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Biomedical subjects

J K Wing

Publications and source records attributed to J K Wing.

At least 19 recordsLinked to original sources
PubMed1990

SCAN. Schedules for Clinical Assessment in Neuropsychiatry.

After more than 12 years of development, the ninth edition of the Present State Examination (PSE-9) was published, together with associated instruments and computer algorithm, in 1974. The system has now been expanded, in the framework of the World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration Joint Project on Standardization of Diagnosis and Classification, and is being tested with the aim of developing a comprehensive procedure for clinical examination that is also capable of generating many of the categories of the International Classification of Diseases, 10th edition, and the Diagnostic and Statistical Manual of Mental Disorders, revised third edition. The new system is known as SCAN (Schedules for Clinical Assessment in Neuropsychiatry). It includes the 10th edition of the PSE as one of its core schedules, preliminary tests of which have suggested that reliability is similar to that of PSE-9. SCAN is being field tested in 20 centers in 11 countries. A final version is expected to be available in January 1990.

Algorithms↗
PubMed1990

Meeting the needs of people with psychiatric disorders.

Evaluative research into the provision of psychiatric services to communities and individuals covers the whole spectrum of diagnosis, treatment and care, and the apparatus of policy-making, administration and management concerned in 'delivery'. The problems for research are described in terms of two central concepts--social disablement and need. Emphasis is placed on the importance of a needs assessment system, in spite of the methodological problems it poses. Examples are drawn chiefly from the UK National Health Service (NHS) because of the opportunities it provides for epidemiologically based research, but the issues raised are universal.

Community Mental Health Services↗
PubMed1990

The assessment of psychiatric disability in the community. A comparison of clinical, staff, and family interviews.

Assessments of some of the symptoms and behaviour problems of long-term psychiatric patients living in the community were obtained independently from clinical interviews with such patients, and from interviews with day staff, residential staff and families caring for them. In general, interviews with residential staff and family members revealed much higher levels of symptoms and behaviour problems than either of the other two interviews. These findings have implications for research and clinical practice including the fact that adequate assessments should include the testimony of family or residential staff.

Adolescent↗
PubMed1990

The functions of asylum.

Many of the functions of large psychiatric hospitals were those of asylum. As the structure of services has changed and the role of the large hospital has diminished, the necessity to continue to cover their functions has tended to be forgotten, partly because it has been thought that, even at best, they were purely protective. Such a point of view cannot be sustained. The functions of asylum have always been both refuge and recuperation. 'Community care' will come to deserve the odium now attached to the worst practices of former times if the tradition of asylum practised in the best of the large hospitals is not (with appropriate modification) acknowledged, properly placed in the psychiatric curriculum, and given high priority in service planning.

Deinstitutionalization↗
PubMed1989

Needs for care among the relatives of long-term users of day care. A report from the Camberwell High Contact Survey.

We report the results of a survey of the burdens and needs for items of care of 45 supporters of long-term users of psychiatric day care facilities in Camberwell. The supporters reported high levels of disturbed behaviour and low levels of self-care skills in the attenders. They were also subject to high levels of social and economic burden, not all of which could be attributed to the attenders' problems. The needs assessment identified a large number of unmet needs, although the supporters themselves were largely resigned to their situation and expressed little dissatisfaction with the services they were offered. The advantage of conducting this kind of assessment of supporters' needs as a routine part of clinical practice was discussed.

Adaptation, Psychological↗
PubMed1989

Physical health of the long-term mentally ill in the community. Is there unmet need?

A clinical assessment was made of 145 long-term users of hospital and social-services day psychiatric facilities, and 84 consented to laboratory pathological screening. We recorded data on relevant medical care where that was being provided. Based on clinical assessment, 59 patients (41%) were judged to have medical problems potentially requiring care. Based on pathological screening 39 (44% of those assessed) had unmet needs, and this rating was associated with poor compliance with attendance and treatment plans. Altogether, 12 patients had important unmet needs, mainly for detailed medical investigation, although none required immediate hospital admission. Long-term patients should be medically reassessed and supervised at appropriate intervals.

Adult↗
PubMed1988

The problems of people in long-term psychiatric day care. An introduction to the Camberwell High Contact Survey.

The aims of the Camberwell High Contract Survey (CHCS) were to develop and test a systematic needs assessment procedure and use it to evaluate the services provided to long-term users of day centres and sheltered residential accommodation (excluding hospital wards). This paper describes the background to the study, the sample of 145 attenders and their characteristics, their clinical and social problems and the care provided for them.

Adolescent↗
PubMed1988

Needs for care among the long-term mentally ill: a report from the Camberwell High Contact Survey.

We report the results of a survey of the needs for items of care of 145 long-term users of psychiatric day-hospitals and day-centres in Camberwell. The overall ratio of met to unmet need was almost exactly 5:1. Need was shown to vary according to chronicity, degree of participation, and placement in day-hospital or day-centre. Specific areas of functioning and specific types of care were identified in which there was significant overprovision or underprovision. The utility of our measures, and their ability to identify clinically significant unmet need, are discussed.

Activities of Daily Living↗
PubMed1988

Comments on the long-term outcome of schizophrenia.

Among the many technical issues dealt with in this symposium, two clinical problems are preeminent--how is schizophrenia defined and what is meant by outcome? Each problem is highly complex. Even given adequate designs, sampling, and analysis, the generalizability of the results depends on the extent to which the diagnostic and outcome criteria are independent of each other and reproducible. The authors amply demonstrate how far we are from achieving such comparability. Schizophrenia, at the moment, is diagnosable only on its manifestations, which can be influenced for better or worse by environmental conditions. Several standardized diagnostic systems are available but they recommend different sets of rules. It is premature, therefore, to speak of a "natural" long-term course. It is even doubtful whether further long-term studies (except perhaps of birth cohorts) should be attempted until more discriminating and reliable methods have been found. Short-term studies, however, focused on specific hypotheses, still hold out promise of yielding fruitful results.

Adolescent↗
PubMed1988

Abandoning what?

Explore the source record for details and available documents.

Humans↗
PubMed1987

Principles and practice of measuring needs in the long-term mentally ill: the MRC needs for care assessment.

We report the development of a new procedure for assessing the needs for treatment and care of the long-term mentally ill. This procedure covers 21 areas of clinical and social functioning, and in each of these specifies appropriate interventions. Decision rules are described which permit problems in functioning to be primarily classified as a met need, an unmet need, or as involving no need, and which allow the identification of various secondary needs. We report preliminary data on the reliability and validity of this procedure and discuss its potential applications in the care of the long-term mentally ill.

Activities of Daily Living↗