A ‘dual diagnosis’ community psychiatric nurse service in Lanarkshire: service innovation, Psychiatric Bulletin  2008, 32: 139-142

Abstract:  We established two ‘dual diagnosis’ community psychiatric nurse posts within community mental health teams in Lanarkshire to improve the service care for individuals with comorbidity. A questionnaire-based evaluation of the service over a 2-year period was conducted.

Comorbidity was under-reported by community mental health teams and under-referred to specialist addiction services. The presence of new specialist nurses enhanced the detection of comorbidity, improved staff perceptions of working with patients that misuse substances, and was associated with a clinical and functional improvement in patients over 2 years.

Our findings support the recent trend to provide integrated care for comorbid service users within main-stream mental health services, and suggest a model of service delivery that might be more widely developed to address the concern that such users ‘fall through the gaps’ between services.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Executive dysfunction and its association with personality and behaviour changes in the development of Alzheimer’s disease in adults with Down syndrome and mild to moderate learning disabilities , British Journal of Clinical Psychology, Volume 47, Number 1, March 2008 , pp. 1-29(29)

Abstract:  Background: Recent research suggests that preclinical Alzheimer’s disease (AD) in people with Down syndrome (DS) is characterized by changes in personality/behaviour and executive dysfunction that are more prominent than deterioration in episodic memory. This study examines the relationship between executive dysfunction and the clinical and preclinical features of AD in DS. To determine the specificity of this relationship, performance on executive function (EF) measures is contrasted with performance on memory measures. 

Methods: One hundred and three people with DS (mean age 49 years, range 36-72) with mild to moderate learning disabilities (LD) took part. Dementia diagnosis was based on the CAMDEX informant interview conducted with each participant’s main carer. Reported changes in personality/behaviour and memory were recorded. Participants completed six EF and six memory measures (two of which also had a strong executive component) and the BPVS (as a measure of general intellectual ability). First, performance was compared between those with and without established dementia of Alzheimer’s type (DAT), controlling for age and LD severity using ANCOVA. Next, the degree to which informant-reported changes predicted cognitive test performance was examined within the non-DAT group using multiple regression analyses.

Results: The DAT group (N=25) showed a consistent pattern of impaired performance relative to the non-DAT group (N=78), across all measures. Within the non-DAT group, number of informant-reported personality/behaviour changes was a significant predictor of performance on two EF and two `executive memory’ tests (but not on episodic memory tests). Informant-reported memory changes, however, were associated with impaired performance on a delayed recall task only.

Conclusions: These findings provide further evidence for a specific impairment in frontal-lobe functioning in the preclinical stages of AD in DS. Implications for the assessment, diagnosis, and management of dementia in DS are discussed.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

  Developing the general principles of psychological skills in mental health nursing, Jim Gibson, Graham Sloan. Nursing Older People. Ely: Feb 2008. Vol. 20, Iss. 1; p. 31 (5 pages)

Abstract:  The world’s older population is expected to show a three-fold increase in the next 50 years. In 2000, older people in the UK accounted for nearly one-sixth of the population. As people live longer, pressure on services to deliver interventions that meet the psychological as well as the physical needs of older people will increase (Laidlaw 2004). In the past 20 years, cognitive behavioural therapy has become an increasingly popular approach to a wide range of mental health problems (Hollon 199 and evidence of its efficacy has grown remarkably (Sourial 1997; Hollon et al 1993; Laidlaw 2004). This article shows that older people can and do benefit from CBT provided by clinical nurse specialists. It also argues that providing opportunities for mental health staff to increase their understanding of CBT is another important function of the specialist nurse’s role.

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Public Perception of Privacy & Dignity in Hospitals , 2007, Department of Health

For the full-text of this report click on the title above

Abstract: Is research, conducted by Ipsos MORI, involved 2,000 interviews with members of the public across the country. It was designed to explore perceptions towards privacy and dignity in hospitals, with particular emphasis on the importance of single-sex accommodation. Key findings are that cleanliness and staff attitudes are the most important factors for patients to feel they are treated with privacy and dignity in hospital.

