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This paper aims to disseminate the results of research aiming to identify the prevalence of dysphagia and related clinical factors in nursing home residents.

A cross-sectional descriptive study was developed, including 99 residents in five nursing homes. A sociodemographic questionnaire and the Gugging Swallowing Screen for dysphagia screening were used for data collection.

The prevalence of dysphagia was 59.59%. A significant correlation was found between dysphagia and worse scores for fall risk, pressure ulcer, level of independence for activities of daily living and cognitive functioning.

Results should be interpreted carefully due to sample size and specific country context. A larger sample must be achieved in further research.

Nurses must receive proper training to perform systematic dysphagia screening, and it should be considered, given the high prevalence, the inclusion of professionals specially trained for rehabilitating dysphagic residents in nursing home teams.

The social and economic burden of dysphagia, in addition to all the implications on the person’s quality of life, requires a differentiated focus on this issue by nursing home managers.

Nursing homes have nurses providing health care; however, trained professionals for dysphagia treatment commonly are not. These results highlight the importance of systematic screening for dysphagia in all residents, thus promoting timely intervention to prevent respiratory and nutritional complications.

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual disability and/or autism guidelines for a cohort of outpatients seen in the outpatients’ clinics in the two teams who participated in this study to review the trend of psychotropic prescribing with a prescription indication along with the utilisation of non-pharmacological interventions.

Data was retrospectively collected over a period of one year for patients sampled conveniently in the outpatient’s clinic. The data was collected from two sites from psychiatric letters to the general practitioners (GPs), with the focus being psychotropic prescription indication and their adherence to British National Formulary limits, inclusion of a wider multi-disciplinary team or MDT (including nurses, psychologists and health support workers), use of Clinical Global Impression (CGI) scale for assessing medication side effects and response to treatment.

Most of the patients had at least one review in the previous six months. Antipsychotics were the highest prescribed medications without an indication for their use (13.3%) followed by anxiolytics and other medications. CGI recording was suboptimal, with 26% of the patient population did not have medication side effects and effectiveness monitored through this method. In total, 41% of patients were open to community nurses followed by other disciplines.

To the best of the authors’ knowledge, this is an original article following the pilot study completed by the authors.

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

This study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.

This service evaluation project was a retrospective analysis of routinely collected data from the care records of all 36 people with intellectual disability discharged from an intellectual disability assessment and treatment unit during the first five years of the Stop Over medicating People with Intellectual Disabilities and/or autistic people (STOMP) initiative. Data were gathered at four time points (pre-admission, discharge, 6- and 12-month follow-up) before being analysed to understand whether psychotropic prescribing differed among people with different clinical characteristics/traits/diagnoses. Changes over time were also explored to ascertain whether and how prescribing altered from admission to discharge, and over the subsequent year of community living.

Most people with intellectual disabilities left the assessment and treatment unit on fewer regular psychotropic medications and at lower doses than at admission. These optimised regimes were still apparent 12 months post-discharge, suggesting effective discharge planning and community care packages. Inpatients with severe intellectual disabilities generally received more anxiolytics and hypnotics, at higher doses. Autistic people tended to receive more psychotropics in total and at higher cumulative doses, a pattern that persisted post discharge. A third of the sample were admitted on regular anti-psychotic medications despite having no corresponding psychotic diagnosis, a proportion that remained relatively stable through discharge and into the community.

This study highlights subsets of the intellectual disability population at particular risk of receiving high doses of psychotropics and a feasible template for providers intending to undertake STOMP-focused evaluations.

This commentary aims to define STOMP and STAMP, describes its history and evolution and the authors’ thoughts about future directions given the lack of clear evidence base for prescribing and deprescribing psychotropic medication given for behaviour thought to be challenging.

This commentary defines the authors’ clinical experience and personal thoughts about STOMP achievements and challenges for the future delivery.

This commentary details STOMP development to date and highlights the potential areas for further study and research to grow understanding, professional confidence and delivery.

