Background The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp. One response to this problem has been the development of CBTp in brief formats that are targeted at a single symptom and the mechanisms that maintain distress. We have developed a brief form of CBTp for distressing voices and reported preliminary evidence for its effectiveness when delivered by highly trained therapists (Clinical Psychologists). This study will investigate the delivery of this intervention by a cost-effective workforce of Assistant Psychologists following a brief training and evaluate the acceptability and feasibility of conducting a future, definitive, randomised control trial (RCT). Methods This is a feasibility study for a pragmatic three-arm parallel group superiority 1:1:1 RCT comparing a Guided self-help CBT intervention for voices and treatment as usual (GiVE) to Supportive Counselling and treatment as usual (SC) to Treatment as usual alone (TAU), recruiting across two sites, with blinded post-treatment and follow-up assessments. A process evaluation will quantitatively and qualitatively explore stakeholder experience. Discussion Expected outcomes will include an assessment of the feasibility of conducting a definitive RCT and data to inform the calculation of its sample size. If evidence from a subsequent fully powered RCT suggests that GiVE is clinically and cost effective when delivered by briefly trained Assistant Psychologists, CBTp offered in these less resource-intensive forms has the potential to generate benefits for individual patients (reduced distress, enhanced recovery and enhanced quality of life), service-level patient benefit (increased access to evidence-based psychological therapies) and economic benefits to the NHS (in terms of the reduced use of mental health inpatient services). Administrative Information Increasing access to CBT for psychosis patients: a feasibility, randomized co 4 Title {1} evaluating brief, targeted CBT for distressing voices delivered by Assistant (GiVE2) Trial registration {2a and 2b}. Current Controlled Trials ISRCTN registration number: 16166070.

No abstract

Aims and MethodsTo evaluate a new integrated weight management and fitness service for long-stay psychiatric patients who were obese or overweight with physical health risks. Body size and fitness were measured before and after each 10- to 12-week programme.ResultsThe number of patients referred to the programme was 145; 102 were accepted, 95 started a programme and 46 completed it. Analysis was by intention-to-treat. There were significant reductions in weight (P=0.001), body mass index (BMI, P=0.001) and waist size (P=0.001), and considerable improvements in hand strength (left hand, P=0.03; right hand, P=0.015), flexibility (P=0.022), lung function (P=0.001) and aerobic capacity (P=0.001).Clinical ImplicationsAn integrated programme of weight management and fitness is effective in reducing body weight and waist size, and in improving physical fitness in long-stay psychiatric patients. The long-term effect on patient's health and fitness needs to be monitored and strategies are needed to reduce patient withdrawal.

Dental disease and psychiatric illness are among the most prevalent health problems in the Western world. While the dental needs of mentally ill people are similar in type to those in the general population (Markette et al, 1975) there is some evidence that patients suffering from mental illness are more vulnerable to dental neglect and poor oral health (Stiefel et al, 1990; Armstrong, 1994). Sims (1987) reports that physical health problems are more common in psychiatric patients. They seem to be poorly recognised by psychiatrists, and oral health is no exception (Hede, 1995). Oral health is an important aspect of quality of life which affects eating, comfort, speech, appearance and social acceptance (Nordenram et al, 1994).

No abstract