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'Goodbye and Good Luck': the Mental Health Needs and Treatment
BRITISH JOURNAL OF PSYCHIATRY (2005), 186, 480^486 ‘Goodbye and good luck’: the mental health needs sample consisted of three randomly selected groups of service personnel: those who and treatment experiences of British ex-service served in the Persian Gulf War in 1990– 1991 (1991(nn¼4250), those who served in Bosnia between 1992 and 1997 (nn¼4250) and an personnelpersonnel ‘Era’ group who served but were not deployed (deployed(nn¼4246). About a quarter of AMY IVERSEN, CLAIRE DYSON, NAOMI SMITH, NEIL GREENBERG, the cohort (nn¼3322) were contacted again REBECCA WALW YN, CATHERINE UNWIN, LISA HULL, MATTHEW HOTOPF, in 2001 (Hotopf et aletal, 2003). Almost all CHRISTOPHER DANDEKER, JOHN ROSS and SIMON WESSELY of those who took part in the 2001 survey (stage 3 of the investigation of this cohort) gave consent for further follow-up by Background Little is known aboutaboutthe the The war in Iraq has heightened recognition telephone.telephone. psychologicalhealth or treatment that active military service can adversely Our case group consisted of 701 in- affect the mental health of some who serve. dividuals for whom we had already collected experiences of those who have leftthe Despite this, little is known about the two waves of data, at baseline (1997) and at British armed forces. health of ex-service personnel in the UK. follow-up (2001). Inclusion criteria were After the Falklands War in 1982, several scores of 3 or more on the 12-item General Aims Todescribe the frequency and small, selective studies demonstrated poor Health Questionnaire (GHQ; Goldberg & associations of common mental disorders mental health among some returnees Williams, 1988) at stages 1 and 3 of our and help-seeking behavioursin a (O’Brien & Hughes, 1991; Orner et al,etal, original investigation (nn¼636), and all those representative sample of UKveterans 1993), but little has been published on the who were unemployed at stage 3, having left at high risk of mental health problems. -
Professor Simon Wessely MA BM Bch Msc MD FRCP Frcpsych Fmedsci a Career in Psychiatry
Professor Simon Wessely MA BM BCh MSc MD FRCP FRCPsych FMedSci A Career in Psychiatry SIMON, TELL US A LITTLE ABOUT YOURSELF AND WHAT LED YOU TO PHYSCHIATRY I was doing medicine because I wanted to be a doctor, but I can’t remember why that was now. However, I did and I was enjoying it. I first went to Cambridge and took an art degree, but I was going through the medical curriculum and courses; then went to on to Oxford and I became more and more interested in the wider issues. It wasn’t just about pulling out drips, doing cardiac arrests and learning the more practical side of medicine, although that is crucial; I found myself being drawn to the more complicated parts of medicine and more and more into psychiatry which takes a broader view of people than just seeing them as a collection of cells or a collection of organs. Psychiatry did see people like that, but also it is the main discipline that sees people actually as people as well. And I found that fascinating. SO WHAT WHO MAKES A REALLY GOOD PSYCHIATRIST? Well psychiatrists… There are certain things that they are not! They are not normally decisive action figures like our surgeons like to think of themselves. We are a little bit more patient, a little bit more reflective, but I think most of all we are more curious about people; how they are; how they think; what they do’ what is it that make them tick. We see people as more than the sum of their parts. -
The Rise and Fall of the Wessely School