This commentary highlights much of the currently accepted research and areas that have poor quality evidence or are of interest for future study. STOMP definition, especially of inappropriate prescribing, is key to redefining the work.

This commentary highlights the potential impact of STOMP and STAMP on prescribing rates and the need for better definition, processes and education for workforce development. There is a major need to understand the benefit of behavioural intervention to support the optimisation of medication.

This commentary builds on personal experience and current understanding to postulate considerations to further the delivery of STOMP and STAMP.

This study aims to explore how young people in child and adolescent mental health services (CAMHS) in the UK, Ireland, The Netherlands and Croatia, experienced leaving CAMHS and identified a range of factors impeding optimal discharge or transition to adult mental health services (AMHS).

Interviews about discharge or transition planning, including what information was provided about their ongoing mental health needs, undertaken with 34 young people aged 17–24, all previous or current attendees of CAMHS. Some interviews included accounts by parents or carers. Data were thematically analysed.

A number of previously well-documented barriers to a well-delivered discharge or transition were noted. Two issues less frequently reported on were identified and further discussed; they are the provision of an adequately explained, timely and appropriately used diagnosis and post-CAMHS medication management. Overall, planning processes for discharging or transitioning young people from CAMHS are often sub-optimal. Practice with regard to how and when young people are given a diagnosis and arrangements for the continuation of prescribed medication appear to be areas requiring improvement.

Study participants came from a large cohort involving a wide range of different services and health systems in the first pan-European study exploring the CAMHS to adult service interface. Two novel and infrequently discussed issues in the literature about young people’s mental health transitions, diagnosis and medication management were identified in this cohort and worthy of further study.

Prison settings have limited resources, and it is of particular interest to analyze which antipsychotics are commonly prescribed in these conditions and to determine the prevalence of the adverse effects.

A cross-sectional, epidemiological survey was used to measure the prevalence of antipsychotic prescribing among adult prisoners in Sremska Mitrovica Prison in 2020.

The prevalence of antipsychotic use was 7.58%. The most commonly prescribed antipsychotic was clozapine (45.36%), but also olanzapine, haloperidol and risperidone were prescribed. The incidence of extrapyramidal adverse effects was nonexistent and the metabolic parameters did not differ between participants using metabolic syndrome–inducing antipsychotics and those who were prescribed metabolically inert medications. The prescribed doses were lower compared with the recommended.

This research includes certain points that should be cautiously considered. First, the data were cross-sectional and the findings did not provide causal interpretations. Second, the data are from a single penitentiary institution, albeit the largest in the country; however, that may affect the generalizability of the findings. Third, because the included subjects were not hospitalized, some laboratory analyses were not available, according to the local regulations, and thus the prevalence of metabolic syndrome could not be precisely determined.

The prevalence of the antipsychotic use in prison environment is significantly higher than in general population. The most frequently prescribed antipsychotics are clozapine and olanzapine. The prevalence of adverse effects is rare, however, that is possibly due to low doses of the prescribed antipsychotics. The list of therapeutic options available to the incarcerated persons in this facility is also limited. The list of available antipsychotics does not include some atypical antipsychotics with more favorable safety and tolerability profile, such as aripiprazole or cariprazine. Long-acting antipsychotic injectables were also not available to these patients. Laboratory analyses are not regularly conducted and do not include some essential parameters such as lipid status or differential blood count. Low-dose antipsychotics for behavioral symptoms appears to be well tolerated under prison conditions where adherence is assured. It is effective during the prison stay but long-term effects, especially after release from prison, had not been studied.

This paper advocates for better quality of health care in this correctional facility: more therapeutic options and better laboratory monitoring. The authors justify the use of clozapine in this settings due its benefits in reducing violence and aggression; however, further research would be necessary to clarify does the use of clozapine in incarcerated persons cause behavioral improvements that could result in shorter incarcerations, less recidivism and better quality of life.

