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A literature search of psychological trauma related outcome measures for adult mental health services
No full textIt is important to measure the impact of psychological trauma within mental health services designed to treat individuals after traumatic experiences. However, there are challenges in capturing the impact of trauma and the recovery from it accurately whilst also considering patient preferences and expectations. This study aims to explore the range of pre-existing outcome measures of trauma symptomatology and determine the relative prevalence of these measures within related research. This is addressed through systematically searching literature for outcome measures available in the assessment of psychological trauma symptomatology across adult mental health populations. Databases Medline, CINAHL and PsychInfo were searched to find papers that described the use of measures within psychological trauma-specific outcome research. 228 articles were found after the exclusion criteria were applied. The most prevalence trauma-specific outcome measures utilised within the evidence base were versions of the Post-Traumatic Disorder Checklist (PCL) and the Clinician Administered PTSD Scale (CAPS). Non-trauma specific measures were also identified within this sample. This paper lists both trauma-specific and non-trauma specific measures found in order of prevalence. Consideration is given to the most frequent measures found. These findings provide insight into gold-standard measures for services wishing to implement outcome measures that will meaningfully capture recovery amongst trauma survivors. Practitioner points • The impact of trauma has challenges in its conceptualisation and measurement, and additional attention is needed to ensure that services are capturing helpful treatment outcomes. • Key measures used within trauma-specific research include gold standard PTSD and CPTSD measures as well as non-specific trauma measures. • Reviewing the measures most used in trauma research highlights the areas of most critical change within recovery after trauma therapy and therefore provides valuable insights into how service evaluation can capture meaningful change.https://www.sciencedirect.com/science/article/abs/pii/S246874992500079
Unmasking a cerebral arteriovenous malformation presenting as a chronic migraine-type headache at a district general hospital
No full textA female in her 50s was referred by her General Practitioner (GP) to our Same Day Emergency Care (SDEC) unit due to an unresponsive migraine attack. Associated features included nausea, photophobia, phonophobia, intermittent visual aura, and unintentional weight loss over the last two weeks. Arteriovenous malformations (AVMs) are rare vascular anomalies, with a prevalence of approximately 18 per 100,000 individuals. Although often asymptomatic, they may present atypically with migraine-like headaches, posing a diagnostic challenge. Her full neurological assessment, including cranial nerves, cerebellar function, and motor and sensory systems, was unremarkable. However, neuroimaging revealed a large, unruptured, complex AVM in the left parieto-occipital region, associated with cerebral oedema and midline shift. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) confirmed a Spetzler-Martin Grade III AVM. Her imaging was urgently discussed with the Neurosurgery Department at Oxford University Hospitals for further intervention, as our institution does not have a neurosurgery department being a district general hospital. The multidisciplinary team (MDT) recommended radiosurgery, and her symptoms resolved after the intervention. This case illustrates the importance of neuroimaging in patients with refractory or unresponsive migraine, enabling early detection of serious intracranial pathology such as AVMs. It also highlights the value of timely specialist referral, inter-hospital collaboration, and patient-centred care in optimising outcomes.https://www.cureus.com/articles/419397-unmasking-a-cerebral-arteriovenous-malformation-presenting-as-a-chronic-migraine-type-headache-at-a-district-general-hospital#!