THE RISE AND FALL OF THE WESSELY SCHOOL David F Marks* Independent Researcher Arles, Bouches-du-Rhône, Provence-Alpes-Côte d'Azur, 13200, France *Address for correspondence: [email protected] Rise and Fall of the Wessely School THE RISE AND FALL OF THE WESSELY SCHOOL 2 Rise and Fall of the Wessely School ABSTRACT The Wessely School’s (WS) approach to medically unexplained symptoms, myalgic encephalomyelitis and chronic fatigue syndrome (MUS/MECFS) is critically reviewed using scientific criteria. Based on the ‘Biopsychosocial Model’, the WS proposes that patients’ dysfunctional beliefs, deconditioning and attentional biases cause illness, disrupt therapies, and lead to preventable deaths. The evidence reviewed here suggests that none of the WS hypotheses is empirically supported. The lack of robust supportive evidence, fallacious causal assumptions, inappropriate and harmful therapies, broken scientific principles, repeated methodological flaws and unwillingness to share data all give the appearance of cargo cult science. The WS approach needs to be replaced by an evidence-based, biologically-grounded, scientific approach to MUS/MECFS. 3 Rise and Fall of the Wessely School Sickness doesn’t terrify me and death doesn’t terrify me. What terrifies me is that you can disappear because someone is telling the wrong story about you. I feel like that’s what happened to all of us who are living this. And I remember thinking that nobody’s coming to look for me because no one even knows that I went missing. Jennifer Brea, Unrest, 20171. 1. INTRODUCTION This review concerns a story filled with drama, pathos and tragedy. It is relevant to millions of seriously ill people with conditions that have no known cause or cure. -
Current Strategies for Investigating the Genetic and Environmental Risk
BRITISH JOURNAL OF PSYCHIATRY (2005), 186, 179^181 EDITORIAL Current strategies for investigating the genetic and positional candidate gene G72G72 in bothinboth disorders (Elkin et aletal, 2004). Thus, the environmental risk factors for affective disorders* molecular and the quantitative genetic findings appear to be convergent in suggest- ing three sets of genes: one conferring liab- ANNE FARMER, THALIA C. ELEY and PETER McGUFFIN ility to both schizophrenia and bipolar disorder, and two that are specific for each of the two main Kraepelinian syndromes. Interestingly, in the quantitative analyses the environmental risk factors appeared to be specific to each psychotic disorder. A rather different type of analysis seeks It is probable that the genetic components schemes of subtyping are of any use (Ken- to tease out dimensions within the broad of affective disorders (bipolar affective dell, 1976; Farmer & McGuffin, 1989). category of recurrent depression. Using disorder, major depressive disorder and One typology that has stood the test of time phenotypic data from participants in cur- anxiety states) result from multiple genes and seems clinically useful is the unipolar/ rent large-scale genetic studies of depres- that confer a susceptibility or liability to bipolar subdivision. Until recently, a sion (see below), this has produced some develop the disorder when other (environ- common view (Gershon et aletal, 1982) was interesting early results. Factor analysis of mental) risk factors are also present. In that bipolar affective disorder and major psychopathology from worst and second- general, bipolar affective disorder has been depressive disorder lie on the same severity worst episodes of depression in sibling pairs found to have the highest heritability (i.e. -
A Breath of Fresh Air
European Journal of Human Genetics (2006) 14, 1145–1146 & 2006 Nature Publishing Group All rights reserved 1018-4813/06 $30.00 www.nature.com/ejhg familiar with genetic terminology. Chap- BOOK REVIEW ter references are indicated with an * or a diamond } depending on relevance and an excellent way to find a good reference A breath of fresh air quickly. ...................................... I enjoyed the miscellaneous section Respiratory Genetics most – covering rare diseases and syn- dromes. It is up to date and includes EK Silverman, SD Shapiro, DA Lomas, ST Weiss. Hodder Arnold, 2005. discussion of causes of hereditary and ........... sporadic pneumothorax including certain Patrick J Morrison mutations in Birt-Hogg-Dube´ syndrome – ......................................................................... something