Trauma-Focused Guided Self-Help Interventions for Posttraumatic Stress Disorder: A Meta-analysis of Randomised Controlled Trials. Depression and Anxiety

Trauma-focused guided self-help (TF-GSH) is an important alternative to psychological therapy delivered by a therapist. This meta-analysis evaluates the efficacy of TF-GSH in reducing posttraumatic stress disorder  (PTSD) symptoms and comorbid depressive and anxiety symptoms. A total of 17 trials were included that compared a TF-GSH intervention (N = 610) to various control comparators (N = 570). Control conditions included treatment as usual (k = 2), waiting list (k = 11), phone monitoring (k = 1), nontrauma writing (k = 1), general support (k = 1), and supportive counseling (k = 1). A moderate- to large-sized effect favouring TF-GSH was observed for PTSD (k = 17, g = −0.81, 95% confidence interval [CI]: −1.24, −0.39) and a moderate-sized effect was observed for depressive (k = 13, g = −0.73, 95% CI: −1.16, −0.31) and anxiety (k = 11, g = −0.72, 95% CI: −1.18, −0.27) symptoms, with considerable heterogeneity. Moderator analyses were all not statistically significant. Results indicate that TF-GSH is a promising treatment for PTSD and comorbid depressive and anxiety symptoms. We discuss the nature, extent, and quality of the literature to provide a point of departure for future research. TF-GSH (and unguided self-help) may not be appropriate for certain individuals at certain times. Exploring a broad range of treatment delivery modalities will move the field closer towards a model of evidence-based care in which the likely appropriate dose and type of intervention can be matched to individuals based on presenting problems and other variables.


Contributors

Siddaway, A.P., Meiser-Stedman, R., Chester, V., Finn, J., O Leary, C., Peck, D. & Loveridge, C.

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Intellectual disability

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  • Provides a comprehensive up-to-date look at social psychiatry around the world
  • Part of the authoritative Oxford Textbooks in Psychiatry series

Contributors

Jesu, A.J.M., Gangadharan, S.K., Bhaumik, S., & Alexander, R.T.

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The role of mindfulness training in sustaining weight reduction: retrospective cohort analysis

Psychological stress has an established bi-directional relationship with obesity. Mindfulness techniques reduce stress and improve eating behaviours, but their long-term impact remains untested. CALMPOD (Compassionate Approach to Living Mindfully for Prevention of Disease) is a psychoeducational mindfulness-based course evidenced to improve eating patterns across a 6-month period, possibly by reducing stress. However, no long-term evaluation of impact exists.

This study retrospectively evaluates 2-year outcomes of CALMPOD on patient engagement, weight and metabolic markers.


Contributors

Hanson, P., Lange, M., Oduro-Donkor, D., Shuttlewood, E., Weickert, M.O., Randeva, H.S., Menon, V., Alexander, R.T., Basset, P., Shankar, R., & Barber, T.M.

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A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience

An increasing number of children, adolescents and adults with intellectual disabilities and/or autism are being admitted to general psychiatric wards and cared for by general psychiatrists. 

The aim of this systematic review was to consider the likely effectiveness of in-patient treatment for this population, and compare and contrast differing models of in-patient care.


Contributors

Melvin, C. L., Barnoux, M., Alexander, R., Roy, A., Devapriam, J., Blair, R., Tromans, S., Shepstone, L., & Langdon, P. E.

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Psychiatric inpatient admissions and discharges of people with intellectual disabilities: A time series analysis of English national data

We examined whether a series of variables were related to the number of psychiatric inpatients using publicly available data about English psychiatric bed utilisation and NHS workforce.


Contributors

Langdon, P. E., Thompson, P. A., Shepstone, L., Perez-Olivas, G., Melvin, C. L., Barnoux, M., Alexander, R., Roy, A., & Devapriam, J.

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Telepsychiatry for people with intellectual disabilities and mental health difficulties during Covid-19 pandemic: survey of self-reported experience and acceptability to patients, carers and psychiatrists in the UK

This project sought to ascertain views and experiences of people with intellectual disabilities, their carers’, and specialist intellectual disability psychiatrists as to use of telepsychiatry consultations.


Contributors

Gates, G., Sawhney, I., Alexander, R., Shardlow, S. & Zia, A

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Anticholinergic adverse effects and oral health

Pharmacists have a critical role in monitoring the use of anticholinergic medication and preventing adverse effects on oral health.


Contributors

Tharian, R. Patteril, E. & Shah, C.

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The potential unintended consequences of Mental Health Act reforms in England and Wales on people with intellectual disability and/or autism

The draft Mental Health Bill, which amends the Mental Health Act 1983 for England and Wales, proposes protections for people with intellectual disability and/or autism (ID/A) to prevent detention in hospital in the absence of mental illness. This editorial critically appraises the positive impact and unintended consequences of the proposed reforms for people with ID/A.


Contributors

Tromans, S., Bhui, K., Sawhney, I., Odiyoor, M., Courtenay, K., Roy, A., Boer, H., Alexander, A., Biswas, A., McCarthy, J., Gulati, G., Laugharne, R., & Shankar, R.

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