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Experience of CBT in adults with ADHD: A mixed methods study
Get PDF© 2024 William, Horrocks, Richmond, Hall and
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which does not comply with these termsINTRODUCTION: The National Institute for Health and Care Excellence (NICE) recommends Cognitive-Behavioural therapy (CBT) as the psychotherapeutic treatment of choice for adults with Attention Deficit Hyperactivity Disorder (ADHD) in the UK. However, the literature often refers to adapted CBT programs tailored for ADHD and provides limited insight into how adults with ADHD experience and perceive this form of treatment in routine clinical practice. METHODS: This mixed-methods study aims to explore ADHD individuals' experience and perception of CBT delivered in routine clinical practice, to gain a better understanding of this treatment's helpfulness and perceived effectiveness. RESULTS: A survey (n=46) and semi-structured in-depth interviews (n=10) were conducted to explore the experience of CBT and its perceived effectiveness in managing ADHD. The interviews were analysed using thematic analysis and the survey was synthesised using descriptive narratives. The thematic analysis highlighted three key themes: difficulties with the CBT framework, difficulties with CBT therapists, and consequences of CBT. The survey highlighted similar findings. Participants described the CBT framework as, generic, rigid, and too short, and described the CBT therapist as unspecialised, unempathetic, and not sufficiently adapting CBT to ADHD-related difficulties. DISCUSSIONS: Overall, participants found non-adapted, generic CBT in the UK to be unhelpful, overwhelming, and at times harmful to their mental well-being. Therefore, it is necessary for clinical bodies in the UK, while following the indicated NICE guidelines, to be mindful of adapting CBT delivery of CBT, to be most effective for people with ADHD and to mitigate potential harm.https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1341624/ful
Pregnancy and hereditary neuropathy with liability to pressure palsies: A case report and narrative review of the literature
No full textPregnancy in patients with hereditary neuropathy with liability to pressure palsy (HNPP) can present unique challenges. This is due to the potential exacerbation of neurological symptoms and the need for careful management during the antepartum, intrapartum, and postpartum periods. In this case report, we will discuss the successful management of a young pregnant female with a history of HNPP delivered by cesarean section. We will also review the existing literature on the management of pregnant patients with HNPP, focusing on the multidisciplinary input and strategies to minimize the risk of complications during labor and delivery. Reporting cases of pregnancy in HNPP is important for increasing awareness among clinicians and optimizing patient care.https://www.cureus.com/articles/248130-pregnancy-and-hereditary-neuropathy-with-liability-to-pressure-palsies-a-case-report-and-narrative-review-of-the-literature#!
The psychosocial impact of prostate cancer screening for BRCA1 and BRCA2 carriers
No full textObjectives: To report the long-term outcomes from a longitudinal psychosocial study that forms part of the 'Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted Screening in men at higher genetic risk and controls' (IMPACT) study. The IMPACT study is a multi-national study of targeted prostate cancer (PrCa) screening in individuals with a known germline pathogenic variant (GPV) in either the BReast CAncer gene 1 (BRCA1) or the BReast CAncer gene 2 (BRCA2). Subjects and methods: Participants enrolled in the IMPACT study were invited to complete a psychosocial questionnaire prior to each annual screening visit for a minimum of 5 years. The questionnaire included questions on sociodemographics and the following measures: Hospital Anxiety and Depression Scale, Impact of Event Scale, 36-item Short-Form Health Survey, Memorial Anxiety Scale for PrCa, Cancer Worry Scale, risk perception and knowledge. Results: A total of 760 participants completed questionnaires: 207 participants with GPV in BRCA1, 265 with GPV in BRCA2 and 288 controls (non-carriers from families with a known GPV). We found no evidence of clinically concerning levels of general or cancer-specific distress or poor health-related quality of life in the cohort as a whole. Individuals in the control group had significantly less worry about PrCa compared with the carriers; however, all mean scores were low and within reported general population norms, where available. BRCA2 carriers with previously high prostate-specific antigen (PSA) levels experience a small but significant increase in PrCa anxiety (P = 0.01) and PSA-specific anxiety (P < 0.001). Cancer risk perceptions reflected information provided during genetic counselling and participants had good levels of knowledge, although this declined over time. Conclusion: This is the first study to report the longitudinal psychosocial impact of a targeted PrCa screening programme for BRCA1 and BRCA2 carriers. The results reassure that an annual PSA-based screening programme does not have an adverse impact on psychosocial health or health-related quality of life in these higher-risk individuals. These results are important as more PrCa screening is targeted to higher-risk groups.https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bju.1643
The effects of inhaled corticosteroids on healthy airways