that was not really recognised until recently. European Journal of Human Genetics (2006) 14, 1145 . There are only six colour plates – doi:10.1038/sj.ejhg.5201672 disappointing in a book of this size but overall, this is a great book for respiratory and interested general physicians. General his is an excellent new textbook to carry out a good Pub Med search, and a clinical geneticists will find it useful to on respiratory genetics – an area succinct guide to SNPs and microarrays. have a copy in the library for reference, that has suddenly emerged over Other chapters cover pharmacokinetics and may find their laboratory colleagues T the last decade. and functional genomics. having a look at the more clinical sec- It is well written and divided into four Parts 2–4 cover three clinical respira- tions. This book should become the clear sections: tory disease sections – Part 2 covers standard reference text in this area’ Part 1 deals with key concepts in obstructive lung disease – asthma, chronic respiratory genetics – this section is tar- pulmonary disease and cystic fibrosis are Patrick J Morrison is a Professor in the geted at nongeneticists and will not be of covered comprehensively. -
Cohort Study Within UK Armed Forces Deployed to Iraq
Downloaded from bmj.com on 1 July 2008 Multiple vaccinations, health, and recall bias within UK armed forces deployed to Iraq: cohort study Dominic Murphy, Matthew Hotopf and Simon Wessely BMJ 2008;337;220- doi:10.1136/bmj.a220 Updated information and services can be found at: http://bmj.com/cgi/content/full/337/jun30_1/a220 These include: References This article cites 23 articles, 8 of which can be accessed free at: http://bmj.com/cgi/content/full/337/jun30_1/a220#BIBL Rapid responses You can respond to this article at: http://bmj.com/cgi/eletter-submit/337/jun30_1/a220 Email alerting Receive free email alerts when new articles cite this article - sign up in the service box at the top left of the article Topic collections Articles on similar topics can be found in the following collections Occupational Health (1301 articles) Anxiety disorders (including OCD and PTSD) (230 articles) Other Epidemiology (1717 articles) Chronic diseases (129 articles) Drugs: immunological products and vaccines (461 articles) Notes To order reprints follow the "Request Permissions" link in the navigation box To subscribe to BMJ go to: http://resources.bmj.com/bmj/subscribers Downloaded from bmj.com on 1 July 2008 RESEARCH Multiple vaccinations, health, and recall bias within UK armed forces deployed to Iraq: cohort study Dominic Murphy, research worker , Matthew Hotopf, professor of general hospital psychiatry, Simon Wessely, professor of epidemiology and liaison psychiatry King’s Centre for Military Health ABSTRACT and that recall bias was responsible for the results. ’ Research, King s College London Objective To assess the relation between self reported Retrospective recall of symptoms can be affected by SE5 9RJ number of vaccinations received and health, and between 12 Correspondence to: D Murphy recall bias. -
Rapid Research for the COVID-19 Response
Rapid research for the COVID-19 response The role of the Emergency Preparedness and Response HPRU The Health Protection Research Unit in Emergency Preparedness & Response About the Unit The National Institute for Health Research Health Protection Research Unit (HPRU) in Emergency Preparedness and Response is a partnership between King’s College London, Public Health England and the University of East Anglia. The Unit was set up on 1 April 2014 and, following two rounds of renewal, it is funded until 31 March 2025. To date, we have received core funding of over £8million from the NIHR. Our mission statement is simple: We conduct research to minimise the impact of emergencies. Over the past decade, we have supported Public Health England and other Government agencies to respond to, and learn lessons from, incidents including the swine flu pandemic, the Fukushima meltdown, the Ebola outbreak, several episodes of