243 results found
Sanatinia R, Afzal S, MacLaren T, et al., 2019, Improved mental health among LABILE study participants: A qualitative exploration, PERSONALITY AND MENTAL HEALTH, Vol: 13, Pages: 75-83, ISSN: 1932-8621
Lei H, Barnicot K, Maynard E, et al., 2019, Factors influencing use of community treatment orders and quality of care that people receive: results of a national survey in England and Wales., BJPsych Bull, Pages: 1-9, ISSN: 2056-4694
Aims and methodWe conducted a secondary analysis of data from the National Audit of Psychosis to identify factors associated with use of community treatment orders (CTOs) and assess the quality of care that people on CTOs receive. RESULTS: Between 1.1 and 20.2% of patients in each trust were being treated on a CTO. Male gender, younger age, greater use of in-patient services, coexisting substance misuse and problems with cognition predicted use of CTOs. Patients on CTOs were more likely to be screened for physical health, have a current care plan, be given contact details for crisis support, and be offered cognitive-behavioural therapy.Clinical implicationsCTOs appear to be used as a framework for delivering higher-quality care to people with more complex needs. High levels of variation in the use of CTOs indicate a need for better evidence about the effects of this approach to patient care.Declaration of interestNone.
Hall K, Barnicot K, Crawford M, et al., 2019, A systematic review of interventions aimed at improving the cardiovascular health of people diagnosed with personality disorders., Soc Psychiatry Psychiatr Epidemiol
PURPOSE: People with personality disorders have significantly reduced life expectancy and increased rates of cardiovascular disease compared to members of the general population. Given that more people die annually of cardiovascular disease across the globe than from any other cause, it is important to identify the evidence for interventions aimed at improving cardiovascular health among people with personality disorders. METHODS: Systematic literature review. PsycINFO, MEDLINE and EMBASE were searched using NICE Healthcare Databases, as well as CENTRAL and trial registries. We sought to identify randomised controlled trials of interventions pertaining to adults with a primary diagnosis of personality disorder, where the primary outcome measure was cardiovascular health before and after the intervention. RESULTS: A total of 1740 records were identified and screened by two independent reviewers. No papers meeting the inclusion criteria were identified. CONCLUSIONS: This systematic review did not identify any randomised controlled trials testing interventions aimed at improving the cardiovascular health of people with personality disorders. Research in this area could have important public health implications, spanning the fields of psychiatry and general medicine.
Ntouva A, Porter J, Crawford MJ, et al., 2019, Alcohol Screening and Brief Advice in NHS General Dental Practices: A Cluster Randomized Controlled Feasibility Trial., Alcohol Alcohol
AIM: To assess the feasibility and acceptability of screening for alcohol misuse and delivering brief advice to eligible patients attending NHS dental practices in London. METHODS: A two-arm cluster randomized controlled feasibility trial was conducted. Twelve dental practices were recruited and randomized to intervention and control arms. Participants attending for a dental check were recruited into the study and were eligible if they consumed alcohol above recommended levels assessed by the AUDIT-C screening tool. All eligible participants were asked to complete a baseline socio-demographic questionnaire. Six months after the completion of baseline measures, participants were contacted via telephone by a researcher masked to their allocation status. The full AUDIT tool was then administered. Alcohol consumption in the last 90 days was also assessed using the Form 90. A process evaluation assessed the acceptability of the intervention. RESULTS: Over a 7-month period, 229 participants were recruited (95.4% recruitment rate) and at the 6 months follow-up, 176 participants were assessed (76.9% retention rate). At the follow-up, participants in the intervention arm were significantly more likely to report a longer abstinence period (3.2 vs. 2.3 weeks respectively, P = 0.04) and non-significant differences in AUDIT (44.9% vs. 59.8% AUDIT positive respectively, P = 0.053) and AUDIT C difference between baseline and follow-up (-0.67 units vs. -0.29 units respectively, P = 0.058). Results from the process evaluation indicated that the intervention and study procedures were acceptable to dentists and patients. CONCLUSIONS: This study has demonstrated the feasibility and acceptability of dentists screening for alcohol misuse and providing brief advice.
