Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

62 results

Page 1 of 4

  • Real-world clinical and cost-effectiveness of community clozapine initiation: mirror cohort study

  • Emma Butler, Toby Pillinger, Kirsten Brown, Faith Borgan, Alice Bowen, Katherine Beck, Enrico D'Ambrosio, Lisa Donaldson, Sameer Jauhar, Stephen Kaar, Tiago Reis Marques, Robert A. McCutcheon, Maria Rogdaki, Fiona Gaughran, James MacCabe, Rosalind Ramsay, David Taylor, Paul McCrone, Alice Egerton, Oliver D. Howes
  • Journal:
    The British Journal of Psychiatry / Volume 221 / Issue 6 / December 2022
    Published online by Cambridge University Press:
    19 April 2022, pp. 740-747
    Print publication:
    December 2022
    • Article
      • You have access
    • PDF
    • HTML
    • Export citation
  • Background

    Clozapine is the only drug licensed for treatment-resistant schizophrenia (TRS) but the real-world clinical and cost-effectiveness of community initiation of clozapine is unclear.

    Aims

    The aim was to assess the feasibility and cost-effectiveness of community initiation of clozapine.

    Method

    This was a naturalistic study of community patients recommended for clozapine treatment.

    Results

    Of 158 patients recommended for clozapine treatment, 88 (56%) patients agreed to clozapine initiation and, of these, 58 (66%) were successfully established on clozapine. The success rate for community initiation was 65.4%; which was not significantly different from that for in-patient initiation (58.82%, χ2(1,88) = 0.47, P = 0.49). Following clozapine initiation, there was a significant reduction in median out-patient visits over 1 year (from 24.00 (interquartile range (IQR) = 14.00–41.00) to 13.00 visits (IQR = 5.00–24.00), P < 0.001), and 2 years (from 47.50 visits (IQR = 24.75–71.00) to 22.00 (IQR = 11.00–42.00), P < 0.001), and a 74.71% decrease in psychiatric hospital bed days (z = −2.50, P = 0.01). Service-use costs decreased (1 year: –£963/patient (P < 0.001); 2 years: –£1598.10/patient (P < 0.001). Subanalyses for community-only initiation also showed significant cost reductions (1 year: –£827.40/patient (P < 0.001); 2 year: –£1668.50/patient (P < 0.001) relative to costs prior to starting clozapine. Relative to before initiation, symptom severity was improved in patients taking clozapine at discharge (median Positive and Negative Syndrome Scale total score: initial visit: 80 (IQR = 71.00–104.00); discharge visit 50.5 (IQR = 44.75–75.00), P < 0.001) and at 2 year follow-up (Health of Nation Outcome Scales total score median initial visit: 13.00 (IQR = 9.00–15.00); 2 year follow-up: 8.00 (IQR = 3.00–13.00), P = 0.023).

    Conclusions

    These findings indicate that community initiation of clozapine is feasible and is associated with significant reductions in costs, service use and symptom severity.

  • Effectiveness of automated appointment reminders in psychosis community services: a randomised controlled trial

  • Eugenia Kravariti, Christopher Reeve-Mates, Rafaela Da Gama Pires, Elias Tsakanikos, Daniel Hayes, Siobhan Renshaw, Sarah McAllister, Vishal Bhavsar, Pam Patterson, Emily Daley, Jane Stewart, Megan Pritchard, Hitesh Shetty, Rosalind Ramsay, Rocio Perez-Iglesias, Philip McGuire
  • Journal:
    BJPsych Open / Volume 4 / Issue 1 / January 2018
    Published online by Cambridge University Press:
    30 January 2018, pp. 15-17
    • Article
      • You have access
      • Open access
    • PDF
    • HTML
    • Export citation

  • We report on the first open-label, parallel group randomised controlled trial of automated appointment reminders in a psychosis community service in the UK. Ninety-five patients were randomly allocated to receiving/not receiving automated messaging reminders 7 days and 1 day before appointments. All ‘Attended’ and ‘Missed’ appointment outcomes over 6 months were analysed using cluster regression analysis. Reminded appointments were significantly more frequently attended than non-reminded appointments (unadjusted odds ratio (OR) = 3.54, 95% CI 1.36–9.22, P = 0.01; adjusted OR = 2.95, 95% CI 1.05–8.85, P < 0.05). Automated messaging reminders can provide a robust strategy for promoting engagement with psychosis services.

    Declaration of interest

    The authors have no competing financial interests to declare in relation to the current work. Sarah McAllister was supported by a King's Undergraduate Research Fellowship.

The Female Mind
  • User's Guide
  • Edited by Kathryn M. Abel, Rosalind Ramsay
  • Published online:
    02 January 2018
    Print publication:
    01 October 2017
  • This great book offers an up-to-date overview of how gender and sexuality affect mental health. It will help women to self-identify and self-manage the symptoms of mental ill health. The book covers a wide range of specific mental health disorders - many of which are more common in women - and includes real-life case studies, the latest treatments and where to find further help and support. It's written in an easy-to-read format to give an invaluable guide for women.

  • Foreword

  • Edited by Kathryn M. Abel, Rosalind Ramsay
  • Book:
    The Female Mind
    Published online:
    02 January 2018
    Print publication:
    01 October 2017, pp x-xi

  • Summary

    Until I reached my early 20s, I was happy to ignore the social realities of being a woman. As a child, I had an anxious temperament and I understood that a lot would be expected of me as an adult. It's no secret that the 21st-century woman is supposed to ‘do it all’. On top of the career, relationships, babies and having the perfect body (cheers for that), women are also expected to be the caregivers, the domestic goddesses and the ones who remember everybody's birthdays. Never mind if you have the flu or your period is giving you grief, those plates mustn't stop spinning, and perish the thought that you drop one. I was intimidated, but thought that if other women could do it without complaint, then surely I could, too.

    By the age of 24, that anxious ‘temperament’ of mine morphed into a full-blown anxiety disorder, eventually triggering a breakdown. I felt like a failure – everybody else seemed able to cope with life just fine, so what was wrong with me? I felt on edge constantly, tortured by panic attacks and bouts of insomnia. I was lost.

    In my quest for knowledge about my condition, I devoured a great deal of reading material. Unfortunately, I only understood around 9% of what I read, and the dictionary became my best friend. The more I read, the more frustrated I became. It was all so complicated and scary. That's why I started my blog, We're All Mad Here, to write about mental health without the use of unexplained medical jargon.

    In short, what I was looking for was this book.

    I'll admit that when I was originally approached to write the foreword I rolled my eyes. ‘Here we go again,’ I thought, ‘another stuffy academic textbook that only PhD students will understand’. However, within minutes of reading the first chapter I knew I was mistaken.

  • Introduction: being female

  • Edited by Kathryn M. Abel, Rosalind Ramsay
  • Book:
    The Female Mind
    Published online:
    02 January 2018
    Print publication:
    01 October 2017, pp xii-xiv

  • Summary

    What does it mean to be female? When we ask people this question, they all have an answer to it, in some form or another. And in some ways, we all know that the answer will depend on every individual's particular context or place in the world and, indeed, their age.

    But never has there been a time when the question of sex or gender is more in play. Some people do not wish to describe their gender as female or male. We need to understand the meaning of new terms like ‘gender fluidity’ where a person likes to describe themselves as a mix of girl and boy, identifying differently depending on time and place.

    By contrast perhaps, asexuality is used to describe a state in which sexual orientation is characterised by a persistent lack of sexual attraction towards any gender.

    Given this change in the landscape from a simple binary idea of being female or being male, and of gender or sexual identity, you may well ask how we can poduce a book entitled The Female Mind with any degree of confidence.

    We now know that being female is a very active process. In all mammals, the developing brain becomes actively masculinised so that the adult brain and adult reproductive behaviour are consistent with each other and with the sex cells (differentiated gonads) of the individual body. And although brain is thought of as being ‘destined to be female’ unless exposed to male hormones (testosterone) during pregnancy, we are now discovering that becoming female is not just a passive result of not having testes and not being exposed to testosterone. In fact, being female is a very active process indeed. To be female, the ‘male genetic programme’ has to be actively suppressed in females by a female-specific pattern of switching genes on and off by a process called methylation. Even more surprising perhaps, this brain feminisation is maintained by active suppression of masculinisation throughout life. More recent work suggests that this process can be influenced by a range of environmental effects (e.g. smoking/nutritional/ stress) to a greater or lesser extent.