major flooding, the novichok incident, heatwaves, the Zika outbreak, climate change, anthrax incidents, humanitarian crises , major terrorist attacks and of course COVID-19. In working on these issues, we focus particularly on our strengths in behavioural science, mental health, emergency preparedness exercises, syndromic surveillance and mass casualty decontamination. The Unit regularly contributes experts to national and international panels, including: • the Government Chief Science Advisor’s Scientific Advisory Group for Emergencies (SAGE); • the Department of Health and Social Care’s New and Emerging Respiratory Virus Technical -
Eliot Slater's Contribution
Causes of common mental health problems in adults Peter McGuffin MRC SGDP Centre Institute of Psychiatry, King‟s College London Sir Francis Galton (1822-1911) „…Nature prevails enormously over nurture‟(1883) The history of twins as a criterion of the relative powers of nature and nurture (1876) „..a born devil,on who‟s nature, nurture cannot stick.‟ Prospero of Caliban in Shakespeare‟s „The Tempest‟ Act iv scene i (Michael Horton as Caliban) Psychiatrists‟ opening gambits 1 Have you suffered vexation, grief or reverse of fortune? Phillipe Pinel (quoted by Sir Michael Rutter) Psychiatrists‟ opening gambits 2 Are you a twin? Eliot Slater (quoted by Sir Denis Hill) Excerpt from a Bethlem Royal Hospital front sheet 1823 Cardiff Study of Depression in Siblings (Farmer et al 2000) % reported % CATEGO current past cases D-siblings 7.4 17.6 18.5 C-siblings 0 4.8 1.9 Behaviours that run in families . Huntington‟s disease . Alzheimer‟s disease . Depression . Schizophrenia . Personality . Intelligence . Religious involvement . Attending medical school Why might a disorder run in families? . Shared genes . Shared environment . A combination of the two behaviour Natural experiments teasing apart genes and environment Twin studies : is there more similarity monozygotic ( one egg) than dizygotic ( two egg) pairs? Adoption studies: do individuals resemble their biological relatives more than adopting relatives? The Cholmondeley Ladies c.1600-10 MZ TWINS . MZ (monozygotic) twins have 100% of their genes in common (they‟re „natural clones‟) . Shared environment -
FORUM Annual Lecture 2016 Report
What can research do to improve productivity in the NHS? 6 April 2016 Summary report of the 2016 FORUM Annual Lecture, given by Dame Julie Moore, Chief Executive, University Hospitals Birmingham NHS Foundation Trust, and following panel discussion The Academy of Medical Sciences The Academy of Medical Sciences is the independent body in the UK representing the diversity of medical science. Our mission is to promote medical science and its translation into benefits for society. The Academy’s elected Fellows are the United Kingdom’s leading medical scientists from hospitals, academia, industry and the public service. We work with them to promote excellence, influence policy to improve health and wealth, nurture the next generation of medical researchers, link academia, industry and the NHS, seize international opportunities and encourage dialogue about the medical sciences. The Academy of Medical Sciences’ FORUM The Academy’s FORUM was established in 2003 to recognise the role of industry in medical research, and to catalyse connections across industry, academia and the NHS. Since then, a range of FORUM activities and events have brought together researchers, research funders and research users from across academia, industry, government, and the charity, healthcare and regulatory sectors. The FORUM is a major component of the Academy's work to deliver the strategic objective of 'linking academia, industry and the NHS' and its success relies on supporter organisations who make an annual donation. We are grateful for the support provided by the members and are keen to encourage more organisations to take part. If you would like information on becoming a member please contact [email protected]. -
Ten Years On: What Do We Know About the Gulf War Syndrome?
