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122 results

Page 1 of 7

  • Chapter 6 - Psychotherapy

  • Edited by Christopher C. H. Cook, Andrew Powell
  • Book:
    Spirituality and Psychiatry
    Published online:
    07 October 2022
    Print publication:
    20 October 2022, pp 118-138

  • Summary

    In this chapter, the author sets out a unitive way of thinking about the relationship between spirituality, psychiatry and psychotherapy. An introduction to spirituality in mental health care is followed by a discussion of the meaning of ‘spirit’, ‘soul’ and ‘ego’ and how these terms may be understood with reference to ongoing developmental tasks. The poem I AM, written by the nineteenth-century poet John Clare, who suffered from enduring mental illness, is considered in depth from both psychoanalytic and Jungian approaches in order to illustrate different perspectives on Clare’s anguish and spiritual yearning. The evolution of transpersonal psychology, in which Jung’s concepts play an important part, is traced historically, with the increasing recognition of the value of spiritually orientated psychotherapy. The chapter concludes with several case studies by the author, illustrating how a range of soul-centred approaches can readily and helpfully engage with the spiritual reality of the patient.

    Referencing the poem I AM by John Clare, who suffered from mental illness. Psychoanalytic and Jungian therapies are compared in order to illustrate different perspectives on Clare’s anguish and spiritual yearning. A brief history of the evolution of transpersonal theory and of spiritually oriented therapeutic approaches is provided, and the chapter concludes with case studies illustrating how soul-centred therapy can readily and helpfully engage with the spiritual reality of the patient.

Spirituality and Psychiatry
  • 2nd edition
  • Edited by Christopher C. H. Cook, Andrew Powell
  • Published online:
    07 October 2022
    Print publication:
    20 October 2022
  • Spirituality and Psychiatry addresses the crucial but often overlooked relevance of spirituality to mental well-being and psychiatric care. This updated and expanded second edition explores the nature of spirituality, its relationship to religion, and the reasons for its importance in clinical practice. Contributors discuss the prevention and management of illness, and the maintenance of recovery. Different chapters focus on the subspecialties of psychiatry, including psychotherapy, child and adolescent psychiatry, intellectual disability, forensic psychiatry, substance misuse, and old age psychiatry. The book provides a critical review of the literature and a response to the questions posed by researchers, service users and clinicians, concerning the importance of spirituality in mental healthcare. With contributions from psychiatrists, psychologists, psychotherapists, nurses, mental healthcare chaplains and neuroscientists, and a patient perspective, this book is an invaluable clinical handbook for anyone interested in the place of spirituality in psychiatric practice.

  • Effectiveness and cost-effectiveness of psychiatric mother and baby units: quasi-experimental study

  • Louise M. Howard, Kylee Trevillion, Laura Potts, Margaret Heslin, Andrew Pickles, Sarah Byford, Lauren E. Carson, Clare Dolman, Stacey Jennings, Sonia Johnson, Ian Jones, Rebecca McDonald, Susan Pawlby, Claire Powell, Gertrude Seneviratne, Rebekah Shallcross, Nicky Stanley, Angelika Wieck, Kathryn M. Abel
  • Journal:
    The British Journal of Psychiatry / Volume 221 / Issue 4 / October 2022
    Published online by Cambridge University Press:
    04 May 2022, pp. 628-636
    Print publication:
    October 2022
    • Article
      • You have access
      • Open access
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  • Background

    Psychiatric mother and baby units (MBUs) are recommended for severe perinatal mental illness, but effectiveness compared with other forms of acute care remains unknown.

    Aims

    We hypothesised that women admitted to MBUs would be less likely to be readmitted to acute care in the 12 months following discharge, compared with women admitted to non-MBU acute care (generic psychiatric wards or crisis resolution teams (CRTs)).

    Method

    Quasi-experimental cohort study of women accessing acute psychiatric care up to 1 year postpartum in 42 healthcare organisations across England and Wales. Primary outcome was readmission within 12 months post-discharge. Propensity scores were used to account for systematic differences between MBU and non-MBU participants. Secondary outcomes included assessment of cost-effectiveness, experience of services, unmet needs, perceived bonding, observed mother–infant interaction quality and safeguarding outcome.

    Results

    Of 279 women, 108 (39%) received MBU care, 62 (22%) generic ward care and 109 (39%) CRT care only. The MBU group (n = 105) had similar readmission rates to the non-MBU group (n = 158) (aOR = 0.95, 95% CI 0.86–1.04, P = 0.29; an absolute difference of −5%, 95% CI −14 to 4%). Service satisfaction was significantly higher among women accessing MBUs compared with non-MBUs; no significant differences were observed for any other secondary outcomes.

    Conclusions

    We found no significant differences in rates of readmission, but MBU advantage might have been masked by residual confounders; readmission will also depend on quality of care after discharge and type of illness. Future studies should attempt to identify the effective ingredients of specialist perinatal in-patient and community care to improve outcomes.

  • Canadian Transport Medicine: Waypoints and Destinations

  • D. Gregory Powell, Andrew L. McCallum
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 22 / Issue S2 / September 2020
    Published online by Cambridge University Press:
    21 October 2020, pp. S1-S3
    Print publication:
    September 2020
    • Article
      • You have access
      • Open access
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  • Septic Shock: A Genomewide Association Study and Polygenic Risk Score Analysis

  • Shannon D’Urso, Dorrilyn Rajbhandari, Elizabeth Peach, Erika de Guzman, Qiang Li, Sarah E. Medland, Scott D. Gordon, Nicholas G. Martin, CHARGE Inflammation Working Group, Symen Ligthart, Matthew A. Brown, Joseph Powell, Colin McArthur, Andrew Rhodes, Jason Meyer, Simon Finfer, John Myburgh, Antje Blumenthal, Jeremy Cohen, Balasubramanian Venkatesh, Gabriel Cuellar-Partida, David M. Evans
  • Journal:
    Twin Research and Human Genetics / Volume 23 / Issue 4 / August 2020
    Published online by Cambridge University Press:
    05 August 2020, pp. 204-213
    • Article
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  • Previous genetic association studies have failed to identify loci robustly associated with sepsis, and there have been no published genetic association studies or polygenic risk score analyses of patients with septic shock, despite evidence suggesting genetic factors may be involved. We systematically collected genotype and clinical outcome data in the context of a randomized controlled trial from patients with septic shock to enrich the presence of disease-associated genetic variants. We performed genomewide association studies of susceptibility and mortality in septic shock using 493 patients with septic shock and 2442 population controls, and polygenic risk score analysis to assess genetic overlap between septic shock risk/mortality with clinically relevant traits. One variant, rs9489328, located in AL589740.1 noncoding RNA, was significantly associated with septic shock (p = 1.05 × 10–10); however, it is likely a false-positive. We were unable to replicate variants previously reported to be associated (p < 1.00 × 10–6 in previous scans) with susceptibility to and mortality from sepsis. Polygenic risk scores for hematocrit and granulocyte count were negatively associated with 28-day mortality (p = 3.04 × 10–3; p = 2.29 × 10–3), and scores for C-reactive protein levels were positively associated with susceptibility to septic shock (p = 1.44 × 10–3). Results suggest that common variants of large effect do not influence septic shock susceptibility, mortality and resolution; however, genetic predispositions to clinically relevant traits are significantly associated with increased susceptibility and mortality in septic individuals.

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