Aimola L, Gordon-Brown J, Etherington A, et al., 2019, Patient-reported experience and quality of care for people with schizophrenia, BMC PSYCHIATRY, Vol: 19, ISSN: 1471-244X
Munjiza J, Britvic D, Crawford MJ, 2019, Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study, BMC PSYCHIATRY, Vol: 19, ISSN: 1471-244X
Tyrer P, Mulder R, Kim Y-R, et al., 2019, The Development of the ICD-11 Classification of Personality Disorders: An Amalgam of Science, Pragmatism, and Politics., Annu Rev Clin Psychol
The nomenclature of personality disorders in the 11th revision of the International Classification of Diseases and Related Health Problems represents the most radical change in the classification history of personality disorders. A dimensional structure now replaces categorical description. It was argued by the Working Group that only a dimensional system was consistent with the empirical evidence and, in the spirit of clinical utility, the new system is based on two steps. The first step is to assign one of five levels of severity, and the second step is to assign up to five prominent domain traits. There was resistance to this structure from those who feel that categorical diagnosis, particularly of borderline personality disorder, should be retained. After lengthy discussion, described in detail here, there is now an option for a borderline pattern descriptor to be selected as a diagnostic option after severity has been determined. Expected final online publication date for the Annual Review of Clinical Psychology Volume 15 is May 7, 2019. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Aimola L, Jasim S, Tripathi N, et al., 2018, Impact of a peer-review network on the quality of inpatient low secure mental health services: cluster randomised control trial, BMC HEALTH SERVICES RESEARCH, Vol: 18, ISSN: 1472-6963
Crawford MJ, Sanatinia R, Tan W, 2018, No Effect of Lamotrigine in Subgroups of Patients With Borderline Personality Disorder: Response to Smith, AMERICAN JOURNAL OF PSYCHIATRY, Vol: 175, Pages: 1265-1266, ISSN: 0002-953X
Barnicot K, Crawford M, 2018, Posttraumatic Stress Disorder in Patients With Borderline Personality Disorder: Treatment Outcomes and Mediators, JOURNAL OF TRAUMATIC STRESS, Vol: 31, Pages: 899-908, ISSN: 0894-9867
Ogundipe E, Tusor N, Wang Y, et al., 2018, Randomized controlled trial of brain specific fatty acid supplementation in pregnant women increases brain volumes on MRI scans of their newborn infants, PROSTAGLANDINS LEUKOTRIENES AND ESSENTIAL FATTY ACIDS, Vol: 138, Pages: 6-13, ISSN: 0952-3278
Barnicot K, Crawford M, 2018, Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder, Psychological Medicine, Pages: 1-9, ISSN: 0033-2917
BACKGROUND: Dialectical behaviour therapy (DBT) and mentalisation-based therapy (MBT) are both widely used evidence-based treatments for borderline personality disorder (BPD), yet a head-to-head comparison of outcomes has never been conducted. The present study therefore aimed to compare the clinical outcomes of DBT v. MBT in patients with BPD. METHODS: A non-randomised comparison of clinical outcomes in N = 90 patients with BPD receiving either DBT or MBT over a 12-month period. RESULTS: After adjusting for potentially confounding differences between participants, participants receiving DBT reported a significantly steeper decline over time in incidents of self-harm (adjusted IRR = 0.93, 95% CI 0.87-0.99, p = 0.02) and in emotional dysregulation (adjusted β = -1.94, 95% CI -3.37 to -0.51, p < 0.01) than participants receiving MBT. Differences in treatment dropout and use of crisis services were no longer significant after adjusting for confounding, and there were no significant differences in BPD symptoms or interpersonal problems. CONCLUSIONS: Within this sample of people using specialist personality disorder treatment services, reductions in self-harm and improvements in emotional regulation at 12 months were greater amongst those receiving DBT than amongst those receiving MBT. Experimental studies assessing outcomes beyond 12 months are needed to examine whether these findings represent differences in the clinical effectiveness of these therapies.
