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Patient preference randomised controlled trials in mental health research
- Authors:
- HOWARD Louise, THORNICROFT Graham
- Journal article citation:
- British Journal of Psychiatry, 188(4), April 2006, pp.303-304.
- Publisher:
- Cambridge University Press
The relationship between psychiatric patients’ preferences for different treatments and the outcome of interventions is unclear, as the few relevant trials have tended to be underpowered. Strong patient preferences result in patients refusing to enter a trial. This leads to bias and limits generalisability, and the patient preference randomised controlled trial (RCT) design has been proposed as an alternative. Limitations and advantages of patient preference RCTs are discussed.
Screening for smoking and substance misuse in pregnant women with mental illness
- Authors:
- SHAH Nisha, HOWARD Louise
- Journal article citation:
- Psychiatric Bulletin, 30(8), August 2006, pp.294-297.
- Publisher:
- Royal College of Psychiatrists
Smoking and substance misuse adversely affect the outcome of pregnancy and psychiatric patients are known to smoke more than other patients. Data collected at the time of routine antenatal booking were analysed to investigate whether pregnant women with mental health problems smoke more than other pregnant women. Data were collected from 156 women. Those with a psychiatric diagnosis (n=76) were significantly more likely to smoke (P50.001). Associations were also found with illicit drug use and previous termination of pregnancy. The most common psychiatric diagnosis was depression (62%). A diagnosis of schizophrenia was not recorded for any of the women. The strong association between smoking and psychiatric diagnosis results in an increased risk of obstetric complications in psychiatric patients. Anti-smoking interventions might be delivered by adequately trained midwives and opportunistically during contact with mental health professionals.