Unilateral and bilateral electroconvulsive therapy: what informs Scottish psychiatrists' choices?

2009 ◽  
Vol 33 (3) ◽  
pp. 95-98 ◽  
Author(s):  
Kevin A. Brown
Keyword(s):  
Electroconvulsive Therapy ◽  
Response Rate ◽  
Remission Rate ◽  
Postal Questionnaire ◽  
Absolute Difference ◽  
Clinical Implications ◽  
Remission Rates ◽  
The Difference ◽  
Clinically Significant

Aims and MethodA postal questionnaire was sent to Scottish consultant psychiatrists asking about their attitudes towards unilateral and bilateral electroconvulsive therapy (ECT), and the difference in effectiveness between the two ECT types that they considered clinically significant.ResultsThe response rate was 61%. of those that responded, 62% were prescribers of ECT and most (79%) favoured bilateral ECT over unilateral ECT. the outcome that they were most concerned with was remission rate: 97% believe that an absolute difference of more than 5% in remission rate would make the difference in effectiveness between the two types of ECT clinically important.Clinical ImplicationsFuture investigators should focus on comparative remission rates of bilateral and unilateral ECT.

scholarly journals Cognitive therapy training for psychiatrists: impact on individual clinical practice

2004 ◽  
Vol 28 (4) ◽  
pp. 117-119 ◽  
Author(s):  
G. Swift ◽  
I. Durkin ◽  
C. Beuster
Keyword(s):  
Clinical Practice ◽  
Cognitive Therapy ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Previous Survey ◽  
Therapy Training ◽  
Training And Supervision ◽  
Improved Outcomes ◽  
Therapy Sessions

Aims and MethodWe aimed to survey how psychiatrists with in-depth training in cognitive therapy use these skills. A postal questionnaire based on a previous survey was sent to all psychiatrists who are accredited members of the British Association for Behavioural and Cognitive Psychotherapies.ResultsThere was a 94% response rate. Psychiatrists in non-psychotherapy posts used formal cognitive therapy, with an average of 20% of new patients compared with 65% for those in psychotherapy posts, and were less satisfied with the extent to which they were able to use their skills (20%v. 80%). A total of 85% of respondents described themselves as being involved in teaching, training and supervision of cognitive therapy.Clinical ImplicationsUnless psychiatrists are planning on working in specialised psychotherapy posts, they are unlikely to use cognitive therapy training in formal therapy sessions. Further research is needed to determine whether cognitive therapy training for psychiatrists translates into improved outcomes for patients.

scholarly journals Attitudes of psychiatrists to evidence-based guidelines

2002 ◽  
Vol 26 (11) ◽  
pp. 421-424 ◽  
Author(s):  
Harvey Rees ◽  
Attila Sipos ◽  
Matthew Spence ◽  
Glynn Harrison
Keyword(s):  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Evidence Based ◽  
Previous Survey ◽  
Health Partnership ◽  
Improved Outcomes ◽  
Actual Use ◽  
Evidence Based Guidelines ◽  
Improving Patient Care

Aims and MethodWe aimed to survey clinicians' attitudes on using evidence-based guidelines. A postal questionnaire based on a previous survey of general practitioners was sent to 105 psychiatrists working within Avon and Western Wiltshire Mental Health Partnership NHS Trust.ResultsThere was a 91% response rate. Respondents were generally in favour of clinical guidelines, with scores indicating a positive attitude to guidelines in 13 of the 18 statements. The majority felt that guidelines were effective in improving patient care, could be used flexibly to suit individual patients and did not impinge on their clinical judgement.Clinical ImplicationsPsychiatrists welcomed the increasing use of guidelines. Further research is needed to determine whether this will translate into actual use and improved outcomes for patients.

scholarly journals Capacity, compliance and electroconvulsive therapy (ECT): the practice of ECT among consultant psychiatrists

2006 ◽  
Vol 30 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Richard Law-Min ◽  
John Patrick Stephens
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Best Practice ◽  
Response Rate ◽  
Common Law ◽  
Good Practice ◽  
Legal Framework ◽  
Clinical Implications ◽  
Clinical Vignettes