Adapted safety plans to address self-harm and suicide behaviours in autistic adults : single arm feasibility trial and external pilot RCT
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be cited.Background Suicide prevention is a national priority for United Kingdom government policy, and autistic people have recently been identified as a high-risk group in both the Department of Health and Social Care suicide prevention strategy and National Institute for Health and Care Excellence suicide prevention guidelines. No suicide prevention interventions have been developed specifically for autistic people. Safety plans are a simple, cost-effective, potentially life-saving intervention. Aims To evaluate the feasibility and acceptability of the use of Autism Adapted Safety Plans for autistic adults and to undertake an external pilot to explore whether a larger future definitive trial is achievable. Methods Stage 1 involved focus groups with autistic adults (n = 15), family members (n = 5) and service providers (n = 10) to inform adaptations to the Autism Adapted Safety Plans. Stage 2 was an interventional single-arm feasibility trial where autistic adults (n = 8) completed an Autism Adapted Safety Plans with a supporter (n = 8). Data on recruitment, completion of study measures and participant feedback informed final adaptations to the Autism Adapted Safety Plans and research methods prior to stage 3. Stage 3 was a pilot feasibility randomised controlled trial of Autism Adapted Safety Plans. Autistic adults were recruited via non-National Health Service organisations and self-referral. Participants were randomised without stratification to usual care ± Autism Adapted Safety Plans. The Autism Adapted Safety Plan was completed by the autistic adults with someone trained to support them. Research staff completing follow-up assessments were blind to participant allocation. Primary outcomes were feasibility and acceptability of the Autism Adapted Safety Plans to inform the parameters of a definitive randomised controlled trial. Participants were assessed at baseline, 1 and 6 months. Results Stage 1 and 2 interviews highlighted the conditions needed to make the process of creating the Autism Adapted Safety Plans acceptable for autistic adults. Stage 2 also informed modifications to recruitment (to include self-referral) in stage 3. In stage 3, 53 participants consented, 49 were randomised to either Autism Adapted Safety Plans + usual care (n = 25) or usual care (n = 24). Sixty-eight per cent of participants were satisfied with the Autism Adapted Safety Plans and 41% rated it as usable. Feedback on the Autism Adapted Safety Plans and study processes employed in the trial were positive with suggested minor adaptations to some outcome measures. Retention of those randomised was 95% at 6-month follow-up. Completion rates for outcome measures were generally high (> 85%). Fidelity ratings for delivery of the Autism Adapted Safety Plans were 94% for therapeutic components and 91% for adherence to content. Conclusion Autism Adapted Safety Plans are a potentially valuable intervention for autistic adults, provided that the process of creating it is flexible and sensitive to individual needs. The parameters of a future definitive trial of the clinical and cost-effectiveness of Autism Adapted Safety Plans are achievable, with minor recommended adaptations. Further testing of the Autism Adapted Safety Plans to assess its clinical and cost-effectiveness in National Health Service clinical services is urgently needed. Limitations The sample size was below the initially intended sample of 70 participants due to difficulties with recruitment during the COVID-19 pandemic. As autistic participants self-referred into the study, data are not available regarding how many participants were approached to take part in the study. The majority of the study sample was White. Future work A full definitive trial testing the clinical and cost-effectiveness of Autism Adapted Safety Plans in National Health Service clinical services is warranted. This fully powered trial will need to recruit a more diverse sample than was possible in the pilot trial. Results suggest that minor adaptations to the Autism Adapted Safety Plans could make this more personalised and accessible, such as through an app or website. Funding This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR129196.https://www.journalslibrary.nihr.ac.uk/phr/CGDF852
The impact of nutrition misinformation on public health and practice: a review
No full textThe widespread use of digital platforms, particularly social media, has transformed public access to nutrition information, presenting both opportunities and problems for public health. Although these platforms can enhance health education, they also facilitate the rapid spread of misinformation, often propagated by individuals without professional credentials. Nutrition misinformation shapes public perceptions and behaviours, with detrimental effects on dietary practices and increasing the burden of non-communicable diseases. Online content lacking peer review, scientific grounding or transparency can mislead individuals and erode trust in evidence-based nutrition science. Strategies to counter these effects include strengthening digital and health literacy, implementing policy reforms and ensuring that public health bodies provide accurate, engaging online information to build public resilience against misleading dietary claims.https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2025.030
