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A utilitarian perspective of social and medical contributions to three illustrative conditions, and recent UK NHS policy initiatives
- Authors:
- MIDDLETON Hugh, SHAW Ian
- Journal article citation:
- Journal of Mental Health, 16(3), June 2007, pp.291-305.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
To date debate concerning the relative merits of social and medical sciences has been largely academic. This study aimed to outline and critically appraise a utilitarian approach to mental health research that reflects a critical realist perspective. Consideration of the relative utility of differing approaches to illustrative "psychiatric" disorders, and recent policy initiatives were the methods used in the study. Socially relevant outcomes of Bipolar Affective Disorder are determined by influences that operate independently of the characteristic instability of mood. There is now a highly specific and effective psychological treatment for Panic Disorder. Its benefits are still not fully exploited because of continuing lay and professional focus upon the condition's social manifestations. Great numbers of people presenting in primary care are unhelpfully caused to adopt the role of "patient" due to practices limiting the professional response to a medical one. Such practices reflect public and professional perceptions of the nature of "mental health difficulties" much more than they do the achievements of medicine. Recent policy-supporting initiatives influencing UK NHS mental health services are much more likely to be supported by social sciences than by medical research. It is concluded that there is considerable scope for a contribution to applied mental health research from frameworks and methodologies that are rooted in a social sciences perspective.
Unrecognised bipolar disorder in primary care patients with depression
- Authors:
- SMITH Daniel J., et al
- Journal article citation:
- British Journal of Psychiatry, 199(1), July 2011, pp.49-56.
- Publisher:
- Cambridge University Press
Bipolar disorder is complex, can be difficult to diagnose, and is often misdiagnosed as recurrent major depressive disorder. This study aimed to estimate the proportion of primary care patients with a working diagnosis of unipolar depression who satisfy criteria for bipolar disorder, to test 2 screening instruments for bipolar disorder, and to assess individuals with major depressive disorder who screen false positive for bipolar disorder. The study used a sample of 576 volunteer participants from general practices in 3 local health boards in South Wales. All participants completed questionnaires and 154 took part in a comprehensive diagnostic and clinical assessment. The main findings from the study were that unrecognised bipolar disorder may be relatively common in primary care patients with a working diagnosis of unipolar depression (unrecognised bipolar disorder could be diagnosed in at least 3.3% and at most 21.6% of the sample of primary care patients with unipolar depression), and that the positive predictive values for the screening questionnaires used were quite low (50% to 32.1%). The authors discuss the findings and their implications.
Clinical handbook of co-existing mental health and drug and alcohol problems
- Editors:
- BAKER Amanda, VELLEMAN Richard, (eds.)
- Publisher:
- Routledge
- Publication year:
- 2007
- Pagination:
- 402p.
- Place of publication:
- London
Co-existing mental health and drug and alcohol problems occur frequently in primary care and clinical settings. Despite this, health professionals rarely receive training in how to detect, assess and formulate interventions for co-existing problems and few clinical guidelines exist. Leading clinicians from the UK, the US and Australia provide practical descriptions of assessments and interventions for co-existing problems. These will enable professionals working with co-existing problems to understand best practice and ensure that people with co-existing problems receive optimal treatment. A range of overarching approaches are covered, including: working within a cognitive behavioural framework; provision of consultation-liaison services, training and supervision; individual, group and family interventions; and working with rurally isolated populations. The contributors also provide detailed descriptions of assessments and treatments for a range of disorders when accompanied by drug and alcohol problems, including anxiety, depression, schizophrenia, bipolar disorder and learning difficulties.
MIDAS: a new service for the mentally ill with comorbid drug and alcohol misuse
- Authors:
- BAYNEY R., ST. JOHN-SMITH P., CONHYE A.
- Journal article citation:
- Psychiatric Bulletin, 26(7), July 2002, pp.251-254.
- Publisher:
- Royal College of Psychiatrists
Describe the work and patient characteristics of one of the first combined mental illness and drug and alcohol services (MIDAS) in the UK. Examines MIDAS as an assertive community service, for individuals receiving long-term community care. Results found patients with bipolar affective disorder and personality disorders were more likely to use the service than patients with unipolar disorder or schizophrenia. Despite the use of an assertive service, there was difficulty engaging patients with schizophrenia and comorbid drug use.