Publications
308 results found
Tyrer P, Cooper S, Tyrer H, et al., 2011, CHAMP: Cognitive behaviour therapy for health anxiety in medical patients, a randomised controlled trial, BMC Psychiatry, Vol: 11, ISSN: 1471-244X
BackgroundAbnormal health anxiety, also called hypochondriasis, has been successfully treated by cognitive behaviour therapy (CBT) in patients recruited from primary care, but only one pilot trial has been carried out among those attending secondary medical clinics where health anxiety is likely to be more common and have a greater impact on services. The CHAMP study extends this work to examine both the clinical and cost effectiveness of CBT in this population.Method/DesignThe study is a randomized controlled trial with two parallel arms and equal randomization of 466 eligible patients (assuming a 20% drop-out) to an active treatment group of 5-10 sessions of cognitive behaviour therapy and to a control group. The aim at baseline, after completion of all assessments but before randomization, was to give a standard simple explanation of the nature of health anxiety for all participants. Subsequently the control group was to receive whatever care might usually be available in the clinics, which is normally a combination of clinical assessment, appropriate tests and reassurance. Those allocated to the active treatment group were planned to receive between 5 and 10 sessions of an adapted form of cognitive behaviour therapy based on the Salkovskis/Warwick model, in which a set of treatment strategies are chosen aimed at helping patients understand the factors that drive and maintain health anxiety. The therapy was planned to be given by graduate research workers, nurses or other health professionals trained for this intervention whom would also have their competence assessed independently during the course of treatment. The primary outcome is reduction in health anxiety symptoms after one year and the main secondary outcome is the cost of care after two years.DiscussionThis represents the first trial of adapted cognitive behaviour therapy in health anxiety that is large enough to test not only the clinical benefits of treatment but also whether the cost of treatment is
Mulder RT, Newton-Howes G, Crawford MJ, et al., 2011, THE CENTRAL DOMAINS OF PERSONALITY PATHOLOGY IN PSYCHIATRIC PATIENTS, JOURNAL OF PERSONALITY DISORDERS, Vol: 25, Pages: 364-377, ISSN: 0885-579X
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- Citations: 47
Crawford MJ, Koldobsky N, Mulder R, et al., 2011, CLASSIFYING PERSONALITY DISORDER ACCORDING TO SEVERITY, JOURNAL OF PERSONALITY DISORDERS, Vol: 25, Pages: 321-330, ISSN: 0885-579X
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- Citations: 99
Crawford MJ, Thana L, Methuen C, et al., 2011, Impact of screening for risk of suicide: randomised controlled trial, BRITISH JOURNAL OF PSYCHIATRY, Vol: 198, Pages: 379-384, ISSN: 0007-1250
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- Citations: 53
Tyrer P, Crawford M, Mulder R, 2011, Reclassifying personality disorders, LANCET, Vol: 377, Pages: 1814-1815, ISSN: 0140-6736
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- Citations: 94
Tyrer P, Milošeska K, Whittington C, et al., 2011, Nidotherapy in the treatment of substance misuse, psychosis and personality disorder: Secondary analysis of a controlled trial, Psychiatrist, Vol: 35, Pages: 9-14, ISSN: 1758-3209
Aims and method: To examine the clinical outcome and bed usage in patients with comorbid substance misuse and psychosis. The patients were randomised to ordinary assertive outreach team care or to enhanced assertive outreach with nidotherapy. Ratings of clinical symptoms, social function, engagement with services, bed usage (primary outcome after 1 year) and economic costs were assessed at baseline and at 6 and 12 months after randomisation. Results: Patients referred to nidotherapy had similar reduction in symptoms and engagement, with marginal superiority in social function (P = 0.045). There was a 110% reduction in hospital bed use after 1 year compared with control assertive care (P = 0.03). The mean cost savings for each patient allocated to nidotherapy was £14 705 per year, mainly as a consequence of reduced psychiatric bed use. Clinical implications: Nidotherapy shows promise in the treatment of substance misuse and psychosis and may reduce hospital bed usage.
