No abstract

Psychological theories approach the problem of delusional thinking in psychosis from a range of perspectives. Recent attention has focused on the attributional style of sufferers; research points towards the relevance of cognitive deficits; the potential value of cognitive therapy in reducing delusional thinking is being explored; and psychodynamic theories argue for the role of defence mechanisms. Aspects of these approaches are reviewed and ideas for integration discussed within the vulnerability-stress model of psychosis. Implications for therapy are noted.

Psychotherapy with sufferers of psychosis may usefully draw on both cognitive--behavioural and psychodynamic theory. The latter has a long history with fluctuating popularity, whilst cognitive--behavioural approaches are currently attracting the attention of clinicians. Some of the factors which may reduce interest in psychodynamic approaches are reviewed, followed by an overview of core psychodynamic theories of psychosis under the major headings of vulnerability of defence and vulnerability of the ego. A vulnerability-stress formulation of psychodynamic theory is then considered together with implications for intervention.

Assumptions tend to be made about the value of long-stay psychiatric patients living on mixed-sex wards. In this study the views of 71 patients living on single-sex continuing care wards were elicited using a six-item structured interview. The data were analysed by quantitative and qualitative methods. The results show that the majority of patients preferred single-sex living. The benefits and problems of surveys with this population are discussed as well as the implications for decisions about the structure and quality of care.