Involving carers in therapy for adults with intellectual disabilities : a systematic review of client, carer and therapist perspectives
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© 2025 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.BACKGROUND: Adaptations are frequently reported when delivering therapy to people with an intellectual disability, including the involvement of carers. This review aimed to understand the experience of carer involvement from the perspective of the person, therapist and caregiver. METHODS: A systematic search of six databases and of reference lists was conducted. The quality of the included studies was assessed using an adapted version of the Critical Appraisal Skills Programme qualitative checklist. Data was synthesised using meta-ethnography. RESULTS: Sixteen studies were included but their quality varied. Five third-order constructs were identified: safety, therapeutic process, relationships, personal impact on carer and improving the experience. CONCLUSION: Findings suggest that carer involvement can be a positive experience and aid the therapy process. However, this depended on several factors including carer motivation and consistency. Confidentiality issues were highlighted. Limitations of studies included poor reporting on participant demographics and small samples. Future research and clinical implications are suggested.https://onlinelibrary.wiley.com/doi/10.1111/jar.7015
Compassion-focused therapy for mental health : international perspectives
No full textThis book aims to explore the application of Compassion-Focused Therapy (CFT) within international contexts, acknowledging the nuances of mental health and well-being across different regions. By integrating principles of compassion with cultural sensitivity, it offers a comprehensive guide for mental health professionals to effectively address the needs of clients based in various regions of the world. Through case studies, research findings, and practical interventions, this book illuminates how CFT can be tailored and adapted to resonate with the values, beliefs, and norms of different cultures, ultimately promoting greater inclusivity and effectiveness in therapeutic practice.https://link.springer.com/book/978303212437
Evaluating advanced clinical practitioners' engagement with the four pillars of advanced practice in the UK: a scoping review
No full textAims/Background Despite national frameworks outlining the four pillars of advanced practice (clinical practice, leadership and management, education, and research), engagement of Advanced Clinical Practitioners (ACPs) in the UK remains inconsistent, and significant challenges persist. This scoping review aimed to explore ACPs’ engagement with each pillar and to identify both successful and challenging factors. Methods A scoping review was conducted following Arksey and O’Malley’s framework in 2005 and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was undertaken across five databases (CINAHL, MEDLINE, Scopus, PsycInfo, and Cochrane Library) and grey literature sources. The search covered studies published from 2017 to 2025, in line with the introduction of the Multi-professional Framework. A three-stage screening process was used to identify eligible studies, and data were extracted using a standardised form. Thematic analysis was employed to synthesise the findings. Results Thirty-three studies met the inclusion criteria. The review identified strong ACP engagement in clinical practice, including contributions to direct patient care, improved patient satisfaction, and reduced waiting times. However, engagement with the leadership, education, and research pillars was inconsistent and often limited by excessive workload, lack of protected time, and ambiguity in role definitions. Structural variation across National Health Service (NHS) trusts further contributed to disparities in advanced clinical practice role development and utilisation. Conclusion Advanced clinical practice roles are firmly embedded in clinical care but remain underutilised in leadership, research, and education. Addressing these disparities requires clearer career pathways, organisational investment, and structured policy support to enable ACPs to contribute fully across all four pillars of practice.https://www.magonlinelibrary.com/doi/full/10.12968/hmed.2025.010
The Efficacy Of Catheter Ablation Compared To Medical Therapy In Heart Failure Patients With Concomitant Atrial Fibrillation: A Meta-analysis Of Randomized Controlled Trials.
