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May 2017 - Page 4 of 5 - Psychosis Research Unit
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May 2017

Health inequalities and psychosis: time for action.

Shiers D1, Bradshaw T2, Campion J2. Full Article Abstract People with psychosis face a life-restricting and life-shortening epidemic of obesity, diabetes and cardiovascular disease. This can be predicted by the associated antecedent risk factors evident from early in psychosis, yet remain largely ignored. Greater coordination between primary care, secondary care and public health to systematically prevent and intervene earlier for these physical illnesses offers a realistic solution to reduce this health inequality....


Understanding the needs of carers of people with psychosis in primary care

Juliana Onwumere, David Shiers and Carolyn Chew-Graham Full Article INTRODUCTION A couple you have known for years consult with you; they are in despair. Their son’s new psychiatric team has just advised them that, as he is now an adult, he will be able to make his own decisions without his parents attending routine appointments. They have watched their son’s prospects for a normal life disintegrate over the last 2 years — rarely leaving his room, losing his friends, and spending most days without structure or purpose. Many individuals diagnosed with psychotic conditions live with, or remain in close contact with, informal caregivers, typically close relatives such as their parents, partners, siblings, and children. As in the scenario above, the experience of a family member developing psychosis leaves...


Loss of relational continuity of care in schizophrenia: associations with patient satisfaction and quality of care

Rahil Sanatinia, Violet Cowan, Kirsten Barnicot, Krysia Zalewska, David Shiers, Stephen J. Cooper, and Mike J. Crawford Full Article Abstract Background Users of mental health service are concerned about changes in clinicians providing their care, but little is known about their impact. Aims To examine associations between changes in staff, and patient satisfaction and quality of care. Method A national cross-sectional survey of 3379 people aged 18 or over treated in secondary care for schizophrenia or schizoaffective disorder. Results Nearly 41.9% reported at least one change in their key worker during the previous 12 months and 10.5% reported multiple changes. Those reporting multiple changes were less satisfied with their treatment and less likely to report having a care plan, knowing how to obtain help when in a crisis or to have...


Adherence to NICE guidance on lifestyle advice for people with schizophrenia: a survey

Lizzie Swaby, Daniel Hind, Rebecca Gossage-Worrall, David Shiers, Jonathan Mitchell, Richard I. G. Holt Full Article Abstract Aims and method The STEPWISE trial (STructured lifestyle Education for People WIth SchizophrEnia, schizoaffective disorder and first episode psychosis) is currently evaluating a lifestyle education programme in addition to usual care. However, it is difficult to define what constitutes ‘usual care’. We aimed to define ‘usual care’ for lifestyle management in people with schizophrenia, schizoaffective disorder and first-episode psychosis in STEPWISE study sites. Ten National Health Service (NHS) mental health trusts participated in a bespoke survey based on the National Institute for Health and Care Excellence (NICE) guidance. Results Eight trusts reported offering lifestyle education programmes and nine offered smoking cessation support. Reported recording of biomedical measures varied. Clinical implications Although recommended by...


Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

Nancy H. Liu, 1 , 2 Gail L. Daumit, 3 Tarun Dua, 1 Ralph Aquila, 4 Fiona Charlson, 5 Pim Cuijpers, 6 Benjamin Druss, 7 Kenn Dudek, 4 Melvyn Freeman, 8 Chiyo Fujii, 9 Wolfgang Gaebel, 10 Ulrich Hegerl, 11 Itzhak Levav, 12 Thomas Munk Laursen, 13 Hong Ma, 14 Mario Maj, 15 Maria Elena Medina‐Mora, 16 Merete Nordentoft, 17 Dorairaj Prabhakaran, 18 Karen Pratt, 4 Martin Prince, 19 Thara Rangaswamy, 20 David Shiers, 21 Ezra Susser, 22 Graham Thornicroft, 19 Kristian Wahlbeck, 23 Abe Fekadu Wassie, 24 Harvey Whiteford, 5 and Shekhar Saxena 1 Full Article Abstract Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain...