CPD Online eNewsletter June 2015

News:

Attending the RCPsych International Congress this year? Visit the new 'Online Hub' on the College stand for demonstrations of CPD Online, Trainees Online and Portfolio Online. Plus lots of staff on hand to answer your questions.

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Educational feature:

Plus ça change……

By Dr Stuart Leask, CPD Online Editor

"Democracy is the worst form of government, except for all the others”. Since Winston Churchill was a politician, he presumably knew what he was talking about. Here in the UK we are told we have experienced a tectonic shift in our relationship with both Right and Left; that our recent election has destroyed and created in equal measure on an unprecedented scale… leaving us with pretty much the same government and the same policies we had before.

In clinical work we’re all pretty used to this – change heralded as paradigm-shifting and profound, but back in the clinic we carry on seeing the same sort of people with the same sort of problems, requiring the same sort of carefully-considered care, often from the same limited range of responses. Change comes slowly, over extended periods of time; it requires alterations in approach, modifications in treatment and gradual adoption of new services. No earthquakes – which is usually just as well, as it is our patients who tend to be the first to fall down the cracks.

CPD Online’s authors are all experienced senior clinicians who have been working to provide the best care, informed by the evidence base, in turn modified by experience in whatever circumstances they find themselves. For this reason we hope their content will seem relevant and applicable to your clinical setting, and not require huge upheaval for patients to benefit. Two recent modules – Social functioning in schizophrenia and Alcohol-related brain damage – cover topics that are unlikely to win elections or completely change the current landscape… but of course, our patients are only likely to benefit if we can keep abreast of new understanding and approaches to such common, challenging areas.

Leadership and management series: Part 2 – time management for psychiatrists

Consultant psychiatrists are expected to demonstrate flexibility, decisiveness and a high level of organisation, as well as act as positive role models to those around them. They often work long hours and are vulnerable to stress and burnout. It is frequently claimed that successful time management can reduce stress and improve personal efficiency, service delivery and patient care, but time management publications tend to read as long lists of suggestions rather than scientific analyses of various techniques in a range of clinical contexts.This module considers the key theories and models of time management and provides practical strategies to plan and prioritise effectively.

It is estimated that 1 million people in the UK will be living with dementia by 2021, with dementia care currently costing the economy an estimated £23 billion per year. But diagnosis of the condition is becoming easier with the emergence of neuroimaging. This module reviews the role of neuroimaging and provides a practical guide to the appropriate use and evaluation of brain scans.

Stimulants: epidemiology and impact on mental health and Stimulants: treatment approaches and organising services [Revised & updated by the authors]

Stimulants are the most commonly used substances for recreational purposes worldwide. Even occasional misuse may result in a number of detrimental effects by increasing the risks of acute, chronic physical and mental health problems. These modules cover the epidemiology and psychopathological consequences related to substance misuse and explore how treatment approaches should mirror the clinical complexity of stimulant misuse whilst incorporating psychiatric, medical and social management skills.

Immune abnormalities across psychiatric disorders: clinical relevance
Valeria Mondelli et al summarise the evidence linking inflammation in the periphery and central nervous system to the development of depression, schizophrenia and bipolar disorder. They discuss how a pathophysiological role for inflammation has been recognised in some patients across different psychiatric disorders, and consider a role for these findings in future diagnostic classifications and treatment strategies.

Obsessive–compulsive disorder is one of the most debilitating psychiatric conditions in young people. Tim Williams & Roz Shafran review the considerable research into its pharmacological and psychological treatment, concluding that cognitive–behavioural therapy (CBT) is now the first-choice treatment. They explain some of the elements of CBT and describe new directions in treatment research.