Welcome to the October 2014 CPD
Transition: barrier or
By Dr Suhaib Bin Bilal
Hafi, CPD Online Trainee Editor
Since the inception of the word ‘Psychiatry’
by Johann Christian Reil in 1808, the specialty has evolved.
Psychiatry has developed from Kraepelin’s idea of disease
classification, which has fundamentally shaped the way we practice
psychiatry. The explosion of knowledge and the complex nature of
mental disorders have led to the ever-increasing specialisation of
psychiatry, which continues to evolve and expand today. A prime
example is that of interventional psychiatry, a relative newcomer
which focuses on providing treatments for resistant mental
disorders by non-invasively (ECT) and invasively (deep brain
stimulation) stimulating the brain.
This specialist approach to psychiatry has led
to an increase in the number of interfaces. This can interrupt
continuity of care and has made transition between specialties
inevitable for our patients. Listening to an expert patient, it was
apparent that such transitions can be particularly challenging for
people with mental illness. The question of whether the benefits of
the sub-specialist treatment outweigh the risks in contemporary
mental health services is still hotly debated. As described by
Rosen et al (2013), protagonists argue
that specialisation reflects an evolving evidence base for delivery
systems that are most effective; whereas generalists cite the risks
of specialisation to continuity of care and therapeutic
relationships. What is not in doubt is that transitions are a
challenge. With changes in mental health services provision, it is
more important than ever to support patients with mental illness in
their transition between services.
One of our new modules on CPD Online,
Transferring care between age-specific services: young people’s
transitions, reminds us of this challenge that we face, and
explores how we can best provide support to young people with
mental health problems. This can readily be generalised to other
interfaces between psychiatric specialties.
Managing the adverse effects of clozapine
Clozapine is recommended for treatment-resistant schizophrenia,
but concerns over adverse effects can lead to delayed treatment and
premature withdrawal. Improve your understanding of the drug’s
potential adverse effects, gain confidence in alleviating them and
learn effective management strategies.
Transferring care between age-specific services: young
Healthcare transitions faced by young people with mental health
problems and disorders can be extremely challenging, and managing
the transitions well is vital. Dr Moli Paul, Professor Swaran Singh
and Dr Cathy Street set out the principles of good practice and key
aspects of the law. Case studies facilitate reflection on how
personal clinical practice and service development might be
Dr Richard Brown talks about his 'integrative
cognitive' model of medically unexplained symptoms and discusses
the practical implications regarding treatment.
Dr Raj Persaud discusses the meaning and
underlying psychological constructs of optimism with Dr Rebecca
McGuire-Snieckus, author of the Psychiatric Bulletin paper Hope, Optimism and
High Potential - developing talented
Professor Adrian Furnham discusses his book,
co-authored with Ian MacRae, High Potential: How to Spot,
Manage and Develop Talented People at Work, focussing on what
talent really is and recognising how it differs from
instability - the patient experience of the psychiatric assessment
Dr Amy Manley talks to Dr Kate Saunders about
her study on psychiatric assessment of mood instability using
qualitative methods to explore the patient experience of the
Social media and mental health
Social functioning in schizophrenia
View the most popular modules and podcasts over the past
Advances in Psychiatric
Highlights of the
et al discuss the entangled relationship between cognitive
impairment and alcohol use/misuse, covering the spectrum from mild
and subtle cognitive change to severe alcohol-related brain damage.
They highlight aids to the diagnosis and management of these
conditions, review progress in understanding their neurobiology and
suggest a model of improved service configuration.
interventions for dementia: from evidence to
The evidence base for psychosocial interventions for people
with dementia and their carers is not yet robust enough to indicate
which interventions are most suited for which environment. However,
Patel et al find that music therapy, aromatherapy, life
story work, animal-assisted therapy and post-diagnosis/carer
support work show promising results.
Don’t forget to tell your junior colleagues
about CPD Online’s new ‘sister site’ Trainees Online (TrOn) – currently
free to access for trainees and other College Members.
or renew with CPD Online – subscriptions can start
from any point during the year.
With best wishes,
The CPD Online Team