Crawford MJ, Thana L, Parker J, et al., 2018, Psychological Support for Personality (PSP) versus treatment as usual: study protocol for a feasibility randomized controlled trial of a low intensity intervention for people with personality disorder, TRIALS, Vol: 19, ISSN: 1745-6215
House A, Guthrie E, Walker A, et al., 2018, A programme theory for liaison mental health services in England, BMC HEALTH SERVICES RESEARCH, Vol: 18, ISSN: 1472-6963
Crawford MJ, Sanatinia R, Barrett B, et al., 2018, The Clinical Effectiveness and Cost-Effectiveness of Lamotrigine in Borderline Personality Disorder: A Randomized Placebo-Controlled Trial, AMERICAN JOURNAL OF PSYCHIATRY, Vol: 175, Pages: 756-764, ISSN: 0002-953X
Walker A, Barrett JR, Lee W, et al., 2018, Organisation and delivery of liaison psychiatry services in general hospitals in England: results of a national survey, BMJ OPEN, Vol: 8, ISSN: 2044-6055
Deb S, Leeson V, Aimola L, et al., 2018, Aggression Following Traumatic brain injury: Effectiveness of Risperidone (AFTER): study protocol for a feasibility randomised controlled trial, TRIALS, Vol: 19, ISSN: 1745-6215
Das-Munshi J, Bhugra D, Crawford MJ, 2018, Ethnic minority inequalities in access to treatments for schizophrenia and schizoaffective disorders: findings from a nationally representative cross-sectional study, BMC MEDICINE, Vol: 16, ISSN: 1741-7015
Crawford MJ, Sanatinia R, Barrett B, et al., 2018, Lamotrigine for people with borderline personality disorder: a RCT, HEALTH TECHNOLOGY ASSESSMENT, Vol: 22, Pages: 1-+, ISSN: 1366-5278
Hassiotis A, Poppe M, Strydom A, et al., 2018, Positive behaviour support training for staff for treating challenging behaviour in people with intellectual disabilities: a cluster RCT., Health Technology Assessment, Vol: 22, Pages: 1-110, ISSN: 1366-5278
BACKGROUND: Preliminary studies have indicated that training staff in Positive Behaviour Support (PBS) may help to reduce challenging behaviour among people with intellectual disability (ID). OBJECTIVE: To evaluate whether or not such training is clinically effective in reducing challenging behaviour in routine care. The study also included longer-term follow-up (approximately 36 months). DESIGN: A multicentre, single-blind, two-arm, parallel-cluster randomised controlled trial. The unit of randomisation was the community ID service using an independent web-based randomisation system and random permuted blocks on a 1 : 1 allocation stratified by a staff-to-patient ratio for each cluster. SETTING: Community ID services in England. PARTICIPANTS: Adults (aged > 18 years) across the range of ID with challenging behaviour [≥ 15 Aberrant Behaviour Checklist - Community total score (ABC-CT)]. INTERVENTIONS: Manual-assisted face-to-face PBS training to therapists and treatment as usual (TAU) compared with TAU only in the control arm. MAIN OUTCOME MEASURES: Carer-reported changes in challenging behaviour as measured by the ABC-CTover 12 months. Secondary outcomes included psychopathology, community participation, family and paid carer burden, family carer psychopathology, costs of care and quality-adjusted life-years (QALYs). Data on main outcome, service use and health-related quality of life were collected for the 36-month follow-up. RESULTS: A total of 246 participants were recruited from 23 teams, of whom 109 were in the intervention arm (11 teams) and 137 were in the control arm (12 teams). The difference in ABC-CTbetween the intervention and control arms [mean difference -2.14, 95% confidence interval (CI) -8.79 to 4.51;p = 0.528] was not statistically significant. No treatment effects were found for any of the secondary outcomes. The mean cost per participant in the intervention arm was £1201. Over 12 months, there
Hassiotis A, Poppe M, Strydom A, et al., 2018, Clinical outcomes of staff training in positive behaviour support to reduce challenging behaviour in adults with intellectual disability: cluster randomised controlled trial, BRITISH JOURNAL OF PSYCHIATRY, Vol: 212, Pages: 161-168, ISSN: 0007-1250
Olajide K, Munjiza J, Moran P, et al., 2018, DEVELOPMENT AND PSYCHOMETRIC PROPERTIES OF THE STANDARDIZED ASSESSMENT OF SEVERITY OF PERSONALITY DISORDER (SASPD), JOURNAL OF PERSONALITY DISORDERS, Vol: 32, Pages: 44-56, ISSN: 0885-579X
Muñoz M, Ausín B, Santos-Olmo AB, et al., 2018, Alcohol use, abuse and dependence in an older European population: Results from the MentDis_ICF65+ study., PLoS One, Vol: 13
BACKGROUND: Alcohol use disorders (AUD) in older people have been the subject of increasing interest in Europe and worldwide. However, thus far, no reliable data exist regarding the prevalence of AUD in people over the age of 65 years in Europe. OBJECTIVE: To assess the current (past month), 12-month and lifetime prevalence of alcohol use, abuse and dependence in people aged 65-84 years. STUDY DESIGN: The MentDis_ICF65+ study was a representative stepwise cross-sectional survey that was conducted in six European and associated cities (Hamburg, Germany; Ferrara, Italy; London/Canterbury, England; Madrid, Spain; Geneva, Switzerland and Jerusalem, Israel). METHOD: In total, 3,142 community-dwelling people aged between 65 and 84 years who lived in participating cities were assessed with an age-sensitive diagnostic interview (CIDI65+). RESULTS: The prevalence of lifetime alcohol use was 81% for the overall sample. The observed AUD (DSM-IV-TR) prevalence was as follows: current, 1.1%; 12-month, 5.3% and lifetime, 8.8%. Alcohol consumption and AUD were more prevalent in males, and a significant interaction between gender and city was observed; greater gender differences in the prevalence of these disorders were observed in Hamburg, London/Canterbury and Geneva in comparison to the other cities. The prevalence of lifetime alcohol consumption and 12-month AUD tended to be lower in older persons. CONCLUSION: The results highlight the appropriateness of using age-adjusted diagnostic tools (CIDI65+) to identify alcohol use and AUD in older people. Different alcohol use patterns were observed in males and females. The results seem to indicate the presence of different alcohol use patterns between northern and southern European countries. Specialized services are proposed, including brief and/or more intensive interventions framed intensive and more simple interventions framed in stepped care strategies, to improve the social and health resources available for older people across
Day C, Briskman J, Crawford MJ, et al., 2017, Feasibility trial of a psychoeducational intervention for parents with personality difficulties: The Helping Families Programme, CONTEMPORARY CLINICAL TRIALS COMMUNICATIONS, Vol: 8, Pages: 67-74
McMurran M, Day F, Reilly J, et al., 2017, Psychoeducation and Problem Solving (PEPS) Therapy for Adults With Personality Disorder: A Pragmatic Randomized-Controlled Trial., J Pers Disord, Vol: 31, Pages: 810-826
We compared psychoeducation and problem solving (PEPS) therapy against usual treatment in a multisite randomized-controlled trial. The primary outcome was social functioning. We aimed to recruit 444 community-dwelling adults with personality disorder; however, safety concerns led to an early cessation of recruitment. A total of 154 people were randomized to PEPS and 152 to usual treatment. Follow-up at 72 weeks was completed for 68%. PEPS therapy was no more effective than usual treatment for improving social functioning (adjusted difference in mean Social Functioning Questionnaire scores = -0.73; 95% CI [-1.83, 0.38]; p = 0.19). PEPS therapy is not an effective treatment for improving social functioning of adults with personality disorder living in the community.
Volkert J, Härter M, Dehoust MC, et al., 2017, Study approach and field work procedures of the MentDis_ICF65+ project on the prevalence of mental disorders in the older adult European population., BMC Psychiatry, Vol: 17
BACKGROUND: This study describes the study approach and field procedures of the MentDis_ICF65+ study, which aims to assess the prevalence of mental disorders in older adults. METHODS: An age-appropriate version of the Composite International Diagnostic Interview (CIDI65+) was developed and tested with regard to its feasibility and psychometric properties in a pre-test and pilot phase. In the cross-sectional survey an age-stratified, random sample of older adults (65-84 years) living in selected catchment areas of five European countries and Israel was recruited. RESULTS: N = 3142 participants (mean age 73.7 years, 50.7% female) took part in face-to-face interviews. The mean response rate was 20% and varied significantly between centres, age and gender groups. Sociodemographic differences between the study centres appeared for the place of birth, number of grandchildren, close significants, retirement and self-rated financial situation. The comparison of the MentDis_ICF65+ sample with the catchment area and country population of the study centres revealed significant differences, although most of these were numerically small. CONCLUSIONS: The study will generate new information on the prevalence of common mental disorders among older adults across Europe using an age-appropriate, standardized diagnostic instrument and a harmonized approach to sampling. Generalizability of the findings and a potentially limited representativeness are discussed.
Crawford MJ, Gold C, Odell-Miller H, et al., 2017, International multicentre randomised controlled trial of improvisational music therapy for children with autism spectrum disorder: TIME-A study, HEALTH TECHNOLOGY ASSESSMENT, Vol: 21, Pages: 1-+, ISSN: 1366-5278
D'Lima D, Crawford MJ, Darzi A, et al., 2017, Patient safety and quality of care in mental health: a world of its own?, BJPSYCH BULLETIN, Vol: 41, Pages: 241-243, ISSN: 2056-4694
Canuto A, Weber K, Baertschi M, et al., 2017, Anxiety Disorders in old age: Psychiatric comorbidities, quality of life, and prevalence according to age, gender, and country, American Journal of Geriatric Psychiatry, Vol: 26, Pages: 174-185, ISSN: 1064-7481
Objectives: Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. Design: The study used a cross-sectional multicenter survey. Participants: The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Measurements: Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). Results: The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75–84 years compared with those aged 65–74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. Conclusions: The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies.
Tyrer P, Salkovskis P, Tyrer H, et al., 2017, Cognitive-behaviour therapy for health anxiety in medical patients (CHAMP): a randomised controlled trial with outcomes to 5 years, HEALTH TECHNOLOGY ASSESSMENT, Vol: 21, Pages: 1-+, ISSN: 1366-5278
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