Fortune Z, Barrett B, Armstrong D, et al., 2011, Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders, INTERNATIONAL REVIEW OF PSYCHIATRY, Vol: 23, Pages: 61-69, ISSN: 0954-0261
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- Citations: 9
Gold C, Erkkila J, Bonde LO, et al., 2011, Music Therapy or Music Medicine?, PSYCHOTHERAPY AND PSYCHOSOMATICS, Vol: 80, Pages: 304-304, ISSN: 0033-3190
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- Citations: 32
Crawford MJ, Dunlea E, 2010, Providing patients with information about treatment choices: do unto others?, BRITISH JOURNAL OF PSYCHIATRY, Vol: 197, Pages: 429-430, ISSN: 0007-1250
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- Citations: 2
Patterson S, Kramo K, Soteriou T, et al., 2010, The great divide: A qualitative investigation of factors influencing researcher access to potential randomised controlled trial participants in mental health settings, JOURNAL OF MENTAL HEALTH, Vol: 19, Pages: 532-541, ISSN: 0963-8237
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- Citations: 39
Crawford MJ, Csipke E, Brown A, et al., 2010, The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial, PSYCHOLOGICAL MEDICINE, Vol: 40, Pages: 1821-1828, ISSN: 0033-2917
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- Citations: 23
Crawford MJ, Killaspy H, Kalaitzaki E, et al., 2010, The MATISSE study: a randomised trial of group art therapy for people with schizophrenia, BMC PSYCHIATRY, Vol: 10
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- Citations: 20
Crawford MJ, Kuforiji B, Ghosh P, 2010, The impact of social context on socio-demographic risk factors for suicide: a synthesis of data from case-control studies, JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, Vol: 64, Pages: 530-534, ISSN: 0143-005X
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- Citations: 17
Miller S, Crawford MJ, 2010, Open access community support groups for people with personality disorder: Attendance and impact on use of other services, Psychiatrist, Vol: 34, Pages: 177-181, ISSN: 1758-3209
Aims and method: To describe a new open access community service for people with personality disorder and to explore interim service utilisation and outcomes. Routine data were analysed together with those from a cross-sectional survey. Results: During the first 16 months of the service, 171 people attended, of whom 142 (83.0%) returned on at least one other occasion. The median number of attendances was seven (IQR = 3.0-22.0). Over 90% of responders to the survey met criteria for 'probable personality disorder' and levels of social dysfunction were high. Presentations to emergency services, contacts with other services and in-patient admissions were reduced. Social functioning improved. Clinical implications: This service attracted a large number of people with significant health and social problems. Use of the service was associated with improved social functioning and reduced use of other services.
Tyrer P, Duggan C, Cooper S, et al., 2010, The successes and failures of the DSPD experiment: the assessment and management of severe personality disorder, MEDICINE SCIENCE AND THE LAW, Vol: 50, Pages: 95-99, ISSN: 0025-8024
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- Citations: 44
Bajaj P, Crawford M, 2010, Personality Disorder, Principles of Social Psychiatry: Second Edition, Pages: 249-257, ISBN: 9780470697139
Crawford MJ, Adedeji T, Price K, et al., 2010, JOB SATISFACTION AND BURNOUT AMONG STAFF WORKING IN COMMUNITY-BASED PERSONALITY DISORDER SERVICES, INTERNATIONAL JOURNAL OF SOCIAL PSYCHIATRY, Vol: 56, Pages: 196-206, ISSN: 0020-7640
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- Citations: 27
Fortune Z, Rose D, Crawford M, et al., 2010, AN EVALUATION OF NEW SERVICES FOR PERSONALITY-DISORDERED OFFENDERS: STAFF AND SERVICE USER PERSPECTIVES, INTERNATIONAL JOURNAL OF SOCIAL PSYCHIATRY, Vol: 56, Pages: 186-195, ISSN: 0020-7640
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- Citations: 12
Tyrer P, Mulder R, Crawford M, et al., 2010, Personality disorder: a new global perspective, WORLD PSYCHIATRY, Vol: 9, Pages: 56-60, ISSN: 1723-8617
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- Citations: 70
Price K, Gillespie S, Rutter D, et al., 2009, Dedicated personality disorder services: A qualitative analysis of service structure and treatment process, JOURNAL OF MENTAL HEALTH, Vol: 18, Pages: 467-475, ISSN: 0963-8237
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- Citations: 12
Crawford MJ, Sharpe D, Rutter D, et al., 2009, Prevention of suicidal behaviour among army personnel: a qualitative study., J R Army Med Corps, Vol: 155, Pages: 203-207, ISSN: 0035-8665