Thanks to Kieran over at Fade for this link, cheers

  Clients’ experience of case formulation in cognitive behaviour therapy for psychosis , British Journal of Clinical Psychology, Volume 47, Number 2, June 2008 , pp. 127-138(12)

Abstract: Objectives Case formulation (CF) is considered essential to the practice of cognitive behaviour therapy, and crucial when working with more complex problems such as psychosis. Several claims are made for the beneficial impact of CF on clients, although little empirical research has been conducted.

Fo

r the full-text of the above article please email: susan.jennings@lancashirecare.nhs.uk

Government response to the Joint Committee on Human Rights: a life like any other? human rights of adults with learning disabilities, 7th May 2008, Department of Health

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Abstract: 

The Government introduced the Human Rights Act to make rights drawn from the European Convention on Human Rights enforceable in our domestic Courts. The Government recognises that it is often the most vulnerable in our society, such as people with learning disabilities, who have the greatest need for protection and promotion of their rights under the Human Rights Act and Disablity Discrimination legislation.

The Joint Committee on Human Rights (the Committee) published its report ‘A life like any other? human rights of adults with learning disabilities’ on 6 March 2008. This memorandum sets out the Government response to the conclusions and recommendations in that report.

Improving services for substance misuse: commissioning drug treatment and harm reduction services, May 2008, The Healthcare Commission

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The Healthcare Commission and the National Treatment Agency have published a report which shows results from the second of three annual reviews to assess the performance of substance misuse treatment services. Focusing specifically on how services are commissioned and harm reduction service provision, the findings reveal the majority of services are performing well within acceptable levels across these categories. However, there were significant deficits, particularly in the provision of vaccination for hepatitis B and testing and treatment for hepatitis C. As 90% of all hepatitis C diagnoses are associated with injecting drug use, this is a key area of concern. The review covered 149 ‘local drug partnerships’ in England.

Attitudes to Mental Illness 2008 Research Report, 8th May 2008, TNS UK for the Care Services Improvement Partnership, Department of Health

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Abstract: 

The latest national statistics on Attitudes to  Mental Illness produced by the Department of Health were released on 8 May 2008 according to the arrangements approved by the UK Statistics Authority.

Since March 1993, the Department of Health has placed a set of  questions on TNS’s Face-to-Face Consumer Omnibus about public  attitudes towards mental illness. From 1993 to 1997 the questions were  asked on an annual basis and then every third year up until 2003.  

Since 2007 the survey has again been carried out annually. The surveys  serve as a benchmark, enabling measurement of whether attitudes are improving or worsening over time.

Key points from the report:

• The general public are broadly sympathetic to people with mental health problems and community care.
• However, some attitudes towards people with mental health problems are worse compared to when the Department of Health first commissioned the poll in 1994, including two relating to fears of patients.
• On the other hand, several attitudes that had worsened over the period up until 1997 have since improved.
• Only two attitudes have changed significantly since last year, both an improvement – more think people with mental illness have been subject to ridicule for too long and less think it is easy to tell them from ‘normal people’.

Time use among individuals with persistent mental illness: Identifying risk factors for imbalance in daily activities, Scandinavian Journal of Occupational Therapy, Volume 15, Issue 1 2008 , pages 23 - 33

Abstract:

For the full-text of this article please email: susan.jennings@lancashirecare.nhs.uk

Social Cognition in Schizophrenia: An Overview, Schizophrenia Bulletin 2008 34(3):408-411

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Abstract:  The purpose of this column is to provide an overview of social cognition in schizophrenia. The column begins with a short introduction to social cognition. Then, we describe the application of social cognition to the study of schizophrenia, with an emphasis on key domains (i.e., emotion perception, Theory of Mind, and attributional style). We conclude the column by discussing the relationship of social cognition to neurocognition, negative symptoms, and functioning, with an eye toward strategies for improving social cognition in schizophrenia.