of the 20 variables assessed, including all clinical variables. Agreement was poor for the majority of comparisons, including the assessments of seizure occurrence and adverse events. For example, only 23/62 (37%) participants had a date of first-ever seizure identified in routine datasets. Agreement was satisfactory for the date of prescription of antiepileptic drugs and episodes of healthcare resource use. Conclusions There are currently significant limitations preventing the use of routinely recorded data for participant identification and assessment of clinical outcomes in epilepsy, and potentially other chronic conditions. Further research is urgently required to assess the attributes, agreement, additional benefits, cost-effectiveness and ‘optimal mix’ of routinely recorded data compared to data collected using standard methods such as case report forms at clinic visits for people with epilepsy. Trial registration Standard and New Antiepileptic Drugs II (SANAD II (EudraCT No: 2012-001884-64, registered 05/09/2012; ISRCTN Number: ISRCTN30294119, registered 03/07/2012))

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