OBJECTIVES: To examine the context of suicidal behaviour among soldiers in the United Kingdom and identify factors that could reduce the risk of such behaviour. METHOD: A series of in-depth interviews with service providers involved in treating soldiers following deliberate self harm. Their responses were compared with those of a small sub-sample of soldiers who presented to Army medical services following self harm. RESULTS: We interviewed 21 service providers with a range of experience and professional backgrounds and 10 soldiers. Service providers told us that the rarity of suicide among soldiers together with lower levels of mental illness amongst those who end their lives made suicide prevention in the Army a difficult task. However they highlighted concerns about recruitment and retention of young soldiers, and stated that stigmatisation of mental illness in the Army sometimes prevented those with suicidal ideation seeking help. They also highlighted the role of alcohol use in precipitating self-harm. Soldiers who had self-harmed told us that they struggled to balance the demands of work and family life and described harming themselves impulsively often while intoxicated with alcohol. Soldiers look to sources of support outside the Army, and see commanding officers, rather than healthcare professionals, as helping resolve their problems. Neither service providers nor soldiers mentioned helplines and other 'independent' sources of confidential advice and support which are available to soldiers serving with the British Army. CONCLUSION: Our findings highlight problems associated with efforts to reduce suicide among soldiers but suggest that these should focus continuing to try to reduce stigmatisation of mental distress and specifically on the role of commanding officers. Greater efforts should also be made to publicise existing sources of help and reduce levels of alcohol misuse.
Crawford MJ, Sahib L, Bratton H, et al., 2009, Service provision for men with antisocial personality disorder who make contact with mental health services, PERSONALITY AND MENTAL HEALTH, Vol: 3, Pages: 165-171, ISSN: 1932-8621
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- Citations: 11
Coulton S, Perryman K, Bland M, et al., 2009, Screening and brief interventions for hazardous alcohol use in accident and emergency departments: a randomised controlled trial protocol, BMC HEALTH SERVICES RESEARCH, Vol: 9
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- Citations: 35
Romeo R, Knapp M, Tyrer P, et al., 2009, The treatment of challenging behaviour in intellectual disabilities: cost-effectiveness analysis, JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Vol: 53, Pages: 633-643, ISSN: 0964-2633
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- Citations: 28
Tyrer P, Oliver-Africano P, Romeo R, et al., 2009, Neuroleptics in the treatment of aggressive challenging behaviour for people with intellectual disabilities: a randomised controlled trial (NACHBID), HEALTH TECHNOLOGY ASSESSMENT, Vol: 13, Pages: 1-+, ISSN: 1366-5278
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- Citations: 27
Crawford MJ, Price K, Gordon F, et al., 2009, Engagement and retention in specialist services for people with personality disorder, ACTA PSYCHIATRICA SCANDINAVICA, Vol: 119, Pages: 304-311, ISSN: 0001-690X
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- Citations: 43
Davidson KM, Tyrer P, Tata P, et al., 2009, Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial, PSYCHOLOGICAL MEDICINE, Vol: 39, Pages: 569-577, ISSN: 0033-2917
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- Citations: 59
Patterson S, Weaver T, Agath K, et al., 2009, 'They can't solve the problem without us': a qualitative study of stakeholder perspectives on user involvement in drug treatment services in England, HEALTH & SOCIAL CARE IN THE COMMUNITY, Vol: 17, Pages: 54-62, ISSN: 0966-0410
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- Citations: 17
Tyrer P, Cooper S, Rutter D, et al., 2009, The assessment of dangerous and severe personality disorder: lessons from a randomised controlled trial linked to qualitative analysis, JOURNAL OF FORENSIC PSYCHIATRY & PSYCHOLOGY, Vol: 20, Pages: 132-146, ISSN: 1478-9949
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- Citations: 25
Patterson S, Weaver T, Agath K, et al., 2009, User involvement in efforts to improve the quality of drug misuse services in England: A national survey, DRUGS-EDUCATION PREVENTION AND POLICY, Vol: 16, Pages: 364-377, ISSN: 0968-7637
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- Citations: 17
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