Biomedical subjects

Chris Tennant

Publications and source records attributed to Chris Tennant.

6 recordsLinked to original sources

PubMed2006

Let's get physical: an audit of medical practice in first episode psychosis.

OBJECTIVES: To assess aspects of medical examination, diagnosis and side-effect monitoring, and to consider the role of routine investigations in this group as recommended by national guidelines. METHOD: A retrospective file audit was performed on young people presenting with first episode psychosis (n = 117) over 12 months of treatment contact. RESULTS: Diagnoses were: first episode psychosis (43%), schizophrenia (16%), drug-induced psychosis (12%), affective psychosis (13%) and brief reactive psychosis (2%). Only four of the 52 (8%) subjects undergoing neuroimaging had any abnormality, with only two of these requiring referral. Three of the 33 (9%) electroencephalograms were obviously abnormal, but without epileptiform activity. There was little documentation of the assessment of involuntary movements (4% of sample) or weight (15% of sample). CONCLUSIONS: The low rates of clinically important abnormal findings in computed tomography/magnetic resonance imaging and electroencephalogram re-open debate about the need for routine neuroimaging and electrophysiology in this population.

Adolescent↗

PubMed2004

Psychological trauma: psychiatry and the law in conflict.

OBJECTIVE: To contrast the psychiatric and legal construct of psychological trauma, with posttraumatic stress disorder (PTSD) as the reference disorder. METHOD: Literature relevant to DSM-IV PTSD definition of a traumatic event (Criterion A) was assessed. This construct was compared with the current legal status for psychological trauma arising from recent judgements of the Australian High Court. CONCLUSIONS: The current legal construct of psychological trauma is not only practical and sensible, but is far more evidence-based than the DSM-IV construct of trauma.

Australia↗

PubMed2004

Clinical outcome of an early psychosis intervention program: evaluation in a real-world context.

OBJECTIVE: To examine whether staff training and service restructuring to provide specialized early psychosis services results in improved clinical outcomes for young people with first-episode psychosis. METHOD: Staff attended workshops on the treatment of early psychosis throughout 1997-2000 and specialized early psychosis teams began operating between 1998 and 2000 following service restructure. There was no additional funding provided for clinical services, but through the restructure, there was a shift in resources. During this period a comprehensive package including the Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms and the Health of the Nation Outcome Scale was introduced for clinicians to assess patients at intake, 3 months and 12 months into treatment. Symptom scores of patients treated earlier in the project are compared with those patients treated later, after more training and service developments had occurred. RESULTS: Ninety-four of 215 potential first-episode patients consented to take part in the project. They provided data variously at intake, 3 months and 12 months into treatment. Regardless of the year of treatment, significant improvement in psychiatric symptomatology was found over the three assessment periods. Individuals who entered the service in the latter phase of the project experienced fewer negative symptoms (after 12 months of treatment) compared with patients who entered the service in the early phase of the project. CONCLUSIONS: Improvements in both pharmacological and possibly psychosocial treatment may have led to a greater improvement in negative symptoms. Benefits and limitations of conducting research in a "real-world" context are discussed.

Adult↗

PubMed2004

Changes in early psychosis service provision: a file audit.

OBJECTIVE: To measure change in services provided to young people with first-episode psychosis following the introduction of specialized early psychosis teams and staff training. METHOD: A standardized tool was developed to audit services provided to young people with first-episode psychosis. The tool initially comprised 27 clinical indicators measuring aspects of optimal care derived from the Australian clinical guidelines for early psychosis. The first 12 months of treatment, as documented in the case records, were audited for all young people receiving their first treatment for psychosis during a 6-month period prior to the introduction of these service developments (n = 47). These subjects were compared with those who received treatment after the implementation of service development strategies (n = 70). A comparison was also made within the second group, between those receiving some treatment from a specialized early psychosis team and those being exclusively treated by other services. RESULTS: Inter-rater reliability was achieved for 24 of the 27 indicators. Improvements were found on 10 indicators which measured psychosocial interventions, prescribing practices, family interventions and continuity of care. There was no significant deterioration on any of the indicators. Clients who attended early psychosis teams were significantly more likely to receive psychoeducation. CONCLUSIONS: The services increased their provision of "guideline concordant" care for early psychosis. The audit proved useful to monitor performance, to demonstrate improvements in care and to identify those areas of service provision and documentation in need of improvement.

Adolescent↗

PubMedDate not supplied

In protest.

Explore the source record for details and available documents.

Attitude↗

PubMedDate not supplied

Reasons for cannabis use in psychosis.

OBJECTIVE: To examine the reasons for cannabis use among individuals with psychotic disorders. METHOD: Forty-nine people with psychotic disorders in treatment with community health centres in Northern Sydney were interviewed to collect information about their experience of antipsychotic side-effects and their influence on cannabis use. Other information collected on cannabis use included: amount and frequency, effects of use and other general reasons given for use. RESULTS: It was found that boredom, social motives, improving sleep, anxiety and agitation and symptoms associated with negative psychotic symptoms or depression were the most important motivators of cannabis use. Positive symptoms of psychosis and antipsychotic side-effects that were not associated with anxiety, were not important motivators of cannabis use. CONCLUSIONS: As cannabis use may precipitate relapse in this population, it is important to reduce these motivators of use. Clinician's must assess and treat these problems, thus reducing the need for patients to self-medicate with cannabis, and therefore reducing the risk of relapse.

Adolescent↗