The Journal of Medical Ethics (1995, 21, p.234-238)
publishes a study investigating whether an interactive
teaching course can significantly affect the ethical
sensitivity of medical students. Given that previous
research has actually shown a deterioration in
sensitivity over the teaching years of the traditional
medical course, this innovative approach at Liverpool
University, using video and role play, offers a chance to
enhance the role of ethical thinking and also show the
relevance of medical history to the avoidance of past
mistakes and abuses in the care of psychiatric patients.
Further research hopes to focus on how permanent the
change in sensitivity actually is.
Os et al publish an interesting study in the BJPsych
(1995, 166, 750-788) supporting the notion that increased
ventricular size is associated with negative symptoms and
unemployment in psychotic illness (method involved 337
consecutive admissions with at least one psychotic
symptom according to RDC, interview with the PSE and
scanning was by CT).
Is tardive dyskinesia a long-term side-effect of
antipsychotic medication? Current opinion in psychiatry
dictates that this is so, and yet there is accumulating
evidence to suggets that the involuntary movement
disorder is a result of occult brain damage i.e. that the
dyskinesia and the psychotic illness both represent the
end point of fundamental CNS damage. Two studies which
support this view include the Editor's paper on the
community prevalence of Abnormal Involuntary Movements.
(Acta Psychiatrica Scandinavica, 1993), and a study of
young people with psychoses in the BJPsych (1995, 166,
768-772) by Pourcher et al, in which dyskinesia subjects
more often had perinatal or infant brain injuries.
In a relatively large series (for SAD studies) of 68
patients Meesters et al in the BJPsych (166,607-612)
found that for four-day light treatment results were not
dependent upon the timing of the phototherapy. Different
groups received phototherapy in the morning, afternoon,
and evening, with an extra group receiving a mixture.
Response rates ranged from 50% to 80%, but there were no
significant differences, indicating that perhaps the
timing of light treatment is not so critical.
Several studies have suggested an association between
low blood pressure and low mood. An important negative
study by Gimore et al (1995) in Acta Psychiatrica
Scandinavica (91, 126-129) showed that in a three year
prospective community study of 1070 elderly people in
Liverpool, England depression was wholly unrelated to
hypotension.
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