All will be sad to learn that L. G. Grimmett died suddenly from heart failure on May 27 at Houston, Texas, U.S.A. Although I worked as his assistant for only 18 months, in 1934–35, I always felt a surge of pleasure on meeting him again and on hearing of his exploits. His was a unique personality, not to be forgotten. He was a pianist of the first rank, a script writer, a bookbinder, and a worker with precious metals. On leaving a secondary school he paid the expenses of a degree course at King's College from his earnings in restaurant and theatre bands. In a vacation he made a voyage as ship's pianist to Buenos Aires.
Our auditIn March 2021 we published our second audit of how ECT is administered and monitored.As in our first review (Read et al., 2018), most recipients were women and over 60.Four NHS Trusts had given ECT to a child (under 18).More than a third of patients were given ECT without consent, under the Mental Health Act.As before, most Trusts were unable to report how many patients were offered psychological therapy before being given ECT.Most Trusts were not using standardised measures of depression or cognitive dysfunction.Fewer than one in five had any outcome data during treatments.None had follow-up data.There was a 47fold difference in usage between the highest and lowest using Trusts.
The traditional starting place when attempting to summarize a body of research
is to search a database such as PsycINFO. Searching ‘families’ or ‘family’ and
‘schizophrenia’ or ‘psychosis’ produced 10,296 articles. A scan of the fi rst 100 of
these, however, revealed that none had asked the relatives themselves what they
thought, or felt. They were mostly about genetics, biological abnormalities and
psychiatric drugs. Refi ning the search using ‘subjective experience’ or ‘fi rst
person’ produced just 71 papers.
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Evidence suggests that adverse experiences in childhood are associated with psychosis. To examine the association between childhood adversity and trauma (sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death, and bullying) and psychosis outcome, MEDLINE, EMBASE, PsychINFO, and Web of Science were searched from January 1980 through November 2011. We included prospective cohort studies, large-scale cross-sectional studies investigating the association between childhood adversity and psychotic symptoms or illness, case-control studies comparing the prevalence of adverse events between psychotic patients and controls using dichotomous or continuous measures, and case-control studies comparing the prevalence of psychotic symptoms between exposed and nonexposed subjects using dichotomous or continuous measures of adversity and psychosis. The analysis included 18 case-control studies (n = 2048 psychotic patients and 1856 nonpsychiatric controls), 10 prospective and quasi-prospective studies (n = 41 803) and 8 population-based cross-sectional studies (n = 35 546). There were significant associations between adversity and psychosis across all research designs, with an overall effect of OR = 2.78 (95% CI = 2.34–3.31). The integration of the case-control studies indicated that patients with psychosis were 2.72 times more likely to have been exposed to childhood adversity than controls (95% CI = 1.90–3.88). The association between childhood adversity and psychosis was also significant in population-based cross-sectional studies (OR = 2.99 [95% CI = 2.12–4.20]) as well as in prospective and quasi-prospective studies (OR = 2.75 [95% CI = 2.17–3.47]). The estimated population attributable risk was 33% (16%–47%). These findings indicate that childhood adversity is strongly associated with increased risk for psychosis.
ABSTRACT Identification of child abuse by mental health services is important for formulation of the causes of presenting problems and for development of comprehensive treatment plans. A small but growing number of studies suggest, however, that the majority of child sexual abuse cases are not identified by mental health services. A similarly small literature also suggests that abuse survivors are extremely reluctant to spontaneously tell anyone about the abuse, indicating that professionals have a responsibility to ask rather than wait for spontaneous disclosures. The purpose of this study, therefore, was to add to these two bodies of literature with a New Zealand sample. A postal questionnaire was completed by 191 women who had received counselling for childhood sexual abuse. The average amount of time taken to tell anyone about the abuse was 16 years. Only 22% of those who had been in contact with public mental health services had ever been asked about abuse by those services. It was concluded that New Zealand women are reluctant to disclose abuse and that mental health services are, as is the case elsewhere, failing to assist them with this process. The need for staff training is discussed, and an example described.
Given the apparent failure of the "mental illness is an illness like any other" approach to reducing negative stereotypes of people with mental health problems, the differential effects of biogenetic and psychosocial explanations of psychiatric symptoms were evaluated. Attitude measures were administered to young New Zealand adults before and after a video portraying a young man with psychotic symptoms followed by either biogenetic or psychosocial explanations. Consistent with previous studies, the "medical model" approach significantly increased perceptions of dangerousness and unpredictability. Following the psychosocial explanation there was a slight but statistically insignificant improvement in attitudes. Participants who knew users of psychiatric services, or who had used services themselves, had more positive attitudes than other participants. It is recommended that destigmatization programs minimize efforts to persuade the public that mental health problems are biogenetic illnesses, and focus instead on increasing exposure to users of mental health services. Further research is required to determine whether such exposure should include life histories, so as to highlight the psychosocial causes of mental health problems.
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