No full textBackground: The effects of inhaled corticosteroids (ICS) on healthy airways are poorly defined. Objectives: To delineate the effects of ICS on gene expression in healthy airways, without confounding caused by changes in disease-related genes and disease-related alterations in ICS responsiveness. Methods: Randomized open-label bronchoscopy study of high-dose ICS therapy in 30 healthy adult volunteers randomized 2:1 to (i) fluticasone propionate 500 mcg bd daily or (ii) no treatment, for 4 weeks. Laboratory staff were blinded to allocation. Biopsies and brushings were analysed by immunohistochemistry, bulk RNA sequencing, DNA methylation array and metagenomics. Results: ICS induced small between-group differences in blood and lamina propria eosinophil numbers, but not in other immunopathological features, blood neutrophils, FeNO, FEV1, microbiome or DNA methylation. ICS treatment upregulated 72 genes in brushings and 53 genes in biopsies, and downregulated 82 genes in brushings and 416 genes in biopsies. The most downregulated genes in both tissues were canonical markers of type-2 inflammation (FCER1A, CPA3, IL33, CLEC10A, SERPINB10 and CCR5), T cell-mediated adaptive immunity (TARP, TRBC1, TRBC2, PTPN22, TRAC, CD2, CD8A, HLA-DQB2, CD96, PTPN7), B-cell immunity (CD20, immunoglobulin heavy and light chains) and innate immunity, including CD48, Hobit, RANTES, Langerin and GFI1. An IL-17-dependent gene signature was not upregulated by ICS. Conclusions: In healthy airways, 4-week ICS exposure reduces gene expression related to both innate and adaptive immunity, and reduces markers of type-2 inflammation. This implies that homeostasis in health involves tonic type-2 signalling in the airway mucosa, which is exquisitely sensitive to ICS. Trial registration: ClinicalTrials.gov NCT02476825.https://onlinelibrary.wiley.com/doi/10.1111/all.1614
Editorial: Overcoming challenges in microbial immunology: 2022
No full texthttps://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1436631/ful
Synthesizing perspectives: Crafting an Interdisciplinary view of social media's impact on young people's mental health
No full textThis study explores the intricate relationship between social media usage and the mental health of young individuals by leveraging the insights of 492 UK school headteachers. It adopts a novel multidisciplinary approach, integrating perspectives from psychology, sociology, education studies, political science, philosophy, media studies, linguistics, social work, anthropology, and health sciences. The application of thematic analysis, powered by ChatGPT-4, identifies a predominantly negative perspective on the impact of social media on young people, focusing on key themes across various disciplines, including mental health, identity formation, social interaction and comparison, bullying, digital literacy, and governance policies. These findings culminated in the development of the five-factor Comprehensive Digital Influence Model, suggesting five key themes (Self-Identity and Perception Formation, Social Interaction Skills and Peer Communication, Mental and Emotional Well-Being, Digital Literacy, Critical Thinking, and Information Perception, and Governance, Policy, and Cultural Influence in Digital Spaces) to focus the impacts of social media on young peoples' mental health across primary and secondary educational stages. This study not only advances academic discourse across multiple disciplines but also provides practical insights for educators, policymakers, and mental health professionals, seeking to navigate the challenges and opportunities presented by social media in the digital era.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.030716
The swallowing and speech after transoral robotic surgery—does the site impact the outcome?
No full textTransoral robotic surgery (TORS) has been introduced to head and neck surgery as a minimally invasive techqniques to improve the functional outcomes of patients. Compare the functional outcome for swallowing and speech in each site of TORS within the head and neck. Retrospective cohort study for patients who underwent TORS within the head and neck unit. Patients were assessed at four different time points (one day, one month, six months and twelve months, respectively) with bedside/office testing. Methods of testing for swallowing assessment were by the International Dysphagia Diet Standardization Initiative (IDDSI), and speech assessments were carried out using the Understandability of Speech score (USS). Outcomes were compared to patient-specific pre-treatment baseline levels. 68 patients were included. 75% and 40% of the patients resumed normal fluid intake and normal diet immediately after surgery. 8.8% required a temporary feeding tube, with 1% required gastrostomy. There was a steep improvement in diet between 3 and 6 months. Fluid and diet consistency dropped significantly following the majority of transoral robotic surgery with more noticeable diet changes. Early deterioration in diet is temporary and manageable with a modified diet. Rapid recovery of swallowing is achieved before the first year. There is no long-term effect on speech
Neutropenia Induced by Ceftriaxone and Meropenem
Get PDFNeutropenia by non-chemotherapy drugs is an extremely rare idiosyncratic life-threatening drug reaction. Ceftriaxone and meropenem are widely used broad-spectrum antibiotics and are generally safe and well tolerated. The authors present a case of neutropenia induced by ceftriaxone and meropenem in an adult patient. The resolution of neutropenia occurred within 48 hours of ceftriaxone and meropenem being discontinued. Although antibiotic-induced neutropenia is uncommon, clinicians should be mindful of this adverse drug effect because of its potential development of severe neutropenia, septicaemia, septic shock, deep-seated infections and even death. Therefore, neutropenic sepsis treatment should be initiated without delay, particularly if the patient becomes septic and febrile. Granulocyte-colony stimulation factor (G-CSF) may be administered to facilitate the recovery process with daily monitoring of neutrophil count. Mortalities from antibiotic-induced neutropenia remain rare, with a range of 2.5–5%.https://www.ejcrim.com/index.php/EJCRIM/article/view/459
Racialised minority women's experiences of psychological intervention across perinatal and maternal mental health services.