Aims and MethodThe aim of this study was to seek the views of consultant psychiatrists on the legal framework they would use when considering treatment with electroconvulsive therapy (ECT). A questionnaire, consisting of three clinical vignettes, was sent to 70 consultants in the Wessex rotation (East Dorset/Hampshire region).ResultsA total of 56 questionnaires were returned; a response rate of 80%. Most consultant psychiatrists agree when giving ECT to capacitated and non-consenting patients. However, there was a lack of consensus when dealing with seemingly incapacitated but compliant patients.Clinical ImplicationsMore clarification in this area is needed. Trusts can assist clinicians by devising their own policies based on nationally agreed standards of best practice. The treatment of mentally incapacitated but compliant patients is an area of practice where uncertainty exists. If proceeding under common law in such cases, it is good practice to discuss with relatives/carers and obtain a second opinion from a consultant colleague. The most recent Bournewood judgement and the new Mental Health Bill will have further implications for clinical practice.

scholarly journals Psychotherapy training experience in an inner-city psychiatry rotation

2003 ◽  
Vol 27 (5) ◽  
pp. 179-182
Author(s):  
Maria Podlejska-Eyres ◽  
Julian Stern
Keyword(s):  
Inner City ◽  
Response Rate ◽  
Psychotherapy Training ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Basic Training ◽  
Specialist Training ◽  
Training Experience ◽  
Training Scheme ◽  
Royal London Hospital

Aims and MethodA postal questionnaire was circulated to all psychiatrists who had completed their basic specialist training on the Royal London Hospital training scheme within the last 7.5 years. The aim of the questionnaire was to explore their psychotherapy experience while on the rotation.ResultsThe response rate was 95%. The respondents had a broad experience of both didactic and case work that they valued highly. Over half of them wished for an even greater exposure to psychotherapy during their basic training.Clinical ImplicationsThe results of our survey suggest that with the dedication of both the trainees and trainers, it is possible to have a comprehensive psychotherapy experience while working on a busy inner-city rotation.

scholarly journals The role of the educational supervisor

2000 ◽  
Vol 24 (6) ◽  
pp. 216-218 ◽  
Author(s):  
Edward Day ◽  
Nick Brown
Keyword(s):  
Response Rate ◽  
Educational Development ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Educational Plan ◽  
West Midlands ◽  
Educational Supervision ◽  
Educational Supervisor

Aims and MethodsA postal questionnaire of all pre-membership psychiatric trainees in the West Midlands was used to investigate the role of the educational supervisor. The trainees were asked about their experience of educational supervision, and also asked to rank a number of possible roles for their supervisor in order of importance.ResultsA response rate of 70% was achieved. Trainees rated regular appraisal and assessment of skills and deficits as the most important role of the educational supervisor, but had only experienced this in 55% of their training posts thus far. Less than half of the respondents had developed a written educational plan with their educational supervisors, and trainees rated this the least important task of good educational supervision.Clinical ImplicationsThe results of this survey inform the training agenda for trainers, and emphasise the need to equip consultants with the skills to appraise their trainee's educational development.

scholarly journals Impact of positive images of a person with intellectual disability on attitudes: randomised controlled trial

2011 ◽  
Vol 35 (11) ◽  
pp. 404-408 ◽  
Author(s):  
Sabu John Varughese ◽  
Vania Mendes ◽  
Jason Luty
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Intellectual Disability ◽  
Response Rate ◽  
Controlled Trial ◽  
Clinical Implications ◽  
Stigma Score ◽  
The Mean ◽  
The Difference ◽  
Randomised Controlled

Aims and methodTackling discrimination, stigma and inequalities in mental health is a major UK government objective yet people with intellectual disability (also known as learning disability in UK health services) continue to suffer serious stigma and discrimination. We examine the effect of viewing pictures of a person with intellectual disability on stigmatised attitudes. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes. Members of the general public were randomised to complete the questionnaire having looked at a good (attractive) or bad (unattractive) photograph of a person with intellectual disability.ResultsQuestionnaires were received from 187 participants (response rate 74%). The mean AMIQ stigma score for the bad photo group was 1.3 (s.e. = 0.3, median 1, interquartile range (IQR) = 0–3,n= 82). The mean AMIQ score for the good photo group was 2.8 (s.e. = 0.3, median 3, IQR = 1–5,n= 105). The difference in AMIQ stigma score was highly significant (two-sidedP= 0.0001, median difference 2, Mann–WhitneyU-test).Clinical implicationsLooking at a good (attractive) picture of a person with intellectual disability significantly reduces reported stigmatised attitudes, whereas a bad (unattractive) picture has no effect.