To the best of the authors’ knowledge, this is the first insight of the antipsychotic prescribing practice in Serbia. There is very limited data on prisoners’ health care, especially mental health care, in Balkan countries. The antipsychotic prescribing pattern in this sample is characterized with higher than expected clozapine use, but without expected adverse effects.

The purpose of this study was to explore the potential benefits of Coriandrum sativum (C. sativum) on anxiety, depression, sleep quality and memory among students.

This randomized controlled trial involved university students aged 18–25 years, who had no known allergies to C. sativum or were using psychotropic medication. After giving informed consent, participants were randomly assigned using a computer-generated random sequence to either 500 mg C. sativum seeds or a placebo. Primary outcomes measured changes in memory (prospective and retrospective memory questionnaire [PRMQ]), anxiety and depression (Hospital Anxiety and Depression Scale), while secondary outcomes assessed sleep quality (Pittsburgh sleep quality inventory [PSQI]).

A sample of 86 students with a mean age of 20.05 ± 1.6 years was selected for the study. Initial assessments ensured no significant differences in demographic or study variables between the control and intervention groups. Statistical analysis revealed significant improvements in memory (PRMQ: p = 0.006), anxiety (Hospital Anxiety Scale: p = 0.04) and depression (Hospital Depression Scale: p = 0.002), as well as in sleep quality (PSQI: p = 0.03) in the group receiving C. sativum compared to the control group.

This research offers initial insights into the potential benefits of C. sativum intake, specifically its role in enhancing memory performance and mitigating anxiety among student populations. The results present a compelling case for further research in this domain to solidify these preliminary conclusions.

The purpose of this paper is to analyse how novel homicide defences predicated on contemporary neuroscience align with legal insanity.

Doctrinal analysis, systematic investigation of relevant statutes and cases, was used to elucidate how the law of insanity is evolving. Cases represent the first recorded instance of a particular neuroscientific defence. US appellate cases were categorised according to the mechanism of action of neurotransmitter relied upon in court. A case study approach was also used to provide a contextualised understanding of the case outcome in depth.

Findings broadly depict how the employment of expert testimony runs parallel with our contemporary understanding of key neurotransmitters and their function in human behaviour. Generally, medico-legal evidence concerning neuromodulating agents and violent behaviour was inconclusive. However, the outcome of defence strategy may depend on the underlying neurotransmitter involved.

This study shows that as more discoveries are made about the neurobiological underpinnings of human behaviour; this new knowledge will continue to seep into the US court system as innovative defence strategies with varying success. Medical and legal practitioners may gauge the success of a defence depending on the neuromodulating agent.

Many scholars have focused on the role of neuroimaging as neuroscientific evidence and how it is used is shaping US criminal jurisprudence. To the best of the author’s knowledge, no study has incorporated the true origin of neuroscientific evidence as being underpinned by the understanding of neurotransmitters.

This commentary explores the challenges and themes enumerated by the associated article “Why am I still in hospital? Evaluation of delayed discharges from two learning disability assessment and treatment units in England”. This commentary broadens and outlines the research’s background, premise and potential impact. This paper aims to critically examine the evidence on this subject.

This commentary considers the attitudes to inpatient care for people with learning disabilities in the past decade and outlines a possible compact for the future.

Contrary to popular and emotive beliefs that using specialist inpatient psychiatric settings for people with learning disabilities is universally a poor practice, there are defined occasions when such settings are needed and imperative in the clinical pathway. If people with learning disabilities can access inpatient settings at the right time for the right reason, psychiatric outcomes could be improved. Timely discharge is imperative and currently lacking due to a lack of suitable engagement mechanisms between inpatient settings and the community. Thus, evidence-based outcome tools are essential to facilitate appropriate discharge.

There is an ongoing debate on the value and utility of specialist inpatient psychiatric units for people with learning disabilities. This commentary provides a balanced, evidence-based insight into this discussion.