No full textPolicies such as The Perinatal Mental Health Care Pathways document (2018) state mothers and birthing people experiencing psychological difficulties should have timely access to evidence-based psychological therapies. However, psychological distress often goes unidentified in racialised minority women and birthing people who have poorer experiences and outcomes within perinatal contexts compared to White women. Whilst limited research has focused on this within the perinatal period, there is greater recognition concerning how culturally sensitive practices can facilitate equity in care outcomes. This service evaluation aimed to explore racialised minority women's experiences of psychological intervention within a Perinatal and a Maternal Mental Health Service to evaluate service provision and inform service development. Semi-structured interviews with eight women who accessed psychological intervention were analysed using thematic analysis. Two superordinate themes were constructed, with findings suggesting participants had mostly positive experiences of psychological intervention. Cornerstones of therapeutic engagement comprised six subthemes: empathy, flexibility, the utility of psychological approaches, acknowledging family and community systems, points of difference and cultural context as a 'spotlight'. This theme encapsulated psychological therapist's relational and interventional approaches alongside participant preferences which influenced intervention experiences. Therapists were generally experienced as empathic and flexible although some participants desired greater flexibility relating to various practical aspects. Psychological approaches were experienced as beneficial although some wanted greater exploration of childhood trauma and found trauma-focused CBT emotionally demanding. Most participants preferred female therapists due to various socio-cultural reasons and felt systemic factors and their cultural context were acknowledged which enhanced the therapeutic relationship and outcomes where relevant with the inverse also apparent. History repeating itself comprised three subthemes (lack of representation, mistrust of the system and disorientation in help-seeking). This reflected mainly Black participants' negative healthcare experiences and structural racism. Therapeutic and organisational implications are discussed. Copyright © 2024, British Psychological Society. All rights reserved.https://explore.bps.org.uk/content/bpscpf/1/373/2
The relationship between line manager training in mental health and organisational outcomes
Get PDF© 2024 Hassard et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which
permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.BACKGROUND: Line manager (LM) training in mental health is gaining recognition as an effective method for improving the mental health and wellbeing of workers. However, research predominantly focuses on the impacts of training at the employee-level, often neglecting the broader organisational-level outcomes. Most studies derive insights from LMs using self-reported data, with very few studies examining impacts on organisational-level outcomes. AIM: To explore the relationship between LM training in mental health and organisational-level outcomes using company-level data from a diverse range of organisations. METHODS: This study is a secondary analysis of anonymised panel survey data from firms in England, with data derived from computer-assisted telephone surveys over four waves (2020, 1899 firms; 2021, 1551; 2022, 1904; and 2023, 1902). The analysis merged the four datasets to control for temporal variations. Probit regression was conducted including controls for age of organisation, sector, size, and wave to isolate specific relationships of interest. RESULTS: We found that LM training in mental health is significantly associated with several organisational-level outcomes, including: improved staff recruitment (β = .317, p < .001) and retention (β = .453, p < .001), customer service (β = .453, p < .001), business performance (β = .349, p < .001), and lower long-term sickness absence due to mental ill-health (β = -.132, p < .05). CONCLUSION: This is the first study to explore the organisational-level outcomes of LM training in mental health in a large sample of organisations of different types, sizes, and sectors. Training LM in mental health is directly related to diverse aspects of an organisations' functioning and, therefore, has strategic business value for organisations. This knowledge has international relevance for policy and practice in workforce health and business performance.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.030606