No century for old philosophy

This paper introduces the reader to some of the central themes and tenets of Slavoj Zizek's magnusm opus, Less than Nothing. Why does Zizek ascribe fundamental importance to the "old philosophy" Hegel? Relatedly. Why do we need to move beyond the Kantian universe

Essential ingredients of engagement when working alongside people after their first episode of psychosis: A qualitative meta-synthesis

AIM: Early intervention services (EISs) for first-episode psychosis (FEP) have been established internationally, however, service disengagement is a recurrent concern resulting in unplanned treatment cessation. The implications of this are far-reaching due to the financial and personal costs associated with untreated symptoms. The aim of this meta-synthesis was to collect, interpret and synthesize qualitative research about how engagement is experienced within EISs for FEP. METHODS: A systematic search was conducted in PsycINFO, Ovid MEDLINE and Ovid Emcare from date of conception to November 2016. Following initial screening, 91 abstracts and 13 full texts were reviewed for eligibility. Nine studies were then critically appraised using the CASP tool for qualitative studies, data were systematically extracted and results were synthesized using constant comparison and reciprocal translational analysis. RESULTS: Nine qualitative studies explored engagement with EISs, from the perspectives of service users and their caregivers. No studies were found from the perspectives of clinicians or services. All 9 studies employed an inductive methodology, within an interpretivist epistemology. Five main themes were identified: experiences of finding help; factors promoting engagement; the therapeutic relationship; the role of caregivers in supporting engagement; and factors impacting ongoing engagement. CONCLUSIONS: There is a critical need to stimulate discussion around this multifaceted phenomenon, including a continued focus on the roles of key stakeholders and clinical models that may further facilitate collaboration in treatment plans and recovery

Views of early psychosis clinicians on discontinuation of antipsychotic medication following symptom remission in first episode psychosis

Aims Discontinuation of antipsychotics following remission in first episode psychosis (FEP) is a contentious area of practice. We aimed to investigate the views of early psychosis clinicians on this important clinical question. Methods We designed an 11 question online survey on medication discontinuation following remission of symptoms in FEP. The questionnaire was distributed to early intervention team workers in England and Wales via members of the National Early Psychosis Network who were requested to distribute it to their teams. Results We received 172 questionnaire responses; 37% were nurses, 33% doctors, 11% psychologists and 19% were other allied health professionals. The average years of experience in psychiatry was 16.9. 75.4% of respondents thought that greater than 60% of patients would like to be considered for guided medication reduction/discontinuation. Only 31.4% of respondents said that medication should be continued for over a year following remission. 61.4% of respondents felt that the quality of life of individuals was better in those who stop medication following remission. There was a significant difference in the response of professional groups to this question. 82.6% of respondents said they would be happy to support their patients in participating in a randomized trial of graded antipsychotic reduction/discontinuation versus maintenance medication. Conclusions The views of clinicians regarding prophylactic antipsychotic medication following remission in FEP are much less conservative than those in current guidelines; concern was expressed by many about the impact of antipsychotic medication on quality of life. A randomized trial of maintenance antipsychotic medication versus graded reduction/discontinuation is feasible and has considerable clinician support