  • 19 - Quality and quality governance

  • from Part II - Changes and conflicts
    • By Sarah Cornick, Specialist Registrar, General Adult Psychiatry, South London and Maudsley NHS Foundation Trust, Eleanor Cole, Consultant Psychiatrist and Associate Medical Director, South London and Maudsley NHS Foundation Trust, Rosalind Ramsay, Consultant Psychiatrist and Associate Clinical Director, South London and Maudsley NHS Foundation Trust
  • Edited by Dinesh Bhugra, Stuart Bell, Alistair Burns
  • Book:
    Management for Psychiatrists
    Published online:
    02 January 2018
    Print publication:
    23 September 2016, pp 277-295

  • Summary

    ‘Quality improvement is everyday business and work.’ (Juran, 1951)

    Quality of care in mental health services is important. Not only does it impact directly on health outcomes, safety and patient experience, but it also impacts on the cost of care and the reputation of each local organisation and the NHS as a whole.

    The Oxford English Dictionary defines quality as:

    ‘the standard of something as measured against other things of a similar kind; the degree of excellence of something.’

    Within healthcare, it has been less easy to define the concept of quality. The current definition of quality (see also Chapters 1 and 18) as applied in the NHS and enshrined in law through the Health and Social Care Act 2012 considers three dimensions:

  • • safety

  • • patient experience

  • • clinical effectiveness.

    • This definition fits with the US Institute of Medicine concept of quality which is often used in healthcare settings:

    ‘[quality is] the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.’ (Lohr, 1990)

    The US Institute of Medicine also identified six dimensions of healthcare quality (Committee on Quality of Health Care in America & Institute of Medicine, 2001), stating that healthcare must be:

  • • safe – avoiding injuries to patients from the care that is intended to help them

  • • effective – providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse)

  • • patient-centred – providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions

  • • timely – reducing waits and sometimes harmful delays for both those who receive and those who give care

  • • efficient – avoiding waste, in particular waste of equipment, supplies, ideas and energy

  • • equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographical allocation and socioeconomic status.

    • History of quality initiatives in the National Health Service

    Our current understanding of quality has, however, developed over many years of quality initiatives within the NHS and it is worth thinking about the development of the quality agenda over the longer term.

  • Dr Stephen McGowan

  • Rosalind Ramsay
  • Journal:
    The Psychiatrist / Volume 36 / Issue 6 / June 2012
    Published online by Cambridge University Press:
    02 January 2018, p. 238
    Print publication:
    June 2012
    • Article
      • You have access
      • Open access
    • PDF
    • HTML
    • Export citation

  • 25 - Women in medicine

    • By Rosalind Ramsay, Maudsley Hospital, London, Sheila Hollins, Professor of Psychiatry of Learning Disability, St George's Hospital, University of London
  • Edited by Tom Brown, John Eagles
  • Book:
    Teaching Psychiatry to Undergraduates
    Published online:
    02 January 2018
    Print publication:
    01 May 2011, pp 301-313

  • Summary

    Introduction

    The relevance of this chapter, in a book which is primarily about teaching students and secondarily about recruitment into psychiatry, may not be immediately obvious. There are, however, several salient reasons for its inclusion. The number of newly qualified doctors who are women has grown significantly over recent years, and the number of women psychiatrists is likely to grow to an even greater extent, since women preferentially select psychiatry as a medical career. We thus predict a higher number of female readers than male readers of this book but, we hope, it will be helpful for all readers to have an understanding of the broader issues relating to women in medicine. More specifically, issues relating to women in medicine will pervade both teaching and recruitment strategies. More female psychiatrists will be teaching more female students with the expectation that identification and role-modelling will be of benefit to teaching, recruitment and career progression in the specialty.