No full textThe management of atrial fibrillation in patients with heart failure continues to be a topic of ongoing debate. We conducted a meticulous comparison between two primary treatment modalities: catheter ablation versus medical therapy. Our aim is to assess the efficacy of these interventions in patients presenting with both atrial fibrillation and heart failure, drawing from the randomized controlled trials. A comprehensive literature search was conducted up to February 2024, utilizing databases including PubMed, EMBASE, and Clinicaltrials.gov. A total of 10 randomized studies were identified and their data were extracted and analyzed. The primary outcomes assessed included the impact of catheter ablation on all-cause mortality, cardiovascular death, left ventricular ejection fraction (LVEF %), and 6-minute walk test (6MWT) in meters. Data were analyzed utilizing a random-effects model to calculate weighted mean differences for LVEF and 6MWT, and risk ratios for all-cause mortality and cardiovascular death on Review Manager 5.3 (RevMan 5.3) software. In totality, data from 1944 heart failure patients (N = 966 on catheter ablation; N = 978 on medical therapy) with concomitant atrial fibrillation were included. Patients in the catheter ablation group exhibited a significant reduction in all-cause mortality (RR 0.63 [95% CI 0.48, 0.83]; P=0.001; I2 = 17%). Moreover, there was a notable decrease in cardiovascular death among patients undergoing catheter ablation (RR 0.53 [95% CI 0.34, 0.81]; P=0.004; I2 = 20%). Patients who underwent catheter ablation demonstrated a marked improvement in LVEF (MD 5.79 [95% CI 3.13, 8.44]; P <0.0001; I2 = 82%). The 6MWT revealed superior outcomes in the catheter ablation group (MD 22.69 [95% CI 9.87, 35.50]; P=0.0005; I2 = 38%). Heart failure patients with concomitant atrial fibrillation undergoing catheter ablation therapy exhibited notable improvements in LVEF and 6MWT, alongside a significantly reduced risk of all-cause mortality and cardiovascular death compared to those receiving solely medical therapy. These findings shed light on the potential advantages and superior outcomes associated with catheter ablation therapy in preserving cardiac chamber function and mitigating mortality in such a patient cohort. However, further investigations are warranted to understand the long-term benefits and optimal management strategies for such individuals. [ABSTRACT FROM AUTHOR]https://www.sciencedirect.com/science/article/abs/pii/S107191642400843
Assessing personal recovery in individuals with severe mental illness: validation of the Dutch Brief INSPIRE-O
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copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.PURPOSE: Recovery is a key objective in mental health services for people with severe mental illness (SMI). In addition to clinical and functional recovery, personal recovery has gained increasing attention. The CHIME Framework identifies five personal recovery processes-Connectedness, Hope, Identity, Meaning, Empowerment-and is the theoretical foundation for the Brief INSPIRE, a validated Patient-Rated Experience Measure (PREM) to evaluate recovery support. Brief INSPIRE was modified to a five-item Patient-Rated Outcome Measure (PROM) assessing recovery, called Brief INSPIRE-Outcome (Brief INSPIRE-O). Subject of this study are the psychometric properties of the Brief INSPIRE-O. METHODS: Data on validity and reliability gathered through annual routine outcome monitoring were collected for 861 individuals with SMI of Flexible Assertive Community Treatment teams and a follow-up measurement was available for 232 of these individuals. Test-retest reliability was evaluated in a separate subset of 30 individuals with SMI. RESULTS: The Brief INSPIRE-O shows good internal consistency (Cronbach's alpha 0.77), test-retest reliability, construct validity, sensitivity to change and no floor or ceiling effects. Furthermore, change in Brief INSPIRE-O was positively related to changes in quality of life and negatively to problems in clinical functioning and unmet care need. CONCLUSION: Brief INSPIRE-O can be used for research and monitoring to better understand and improve processes of personal recovery in individuals with SMI.https://link.springer.com/article/10.1007/s00127-025-02815-
Thematic Analysis of Coroner's Prevention of future deaths (PFDs) reports in Mental Health related suicides Dr Dean Manning Core Psychiatry Trainee
No full textBackground: I am a Core Psychiatry trainee currently working in a Crisis Resolution and Home Treatment Team (CRHT) in which many patients are referred with suicidal ideation in the context of their Mental Health. Aim: To identify professional and organizational-related themes highlighted in Coroner’s PFDs reports in Mental Health related suicides.. Methods: We reviewed Coroner’s PFDs reports via the UK Judiciary website. We filtered reports by those which are both Mental Health related deaths and included the keyword ‘suicide’. 100 reports were reviewed starting with the most recent. Themes were identified and grouped into patient-related, professional-related, and organizational-related factors that may have contributed to the death by suicide. Results: Reports were reviewed from across the UK. The highest number of reports were from the Coroner area of Manchester South (12%). 61% of reports were of males. Analysis: The main professional-related factors identified from thematic analysis of the PFDs reports were; issues around risk assessment and management (45%), lack of interprofessional communication and collaboration (33%), inadequate clinical queries/assessments (25%), Conclusions and Recommendations: It is hoped by identifying common themes arising from PFDs reports in Mental Health related suicides we can identify areas for change in practice that could lead to reduction in death by suicides.https://journals.lww.com/indianjpsychiatry/fulltext/2025/01001/ancips___2025___e_posters.17.asp