n PROFESSIONAL ISSUES Ten years on: what do we know about the Gulf War syndrome? Simon Wessely and the King’s College Gulf War Research Unit Simon Wessely The Gulf War and its aftermath The evidence so far Professor of Epidemiology and We have just passed the tenth anniversary of Case series Liaison Psychiatry, Operation Desert Storm, the start of the The first co-ordinated response to the problem was Guy’s, King’s and Persian Gulf War. The facts are clear. Iraq occupied to invite any veteran with health problems to come St Thomas’ School Kuwait on 2 August 1990. Shortly after Coalition forward for detailed medical evaluation. This began of Medicine, Forces, led by the United States, began a military in the United States, and was then repeated in the London deployment known as Operation Desert Shield. On United Kingdom with the establishment of the 17 January 1991 an active air campaign began Medical Assessment Programme (MAP). Over Clin Med JRCPL against Iraq, Operation Desert Storm, and on 200,000 US and 2,000 UK veterans have now 2001;1:28–37 24 February a ground war began, lasting only four attended these programmes. Studies of these groups days. It was a resounding military success. Iraqi have not suggested any unusual pattern of illness – forces were beaten in the field and expelled from instead the largest diagnostic category has symptoms Kuwait. and syndromes such as chronic fatigue, pain and Not only was the campaign a military success, it others without an adequate medical explanation 2–4. was also a medical success. -
The Social Distancing Norm Cascade
The Social Distancing Norm Cascade The role of belief systems in accelerating normative change during the COVID-19 pandemic Scott Janzwood CI Technical Paper #2020-1 Version 1.2 April 27. 2020 About the author Scott Janzwood is the Deputy Director of Research and Operations at the Cascade Institute. His research focuses on how scientists and policymakers collaborate to address global catastrophic risks such as climate change, pandemics, and other emerging threats. He also studies strategies and tools that we can use to make decisions under deep uncertainty. Contributors: Michael Lawrence, Postdoctoral Researcher, Cascade Institute Thomas Homer-Dixon, Founder and Director, Cascade Institute The views expressed herein are those of the author(s) and do not necessarily reflect the views of the Cascade Institute, its other researchers, its funders, or any institutions and organizations with which the Institute is affiliated. Citation Information Janzwood, Scott. (2020): “The social distancing norm cascade: the role of belief systems in accelerating normative change during the COVID-19 pandemic.” Technical Paper #2020-1, v1.2, Cascade Institute: pp. 1-31. Copyright © 2020 by Cascade Institute Partners and Collaborators Partner Institution: Collaborating Institutions: The Winslow Foundation 13 Summary Over a period of roughly four weeks, from early March to early April 2020, countries around the world experienced rapid and widespread changes in attitudes and behaviours toward social distancing practices, in response to the COVID-19 pandemic. (In Canada, the change occurred in about a week, from March 11 to March 18.) These changes were particularly impressive in liberal democracies that did not implement harsh penalties to enforce compliance with social distancing rules, but instead largely relied on the strategic communication of government guidelines and the voluntary adoption of “encouraged” social distancing practices. -
A Point of Rarity in Genetic Risk for Bipolar Disorder and Schizophrenia
ORIGINAL ARTICLE Rare Copy Number Variants A Point of Rarity in Genetic Risk for Bipolar Disorder and Schizophrenia Detelina Grozeva, MSc; George Kirov, PhD, MRCPsych; Dobril Ivanov, MSc; Ian R. Jones, PhD, MRCPsych; Lisa Jones, PhD; Elaine K. Green, PhD; David M. St Clair, MD, PhD; Allan H. Young, PhD, FRCPsych; Nicol Ferrier, PhD, FRCPsych; Anne E. Farmer, PhD, FRCPsych; Peter McGuffin, PhD, FRCPsych; Peter A. Holmans, PhD*; Michael J. Owen, PhD, FRCPsych*; Michael C. O’Donovan, PhD, FRCPsych*; Nick Craddock, PhD, FRCPsych*; for the Wellcome Trust Case Control Consortium Context: Recent studies suggest that copy number varia- Main Outcome Measures: Overall load of CNVs and tion in the human genome is extensive and may play an presence of rare CNVs. important role in susceptibility to disease, including neu- ropsychiatric disorders such as schizophrenia and autism. Results: The burden of CNVs in bipolar disorder was The possible involvement of copy number variants (CNVs) not increased compared with controls and was signifi- in bipolar disorder has received little attention to date. cantly less than in schizophrenia cases. The CNVs pre- viously implicated in the etiology of schizophrenia were Objectives: To determine whether large (Ͼ100 000 base not more common in cases with bipolar disorder. pairs) and rare (found in Ͻ1% of the population) CNVs are associated with susceptibility to bipolar disorder and Conclusions: Schizophrenia and bipolar disorder dif- to compare with findings in schizophrenia. fer with respect to CNV burden in general and associa- tion with specific CNVs in particular. Our data are con- Design: A genome-wide survey of large, rare CNVs in a sistent with the possibility that possession of large, rare case-control sample using a high-density microarray.