    Historical background

    In ancient civilisations such as Egypt and Greece, women played a role in the healing professions, while in England in the Middle Ages nuns would provide care within convents and for their surrounding communities. A few women gained formal qualifications, for example at the famous medical school in Bologna. However, as medical training became defined through formal education and qualifications rather than apprenticeship, a professional medical monopoly developed and women were excluded. The female Scottish surgeon James Miranda Barry (1792–1865) qualified and worked in the Army Medical Service, in disguise as a man. During the 19th century there were demands that women be able to gain admission to the medical profession but medical schools and examining bodies refused to accept them.

    Elizabeth Garrett Anderson (1836–1917) was inspired by the example of the first female American medical graduate, Elizabeth Blackwell (1821– 1910), and eventually succeeded in joining the medical register in 1866, via the Society of Apothecaries, after her father threatened to take the Society to court. Some British women obtained a medical education at universities on the Continent. Garrett Anderson and other pioneering women along with some male allies set up the London Medical School for Women in 1874.

  • 25 - Women in medicine

  • Edited by Tom Brown, {Author Role=Brown Doesn't exist.}, John Eagles, { Author Role= exceeds the limit of 5 characters including spacing}
  • Book:
    Teaching Psychiatry to Undergraduates
    Published by:
    Royal College of Psychiatrists
    Published online:
    25 February 2017
    Print publication:
    01 May 2011, pp 301-313

  • Summary

    Introduction

    The relevance of this chapter, in a book which is primarily about teaching students and secondarily about recruitment into psychiatry, may not be immediately obvious. There are, however, several salient reasons for its inclusion. The number of newly qualified doctors who are women has grown significantly over recent years, and the number of women psychiatrists is likely to grow to an even greater extent, since women preferentially select psychiatry as a medical career. We thus predict a higher number of female readers than male readers of this book but, we hope, it will be helpful for all readers to have an understanding of the broader issues relating to women in medicine. More specifically, issues relating to women in medicine will pervade both teaching and recruitment strategies. More female psychiatrists will be teaching more female students with the expectation that identification and role-modelling will be of benefit to teaching, recruitment and career progression in the specialty.

    Historical background

    In ancient civilisations such as Egypt and Greece, women played a role in the healing professions, while in England in the Middle Ages nuns would provide care within convents and for their surrounding communities. A few women gained formal qualifications, for example at the famous medical school in Bologna. However, as medical training became defined through formal education and qualifications rather than apprenticeship, a professional medical monopoly developed and women were excluded. The female Scottish surgeon James Miranda Barry (1792–1865) qualified and worked in the Army Medical Service, in disguise as a man. During the 19th century there were demands that women be able to gain admission to the medical profession but medical schools and examining bodies refused to accept them.

    Elizabeth Garrett Anderson (1836–1917) was inspired by the example of the first female American medical graduate, Elizabeth Blackwell (1821– 1910), and eventually succeeded in joining the medical register in 1866, via the Society of Apothecaries, after her father threatened to take the Society to court. Some British women obtained a medical education at universities on the Continent. Garrett Anderson and other pioneering women along with some male allies set up the London Medical School for Women in 1874.

  • Peer reviewing made easy

  • Neel Halder, Rosalind Ramsay, Peter Tyrer, Patricia Casey
  • Journal:
    Advances in Psychiatric Treatment / Volume 17 / Issue 2 / March 2011
    Published online by Cambridge University Press:
    02 January 2018, pp. 150-157
    Print publication:
    March 2011
    • Article
      • You have access
    • PDF
    • HTML
    • Export citation

  • Peer review in scientific journals has existed for over 200 years. This process is currently the accepted way of assessing scientific manuscripts prior to publication for most journals. Despite this, little has been written about the process of peer reviewing, with hardly anything specific to psychiatric journals. This article answers fundamental questions related to peer reviewing and includes practical tips to writing reviews. It will be helpful for those keen on improving their knowledge about the peer-review process. It will not only benefit those who are reviewers or thinking about becoming reviewers, but also authors, who can use the information to improve their chances of publication.

Page 1 of 4