Tavistock and Portman E-Prints Online
Not a member yet
2774 research outputs found
Sort by
Supervision and consultation: Tuning into psychotic communications in frontline mental health settings
No full text
Deliberate self-poisoning by teenagers
No full textSuicidal self-poisoning is a medical emergency but it is also a psychiatric one. Yet before a psychiatrist can be engaged it is often necessary for a physician or paediatrician to set the scene. Young people who have just taken a massive risk with their lives are in a turmoil of rage, fear, grief and shame. Though some will be keen to talk, others may be harder to reach. ‘The fact that young people who have self-harmed arrive at A&E feeling like ‘rubbish’ may predispose them to perceive staff attitudes and behaviours as hostile and punitive, even when staff do not intend them as such.’ An attentive and careful medical assessment conveys that the problem is taken seriously by the hospital, for which patients will often in time be grateful.
Whether or not a mental health practitioner will be seeing the patient soon after admission, I argue that a medical assessment is therapeutic in its own right. You should enquire about the dosage and timing of overdose, and about the motive and the context. This practice both enriches medical clinical skills and also fosters a spirit of collaboration between mental and physical medicine, a benefit to patients who experience it
Evidence for a change in the sex ratio of children referred for gender dysphoria: Data from the gender identity development service in London (2000–2017)
No full textIntroduction: The prevalence of gender dysphoria in children is not known; however, there are some data on the sex ratio of children referred to specialized gender identity clinics.
Aim: We sought to examine the sex ratio of children, and some associated factors (age at referral and year of referral), referred to the Gender Identity Development Service in the United Kingdom, the largest such clinic in the world.
Methods: The sex ratio of children (N = 1,215) referred to the Gender Identity Development Service between 2000–2017 was examined, along with year of referral, age-related patterns, and age at referral.
Main Outcome Measure: Sex ratio of birth-assigned boys vs birth-assigned girls.
Results: The sex ratio significantly favored birth-assigned boys over birth-assigned girls (1.27:1), but there were also age and year of referral effects. The sex ratio favored birth-assigned boys at younger ages (3–9 years), but favored birth-assigned girls at older ages (10–12 years). The percentage of referred birth-assigned boys significantly decreased when 2 cohorts were compared (2000–2006 vs 2007–2017). On average, birth-assigned boys were referred at a younger age than birth-assigned girls.
Clinical Implications: The evidence for a change in the sex ratio of children referred for gender dysphoria, particularly in recent years, matches a similar change in the sex ratio of adolescents referred for gender dysphoria. The reasons for this remain understudied.
Strength & Limitations: The United Kingdom data showed both similarities and differences when compared to data from 2 other gender identity clinics for children (Toronto, Ontario, Canada, and Amsterdam, The Netherlands). Such data need to be studied in more gender identity clinics for children, perhaps with the establishment of an international registry.
Conclusion: Further study of the correlates of the sex ratio for children referred for gender dysphoria will be useful in clinical care and management
Buried secrets: Remembrance of things past - Learning to live with those unwelcome feelings
No full textUsing simple language for the everyday reader, Buried Secrets gives descriptive accounts from real people who have been depressed with who they are, and how they’ve changed their personality for the better using psychotherapy or ‘the talking cure’. Regardless of age, unwelcome feelings from early memories can return to haunt the present and cause distress, anxiety, mild depression and feelings of revenge. Section one recounts reconstructed stories that indicate how some older people have conquered this and improved their lifestyle, while section two tells of changes made by younger people for the better.
The book states that cognitive, positive attributions are memorised and recalled - so why not negative ones? They can be negotiated with and worked through, either with or without support. One can learn that through grieving these feelings, forgiving and moving forward can enhance your life. Buried Secrets leads the way to a brighter future
Achieving a satisfactory outcome with a difficult patient
No full textInteractions can be challenging for a number of reasons and these reasons can be grouped into the following: patient, doctor, disease, and system, says Dr Gabrielle Pendlebury, medicolegal consultant at Medical Protection