scholarly journals Survey of clozapine use by consultant old age psychiatrists

2006 ◽  
Vol 30 (11) ◽  
pp. 410-412 ◽  
Author(s):  
Raghupathy Paranthaman ◽  
Robert C. Baldwin
Keyword(s):  
Elderly Patients ◽  
Old Age ◽  
Random Sample ◽  
Older Patients ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Published Data ◽  
Clinical Implications ◽  
Old Age Psychiatry

Aims and MethodThe aim of the survey was to assess the attitudes of specialists in old age psychiatry towards the use of clozapine in elderly patients. A postal questionnaire was sent to a random sample of 155 consultant old age psychiatrists in England.ResultsThe response rate was 87%. A majority of respondents felt that clozapine had a useful place in the treatment of elderly patients, although they expressed concerns about the lack of published data and about safety and practical difficulties in monitoring. Prescribers of clozapine (n=45) were significantly more positive about its role in treating older patients than those who had not used it.Clinical ImplicationsThe findings suggest that familiarity with and confidence in clozapine and practical difficulties in monitoring are important determinants of its use in older patients.

Usage of clozapine and the new neuroleptics

1999 ◽  
Vol 23 (8) ◽  
pp. 478-480
Author(s):  
M. F. Bristow
Keyword(s):  
General Practitioner ◽  
General Practitioners ◽  
Atypical Antipsychotic ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
England And Wales

Aims and methodTo explore clozapine and atypical antipsychotic usage in England and Wales, particularly availability, restrictions on use and shifting of prescribing to general practitioners. To examine the hypothesis that respondents in acute trusts would encounter more restrictions. Method used – postal questionnaire sent to general psychiatrists derived from the 1996 Medical Directory.ResultsThere was an 80% response rate and over 90% of respondents used clozapine, with only 9% reporting any difficulty in obtaining it. Difficulty was not associated with any particular type of trust. Only about 4% of respondents suggested that general practitioners regularly took over the prescribing costs of the drug.Clinical implicationsOptimistic, with widespread usage and few difficulties in obtaining clozapine. General practitioner prescribing is still very low and needs to increase.

Electroconvulsive therapy in Hong Kong

2003 ◽  
Vol 27 (3) ◽  
pp. 102-104 ◽  
Author(s):  
K.-F. Chung ◽  
Y.-K. Ng ◽  
G.-C. Yiu ◽  
H.-K. Cheung
Keyword(s):  
Hong Kong ◽  
Electroconvulsive Therapy ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Basic Information ◽  
The Public ◽  
Western Countries ◽  
Private Practitioners

Aims and MethodWe conducted the first systematic territory-wide survey of electroconvulsive therapy (ECT) practice and utilisation in Hong Kong. All public ECT services were evaluated with a postal questionnaire, a visit and observations of ECT administration. All private ECT practitioners were surveyed using a postal questionnaire.ResultsMost practice areas at the public ECT services in Hong Kong complied with College guidelines. However, a few private practitioners were still using outdated ECT machines. The number of ECT courses completed in 1998 was 0.34 per 10 000 population, which was much lower than the rate of ECT use in Western countries.Clinical ImplicationsWe obtained basic information on ECT services in Hong Kong and on areas requiring immediate attention.

scholarly journals Survey of staff attitudes to smoking in a large psychiatric hospital

2004 ◽  
Vol 28 (6) ◽  
pp. 204-207 ◽  
Author(s):  
Jean Stubbs ◽  
Camilla Haw ◽  
Liz Garner
Keyword(s):  
Psychiatric Hospital ◽  
Nursing Staff ◽  
Response Rate ◽  
Smoking Habit ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Staff Attitudes ◽  
Full Compliance ◽  
Psychiatric Units ◽  
Preparatory Work

Aims and MethodThe aim of this survey was to examine staff views on smoking at work in a large psychiatric hospital. A postal questionnaire was sent to all clinical staff (n=1471) asking about their smoking habits and attitudes to smoking at work.ResultsThe response rate was 40.7%. Overall, 22.0% of respondents were smokers, with unqualified nursing staff having the highest rate (31.0%). The majority of staff did not favour a total ban on smoking by staff, patients or visitors. Smoking habit and profession influenced responses. Smokers and nurses were more permissive in their attitude towards smoking on wards than non-smokers and psychiatrists.Clinical ImplicationsImplementation of the government's recommendations on tobacco control in psychiatric units is likely to require considerable preparatory work with staff to ensure full compliance.

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