SUMMARYThis paper examines the characteristics of a foundation year 2 post in psychiatry from the Leicestershire, Northamptonshire and Rutland

The aim of this paper is to present the outcomes data from the largest United Kingdom's (UK) National Health Service (NHS) clinical rTMS service treating treatment resistant depression (TRD). Methods The study was a retrospective investigation of routinely collected data on patients receiving rTMS between 2015 and 2017. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Beck Depression Inventory (BDI). The outcome data of 73 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis. Results Response and remission rates respectively were 40.4% and 25.5% for the HAM-D; 35.6% and 20.8% for the BDI; and 51.1% and 52.1% for the CGI. Effect sizes were medium (.54, .52 and .56 respectively). Conclusions The results show that a UK based clinical service achieves similar results to those published internationally and that clinical rTMS can have significant impact on symptoms of depression in many patients with TRD. Health services are under pressure to make financial savings, investment in rTMS could reduce the long term treatment costs associated with TRD.

The aim of this paper is to present the outcomes data from the largest United Kingdom's (UK) National Health Service (NHS) clinical rTMS service treating treatment resistant depression (TRD). Methods The study was a retrospective investigation of routinely collected data on patients receiving rTMS between 2015 and 2017. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Beck Depression Inventory (BDI). The outcome data of 73 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis. Results Response and remission rates respectively were 40.4% and 25.5% for the HAM-D; 35.6% and 20.8% for the BDI; and 51.1% and 52.1% for the CGI. Effect sizes were medium (.54, .52 and .56 respectively). Conclusions The results show that a UK based clinical service achieves similar results to those published internationally and that clinical rTMS can have significant impact on symptoms of depression in many patients with TRD. Health services are under pressure to make financial savings, investment in rTMS could reduce the long term treatment costs associated with TRD.

Aims and methodA baseline audit of trainees' ability to recognise Wernicke's encephalopathy and initiate appropriate thiamine regimes in an in-patient alcohol detoxification unit was carried out. Based on the findings, gaps were addressed using targeted education and training, and their impact on improving standards of managing Wernicke's encephalopathy was re-audited.ResultsThe initial audit revealed that trainees' ability to recognise Wernicke's encephalopathy and initiate thiamine was inadequate. Significant improvement in appropriate use of treatment regime (P < 0.05) of thiamine and the monitoring of clinical response was observed after addressing the initial gaps through education.Clinical implicationsTreatment of Wernicke's encephalopathy can be inadequate, given a lack of awareness of clinical presentation and appropriate management. This can be addressed through education and training.