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Dr David Shiers Archives - Psychosis Research Unit
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Dr David Shiers

A pilot randomised controlled trial comparing antipsychotic medication, to cognitive behavioural therapy to a combination of both in people with psychosis: rationale, study design and baseline data of the COMPARE trial

Heather Law, Lucy Carter, Rachel Sellers, Richard Emsley, Rory Byrne, Linda Davies, Paul French, Peter M. Haddad, Elizabeth Pitt, Melissa Pyle, David Shiers, Alison R. Yung & Anthony P. Morrison Full Article Abstract Aims: Ongoing NICE guidance recommends research on the clinical and cost effectiveness of psychological treatment alone, compared to antipsychotic medication and compared to psychological treatment and antipsychotic medication combined. The COMPARE study (Cognitive behaviour therapy or Medication for Psychosis- A Randomised Evaluation) was a pilot trial designed to inform a definitive trial to answer this question. Method: COMPARE was a single-site pilot randomised controlled trial to compare a standardised Cognitive Behaviour Therapy (CBT) intervention to treatment with antipsychotic medication (APs) and a combined treatment (CBT plus APs) in adults with psychosis. Participants were assessed using...


Quality of prescribing for schizophrenia: Evidence from a national audit in England and Wales

Patel MX, Bishara D, Jayakumar S, Zalewska K, Shiers D, Crawford MJ, et al. (2014) Full Article Abstract The National Audit of Schizophrenia (NAS) examined the quality of care received in England and Wales. Part of the audit set out to determine whether six prescribing standards, set by the national clinical guidelines for schizophrenia, were being implemented and to prompt improvements in care. Mental Health Trusts and Health Boards provided data obtained from case-notes for adult patients living in the community with schizophrenia or schizoaffective disorder. An audit of practice tool was developed for data collection. Most of the 5055 patients reviewed were receiving pharmacological treatment according to national guidelines. However, 15.9% of the total sample (95%CI: 14.9–16.9) were prescribed two or more antipsychotics concurrently and 10.1% of...


Cardiometabolic health in young people with psychosis

Shiers D & Curtis J Full Article Summary The International Early Psychosis Association formally launched Healthy Active Lives (HeAL) on Nov 19, 2014 in Tokyo. This international consensus declaration is a call to arms for health professionals and service providers to pay far greater attention to the cardiovascular and metabolic health of people experiencing psychosis for the first time, right from the onset of treatment. HeAL is an international statement with a focus on prevention of the 20 year life expectancy gap for people with severe mental illness that was highlighted in The Lancet Psychiatry's recent demand for activism for poor physical health...


Assessment and treatment of physical health problems among people with schizophrenia: national cross-sectional study.

Crawford MJ, Jayakumar S , Lemmey SJ, Zalewska K, Patel M, Cooper SJ, Shiers D (2014) Full Article Abstract BACKGROUND: In the UK and other high-income countries, life expectancy in people with schizophrenia is 20% lower than in the general population. AIMS: To examine the quality of assessment and treatment of physical health problems in people with schizophrenia. Method Retrospective audit of records of people with schizophrenia or schizoaffective disorder aged ⩾18. We collected data on nine key aspects of physical health for 5091 patients and combined these with a cross-sectional patient survey. RESULTS: Body mass index was recorded in 2599 (51.1%) patients during the previous 12 months and 1102 (21.6%) had evidence of assessment of all nine key measures. Among those with high blood sugar, there was...


Interventions to improve the experience of caring for people with severe mental illness: A systematic review and meta-analysis

Udechuku A,  Mayo-Wilson E,  Harrison B,  Young N,  Woodhams P,  Shiers D,  Kuipers E,  Kendall T Full Article  Abstract BACKGROUND: Informal caregiving is an integral part of the care of people with severe mental illness, but the support needs of those providing such care are not often met. AIMS: To determine whether interventions provided to people caring for those with severe mental illness improve the experience of caring and reduce caregiver burden. METHOD: We conducted a systematic review and meta-analyses of randomised controlled trials (RCTs) of interventions delivered by health and social care services to informal carers (i.e. family or friends who provide support to someone with severe mental illness). RESULTS: Twenty-one RCTs with 1589 carers were included in the review. There was evidence suggesting that the carers' experience of care was improved at...