CLASSIFICATION OF RISK IN PSYCHIATRY

Psychiatric risk-assessments generally quantify risk using broad, categorical, indicators (e.g., high-risk, low-risk). We examined reliability of such indicators when applied by mental-health professionals. Four versions of a questionnaire were used, each specifying a different clinical outcome along with a range of different probabilities at which that outcome might occur. Respondents classified each probability, allowing a comparison of the level of likelihood at which different professionals would apply the terms \u27high-risk\u27, \u27medium-risk\u27 and \u27low-risk\u27. We found little consistency among professionals who assessed risk for the same outcomes. Moreover, there were also large and unpredicted differences in response-profiles between the 4 clinical outcomes. These findings raise concerns about the communication value of current risk-assessment terminology

Does Obsessive-Compulsive Personality Disorder Belong Within the Obsessive-Compulsive Spectrum? Focus Points

• In this article, we consider the advantages and disadvantages of current categorical models for diagnosing obsessive-compulsive personality disorder (OCPD). • We review the similarities and differences between OCPD and obsessive-compulsive spectrum disorders. • We present a novel, neurocognitive approach to investigating OCPD. Abstract It has been proposed that certai

Structure and content of risk assessment proformas in mental healthcare

Original article can be found at: http://www.informaworld.com/smpp/title~content=t713432595 Copyright Informa / Taylor and Francis Group DOI: 10.1080/09638230600801462The NSF specifies that mental health service providers should have a locally agreed proforma for assessing risk. Risk assessment proformas (RAPs) currently in use vary considerably in both structure and content. This study describes some similarities and differences.Peer reviewe

A review of antipsychotics in the treatment of obsessive compulsive disorder

Original article can be found at: http://jop.sagepub.com/ Copyright British Association for Psychopharmacology. DOI: 10.1177/0269881105056640 [Full text of this article is not available in the UHRA]Although many individuals with obsessive compulsive disorder (OCD) show significant improvement after treatment with serotonin reuptake inhibitors (SRIs), the treatment effect is usually partial and residual symptoms remain in most cases despite continued treatment. The proportion of patients failing to achieve a satisfactory outcome is difficult to define, but may be estimated at approximately 40% of cases. Even after switching to a second SRI, approximately 30% of cases do not respond (March et al., 1997). While there is a wealth of empirical data supporting first-line treatment of OCD, the evidence–base for second-line treatments is slim. In this paper we review current evidence for co-administration of antipsychotics in SRI resistant cases of OCD, based upon, wherever possible, randomized controlled trials (RCTs). Uncontrolled studies are cited where systematic data are lacking (so far there have been no meta-analyses of treatment studies for this subgroup). A systematic search of electronic databases (EMBase [1974-date], MEDLINE [1966-date], PsychInfo [1987-date]) was run using combinations of the terms obsessive compulsive and (randomized or control or clinical trial or placebo or blind) or (systematic or review or meta-analysis), as well as individual drug names. This was complemented by consulting with colleagues in the field and reviewing recent unpublished data presented at international, peer-reviewed symposia. Most published studies have investigated acute treatment of OCD, with a shortage of data relating to the treatment-resistant condition. Previous reviews of this area (e.g., Sareen et al., 2004) have been superceded by the publication of several new studies within the last 12 months.Peer reviewe